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File: 970207_aadch_012.txt4. The USCINCCENT and USCENTAF preventive medicine guidelines for deployment of USAF personnel under Operation DESERT SHIELD included the reauirement to receive immune serum globulin for prevention of Hepatitis A. We believe most USAF people did receive this. III. FOOD SERVICE OPERATIONS AND FOOD SOURCES. 1. Much of the food and a small army of food service workers were provided to USCENTAF bases by the host nation at no cost to the Air Force. The source of this food ranged from high-tech food processing plants to small local bakeries. Some food was imported from other countries and continents and other foods were locally produced and processed. Air Force commanders generally lacked the authority to select from the available food suppliers. This was determined by host nation authorities. Similarly, Air Force commanders had no real authority over local national foo'd service workers and were not directly able to influence their performance or restrict those suspected of harboring common foodborne enteric pathogens from working with food . 2. In some cases, a clear variance existed between local and U.S. sanitary standards. Sanitation standards in local commercial food processing factlities ranged from state-of-the- art to primitive. The knowledge of local national and third country nationals of food safety also varied widely. Some were well versed in foodborne illness prevention. However, others seemed to be unaware of the most basic concepts of personal hygiene. For example an inspector reported that a local food service worker he observed squatting in a sunply tent had urinated against some boxes of corn. 3. Communication with local food service workers was extremely difficult. Many nationalities were represented in this workforce, including people from the countries of the Arabian Peninsula, Sri Lanka, Pakistan, and the Philippines. Reportedly, few of them spoke English and we are aware of no EH personnel that spoke any of these languages. However, some local national food service supervisors did speak English and could serve as translators. 4. Local national health standards for food service workers were not known for every country in which USCENTAF operated. At some bases, EH was able to influence authorities to collect stool specimens of local and third country national focd service workers. At one base, 13 of 25 specimens contained Giardia and Histolytica cysts and hook, round and whiowo-m ova, indicating significant intestinal parasite infections in this soup. At another base, only roundworms were identified. To our knowledge, most bases did not pursue such testing and or those that did, no bacteriological evaluation was included. The health status of most local food service workers was never determined. 2
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