exude serum, itch for several days, or be complicated by secondary infections fromscratching. Enormous numbers of these tiny flies often emerge from breeding sites,causing intolerable annoyance.Breeding habits vary widely from species to species. The larvae are primarily aquatic orsemiaquatic, occurring in the sand or mud of fresh, salt, or brackish water habitats,notably salt marshes and mangrove swamps. Many species exploit specialized habitatssuch as tree holes, decaying vegetation, and cattle dung. Most species remain within 500m of their breeding grounds. Punkies are troublesome mainly under calm conditions, andthe number of flies declines rapidly with increasing wind speed. In militarily secure areas,locate encampments in the open, away from breeding sites, to avoid the nuisance causedby these insects.Larvae are difficult to find, but adults are easily collected in biting collections and lighttraps. Larval stages are best controlled by environmental management. Adult controltypically includes applying residual insecticides to fly harborages, treating screens andbednets with pyrethroids, and using repellents.4. Chilopoda (centipedes) and Diplopoda (millipedes). Centipedes in tropical countriescan attain considerable size. Members of the genus Scolopendra can be over 25 cm longand are capable of inflicting painful bites, with discomfort lasting 1 to 5 hours. Twopuncture wounds at the site of attack characterize the bite. Neurotoxic and hemolyticcomponents of a centipede's venom normally produce only a localized reaction, butgeneralized symptoms such as vomiting, irregular pulse, dizziness and headache mayoccur. Most centipede bites are uncomplicated and self-limiting, but secondary infectionscan occur at the bite site. Centipede bites are rarely fatal to humans, but deaths have beenreported.Centipedes are flattened in appearance and have one pair of legs per body segment. Largespecies may have over 100 pairs of legs. They are fast-moving, nocturnal predators ofsmall arthropods. During the day, they hide under rocks, boards, bark, stones and leaflitter, but occasionally they find their way into homes, buildings, and tents. Mostcentipede bites occur when the victim is sleeping or when putting on clothes in whichcentipedes have hidden. Troops should be taught to inspect clothing and footwear whenliving in the field.Scolopendra spp. are very common in the <strong>Middle</strong> <strong>East</strong>. Scolopendra cingulata, S.scutigera, and S. lithobius are species frequently recorded as biting humans in Israel.Millipedes are similar to centipedes except that they have two pair of legs per bodysegment and are rounded or cylindrical instead of flattened. Millipedes are commonlyfound under stones, in soil and in leaf litter. They are nocturnal and feed on decayingorganic matter. They are more abundant during the wet season. When disturbed they coilup into a tight spiral. Millipedes do not bite or sting, but some species secrete defensivebody fluids containing quinones and cyanides that discolor and burn the skin. An initialyellowish-brown tanning turns to deep mahogany or purple-brown within a few hours ofexposure. Blistering may follow in a day or two. Eye exposure may require medicaltreatment. A few species from the genera Spirobolida, Spirostreptus, and Rhinocrichus135
can squirt their secretions a distance of 80 cm or more.5. Cimicidae (bed bugs). The common bed bug, Cimex lectularis, has been associatedwith humans for centuries and is cosmopolitan in distribution. Bed bug infestations aretypical of unsanitary conditions, but they can still be found in developed countries. Thereis little evidence that bed bugs transmit any pathogens. Bites can be very irritating, proneto secondary infection after scratching, and may produce hard swellings or welts. Bedbugs feed at night while their hosts are sleeping and hide during the day in cracks andcrevices, under mattresses, in mattress seams, spaces under baseboards, or loosewallpaper. Chronic exposure to bed bugs can result in insomnia, nervousness and fatigue.There are five nymphal instars before development to adults. Each nymph must take abloodmeal in order to molt. Adults live up to one year. Bed bugs take about five minutesto obtain a full bloodmeal. They can survive long periods of time without feeding. Bedbugs possess scent glands and emit a characteristic odor that can easily be detected inheavily infested areas. Blood spots on bed clothing and fecal deposits are other signs ofinfestation. Some species attack bats and various birds but do not bite man.Bed bugs have become established in hotels, apartments, and office buildings in Baghdadand are probably common in other areas of the <strong>Middle</strong> <strong>East</strong>. Bed bugs can be introducedinto barracks through infested baggage and belongings. In contingency situations, olddwellings should be surveyed for these and other pests before they are occupied.6. Dipterans Causing Myiasis. Myiasis refers to the condition of fly maggots infestingthe organs and tissues of people or animals. Specific cases of myiasis are clinicallydefined by the affected organ, e.g., cutaneous, enteric, rectal, aural, urogenital, ocular, etc.Myiasis can be accidental when fly larvae occasionally find their way into the humanbody. Accidental enteric myiasis occurs from ingesting fly eggs or young maggots onuncooked foods or previously cooked foods that have been subsequently infested. Othercases may occur from the use of contaminated catheters, douching syringes, or otherinvasive medical equipment in field hospitals. Accidental enteric myiasis is usually abenign event, but larvae may survive temporarily, causing stomach pains, nausea, orvomiting. Numerous fly species in the families Muscidae, Calliphoridae, andSarcophagidae are involved in accidental enteric myiasis. A common example is thecheese skipper, Piophila casei (family Piophilidae), which infests cheese, dried meats andfish.Facultative myiasis occurs when fly larvae infest living tissues opportunistically afterfeeding on decaying tissues in neglected wounds. Considerable pain and injury may beexperienced as fly larvae invade healthy tissues. Facultative myiasis has been common inwounded soldiers throughout military history, and numerous species of Muscidae,Calliphoridae, and Sarcophagidae have been implicated. Species of these families arewidespread throughout the <strong>Middle</strong> <strong>East</strong>.Myiasis is obligate when fly larvae must develop in living tissues. This constitutes trueparasitism and is essentially a zoonosis. Obligate myiasis is a serious medical condition.In humans, obligate myiasis results primarily from fly species that normally parasitizedomestic and wild animals. The sheep bot fly, Oestrus ovis, is widespread in <strong>Middle</strong>136
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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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___________________________________
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Table 1. Drug-Resistant Falciparum
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Saudi Arabia: Malaria occurs in the
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General Bionomics. Female anophelin
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host with the body nearly perpendic
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crevices, leaf litter, or moist tre
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All dengue serotypes are now endemi
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period immediately following it (19
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Military Impact and Historical Pers
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- Page 152 and 153: IX. Selected References.A. Military
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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