tallil ab, iraq 2003 af vector surveillance team (bat-l)
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Tallil AB, Iraq2003
AF Vector Surveillance Team(BAT-L)
Worst Possible Scenario
Leish endemic area Epidemic cutaneous
and visceral
10,000+ troops at Tallil Hundreds of bites/night
for unprotected personnel
Result: Leishmaniasis
Biological Augmentation Team
Normally a WMD response capability
Ruggedized RT-PCR platform (RAPID)– Lyophilized reagents
Lab personnel and equipment + ento = BAT-Leish
Lightweight and mobile
Air Force “System”
Attached to EMEDS Captive military
population– Education, PPE
monitoring Controlled environment
ISO office/laboratory Surveillance/testing of
flies and reservoirs 1Sep-15Nov
So, did we do anything different?
Reservoir Testing
Tested feral dogs, foxes, and rodents
RAPID used to prevent unnecessary euthanasia – Foxes released if neg
“Vatican City” Ecosystem
AF TC (Vatican City) SF infection rate consistently higher even though primary reservoirs uncommon– Few fat sand rats,
jirds, or gerbils– Plenty of mice – 2 rodents came back
PCR positive (WB)
Peak Flight Time
Sand Fly Flight Time (24 Oct 03)
2
42
91
103
76
60
19 21
0 2 0 0 0
5:00 6:00 7:00 8:00 9:00 10:00 11:00 12:00 1:00 2:00 3:00 4:00 5:00
Time
To
tal N
um
ber
Sa
nd
Flie
s
Flight time is dynamic Changes constantly Species shift? Or adaptation to changing environment? Implications: control, education, PPE/avoidance measures
Lessons Learned
The sand flies haven’t read the books There’s not enough time in the day Know the priorities (Leish is not a big
concern when shrapnel is flying) Take everything you need with you!
– Murphy’s Law kicks in as soon as your boots hit the ground
Recommendations
Focus Leishmaniasis control efforts on reservoir control– Easier to find and fewer to control– Identify primary reservoirs and eliminate– Turn the vector into a pest
Alternative approaches to vector control– Vegetation management, baiting, trapping,
aerial spray Monthly flight time studies
Will The Leish Threat Remain?
If the sand fly/Leish threat is exacerbated by dry conditions of forced drought, then what happens when the water comes back?
Converts back to malarious area?
Other Fun Things
Mosquito surveillance Cats for rodent control Where are all the flies?
What Now?
Continue development/validation of new assays
Back to Iraq to assist with surveillance and control of vector-borne diseases
Transition from BAT-L to Medical Entomology Team (MET)
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