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Vector control and pest management.

INTRODUCTION

The first discovery of an arthropod-borne pathogen was in 1893, and it was quickly followed by notable successes in the prevention of yellow fever and malaria through mosquito control. Despite continual progress in the technology of vector control during the last century, US military forces remain vulnerable to many serious diseases caused by pathogens transmitted by mosquitoes, ticks, and other arthropods that cause considerable morbidity and mortality. The hundreds of recently-returning veterans from Iraq and Afghanistan who had contracted cutaneous leishmaniasis transmitted by sand flies is a testimony to this fact. (1) Other recent military operations have also been negatively impacted by arthropod-borne infections. In September 2003, when 290 Marines went ashore in Liberia as military advisors to oversee a civil transition, 80 contracted malaria (28% attack rate). (2) Malaria remains a significant threat on the Korean peninsula and elsewhere throughout Asia. Japanese encephalitis is one of approximately 100 viruses spread by insects and ticks and is a significant threat to US forces in the Pacific region. These are but a few examples of how arthropod-borne disease prevention is a top priority for force health protection of the Army. In addition to vector-borne and zoonotic diseases, biological threats during deployments include biting and stinging arthropods (fire ants, mites/chiggers, scorpions, etc.); vertebrate animals (rodents, bats, snakes, etc.); and poisonous plants (e.g., poison oak and poison sumac). Biting and stinging arthropods can degrade mission readiness and combat effectiveness even when they do not transmit disease. These arthropods can cause casualties ranging in severity from secondary infections to death from allergic reaction. Annoyance from persistent pests, itching bites, and loss of sleep can also erode morale.

Whether engaged in combat operations, or deployed in support of peacekeeping or humanitarian relief, commanders throughout the Army are concerned about vector-borne diseases and pest threats that can adversely affect the health of their troops and compromise the success of the mission. Medical entomologists, as members of the preventive medicine team, work to minimize these threats by applying safe pest control where it is most needed. During deployments, this mission becomes focused on issues that affect the health of Soldiers and their ability to accomplish their mission. Pathogens transmitted by such vectors as mosquitoes, ticks, and mites are the primary concern because outbreaks of associated diseases can occur suddenly and affect the deployed unit. The Department of Defense (DoD) and Department of the Army recognize that vector control to protect the health and lives of personnel must be balanced with the risks associated with the use of pesticides. Thus, the US Army has taken many steps to reduce the chances of unnecessary exposure of its personnel to pesticides through a sustained emphasis on the use of personal protective equipment, integrated pest management practices, the use of safer pesticides, better recordkeeping, and maintenance of a certified pesticide applicator training program.

The Army's constant goal is full spectrum dominance (to defeat any adversary and control any situation across the range of military operations) over the threat of arthropod-borne diseases and direct injury. The Army does this by forming partnerships with industry and supporting academic research to develop improved (more efficacious and cost effective) surveillance and control techniques and equipment, as well as by identifying and implementing the use of off-the-shelf technologies. The Army also strives to attract and retain high-quality military and civilian personnel to initiate, implement, and support these efforts. Achievement of full spectrum dominance requires investment in the development of new military capabilities, which will lead to multidimensional protection against harmful arthropods and the diseases they transmit. The purpose of this article is to describe current methodologies and future developments for vector control and pest management in the US Army.

ENTOMOLOGY JOINT/MULTIAGENCY EFFORT

Military vector control and pest management programs not only must prevent or control pests and disease vectors that adversely impact readiness or military operations, but must also prevent structure, materiel, or property damage. This is a huge joint/multi-agency effort that extends far beyond protecting deployed service members from blood-feeding arthropods. Each of the military components has its own military and civilian pest management personnel employed to counter the threat. The pest management effort is guided by applicable Executive Orders, Federal, State, and local statutory and regulatory requirements in the US. Overseas, US legal requirements as well as international agreements, Status of Forces agreements, Final Governing Standards issued for host nations, and criteria in the Overseas Environmental Baseline Guidance Document must be followed. The DoD requires that its personnel follow the strictest policies, including Environmental Protection Agency (EPA) regulations, relevant to the area in which an operation is occurring, even though an operation may be outside the jurisdiction of EPA. An important exception is possible in case of need. The Command Entomologist of an operation can authorize the use of unregistered pesticides (such as those locally purchased) or the use of registered pesticides in sites not on the label.

The Armed Forces Pest Management Board (AFPMB) is the tri-Service organization which monitors and guides this international effort, recommending policy for the DoD. Military and civilian members of the armed forces actively participate in the joint policy development process. Advisors from other federal agencies such as the EPA, the Centers for Disease Control and Prevention (CDC), the US Dept of Agriculture (USDA), US Dept of Homeland Security, and others provide valuable advice during the process. The AFPMB works with the military services, the Joint Staff (principally the J-4, Medical Readiness Division) and the combatant commands to ensure DoD policy is effective in meeting the threat to personnel, real property, and materiel. Through an Army entomologist assigned as Contingency Liaison Officer, the AFPMB ensures that deploying and deployed entomologists have the tools to complete the mission. In cases where the tools do not exist or are no longer effective, research aimed at developing new technologies or methodologies is necessary. This requirement led to a new research program that began in October 2003, the Deployed Warfighter Research Program Against Insects that Carry Diseases of Military Importance, or DWFP. The goal of the DWFP is to develop new public health insecticides and formulations, personal protection systems, and application equipment for vector control. New insecticides or formulations developed under this program will require EPA registration to ensure the level of chemical safety that Americans expect.

The Defense Pest Management Information Analysis Center (DPMIAC), a subdirectorate of the AFPMB, analyzes open source pest management literature (refereed publications, trade journals, etc.) to provide information on pest issues for deployments and DoD installations. An Army entomologist assigned to DPMIAC ensures that information products (Technical Guides, Disease Vector Ecology Profiles, and literature searches) meet the requirements of Army customers around the world. Information relevant for deployments is provided to the Armed Forces Medical Intelligence Center (AFMIC) for integration with their data. AFMIC then produces intelligence products such as the AFMIC Medical Environmental Disease Intelligence and Countermeasures (MEDIC) CD, Infectious Disease Risk Assessments, and others. The US Army Veterinary Command often collaborates on management issues involving vertebrate pests such as feral animals and rabies control.

The U.S. Army Center for Health Promotion and Preventive Medicine (USACHPPM) also has an important Entomological Sciences Program (ESP) with a mission to maximize the ability for US Army units and installations to protect the Soldier from the health threat posed by vector-borne disease and medically important pests and to minimize the adverse effects of pesticides. For example, under the direction and leadership of ESP, the West Nile virus (WNV) Surveillance Program was a good example of a multiagency effort in pest management. Following the emergence of WNV in the US in the late summer of 1999, the Army Surgeon General directed the creation and implementation of a WNV Surveillance and Control Program for Army installations. Through collaboration with the CDC, state and local health departments, the US Army Center for Health Promotion and Preventive Medicine (USACHPPM), the US Army Veterinary Command, and others, military installations were able to use mosquito surveillance and control, dead bird surveillance, and human case monitoring to minimize the risk of WNV to personnel on Army installations. Navy, Marine, and Air Force installations conducted similar programs with mutual interactions on pest management-related issues discussed by an ad hoc WNV committee of the AFPMB.

PERSONAL PROTECTION

Vector-borne diseases and associated discomfort caused by biting arthropods can be largely prevented with proper use of personal protective measures (PPMs) by individual Soldiers. Personal protective measures include arthropod repellents, clothing impregnants, and equipment and techniques which, when appropriately applied, will preserve the fighting strength of the troops.

History and Military Significance

Of 80 diseases of military importance, over two-thirds are caused by pathogens transmitted by arthropods. (3) In addition, arthropods can inflict severe physical, psychological, and economic stresses that threaten the military mission. For example, arthropod bites can be painfully distracting and can lead to secondary infections, dermatitis, or allergic reactions. During the Vietnam conflict, the irritation caused by blister beetles (family Meloidae) was a major source of casualties in some locations. In the recent military actions, pest control was necessary to stop an outbreak of dermatitis caused by a different kind of beetle (Paederus rove beetles) in Pakistan. If there is one lesson to be learned from the medical management of disease casualties from all past wars, it is that, during peacetime we should prepare our response to any vector-borne diseases we could encounter during future operations. Due to the lack of effective vaccines or chemoprophylaxis for many vector-borne diseases, proper use of PPMs may provide the only available protection from arthropod-borne diseases. Proper use of PPMs by all Soldiers at risk of vector-borne diseases is critical for reducing the occurrence of disease or nonbattle injuries in current conflicts.

Repellents are one commonly used form of PPM. They provide the commander with a quick and inexpensive measure to protect the force in any military situation, no matter how quickly the unit is called into action. They can be applied effectively to prevent any arthropod-borne disease, whether or not surveillance has identified the pathogen. Repellents are often the only means of protection against arthropod-borne diseases in combat environments when vector control measures are not possible or when the speed of military developments prevents the use of chemoprophylaxis or vaccines. In addition, commanders will be able to minimize incidence of any vector-borne disease, providing a tactical advantage against an unprotected enemy force which does not have the benefit of an effective, long-lasting arthropod repellent.

Topical Repellents

The US military has been a major customer for the development of repellents beginning in 1942 when it was recognized that arthropod-borne disease was an important source of casualties during World War II. This program produced a series of active ingredients. The current military repellent, N,N-diethyl-3-methylbenzamide (deet), was first marketed commercially in 1956. Early formulations were effective, but had drawbacks--the application lasted for only 1 or 2 hours in warm and humid conditions, felt very oily on the skin, had an objectionable odor, and was a strong plasticizer (it dissolved some kinds of plastics). (4) As a result, troops did not like to use it, and most did not. Over 62% of 1,500 Soldiers who responded to a questionnaire urged the Army to get a better repellent. In 1990, the standard military topical arthropod repellent was changed to a sustained-release, polymer formulation containing 35% deet and dubbed the Extended Duration Topical Insect and Arthropod Repellent (EDTIAR). This product was developed by the DoD in collaboration with the 3M Corporation following extensive testing of experimental products by the Letterman Army Institute of Research.

The search for better repellents is still going on. In 1999, the Department of the Army approved a Science and Technology Objective (STO) for development of a new topical standard military insect repellent in collaboration with the USDA's Chemicals Affecting Insect Behavior Laboratory in Beltsville, MD. To support this work, the Department of Entomology at the Walter Reed Army Institute of Research (WRAIR) developed new methods--new statistics, computer modeling of repellent activity, (5) in vivo testing, (6) and in vitro testing (7)--for repellent evaluation that expanded on the excellent work at USDA. The STO was completed in 2005, producing a new candidate active ingredient, (1S,2'S)-methylpiperidinyl-3-cyclohexene-1-carboxamide (SS220) in new formulations that are easier to use than the EDTIAR.

In addition to the development of new repellent chemistries, a new formulation of deet was developed. In order to provide Soldiers and Marines in a tactical environment with more convenient protection from biting arthropods, the WRAIR Repellent Program collaborated with Iguana LLC to produce a new, improved formulation of camouflage face paint insect repellent with 30% deet.

The objective in the evaluation of any repellent test is how it performs in the field. With 5 overseas laboratories (Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; US Army Medical Research Unit-Kenya, Nairobi; Naval Medical Research Center Detachment, Lima, Peru; Naval Medical Research Unit-3, Cairo, Egypt; and Naval Medical Research Unit 2, Jakarta, Indonesia) and collaboration with the Australian Army Malaria Institute, the US military is in an excellent position to test repellents against vectors of many disease causing pathogens.

Repellents

Many of the pathogens of military importance are vectored by ticks, chigger mites, fleas, and body lice. All of these vectors have close contact to clothing when they bite, making the development of repellents to be applied to clothing a logical development.

An effective clothing repellent based on the synthetic pyrethroid, permethrin was fielded in 1991 and is still in use today as the standard military clothing repellent. (4) Currently, military personnel use permethrin to repel and kill arthropods that land on many kinds of treated surfaces, including field uniforms, tents, bed nets, and helmet covers.

Clothing and Equipment

Although often neglected, one of the most practical means of reducing arthropod bites is the proper wearing of the BDU/ACU (battle dress uniform/Army combat uniform). Most arthropods cannot bite through the BDU/ACU material unless it is tightly stretched against the skin. Therefore, Soldiers must wear loosely fitted uniforms and minimize the amount of bare skin that is exposed to blood-sucking arthropods. (4) Field observations on the relationship between clothing and localization of cutaneous leishmaniasis lesions (at the site of a sand fly bite) have confirmed the importance of proper clothing wear in personal protection. (8)

Mosquito Bed Net

The mosquito bed net is a finely woven, nylon canopy that can be used with the folding cot, hammock, steel bed, or shelter half-tent. For all applications, the bed net must be supported and tucked in to prevent contact with the occupant's body while sleeping to prevent mosquitoes and other biting arthropods from biting through the mesh. Standard military permethrin and insecticide space spray (2% d-phenothrin) can be sprayed on the mesh or on insects that are trapped inside the net. Details are in the Armed Forces Pest Management Board's (AFPMB) Technical Guide 36. (4)

The new Self-Supporting Low-Profile Bed Net can be carried inside the backpack or between the backpack and frame. It has a built-in frame designed for single step, "pop-up" assembly. Permethrin-impregnated tight weave mesh provides increased protection against very small biting arthropods such as sand flies. The bed net may be used directly on the ground. Infrared signature, forest camouflage pattern and carrying capacity are compatible with military requirements. Thus, the new bed net is less visible to the enemy, lighter in weight (2 lbs), and easier to set up and take down than the older bed net.

DoD Insect Repellent System

The DoD Insect Repellent System is available for use by all leaders and troops to prevent arthropod-borne pathogens that cause diseases such as malaria, leishmaniasis, scrub typhus, West Nile fever, and Lyme disease. When used properly, the DoD Insect Repellent System will prevent disease, pain, and the annoyance caused by bites of insects such as mosquitoes, sand flies, and other arthropods such as ticks and chiggers. The system consists of three components--permethrin on uniforms (and bed nets), deet on exposed skin, and proper wear of the uniform--and is critical to the Army Medical Regiment's motto to "Conserve the Fighting Strength." It is a mission essential task located in STP-21-1-SMCT "Soldier's Manual of Common Task Testing, Skill Level 1" dated 11 Oct 2005. This system is a DoD Policy that every Soldier, Sailor, Airman, and Marine, need to strictly follow. Details are in the AFPMB Technical Guide 36 (4) and in the USACHPPM fact sheet on the DoD Insect Repellent System (9) and at the Army Medical Department Center and School deployment training portal. (10)

Immunizations and Chemoprophylaxis

Both immunizations and chemoprophylactic measures are considered personal protective measures although they are not controlled by the individual Soldier. Chemoprophylaxis is available for some of the protozoan (malaria) and bacterial (scrub typhus) pathogens transmitted by arthropods. Vaccines are routinely available for only a few of the viral pathogens (yellow fever virus, Japanese encephalitis virus) and are available on an experimental use protocol for a few others (Venezuelan equine encephalitis virus, Rift Valley fever virus). Even when appropriate chemoprophylaxis or vaccination is available for the disease of greatest concern, their use entails considerable medical management. When risk is unknown or considered to be low, personal protection may be the appropriate strategy for prevention. Therefore, the proper use of other personal protective measures described earlier offer the most practical means of interrupting and preventing arthropod-borne disease transmission.

In summary, there are 3 required components for effective personal protection. First, the measure itself must be efficacious when properly used. Second, the development and continual maintenance of a well-defined education program is of paramount importance. Every enlisted Soldier, every officer, and especially every commander must be informed about the importance of personal protective measures for reducing the occurrence of disease caused by arthropod-borne pathogens. Field sanitation teams at the company level can serve the commander by educating Soldiers and ensuring adequate personal protective supplies are maintained and used properly. Finally, enforcement of PPM is sometimes appropriate to assure individual compliance. Discipline in using proven personal protective measures must be reinforced through command emphasis and involvement.

The individual Soldier is the most important element in any combat system. Protection of his/her health is absolutely critical to maintenance of a high state of combat readiness. Medical advisors have the job of supporting the commander by providing sound technical advice and training in the prevention of arthropod-borne diseases. Thus, it is imperative that DoD leaders at all levels understand and endorse the need and the use of these personal protective measures.

SURVEILLANCE

Disease vector and pest surveillance is designed to:

1. measure the relative population levels of known pests to determine when and where to begin specific management techniques;

2. detect invasions of new and potentially important vectors and pests;

3. detect breeding sites that can be eliminated; and

4. measure the effectiveness of previous management efforts.

The Army has 2 major groups involved in pest surveillance and management. One group primarily researches medical aspects of arthropod-borne pathogens, conducts medical personnel training in these diseases, and provides pest management in contingency operations. The other group is the facilities engineering element responsible for protecting property and materiel subject to pest infestation or destruction, including most pest management operations at DoD installations. Cooperation between these two elements is essential to ensure complete, efficient protection of DoD personnel, property, and material.

Prevention of vector-borne diseases through timely surveillance and subsequent integrated pest management (IPM) relies on effective decision-making. Decision-making tools include protocols for deciding the need for some management action based on an assessment of the pest population and its potential for the transmission of vector-borne disease to humans. Monitoring and use of action thresholds are standard practice in military preventive medicine. These protocols (also known as control decision rules) consist of standardized procedures for assessing the density of pest populations and an action threshold, in this case the lowest population density above an acceptable baseline value that will cause nuisance and/ or disease. Thus, carefully planned surveillance plays a critical role in assessing vector-borne disease threats because the information gained can influence decisions on the use of medical preventive interventions, such as chemoprophylaxis, and pesticide usage. One recent example of a success in this area was the role mosquito and malaria parasite surveillance played to help shape an improved theater malaria chemoprophylaxis program for Operations Iraqi Freedom (OIF) and Enduring Freedom. Malaria chemoprophylaxis was substantially reduced in areas with no active transmission, thus lowering costs, limiting logistics concerns, and diminishing undesirable side effects of chemoprophylactic drugs.

Flying insect vectors of disease such as mosquitoes and sand flies currently pose the greatest threat to deployed armed forces. Standardized flying insect trapping programs use CDC light traps (small, battery operated traps with flashlight-like bulbs and often supplemented with dry ice as an attractant) during the hours of darkness. Collected mosquitoes can be tested immediately in the field using the VecTest[R] kit (Microgenics Corp., Fremont, CA, 800-232-3342) and results are obtained within 15 minutes. The VecTest[R] is an antigen panel assay that uses a rapid detection dipstick designed to specifically test for presence of malaria parasites in mosquitoes. The test kit employs a wicking dipstick assay that detects Plasmodium falciparum and P. vivax (variants 210 & 247) in pools of up to 10 anopheline mosquitoes. The Malaria VecTest[R] Kit uses specific monoclonal antibodies targeting the circumsporozoite antigens found on the surface of the Plasmodium parasites. This innovative, effective, and inexpensive test was developed cooperatively by WRAIR and Medical Analysis Systems, Inc.

During the early stages of OIF, Soldier complaints of sand fly bites were high, as was the risk of contracting leishmaniasis. Army entomologists working at Tallil Air Base in 2003 collected over 21,000 female phlebotomine sand flies and sent them to WRAIR where they were tested for the presence of leishmania parasites using fluorogenic PCR (polymerase chain reaction) assay. (11) These entomologists quickly calculated that the minimum field infection rate was 1.58%. By mapping out the temporal and geographic distribution of all sand flies and infected sand flies, the team was able to focus control efforts in areas that were at highest risk for leishmaniasis. A diverse team of US Army, Air Force, and Navy entomologists, along with colleagues from various coalition forces (British, Italian, Dutch, and Korean), and pest control contractors implemented an aggressive leishmaniasis control plan.

Accurate vector identification and knowledge of vector biology are essential for arthropod-borne disease risk assessment and for development of appropriate strategies for vector suppression, arthropod-borne disease reduction, and vaccine and drug development. There are hundreds of species with varying capabilities of transmitting diseases, depending on factors such as physiological compatibility with the disease organism, host species preference, and feeding times and locations. Potential vectors must be identified at least to the species level to provide the most useful information. Insect identification is greatly assisted through the reach back capabilities provided by the Walter Reed Biosystematics Unit, part of the WRAIR, located at the Museum Support Center of the Smithsonian Institution in Suitland, MD. This unique national resource provides online mosquito and sand fly identification keys, laboratory and field protocols, high-resolution images of mosquito morphology, and many other online products to assist military entomologists deployed around the world to correctly and quickly identify arthropod vectors of disease.

New and innovative surveillance techniques are currently being developed by military entomologists. The WRAIR, in partnership with the American Biophysics Corp., is currently evaluating new and innovative insect surveillance tools and control devices. Entomologists at WRAIR and the Uniformed Services University of the Health Sciences are developing remote sensing capabilities that can be applied in disease vector surveillance. We have all become accustomed to the "birds-eye" view of the earth provided by photographs and images acquired from aircraft as well as from manned and unmanned spacecraft. It is this birds-eye view that military entomologists plan to exploit to collect more informative and predictive insect surveillance data.

CONTROL

The DoD pest management community is firmly committed to the principles of IPM as stated in DoD Instruction 4150.7. (12) Integrated pest management describes many approaches to pest control including non-chemical activities such as sanitation, habitat modification, and development of surveillance programs to specifically target pest locations and activity times. Use of IPM must not compromise the effectiveness of control and must be tailored to best address the specific needs of each pest or disease vector problem. The Army recognizes that pesticides are indispensable management tools, and takes seriously the responsibility for their safe and effective use. As part of any IPM program, when choosing to use chemical control tools, pest managers are directed to select the least hazardous pesticides that will still provide acceptable results. For example, pesticides in the organophosphate and carbamate chemical classes are still used if specific conditions warrant, but effective substitutes such as newer generation pyrethrins or insect growth regulators are preferred choices. In addition, since the DoD Measures of Merit were instituted over a decade ago with the one stated goal of a 50% reduction in pesticide use by the year 2000, the entire existing pesticide list has been carefully evaluated and updated. When possible, lower application rate pesticides were substituted for higher rate products and lower toxicity chemicals were added to the inventory. This, in addition to a DoD culture that emphasizes IPM, has enabled the DoD to achieve a 61% reduction in pesticide use by 2006. since the program inception, while still maintaining appropriate levels of pest and disease vector control. The DoD has exceeded all its pesticide use reduction goals, and will continue to focus on further reductions wherever possible.

The Defense Logistic Agency regularly updates the national stock list to reflect this goal. However, this effort succeeds only as new, effective, and less toxic active ingredients are developed and registered for use by the EPA, a slow and extremely costly endeavor for pesticide manufacturers. When such products are brought to the market, the AFPMB makes every effort to evaluate their potential for use by DoD components and to add them as needed to the stock list. Examples that appear on the current stock list include insect growth regulators, such as fenoxycarb and methoprene, and microbial pesticides, such as Bacillus thuringiensis and spinosad. Members of the AFPMB are also periodically approached by vendors attempting to sell products to the DoD which they label as "natural" or otherwise having low/no toxicity. Unfortunately, in most of these cases, the data supporting these products is either insufficient or nonexistent, particularly if the product does not require EPA registration. Nevertheless, if these products meet the military's rigorous efficacy requirements, they could be supported by professional pest managers and added to the national stock list.

Use of less toxic and more effective pesticides is obviously advantageous to the DoD Pest Management Program to protect human health and the environment. Pest management professionals in the DoD also recognize the need to maintain a sufficiently diverse inventory of pesticides to delay the onset of resistance, which makes certain pesticides ineffective and threatens the military's ability to prevent diseases. To address these issues, DoD pest management professionals, in conjunction with representatives from the CDC, National Institutes of Health, US Agency for International Development, USDA, private industry, and professional pest control organizations, actively seek more effective and less toxic or environmentally hazardous pesticides that will still meet diverse military pest management needs. This group of concerned stakeholders and pesticide users recognizes the fact that some pesticides are being removed from the inventory not only due to concerns about human exposures and environmental safety, but also due to development of resistance to insecticides and lack of economic incentives to develop and maintain products used for disease vector control. The group is currently identifying strategies to promote and support the development of much-needed new products.

The DoD views careful screening and selection of the pesticides authorized for use as one crucial component of any effective IPM program. Another crucial component is the type of pest management equipment and methodology used in applying pesticides. In addition to using the most effective and efficient commercially produced pesticide application equipment, the military services conduct research, either intramurally or collaboratively, with USDA to develop new or improve existing pesticide application technologies for increasing efficacy of pesticide dispersal, and/or reducing the amount of pesticide needed for effective control. The DWFP supplies competitive funding specifically for research relating to pesticide technologies. Of particular promise is current military research on the integration of global positioning systems, new high-pressure systems for C-130 aircraft aerial pesticide application, and the evaluation of unmanned aerial vehicles for pesticide application in hard-to-reach or dangerous areas. The AFPMB Pesticide and Equipment Committees take the lead on identifying and recommending new products and equipment for inclusion on the national stock list. This process supports the ongoing efforts within the DoD to provide effective pest and vector control in the safest possible manner.

SUMMARY

Entomological hazards, including vector-borne diseases, stinging and biting arthropods, and harmful animals and plants remain a significant threat to US military forces both at home and abroad. Military entomologists continue to use safe, effective, established methods of surveillance and control while continuing to develop new, innovative, safer, and more effective methods. This is due in large part to the synergy that results from joint efforts between the Army, Air Force, and Navy through the continued coordination of the AFPMB. Partnering with other government agencies (USDA), industry, and universities has also stimulated the development and implementation of new and more effective technologies that can be quickly delivered to field forces. All of these activities are continually bringing military entomology closer to the goal of full spectrum dominance over harmful arthropods and noxious animals and plants that otherwise would cause US forces to suffer morbidity and mortality.

ACKNOWLEDGMENT

The authors thank Dr Ed Evans and Sandy Evans from the Entomological Sciences Program at USACHPPM for providing photos and editorial support, and COL (Ret) Daniel Strickman, Dr Rich Robbins, and Zia Mehr for helpful comments and review of this article.

REFERENCES

(1.) Aronson N, Ananthakrishman M, Bernstein W, et al. Update: Cutaneous leishmaniasis in U.S. military personnel-Southwest/Central Asia, 2002-2004. JAMA. 2004;291:2188.

(2.) US Navy Environmental Health Center. Malaria outbreak among members of JTF Liberia Consensus Conference Report. 2003. Available online at: http://www-nehc.med.navy.mil/downloads/prevmed/JFTMalaria.pdf.

(3.) Handbook of Diseases of Military Importance. Washington, DC: US Dept of Defense, Defense Intelligence Agency; 1982.

(4.) Technical Guide No. 36, Personal Protective Measures Against Insects and Other Arthropods of Military Significance. Washington, DC: US Dept of Defense, Armed Forces Pest Management Board; 1996. Available online at: http://www.afpmb.org/coweb/guidance_targets/ppms/TG36/TG36.htm

(5.) Ma D, Bhattacharjee AK, Gupta RK, Carle JM. Predicting mosquito repellent potency of n.n-diethyl-mtoluamide (DEET) analogs from molecular electronic properties. Am J Trop Med Hyg. 1999;60:1-6.

(6.) Klun J, Debboun M. A new module for quantitative evaluation of repellent efficacy using human subjects. J Med Entomol. 2000;37:177-181.

(7.) Klun J, Kramer M, Debboun M. A new in vitro bioassay system for discovery of novel human-use mosquito repellents. J Am Mosq Cont Assoc. 2005;21:64-70.

(8.) Dedet JP, Esterre P, Pradinaud R. Individual clothing prophylaxisof cutaneous leishmaniasis in the Amazonian area. Trans Royal Soc Trop Med Hyg. 1987;81:748

(9.) US Army Center for Health Promotion & Preventive Medicine. DoD insect repellent system. Available at: http://chppm-www.apgea.army.mil/documents/DoDInsectRepellentSys.pdf

(10.) US Army Medical Command Center & School. Deployment relevant web sites. Available at: http://www.cs.amedd.army.mil/deployment2.aspx#

(11.) Berte SB. US Army entomology support to deployed forces. Amer Entomol. 2005; 51;No. 4:208-217.

(12.) DoD Instruction 4150.7, DoD Pest Management Program. Washington, DC: US Dept of Defense; April 22, 1996.

AUTHORS

LTC Debboun is the Chief of Medical Zoology Branch and Deputy Chief of the Department of Preventive Health Services, Academy of Health Sciences, US Army Medical Department Center & School, Fort Sam Houston, Texas.

COL Leon Robert is an Associate Professor, Department of Chemistry and Life Science, US Military Academy, West Point, New York.

MAJ O'Brien is the Chief, Defense Pest Management Information Analysis Center, Armed Forces Pest Management Board, Washington, DC.

COL Johnson is the Director, Armed Forces Pest Management Board, Office of the Deputy Under Secretary of Defense (Installations and Environment), Washington, DC.

COL Berte, a former Medical Entomology Consultant to the Surgeon General of the Army, now serves as the Joint Project Manager of the Chemical Biological Medical Systems Project Management Office, Fort Detrick, Maryland.

LTC Mustapha Debboun, MS, USA COL Leon Robert, MS, USA MAJ Lisa O'Brien, MS, USA COL Richard Johnson, MS, USA COL Stephen Berte, MS, USA
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Author:Debboun, Mustapha; Robert, Leon; O'Brien, Lisa; Johnson, Richard; Berte, Stephen
Publication:U.S. Army Medical Department Journal
Date:Apr 1, 2006
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