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File: 950901_0410pgf_91.txt
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CURRENT DISEASE INFORMATION ON COUNTRIES OF POTENTIAL INTEREST TO 
DESERT SHIELD EXTRACTED FROM DISEASE OCCURRENCE -- WORLDWIDE, [   
(b)(2)   ]                                 REVIEW HAS BEEN 
PROVIDED BY AFMIC SURGEON.

Filename:0410pgf.91
03  07  101500Z  JAN  91  PP  PP  

		FROM: DIRAFMIC FT DETRICK MD //AFMIC PS//

          TO:  CMC WASHINGTON DC //CODE MED//

			CNO WASHINGTON DC //OP-093//

			HQDA WASHINGTON DC //SGPS-PSP-D//

			JCS WASHINGTON DC // J4 MEDICAL//

			HQ USAF BOLLING AFB DC //SGHR//

			USCENTCOM REAR MACDILL AFB FL //CCSG//

			COMUSNAVCENT PEARL HARBOR HI //N45//

			USCENTAF REAR LANGLEY AFB VA //SG//

			USCINCSOC MACDILL AFB FL //SOSG//

			USCINCEUR VAIHINGEN GE //ECMD//

			USCINCPAC HONOLULU HI //SG//

			CINCPACAF HICKAM AFB HI //J07//

			CINCPACFLT PEARL HARBOR HI

			USARPAC FT SHAFTER HI //APMD//

			USTRANSCOM SCOTT AFB IL //TCSG//

			NATNAVMEDCEN BETHESDA MD

			CDRJSOC FT BRAGG NC //CMD-SG

			SFOD-D FT BRAGG NC

			CDRXVIIIABNCORPS FT BRAGG NC //AFZA-MD//






[   (b)(6)   ]					[   (b)(2)   ]
[   (b)(2)   ]


[   (b)(6)   ]


			HQ USCENTCOM  FWD//J2/SG//

			HQ CENTAF FWD//SG//

			USARCENT FWD //MD//

			COMUSMARCENT //SURG//

			COMUSNAVCENT //N4//

			CINCLANTFLT NORFOLK VA //NO2M2//

			USCINCLANT NORFOLK VA //JO2M//

			COMIDEASTFOR //N4//

			COMUSNAVLOGSUPFOR //N4//

			MEDTREFAC COMFORT //N4//

			MEDTREFAC MERCY //N4//

			CG SEVENTH MEB //SURG//

			CG I MEF (FWD> 1/SURG//

			SEAL TEAM SIX

			SOCCENT FWD //SURG//

			32NDABNDIV FWD //

			NAVSPECWARCOM DEPLOYED

			75TH RANGERS DEPLOYED

			CDR24THINFDIV (FWD) //CM&D/G2/SURG//

			CDR7THTRANSGP DEPLOYED //AFFG-C S2/SURG//

			CDR101STABNDIVAASLT {FWD} //CM&D/G2//

			CDR44THMEDBDE //S2//

			CDR30THMEDGP

			5THSFG DEPLOYED

			CDR213THMEDBDE

			CDR127THMEDGP

			CDR1STCAVDIV FT HOOD TX //G2/CM&D//

			CDR1STINFDIV{M} FWD

			CDR3DACR

			33TFW DEPLOYED //IN//

			354TACHOSP DEPLOYED //SG//

			435TAW DEPLOYED //SG//

			CG I MEF (REAR) //G2//

               CG I MEF (FWD) //SURG//

			AIG 8598



SUBJ:  CURRENT DISEASE INFORMATION ON COUNTRIES OF POTENTIAL 
INTEREST TO DESERT SHIELD EXTRACTED FROM DISEASE OCCURRENCE -- 
WORLDWIDE, [   (b)(2)   ]                                 REVIEW 
HAS BEEN PROVIDED BY AFMIC SURGEON.

I.  KUWAIT -- [   (b)(1) sec 1.3(a)(4)   ]
             , DISEASES INCLUDING "SEVERE GASTROINTESTINAL 
PROBLEMS, TYPHOID, AND MENINGOCOCCAL DISEASE" HAVE OCCURRED IN THE 
CIVILIAN POPULATION. INCIDENCE OF SHIGELLOSIS REPORTEDLY HAS 
SIGNIFICANTLY EXCEEDED NORMAL LEVELS SINCE THE IRAQI INVASION 
POSSIBLY BECAUSE OF LACK OF AVAILABLE IODINE FOR DISINFECTING 
FRESH FRUITS AND VEGETABLES. (DETERIORATION OF SANITARY CONDITIONS 
AND PREVENTIVE MEASURES IN GENERAL HAVE CREATED CONDITIONS 
FAVORABLE FOR OUTBREAKS OF FOOD, AND WATERBORNE DISEASES.) IN 
ADDITION, ALTHOUGH NOT SPECIFICALLY MENTIONED IN THE [   (b)(1) 
sec 1.3(a)(4)   ], MULTIPLE DRUG-RESISTANT SALMONELLA AND SHIGELLA 
STRAINS APPEAR COMMON. THE CASES OF "MENINGOCOCCAL DISEASE" 
(PRESUMABLY MEMINGOCOCCAL MENINGITIS) OCCURRED IN CHILDREN, BUT 
WHETHER INCIDENCE EXCEEDED NORMAL LEVELS IS UNCLEAR. NO SEROGROUP 
DATA WERE AVAILABLE ALTHOUGH GROUP A PREDOMINATED DURING THE 
198O'S, GROUP W135 INCREASINGLY HAS BEEN REPORTED. [   (b)(2)   ]


2.  KUWAIT -- A HIGH INCIDENCE OF "INTESTINAL DISORDERS AND 
DERMATOLOGICAL FUNGAL INFECTIONS" HAS BEEN REPORTED AMONG IRAQI 
SOLDIERS IN KUWAIT. KUWAITI DOCTORS HAVE ESTIMATED THAT ABOUT 50 
PERCENT OF IRAQI SOLDIERS HAVE DERMATOLOGICAL FUNGAL INFECTIONS 
ATTRIBUTABLE TO POOR PERSONAL HYGIENE.  ALTHOUGH NOT SPECIFIED, 
THE "INTESTINAL DISORDERS" PROBABLY INCLUDE SHIGELLOSIS AND 
TYPHOID FEVER. [   (b)(2)   ]
              THE OVERALL INFECTIOUS DISEASE ATTACK RATE 
REPORTEDLY IS MUCH HIGHER AMONG PEOPLES' ARMY SOLDIERS THAN AMONG 
THE REPU8LICAN GUARD FORCES.  THE IRAQI MILITARY HISTORICALLY HAS 
HAD POOR FIELD SANITATION CAPABILITIES AND SHOULD BE CONSIDERED 
VULNERABLE TO OUTBREAKS OF COMMUNICABLE DISEASES, PARTICULARLY 
THOSE WITH FOOD (ILLEGIBLE) ETIOLOGIES HOWEVER, INCONSISTENCIES 
AND GAPS IN DISEASE REPORTING HAVE RENDERED ASSESSMENT OF THE 
IMPACT OF INFECTIOUS DISEASES ON IRAQI COMBAT EFFECTIVENESS HIGHLY 
SPECULATIVE.

3.  KUWAIT -- [   (b)(1) sec 1.3(a)(4)   ]                        
INDICATED THAT "CHOLERA" OUTBREAKS HAD OCCURRED. HOWEVER, SEVERE 
GASTROENTERITIS, PARTICULARLY BACILLARY DYSENTERY, OFTEN MAY BE 
INCORRECTLY IDENTIFIED AS "CHOLERA" BY LAY PERSONNEL  [   (b)(2)  
 ]                                                   , AND 
DYSENTERY (PRESUMABLY SHIGELLOSIS> CURRENTLY IS BELIEVED TO BE THE 
ACTUAL CAUSE OF ILLNESS IN THE "CHOLERA" CASES. THIS ASSESSMENT 
HAS BEEN SUBSTANTIATED BY [   (b)(1) sec 1.3(a)(4)   ]            
   .  CH0LERA IS NOT CONSIDERED ENDEMIC TO THE REGION, BUT SPORDIC 
CASES (USUALLY IMPORTED> HAVE BEEN REPORTED IN RECENT YEARS.      
[   (b)(2)   ]                           HOWEVER, CARRIERS IN THE 
IRAQI MILITARY AND THE FOREIGN CIVILIAN LABOR FORCE (FROM ENDEMIC 
AREAS SUCH AS BANGLADESH, PAKISTAN, INDIA) COULD INTRODUCE 
CHOLERA, WITH SUBSEQUENT OUTBREAKS LIKELY BECAUSE OF THE POOR 
SANITARY CONDITIONS AND LACK OF ADEQUATE CONTROL MEASURES.

4.   OMAN -- THE FIRST DOCUMENTED HUMAN DEATH FROM RABIES IN OMAN 
RECENTLY WAS REPORTED.  AN 8-YEAR-OLD BOY DEVELOPED THE DISEASE 4 
MONTHS AFTER BEING BITTEN BY A FOX NEAR HIS HOME, 240 KILOMETERS 
WEST OF MUSCAT. THE REPORT DID NOT INDICATE WHETHER THE FOX WAS 
TESTED FOR RABIES OR IF THE BOY RECEIVED POST EXPOSURE 
PROPHYLAXIS. SYLVATIC RABIES IS ENZOOTIC IN OMAN  WITH THE DESERT 
FOX AS THE PRINCIPAL ENZOOTIC RESERVOIR, SPILLOVER INTO DOMESTIC 
ANIMAL POPULATIONS OCCURS (LABORATORY-CONFIRMED CASES IN TWO FOXES 
AND A GOAT RECENTLY WERE REPORTED), WITH STRAY DOGS (CATS AND 
OTHER ANIMALS TO A LESSER EXTENT> RESPONSIBLE FOR MOST OF THE 
HUMAN BITE/SCRATCH INCIDENTS REQUIRING POST-EXPOSURE PROPHYLAXIS. 
RISK FROM RABIES IN OMAN PREVIOUSLY HAD SEEN CONSIDERED RELATIVELY 
LOW BUT THE IMPLEMENTATION OF STRICTER ANIMAL CONTROL MEASURES 
(DOG VACCINATION AND LICENSURE> IN LATE 1989 AND A PUBLIC 
EDUCATION PROGRAM (SUBSEQUENT TO THE BOY'S DEATH> ON THE DANGERS 
OF ANIMAL BITES MAY INDICATE THAT HEALTH OFFICIALS NOW CONSIDER 
RABIES RISK TO BE ELEVATED 

S.  YEMEN - [   (b)(1) sec 1.3(a)(4)   ]     (AL-HUDAYDAH, ON THE 
RED SEA COAST, ABOUT 140 KILOMETERS WEST SOUTHWEST OF SANAA) 
RECENTLY REPORTED THAT CHOLERA CASES HAVE OCCURRED AMONG YEMENIA 
DISPLACED FROM SAUDI ARABIA AND CURRENTLY LOCATED IN "TENT CITIES" 
THAT HAVE FORMED IN AND AROUND THAT CITY. MOST OF THE ESTIMATED 
600,000 TO 800,000 YEMENI RETURNEES HAVE FOUND HOUSING IN THEIR 
VILLAGES OR WITH RELATIVES, BUT "THOUSANDS" (ACCURATE ESTIMATES 
NOT AVAILABLE> HAVE ESTABLISHED MAKESHIFT DWELLINGS NEAR SEVERAL 
TOWNS ALONG THE RED SEA COAST. ALTHOUGH NOT SPECIFICALLY 
MENTIONED, SANITARY CONDITIONS IN SUCH AREAS PROBABLY ARE 
CONDUCIVE FOR FOOD- AND WATERBORNE DISEASE OUTBREAKS.  CHOLERA 
CURRENTLY IS NOT ENDEMIC IN YEMEN: IMPORTED CASES AND SUBSEQUENT 
OUTBREAKS MAY OCCUR, BUT SELDOM ARE REPORTED.
 



 

 



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