human and animal structures. Abandoned structures and their vegetative overgrowthoften become attractive wild rodent habitats and foci of rural CL.Vegetation is important as a sugar source for both male and female sand flies. Sugar isrequired for females developing parasite infections. Eggs are developed after abloodmeal and are deposited in dark, humid, protected areas. They develop into minutecaterpillar-like larvae that feed on mold spores and organic debris. The larvae go throughfour instars and then pupate near larval feeding sites. Development from egg to adult is30 to 45 days, depending on feeding conditions and environmental temperatures.Phlebotomine sand fly eggs, larvae and pupae have seldom been found in nature,although exhaustive studies and searches have been made. The adult female has beenobserved to spread eggs around rather than ovipositing in single egg laying sites. Thelarvae are believed to be widely distributed in endemic environments but are probablybelow the ground surface in termite mounds, rodent burrows or other tunnels wheretemperature, humidity and mold growth provide ideal growing conditions. Because oftheir minute and delicate nature, larvae have seldom been collected in the wild. The duskto dawn movement of adults is characterized by flight just above the ground surface toavoid wind. Adult sand flies generally do not travel great distances, and most flights arebelieved to be less than 100 meters. The females fly in a low hopping flight just abovethe ground in search of rodent hosts. Both male and female sand flies seek plant sugarsfrom local vegetation. Sand fly habitats in the region range in altitude from desert areasbelow sea level to 2,800 m in the mountains. Where seasonal temperature and rainfallchanges occur, large numbers of adult sand flies are common in the warmer months ofApril through October, especially after rains. However, Le. tropica peak seasonalincidence occurs during January and February.Vector sand flies have short flight ranges. Their dusk to dawn flights coincide with thenomadic activity of peoples of the region, who often travel at night to avoid the extremeheat of daytime hours. Areas with some vegetation, and cliffs, rock outcroppings, orother geologic formations that allow for suitable hiding places and daytime resting sitesare important habitats. Exact information on reservoirs and vectors will require moreextensive study in many countries of the region. Vast areas of these countries remainunsurveyed for vectors and disease. When searches are made, sand fly vectors are oftenfound in areas where they were previously unknown.Vector Surveillance and Suppression. Sand flies may be collected by a variety ofmethods. Light traps used for mosquito collection should be modified with fine meshscreens because the small size of phlebotomine sand flies allows them to pass throughnormal mosquito netting. Sticky traps prepared with paper and vegetable or plant oil areuseful and may be placed near rodent burrows, rock crevices, building debris, in andaround buildings or constructed military earthworks, and in local vegetation where sandflies are likely to rest during daytime hours. The sticky paper trap is also useful wherelight traps are either unavailable or their use is limited due to night security measures.Aspirator collections by trained personnel from sand fly resting sites are useful but laborintensive. Identification requires a microscope and some training; however, with someexperience, sorting and identification by color and size is quite accurate using minimal113
magnification. For proper species identification, laboratory microscopes having 100Xmagnification are required.Sand flies are susceptible to most pesticides, and residual insecticide spraying ofgrounds/structures (inside and outside walls) of encampment areas, coupled with barrierspraying of 200 m of territory surrounding encampment sites, is effective. Consult TIM24, Contingency <strong>Pest</strong> <strong>Management</strong> Pocket Guide, for specific pesticide recommendationsand application techniques. When the use of organophosphates or other insecticides isimpractical due to the combat situation or other operational requirements, personalprotective measures (proper wearing of permethrin-treated uniforms and skin repellents)will provide nearly complete protection. Normal mosquito bednets and screening areineffective because of the ability of sand flies to crawl through the mesh. Commandersmust inform troops of the risks of infection and monitor the proper wearing of uniformsand use of skin repellents.Since small desert rodents are often the normal hosts of sand flies, selection ofencampment sites without vegetation or rock outcroppings that enhance rodent harborageis important. Cleanup and removal of garbage and debris that encourage rodentharborage are necessary for longer periods of occupation. Where combat situationsoutweigh selection and cleanup, residual insecticide spraying will greatly reduce sand flyprevalence. Again, proper wearing of treated uniforms and use of skin repellents willsuffice where other control measures cannot be used to reduce sand fly incidence. Petsmust be strictly prohibited because any small desert rodent and/or local dog may beinfected with cutaneous or visceral leishmaniasis and other infectious diseases.B. Schistosomiasis. (Bilharziasis, Snail fever)This disease is caused by trematodes in the genus Schistosoma that live in the veins ofhumans and other vertebrates. Eggs from adult worms produce minute granulomata andscars in the organs where they lodge. Symptoms are related to the number and locationof the eggs. The WHO considers five species of schistosomes significant in terms ofhuman disease. Schistosoma mansoni, S. japonicum, S. mekongi and S. intercalatum giverise to primarily hepatic and intestinal symptoms. Infection with S. haematobium usuallyproduces urinary manifestations. The most severe pathological effects are thecomplications that result from chronic infection. Symptoms of acute disease appear 2 to8 weeks after initial infection, depending on the parasite species, and can be intense,especially in nonimmune hosts. Clinical manifestations include fever, headache,diarrhea, nausea and vomiting. Blood may be present in the urine but usually occurs laterin the disease. The acute stage of schistosomiasis is usually more severe in the Asianforms S. japonicum and S. mekongi than in S. mansoni, S. intercalatum, or S.haematobium.Military Impact and Historical Perspective. The first documented cases ofschistosomiasis in US military personnel occurred in 1913 among sailors assigned to theYangtze Patrol in China. Significant portions of the crews on some patrol boats wereincapacitated. American forces were not deployed in areas endemic for schistosomiasisduring World War I. However, infection was prevalent among Allied <strong>Forces</strong> engaged inMesopotamia and various parts of Africa. During World War II, the US Army114
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1. Table of ContentsI. Preface.....
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IX.Selected ReferencesA. Military P
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and spills have polluted sea- and l
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Sand fly fever is the most widespre
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VENOMOUS ANIMALSThere are 31 specie
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Middle East11
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leptospires, various bacteria and i
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Bandar Abbas (elevation 10 m)Mean D
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a wide variety of human pathogens.
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The Jordan Valley area is part of t
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still numerous sites where waste di
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highlands (445 m elevation) are sim
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ocky central plateau, the Nejd, whi
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MONTH J F M A M J J A S O N DMaximu
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known as the Liwa, form an arc alon
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A.2. Sand flies continuedBahrain Cy
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A.3. Ticks continuedIXODIDAEBahrain
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A.3. Ticks continuedBahrain Cyprus
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A.4. Fleas continuedBahrain Cyprus
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A.4. Fleas continuedHYSTRICHOPSYLLI
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A.4. Fleas continuedBahrain Cyprus
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A.4. Fleas continuedBahrain Cyprus
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A.5. Reported Distribution of Scorp
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A.5. Scorpions continuedBahrain Cyp
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Appendix B. Vector Ecology Profiles
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Appendix B.2. Vector Ecology Profil
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B.2. Ticks continuedSpecies Geograp
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In recent years, synthetic pyrethro
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Published Reports of Insecticide Re
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Turkey.Calgar, S.S. 1991. An invest
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Appendix ESelected List of Identifi
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MammaliaHarrison, D.L. and P.J.J. B
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Appendix F: Personal Protective Mea
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Appendix GBioscience and State Depa
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8. Kuwait9. Lebanon10. Oman11. Qata
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Appendix H: Glossaryacaricide - a c
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zoonosis - An infectious disease of
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flies.11. Information on ticks and
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APPENDIX J METRIC CONVERSION TABLEM