Vector Control On and Around Tallil Air Base, Iraq or The Indomitable Sand Fly MAJ Jennifer B. Caci Chief, ESD CHPPM-S

Acknowledgements “The 787th Spray Team” Oge Bird SSG Vitek Garrett

Background April Potential for leishmaniasis at Tallil is realized, vector control team requested by 520th TAML; 787th spray team returns to Tallil

Approx 15 miles Initial Area of Operation

The Initial Arsenal Synthetic Pyrethroids Demand CS Tempo WP D- phenothrin Organophosphates Dursban Malathion Natural Pyrethrins Pyronyl Oil (limited)

Initial Application Methods - Limited! 787th not an Ento detachment - two 2- gal hand held sprayers - two tempermental backpack sprayers - one Colt Hand Fogger (through mid- May) - one ULV from Camp Doha, Kuwait (repaired several times)

Observations - Sick call visits for bites continue to increase - Biting is often worse after application of residuals - Effectiveness of synthetic pyrethroids questionable due to extreme weather conditions

Observations cont’d - Biting occurs in buildings and tentage alike - Resistance could exist from years of agricultural pesticide use in the area - Specifics regarding sand fly behavior unknown

Additional Challenges - Nets, DEET and permethrin are extremely limited and resupply is a nightmare - Most units do not have treated uniforms - Nets are not being utilized properly by those who have them - Continually increasing temperatures

Additional Challenges cont’d - No vector control support to outlying areas - Living quarters are extremely varied/ long hours in fighting positions - Conditions for some are extremely austere; climate control rare at best - Soldiers do not feel the effects of bites so do not use protection

Remote Sites without PM Support Approximately 130 miles North

Additional Remote Sites Approximately 150 miles South

Remote Sites Fuel Pipeline Pump Station #10 … as close to nowhere as I’ve ever been

Fighting Positions

Sides rolled up on tents- treatment less effective Living Arrangements Sleep areas inside brick buildings/radio watch inside vehicle Open doors, windows due to temperature

What else could we do? - Team up with Kellogg, Brown & Root pest control personnel- increase available pesticides and equipment - Local purchase additional equipment (787th in Kuwait) - Get PPM somehow and bring supplies to QM unit and outlying sites - Employ newly arrived AF spray team

What else could we do? - Educate. Informal briefings; leish and bednet posters; distribute SF600s - Use substitution, rotation, mosaic & mixture of pesticides - Explain pesticide residual and importance of feedback - Distribute leish cards to outlying sites and convoy support centers

Commercial 2 gal sprayer Preparing to head north with PPM Chitty the “Bugmobile”

Left-Sandfly Right-Mosquito Preventive Measures Avoid habitat (old buildings) Modify habitat (spray) Permethrin treat mosquito nets Permethrin treat uniforms Use Insect Repellant First sandfly found on Tallil Sandfly Feeding Stance Size Comparison Sandfly After a Blood Meal Examples of Skin Lesions from Leishmania. These can last for several months untreated. Leishmania is a parasitic disease of white blood cells. There are two clinical forms: Cutaneous (skin) and Visceral (internal organs). There is no vaccine or preventative drug. There is an IV drug treatment (28 days) done at Walter Reed. The best way to protect yourself is to follow the Preventive Measures. Leishmaniasis Left-Sandfly Right- Mosquito Education

300 gallon sprayer Residual application to trees Brown & Root Contributions Soaking suspected habitat

Track Effectiveness/Longevity DATE REQUESTED: __________ UNIT: _________ POC/PHONE: ____________________ TYPE OF STRUCTURE: _________________ TARGET PEST: ________________________ HAVE THE UNIFORMS BEEN TREATED YES NO. DO ALL SOLDIERS HAVE BED NETTING YES NO. HAS THE NETTING BEEN TREATED YES NO. IS DEET AVAILABLE YES NO, ARE THE SOLDIERS UTILIZING IT YES NO PERSON IN CHARGE OF TREATMENT: __________________________________________ DATE/TIME OF TREATMENT: ______________ CHEMICAL USED: __________________ % OF CONCENTRATION: ______ AMOUNT USED: _______ EPA REG #: _____________ SURFACE TREATED CIRCLE ALL THAT APPLY: INTERIOR EXTERIOR TENTAGE, BUILDINGS, VEGETATION, RUBBLE, BURROWS, LATRINES, SHOWERS HOURS SPENT ON JOB: ____ # OF WORKERS PRESENT: ___ TOTAL MAN HRS: ______

Varied Use of Pesticides

The Final Arsenal Synthetic Pyrethroids Demand CS Demon WP (KBR) Tempo WP (AF & KBR) Scourge D-phenothrin Permethrin (UK) Talstar (KBR) OrganophosphatesCarbamates Dursban(AF)Ficam (KBR) Malathion Sevin (AF) Natural Pyrethrins Pyronyl Oil

Additional Application Methods gallon sprayer for treating trees and soaking suspected breeding areas - Dusting burrows with power duster - AF Thermal Fogger - Locally purchased Colt Hand Fogger and 2 gallon sprayers

PM is everywhere!

Recommendations - Bring your own pesticides/PPM and lots of it - Take extra DEET and permethrin on every mission - Local purchase equipment to augment what you have on hand - Educate at every opportunity, sometimes helps to scare people

- Utilize all available resources- other services, contractors, coalition - we are one team - Continuously gather information from your “customers” - Know the impact of what you are fighting and share it with commanders Recommendations cont’d

- Do not limit yourself; research and utilize new ideas - Communicate with your peers - Proper use of uniform treatment kit, bed net and DEET should be a Skill Level 1 CTT task Recommendations cont’d

Conclusion There is no point to the science if it does not reach the soldier.