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File: 970207_aadch_004.txtreinspected and disapproved by the US Army. Units should have reported these Army food establishment inspection problems to CENTAF for resolution. Locally listed establishments approved by EH personnel did not require Army Veterinary Service inspection. 5. Site Selection: Additional efforts need to be exerted to ensure medical concerns are considered in site selection. One ATH, located beside water storage tanks, was evacuated on at least two occasions because of a chlorine leak. Another ATH, in a flood zone, flooded. It is understood that security or other conce.ns may override medical recommendations. 6. Food Safety: Foodborne illness was the most significant public health problem for deployed air force personnel. Most foodborne illness outbreaks would have been avoided if the USAF had its own deployable food service. TAC/SG should work with TAC/DE to make this happen. EH should inspect food and food service facilities during OREs and ORIs. This would provide necessary training for EH and demonstrate their mission to supervisors and commanders. It will also demonstrate the need for a government vehicle. Inadequate transportation was a common problem for EH and BEE. In some cases foodborne illness outbreaks were not followed by good reports. CENTAF/SGPM should have requested more complete reports when incomplete information was received. Some facilities didn't use ratings or route reports through the chain of command as they should have. Procedures that worked during peacetime and on previous deployments should not have been abandoned. Foodhandler training would have been difficult, but EH should have exerted more effort to train foodhandlers. 7. Disease Reporting and Epidemiology: A very good disease reporting system was established after the deployment began, although not without difficulty. At least two changes were made to the reporting system during the deployment. It would be better to have the reporting system ready for use before a deployment. Lt Col Weiland will draft minor changes to this system to eliminate grouping conditions into a single category and reduce the number of non-communicable diseases reported. It was proposed that this program be presented to the preventive medicine officer of CENTCOM, SOCOM, and others as the system for future conflicts. It was difficult to investigate foodborne illness outbreaks without menus from food service facilities. An attempt should be made to require food service facilities to maintain menus. 8. Communicable Disease Issues: Services provided by the ATH laboratory were too limited. The laboratory needs a microbiology incubator and appropriate media to identify fecal pathogens such as Shigella, Salmonella, and Campylobacter. The laboratory also needs to be able to do fecals for ova and parasites. They need a micrometer for their microscope to be able to measure the size of ova and parasites. The high level of resoiratory disease was expected and no recommendations were 1
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