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Major Douglas A. Burkett, Ph.D. 332nd AEW Expeditionary Medical Group

Surveillance, Trap Evaluations, Bednets, & Assessing Air-Conditioning to Prevent Sand Fly Bites at Tallil AB, Iraq 2003. Major Douglas A. Burkett, Ph.D. 332nd AEW Expeditionary Medical Group

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Major Douglas A. Burkett, Ph.D. 332nd AEW Expeditionary Medical Group

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  1. Surveillance, Trap Evaluations, Bednets, & Assessing Air-Conditioning to Prevent Sand Fly Bites at Tallil AB, Iraq 2003 Major Douglas A. Burkett, Ph.D. 332nd AEW Expeditionary Medical Group Collaborators: LTC Coleman, LTC Sherwood, LtCol McMeans, Maj Caci, Col Swaby, Col Strickman, Capt Blount, Capt Wolf, Don Teig, Capt Dennett, LT Knight, Ed Rowton, Capt Silvernale, Capt Jennings, MSgt Cushing, TSgt Walter, TSgt Long

  2. Army and AF Preventive Medicine/Entomology Assets Working Together… AF relied on Army for vector control/pesticides from Apr - June

  3. Tallil AB

  4. Tallil AB • Two 12K runways, 30 miles of inner fence • 24K US & Coalition Forces (~ 1500 AF) • Most with NO PPE…. • Historically Agricultural Area

  5. Sand Fly Bites WRAIR found 2% Infected June 03

  6. Bednets • AF personnel lucky - tents came with bed nets. • Virturally no AF personnel deployed with bednets/ PPE • Troops concerned about crickets…

  7. Percentage of Personnel Using Bednets in AF Tent City (1st AEF), Tallil AB – June 03 100 n = 35 n = 70 * Didn’t have Commander or NCO support! 80 Everyone Else – AF Tent City 60 % Personnel 40 n = 198 20 n = 61 0 % Males % Males % Females % Females Fliers - A-10 SF Bednets - Bednets - w/ Bednets w/ Bednets - Personnel Cots Beds Cots Beds

  8. 80 June 70 August 60 50 % Bednet Use 40 30 20 10 0 % Males w/ % Males w/ % Females % Females Bednets - Bednets - w/ Bednets - w/ Bednets - Cots Beds Cots Beds N = ~ 30 tents AF Bednet Use Jun 03 vs. Aug 03 • 2nd AEF Rotation: • “Right Start” Brief • Col Swaby Visits • 1st AF case • CC/NCO support

  9. Surveillance: CDC Unbaited Light Traps • Joint Effort • Purpose: • Track sand fly populations • Evaluate Control effectiveness • ID sand fly & disease “hot spots” • Determine Leishmania infection rates • Traps effective w/ NO CO2! • Which trap designs were most effective?

  10. Trap Evaluations Two 4 x 4 Latin Squares CDC Style Up Draft CDC Style Sticky Trap & Chem Lite Black Light

  11. 80 N = 8 nights 70 A 60 Female Sand Flies 50 Female Mosquitoes 40 Mean #/trap/night 30 A 20 B B 10 B C B B 0 Standard CDC UV Down Draft Sticky Trap Chem Lite CDC Up Draft Trap Evaluation - Sand Flies and Mosquitoes, Tallil AB, Iraq

  12. 20 18 n = 8 nights 16 14 A 12 AB Mean Sand Flies/Trap/Night 10 AB 8 6 AB AB 4 B B 2 B 0 Castor Oil Blue Red Yellow Green Orange InfraRed Unbaited Chem-Light & Sticky Trap Evaluation for Sand Flies

  13. 35 n = 15 trap nights 30 25 20 % of Total Sand Flies 15 10 5 0 2000-2200 2200-2400 2400-0200 0200-0400 0400-0600 Sand Fly* Host Seeking Activity Time * Species not yet determined

  14. Lots of Infected Sand Flies… 76 60 120 100 175 Main Gate Control Sites No Insecticide 2220 Trans Co. EPW Camp 75 125 Army MPs Finance 25 Motor Pool Army Tent City AF PO 40 50 AF Tent City 90 A-10 Ops 50 Tower 171 ASG Fire Dept 25 607 MP AIR FIELD WOC Typical Night of Trapping June/July 2003 Graphic: LTC Coleman 100 75 50 25 0 Key

  15. Tallil 2003 20 18 Historical 16 14 12 % of Total 10 8 6 4 2 0 6-12 Jul 1-7 Dec 6-12 Jan 4-10 May 22-28 Jun 20-26 Oct 7-13 Sept 10-16 Nov 13-19 Apr 17-23 Mar 25-31 May 17-23 Aug 22-28 Dec 17-23 Feb 27 Jul-2 Aug 27 Jan-2 Feb 28 Sept-5 Oct Seasonal Sand Fly Distribution Don’t Always Believe What You Read….

  16. Changes in Sand Fly Densities at Standardardized Trap Locations 200 A-10 Ops 180 Motor Pool 744 MP BN 160 AF Postal AF WOC 140 171st ASG Sand Flies/Trap/Night Finance 120 2220 Trans 100 203 MI BN 933 MP CO 80 Control Average 60 40 20 0 6/2 6/4 6/6 6/8 5/23 5/25 5/27 5/29 5/31 6/10 6/12 6/14 6/16 6/18 6/20 Spray Trapping Date

  17. Evaluating Effectiveness of Insecticidal Treatments Untreated Army Quarter Master Tent City

  18. Residuals (Cyhalothrin) Dusting (Carbaryl) Truck Fogging (ULV) (Resmethrin)

  19. Inside Tents Outside Tents Treated Tree Line Controls Sand Fly Control Evaluation - Army Tent City “Classic Vector Control Activities May Not Always Work” 500 450 400 350 300 Mean Sand Flies/Trap/Night 250 200 150 100 50 N/A N/A 0.0 6/19 6/20 6/21 6/22 6/23 6/24 6/25 6/26 6/27 6/28 6/29 6/30 Residual and Fogging Dusting and Fogging Dusting and Fogging

  20. Even habitat destruction didn’t have the desired effect… Pristine Sand Fly Habitat Everywhere Before Tent Cities….

  21. Denuded Habitat in Tent Cities

  22. Air Force Tent City Army Tent City No AC

  23. 100 90 80 Air Force 70 Army 60 Mean Sand Flies/Trap/Night 50 40 30 20 10 0 Control Area Inside Tents Outside Tents Sand Flies Inside vs Outside of Tents, AF With AC - Tallil AB Iraq (May 03) A AC B B B C n = 5 nights

  24. 200 180 Air Force 160 Army 140 120 A 100 AC A Mean Sand Flies/Trap/Night 80 60 40 C C B B 20 0 Control Areas Inside Tents Outside Tents n = 5 nights Sand Flies Inside vs Outside of Tents With AC - Tallil AB Iraq (Aug 03)

  25. Percentage of Male Sand Flies Inside vs Outside Air Force and Army Tents 40 Male Sand Flies AF 35 Male Sand Flies Army 30 25 Percent Males 20 15 10 5 0 Inside Tents Outside Tents Control Area n = 5 nights

  26. Rodents and Sand Flies Breeding Under Tents?

  27. Questions?

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