While the media is focused on pandemic Swine Flu, here along America’s North Shore, we must be wary of other diseases. Here are several articles to remind us all about them.

West Nile virus season returns

It looks like another wet summer for the Rochester, N.Y. and the Monroe County area. Wet summers mean mosquitoes. Mosquitoes mean the West Nile virus is again a threat in the region.

The West Nile virus was first discovered in central Africa in 1937. It was studied and characterized in Egypt in the 1950′s, hence the name. It was first discovered in the United States in 1999, and has been found in every state but Hawaii, Alaska and Oregon.

Rabies and upstate wildlife

Rabies. The name conjures images of large dogs foaming at the mouth and tearing their victims to shreds. In reality, wildlife are the primary sources of rabies and attacks on humans by rabid animals.

On July 16 a seven year old boy and his grandfather were attacked, separately, by a fox at the grandparent’s home in Webster. The grandfather shot and killed the fox during the second attack and a laboratory later confirm that it was rabid.

Plague still to be feared

A second man has died from plague in the city of Ziketan, in northern China. The local authorities have quarantined about ten people who were exposed to either of the dead men.

Plague is the Black Death. It decimated cities and countrysides, and entire nations as it swept across the continent in repeated waves. The National Institute of Allergy and Infectious Diseases suggests that it killed one third of the population of Europe, 30 million people, in the 1300′s. In the mid 1800′s it killed 12 million Chinese.

An Army vaccination program to protect service members and local wildlife from rabies has been going on here and throughout Iraq for more than two and a half years.

Wild animals, like foxes and stray dogs, are captured in traps, inspected by Army veterinarians for any evidence of disease — especially rabies — tagged and then released, said Maj. Randel Rogers, a native of Columbus, Ohio, and a logistics officer with the 371st Sustainment Brigade here.

“We vaccinate them to make sure that they don’t have rabies,” he said. “So we can make sure that the population of the wildlife around our base are safe and are not spreading any disease that could affect us.”

Rabies is a viral disease which causes acute encephalitis (an inflammation of brain tissue). Typically, humans are infected after receiving a bite from an infected animal, usually through its saliva. The virus begins with flu-like symptoms, but once it reaches the central nervous system death could result in a matter of days.

A recent boom in pet populations led to an increase in reported cases in Africa and Asia, where rabies kills more than 55,000 people every year, according to a report from the World Health Organization.

“[The program] is important because rabies is endemic in the country,” said Capt. Brian Smith, of Houston, Texas, 64th Medical Detachment, and officer in charge of veterinary service for Multi-National Forces-West.

“There has been confirmed rabies in the country of Iraq,” and many people were probably exposed to rabid animals and not aware of it, he said. Smith, though, was quick to point out he knew of no rabid animals found here or on other coalition bases in western Iraq, which is his area of responsibility.

However, the vaccination program does not simply protect service members and local wildlife.

“One of the side effects that we realized on our rabies control program is that we were capturing all this data — because we were capturing all these animals on ours bases,” Rogers said.

An amateur naturalist back home with a degree in wildlife management, Rogers partners with an Iraqi non-governmental organization and affiliate of the United Nations Environment Programme, Nature Iraq. Amongst all its other interests, Nature Iraq also endeavors to conduct the first detailed survey of plant and wildlife in Iraq since 1980.

“One of the problems with trying to protect wildlife is first establishing what species live in an area, what habitat they’re using, how large the population is,” Rogers said. “The more data we get, the clearer picture we’ll have.”

Such data is particularly helpful with secretive species like the jungle cat, which are poisoned and hunted extensively throughout the Middle East. Through vaccinations and booster shots — if a cat is caught again — the coalition is helping to preserve a protected species and national treasure of Iraq, Smith said.

Both Smith and Rogers recommend avoiding any contact with wildlife, especially with stray cats or feral dogs, the most common carriers of the rabies virus. This is also why the military implemented policies to prohibit its service members from adopting local pets.

“My recommendation would be: If you are lucky enough to see [a wild animal], keep your distance and try to get a picture,” Rogers said.

DVIDS
Story by Spc. Kiyoshi Freeman

A hospital corpsman with the 2nd Marine Expeditionary Brigade teaches a Marine how to insert a needle into a vein as part of a Combat Lifesaver Course here March 24. Marines gain this knowledge so they can support corpsmen in the field in need of assistance. Photo by Cpl. Aaron Rooks

Combating insurgency in Afghanistan is not the only challenge awaiting the Marines and sailors of the 2nd Marine Expeditionary Brigade.

In addition to enemy combatants, Marines deploying to Afghanistan’s Regional Command-South will also face a number of potential health threats.

The Central Asian country has been labeled by the World Health Organization as one of the least developed countries in the world, with 70 percent of the population living in extreme poverty and health vulnerability.

Several food-, water-, animal-, and vector-borne diseases are found commonly throughout the country. The most common of all, according to Afghanistan’s Ministry of Public Health, is malaria.

More than half of the country’s population, especially women and children, are vulnerable to malaria, according to an April 2008 report from the Integrated Regional Information Networks, the humanitarian news and analysis service of the United Nations Office for the Coordination of Humanitarian Affairs.

The Ministry of Public Health and WHO estimated that up to 1.5 million cases of malaria occur each year throughout Afghanistan, most of which go untreated.

The 2nd MEB Health Services Support Section identified malaria, bacterial and protozoal diarrhea, hepatitis A, rabies, typhoid and paratyphoid fever as the diseases of highest risk in Regional Command-South. The medical staff has also identified tuberculosis, hepatitis E, sand fly fever, typhus, leishmaniasis, west nile fever and anthrax as some of the intermediate risks present in the Marines’ future area of operations.

Navy Petty Officer 3rd Class Matthew Siruchek, a hospital corpsman with 2nd MEB, said preventive medicine is key for Marines and sailors deploying to the region.

The Walden, N.Y., native, who deployed to Afghanistan with the 24th Marine Expeditionary Unit from March to October 2008, said malaria was their largest concern.

“Preventive treatment and education made the difference,” he said. “We always preached to them to take their medications once a week and they would be covered.”

Medication includes Mefloquine, a treatment used to combat malaria, which is transmitted primarily by mosquitoes.

The HSSS is taking these precautions and others. Navy Senior Chief Petty Officer Shannon Dittlinger, medical operations chief for the HSSS, said her team of corpsmen and Navy doctors has worked diligently since February to ensure the brigade is medically ready.

The Weirsdale, Fla., native said they have sprayed uniforms and sleeping systems to deter disease-carrying insects, ordered the necessary medications and conducted health, dental and neurological assessments. They have also performed vaccinations to prevent diseases such as yellow fever, anthrax, smallpox, hepatitis A, typhoid and measles.

But Navy Petty Officer 2nd Class Jose Gonzalezramos, a hospital corpsman and preventive medicine technician for the brigade, said there’s no preventive medicine offered for Marines to combat some of the diseases found in Afghanistan.

The Maunavo, Puerto Rico native said education plays the largest role in combating these diseases and other medical conditions overseas.

“If Marines listen to what we recommend to them, they will be healthier,” he said. “If there is a shot that can prevent you from contracting diseases, why not get it? If you know a water source is contaminated, why go near it? If Marines or sailors contract any of these diseases, they will be taken out of the fight temporarily or permanently.”

The HSSS team members said they are prepared in case anyone contracts one of the many diseases in the country, which the brigade medical planner, Navy Lt. Diana Loffgren, said is possible. She said there are currently several confirmed cases of malaria in troops serving in Afghanistan, but noted that none of these cases involve U.S. service members.

Despite the threats, the MEB medical personnel remain confident in the deployment being a success.

“I’m 100 percent confident in the corpsmen and doctors who will be taking care of the brigade’s medical issues, whether they are combat casualties or diseases,” Dittlinger said.

USMC
by Cpl. Aaron Rooks

Centers for Disease Control

The incidence of communicable diseases is such that they are unlikely to prove a hazard for international travelers greater than that found in their own country. There are, of course, health risks, but in general, the precautions required are minimal.

Certain diseases occasionally occur, such as plague, rabies in wildlife, including bats, raccoons, foxes, and other wild animals. Coccidioidomycosis is endemic in the southwestern United States and can occur in visitors to the area. Its incidence has increased in Arizona and California in recent years. Histoplasmosis is highly endemic, especially in the Mississippi, Ohio, and St. Lawrence River valleys. Sporadic cases and large outbreaks occur.

Cases of hantavirus pulmonary syndrome have been widely distributed in North America, with the greatest concentration in the western and southwestern United States. Infections in animals were reported in agricultural regions of the United States and Canada in 2006; infection in humans is rare.

Lyme disease is endemic in northeastern, north central (upper Midwest), and Pacific coastal areas of North America. West Nile fever was first documented in the United States (New York) in 1999 and has since spread throughout continental United States and southern Canada.

Outbreaks of diarrhea caused by enterohemorrhagic Escherichia coli O157:H7 have occurred in many areas and have increased in the past decade. Campylobacter and Salmonella are the most common causes of acute bacterial diarrhea.

Isolated cases of bovine spongiform encephalopathy (BSE/mad cow disease) have been reported in Canada and the United States. For more information, see http://www.cdc.gov/ncidod/dvrd/bse/ and http://www.usda.gov.

Outbreaks and cases of pertussis have been increasing for more than a decade.