1. Personal Protection From Arthropods

2. Prevent Disease, Disability and Premature Death Objective هدف Explain how to use personal protective measures to minimize the risk of arthropod bites and vector borne diseases. measures to minimize the risk of arthropod bites and vector borne diseases.

3. Prevent Disease, Disability and Premature Death Overview مرور EffectivenessTechniques

4. Prevent Disease, Disability and Premature Death Can this hurt you? 4 Sandfly

5. Prevent Disease, Disability and Premature Death Sure Can!!! 5 Cutaneous Leishmaniasis lesion on arm

6. Prevent Disease, Disability and Premature Death World War II: ~90% of hospital cases due to diseases, most arthropod-borne. Korea: ~60%. Vietnam: ~64%. Desert Shield/Storm -- ~68% -- short, relatively “clean,” reduced vector-borne disease potential. Afghanistan: ~95% of cases due to infectious diseases (diarrhea, influenza, etc.) 6 Military Impact of Diseases and Non-Battle Injuries

7. Prevent Disease, Disability and Premature Death Chemoprophylaxis and Vaccinations Chemoprophylaxis: Chemical ingested before exposure to a disease causing organism, circulates in the body and kills the pathogen Does not change the immune system, thus requiring continued use before, during, and after the deployment Examples: Chloroquine, Mefloquine, Doxycycline 7

8. Prevent Disease, Disability and Premature Death Chemoprophylaxis and Vaccinations Cont… Vaccinations: Live or killed disease organisms introduced before exposure to a disease Change the immune system, allowing the body’s natural defenses to resist the disease Examples: Yellow Fever, Japanese Encephalitis

9. Prevent Disease, Disability and Premature Death Dwelling Places Places where pests occur Always check your shoes…and clothes…and sleeping bag, etc…. Avoid Breeding Places Avoid Habitats Natural and man-made habitats Check often for pests on or around your person Check others for pests Remove pests by picking them off, or with sticky tape, lint roller, etc. 9 Avoidance

10. Prevent Disease, Disability and Premature Death Avoid Times of Peak Abundance Aedes-dusk/dawn, some day feeders Anopheles-dusk/dawn Culex-dusk/dawn and night 10

11. Prevent Disease, Disability and Premature Death Barriers Oils, example: Baby Oil Screens Bed Net Properly Set up Be sure the net is suspended Tucked in, away from skin Treated with permethrin Head Net Suspended on head with hat band Tucked into shirt collar 11

12. Prevent Disease, Disability and Premature Death Barriers: The Uniform Proper Field Wear Pants tucked into and bloused over boots Ticks and other arthropods move up Sleeves rolled down Proper fit Collar up and buttoned if necessary 12

13. Prevent Disease, Disability and Premature Death Repellents Chemicals that repel attacking insects and other arthropods when applied to skin, clothing, or other surfaces. Two modes of action: Vaporepellent -- repels in dispersed form e.g DEET Excitorepellent -- requires contact with concentrate e.g Permethrin 13

14. Prevent Disease, Disability and Premature Death Repellents Many formulations and brands DEET – skin and/or clothing application Exposed skin On personal netting (i.e. head nets) May damage some clothing items… Extended duration (33%) is safe and effective for 6- 12 hours Can be used with a sun screen, although the effectiveness of each will be slightly reduced. Apply the sun screen first, then the DEET lotion 14

15. Prevent Disease, Disability and Premature Death Repellents Permethrin – Fabric application only! Clothing treatment Personal netting Bed net, tent Also “civilian” clothing – cotton and cotton-polyester outerwear items 15

16. Prevent Disease, Disability and Premature Death Permethrin Aerosal 1 aerosol can will treat 1 set of Uniforms (1 shirt & 1 pair of trousers) using about ¾ can Do not treat underwear, socks, hat, etc.! Treat outdoors, stay upwind, wear gloves or use a stick or hanger to handle the wet clothing Use remainder on bet net Let the uniform dry in a well-ventilated place! Effective for 6 weeks or 6 launderings 16

17. Prevent Disease, Disability and Premature Death Individual Dynamic Absorption (IDA) Kit Treat the shirt and pants according to the directions on the kit Do not treat underwear, socks, hat, etc.! Use kit gloves! Let the uniform dry in a well-ventilated place! Lasts for the life of the uniform 50 washes Mark with date treated 17

18. Prevent Disease, Disability and Premature Death Deet and Permethrin Use 18 %Bites on exposed skin Untreated uniform no Deet on skin Untreated uniform Deet on skin Treated uniform no Deet on skin Treated uniform + Deet on skin N/A 83 96 12 98 99.99 2,287 99 54 299.94100 % Bites through uniform 17 88 0.01 0 No. of bites in an 8-9 hr day % Reduction in No. of Bites (Protection)

19. Prevent Disease, Disability and Premature Death Education The most important way to protect yourself and a “Force Multiplier” 19

20. Prevent Disease, Disability and Premature Death Summary EffectivenessTechniques

21. Questions?سوالات