R 231223Z JUL 03 ZYB PSN 111672I18 FM BUMED WASHINGTON DC//M09B// Subject: MEDICAL SITREP ONE FOR WEST NILE VIRUS-CY2003// UNCLASSIFIED// RAAUZYUW RUENMED4984 2041223-UUUU--RUCOBRJ RUCOPAG RUCOVAC RUCOVAN RUCOYAR RUCOGAL RUCOAGB RUCOAGF RUCOAGH RUCOHAU RUCOFAE RUCOYAP RUCOFAQ RUCOSAO RUCOAGZ RUCOBRE RUCOBRV RUCOGCE. ZNR UUUUU R 231223Z JUL 03 ZYB PSN 111672I18 FM BUMED WASHINGTON DC//M09B// TO AIG 7783 RHMFIUU/AIG 6947 RUCBLFC/COMMARCORBASESLANT RHMFIUU/COMMARCORBASESLANT RUHEHMS/COMMARCORBASESPAC CAMP H M SMITH HI//JJJ// RHMFIUU/COMMARCORBASESPAC CAMP H M SMITH HI//JJJ// RUWICBF/CG MCB CAMP PENDLETON CA//CG// RHMFIUU/CG MCB CAMP PENDLETON CA//CG// RUCKSAA/CG MCB CAMP LEJEUNE NC//CG// RHMFIUU/CG MCB CAMP LEJEUNE NC//CG// RULSMCB/CG MCB QUANTICO VA//CG// RHMFIUU/CG MCB QUANTICO VA//CG// RUCKALD/COMMARCORLOGBASES ALBANY GA//JJJ// RHMFIUU/COMMARCORLOGBASES ALBANY GA//JJJ// RUCKFCA/COMCABEAST CHERRY PT NC//JJJ// RHMFIUU/COMCABEAST CHERRY PT NC//JJJ// RUWIKBS/COMCABWEST MIRAMAR CA//JJJ// RHMFIUU/COMCABWEST MIRAMAR CA//JJJ// PAGE 02 RUENMED4984 UNCLAS RUCKNMB/MCAS NEW RIVER NC//JJJ// RHMFIUU/MCAS NEW RIVER NC//JJJ// RUWICBR/MCAS CAMP PENDLETON CA//JJJ// RHMFIUU/MCAS CAMP PENDLETON CA//JJJ// RUCKMCA/MCAS BEAUFORT SC//JJJ// RHMFIUU/MCAS BEAUFORT SC//JJJ// RUWIBHA/MCAS YUMA AZ//JJJ// RHMFIUU/MCAS YUMA AZ//JJJ// RUWIBNA/CO MCLB BARSTOW CA//JJJ// RHMFIUU/CO MCLB BARSTOW CA//JJJ// RUEACMC/MARBKS WASHINGTON DC//JJJ// RHMFIUU/MARBKS WASHINGTON DC//JJJ// RUEACMH/HQBN HQMC ARLINGTON VA//CO// RHMFIUU/HQBN HQMC ARLINGTON VA//CO// INFO RUENAAA/CNO WASHINGTON DC//N931// RUEACMC/CMC WASHINGTON DC//IL/HS// RHMFIUU/CMC WASHINGTON DC//IL/HS// RUCBCLF/COMLANTFLT NORFOLK VA//N02M// RHHMHAA/COMPACFLT PEARL HARBOR HI//N02M// RUCOSSA/COMNAVAIRLANT NORFOLK VA//N02M// PAGE 03 RUENMED4984 UNCLAS RUCBKMC/COMSUBLANT NORFOLK VA//N02M// RHMFIUU/COMMARFORRES RUCBTFA/COMNAVSURFLANT NORFOLK VA//JJJ// RUCOGAB/COMNAVREG MIDLANT NORFOLK VA//JJJ// RUEGNER/COMNAVREG NE GROTON CT//JJJ// RHFJJAH/COMNAVREG SE JACKSONVILLE FL//JJJ// RHMFIUU/COMNAVREG SE JACKSONVILLE FL//JJJ// RULSADC/COMNAVDIST WASHINGTON DC//JJJ// RUCCNOM/COMNAVRESFOR NEW ORLEANS LA//JJJ// RUCOWCA/COMLANTAREA COGARD PORTSMOUTH VA//JJJ// RUWDNAA/CG MCRD WRR SAN DIEGO CA//JJJ// RHMFIUU/CG MCRD WRR SAN DIEGO CA//JJJ// RUCKPIC/CG MCRD ERR PARRIS ISLAND SC//JJJ// RHMFIUU/CG MCRD ERR PARRIS ISLAND SC//JJJ// RUHEKBC/CG MCB HAWAII KANEOHE BAY HI//JJJ// RHMFIUU/CG MCB HAWAII KANEOHE BAY HI//JJJ// RUHBANB/CG MCB CAMP BUTLER JA//JJJ// RHMFIUU/CG MCB CAMP BUTLER JA//JJJ// RUAYFFA/MCAS IWAKUNI JA//JJJ// RHMFIUU/MCAS IWAKUNI JA//JJJ// PAGE 04 RUENMED4984 UNCLAS RULSMJA/MARCORSUPACT KANSAS CITY MO//JJJ// RHMFIUU/MARCORSUPACT KANSAS CITY MO//JJJ// RUCOAGH/HLTHCARE SUPPO NORFOLK VA//JJJ// RHFJJAS/HLTHCARE SUPPO JACKSONVILLE FL//JJJ// RUWDHCX/HLTHCARE SUPPO SAN DIEGO CA//JJJ// RUCOFAE/NAVENVIRHLTHCEN PORTSMOUTH VA//PM// RUCOFAQ/NAVENPVNTMEDU TWO NORFOLK VA//JJJ// RUWDXCM/NAVENPVNTMEDU FIVE SAN DIEGO CA//JJJ// RUHEMBP/NAVENPVNTMEDU SIX PEARL HARBOR HI//JJJ// RUFEPIF/NAVENPVNTMEDU SEVEN SIGONELLA IT//JJJ// RHWIPQZ/NAVDISVECTECOLCONCEN BANGOR WA//JJJ// RHFJJBJ/NAVDISVECTECOLCONCEN JACKSONVILLE FL//JJJ// RHMFIUU/NAVDISVECTECOLCONCEN JACKSONVILLE FL//JJJ// RUERMMA/CHPPMDCSOPSOPNSBRCH ABERDEEN PROVING GROUND MD//JJJ// BT UNCLAS //N06250// PASS FOR WIDEST DISSEMINATION, INCLUDING INSTALLATION AND FACILITY VECTOR SURVEILLANCE AND CONTROL; VETERINARY SERVICES; AND PUBLIC AFFAIRS. MSGID/GENADMIN/M09B// PAGE 05 RUENMED4984 UNCLAS SUBJ/MEDICAL SITREP ONE FOR WEST NILE VIRUS-CY2003// REF/A/GENADMIN/ASD-HA/11JUL2002// REF/B/GENADMIN/SECNAV/271542ZSEP2002// REF/C/GENADMIN/BUMED WASHINGTON DC/301309ZAUG2001// REF/D/GENADMIN/CDC/04FEB2001// REF/E/GENADMIN/BUMEDINST 6220.12A/21OCT1998// REF/F/GENADMIN/BUMED WASHINGTON DC/03JUN2003// NARR/REF A PROVIDES BACKGROUND ON WEST NILE VIRUS (WNV) THREAT. REF B IS SECNAV GUIDANCE ON WNV. REF C PROVIDES BUMED GUIDANCE FOR REPORTING WNV CASES. REF D IS CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) MANUAL OF APR 2001, EPIDEMIC/EPIZOOTIC WEST NILE VIRUS IN THE UNITED STATES: REVISED GUIDELINES FOR SURVEILLANCE, PREVENTION, AND CONTROL. REF E IS BUMEDINST 6220.12A GUIDANCE FOR MEDICAL EVENT REPORTING. REF F IS REVISED GUIDELINES FOR WEST NILE VIRUS SCREENING, DEFERRAL, AND LOOK BACK. REFS B, C, E AND F ARE AVAILABLE AT HTTP:(DOUBLE SLASH)www.nmcphc.med.NAVY.MIL/PREVMED/INDEX.HTM. REF D AVAILABLE AT WWW.CDC.GOV/NCIDOD/ DVBID/WESTNILE/RESOURCES/ WNV-GUIDELINES-APR-2001.PDF.// RMKS/1. THIS MESSAGE HAS BEEN COORDINATED WITH THE COMMANDANT OF PAGE 06 RUENMED4984 UNCLAS THE MARINE CORPS. THE COMMANDANT HAS AUTHORIZED TRANSMISSION TO MARINE CORPS ACTIVITIES. 2. REFS A THROUGH C PROVIDE NAVY BACKGROUND ON WNV. REF D PROVIDES CDC GUIDANCE. WNV ACTIVITY HAS INCREASED SHARPLY WITH VIRUS INFECTED BIRDS, HORSES, OR MOSQUITOES FOUND IN THE DISTRICT OF COLUMBIA AND 44 STATES STRETCHING TO THE WEST COAST LAST YEAR. AS OF JULY 2003, 33 STATES ARE REPORTING WNV ACTIVITY IN BIRDS, HORSES, OR MOSQUITOES. 3. TO DATE, NO HUMAN CASES OF WNV RELATED TO THE MILITARY HAVE BEEN IDENTIFIED ON MILITARY INSTALLATIONS. AS OF JUNE 2003, 33 DOD INSTALLATIONS FROM 20 STATES HAVE SUBMITTED MOSQUITO SAMPLES TO US ARMY CENTER FOR HEALTH PROMOTION AND PREVENTIVE MEDICINE (USACHPPM) NORTH FOR WNV TESTING. ALL MOSQUITO POOLS TO DATE HAVE TESTED NEGATIVE FOR WNV. THE NAVDISVECTECOLCONCEN JAX/ NAVDISVECTECOLCONCEN BANGOR WNV SURVEILLANCE GUIDE, AVAILABLE AT HTTP:/DVECC-JAX.MED.NAVY.MIL/WNV/ WNVGUIDE03.PDF, PROVIDES DETAILED GUIDELINES THAT MAY BE TAILORED TO INDIVIDUAL ACTIVITIES. 4. CONTINUED MOSQUITO SURVEILLANCE AND CONTROL IS STRONGLY ENCOURAGED THROUGH THE REMAINDER OF THE MOSQUITO SEASON, APPROXIMATELY LATE OCTOBER IN THE NORTHERN AND CENTRAL STATES AND PAGE 07 RUENMED4984 UNCLAS AT LEAST LATE NOVEMBER ALONG THE GULF COAST AND FLORIDA. FOLLOWING COORDINATION WITH NAVDISVECTECOLCONCEN JAX OR NAVDISVECTECOLCONCEN BANGOR, ADULT MOSQUITO SPECIMENS SHOULD BE SUBMITTED TO THE COGNIZANT USACHPPM FOR VIRUS TESTING. USACHPPM WILL PROVIDE MATERIALS FOR PRESERVING AND SHIPPING SPECIMENS, AND APPROPRIATE TESTING, TO ACTIVITIES SUBMITTING SPECIMENS. NO MOSQUITOES SHOULD BE SENT DIRECTLY TO THE COGNIZANT USACHPPM WITHOUT FIRST COORDINATING WITH COGNIZANT NAVDISVECTECOLCONCEN. ACTIVITIES ALREADY SUPPORTED BY STATE OR LOCAL LABS SHOULD CONTINUE AS DESIRED. 5. INFECTED BIRDS, PARTICULARLY CROWS AND BLUE JAYS, ARE THE FIRST INDICATORS OF WNV ACTIVITY IN AN AREA. REF B REQUIRES AVIAN SURVEILLANCE ON MILITARY INSTALLATIONS. INDIVIDUALS SHOULD SUBMIT DEAD BIRDS TO INSTALLATION VETERINARIANS FOR IDENTIFICATION AND SUBMISSION FOR WNV TESTING. SUBMIT MOSQUITO, BIRD, AND HORSE DATA WEEKLY TO COGNIZANT NAVDISVECTECOLCONCEN. POCS: LT REMMERS, DVECC JAX FL, COM TEL: 904-542-2424 DSN: 942, EMAIL: JLREMMERS@DVECCJAX.MED.NAVY.MIL, LCDR SCHOELER, DVECC BANGOR, COM TEL: 360-315-4450, DSN: 322, EMAIL: GEORGE.SCHOELER@NDVECC.NAVY.MIL. PAGE 08 RUENMED4984 UNCLAS 6. FOR MEDICAL TREATMENT FACILITIES AND PER REFS B AND C, HUMAN TISSUE SPECIMENS MAY BE SENT TO STATE LABORATORIES, OR TO US ARMY MEDICAL RESEARCH INSTITUTE OF INFECTIOUS DISEASES (USAMRIID), FT DETRICK MD. POC USAMRIID IS DR. GEORGE LUDWIG, COM TEL: 301-619-4941, DSN 343. SPLIT SAMPLES ARE NOT REQUIRED. DIRECT COORDINATION IS INDICATED BEFORE SUBMITTING SAMPLES TO USAMRIID. PER REF C AND USING INFORMATION IN REF E, NOTIFY NAVENVIRHLTHCEN CDO WITHIN 24 HOURS UPON PRESUMPTIVE WNV DIAGNOSIS AT COM TEL 757-953-0700 (WORKING HOURS) OR CELLULAR TEL: NO. 757-621-1967 (AFTER WORKING HOURS). REF F PROVIDES GUIDANCE ON BLOOD BANKING ISSUES RELATED WNV. 7. ADDITIONAL INFORMATION ON WNV AVAILABLE FROM THE CDC HOMEPAGE AT WWW.CDC.GOV/NCIDOD/DVBID/WESTNILE/SURV&CONTROL.HTM. 8. HEALTH THREAT ASSESSMENT. USING CRITERIA IN REF D, THE POTENTIAL HEALTH THREAT TO ACTIVE DUTY POPULATION IS LOW, BUT ISOLATED CASES RELATED TO THE MILITARY CANNOT BE EXCLUDED. SURVEILLANCE IS ONGOING AND PREVENTION STRATEGIES ARE UNDERWAY. APPROPRIATE RISK COMMUNICATION MEASURES ARE ENCOURAGED AT THE LOCAL LEVEL, IN COOPERATION WITH MILITARY PUBLIC HEALTH PROFESSIONALS, MILITARY LEADERSHIP, AND CIVILIAN AUTHORITIES. PAGE 09 RUENMED4984 UNCLAS MOSQUITO CONTROL AND APPROPRIATE USE OF REPELLANTS WILL MINIMIZE RISK OF WNV TRANSMISSION.// BT #4984 NNNN