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          REPLY TO                                         
          ATTN OF: 1640 TAWP/SG                                      28 Jan 91 
                                                           
          SUBJECT: MEDICAL INTELLIGENCE FOR MASIRAH, OMAN         
                                                                   
                                                                   
          TO: CENTAF/SGPM

          1. CLIMATE
            Temperatures are moderate, with Summer time highs in the mid 90s and
         winter highst in the low 80s. Winter lows have been in the low 60s. Only 3 cases
         of heat exhaustion have been seen (none serious) in the past 5 1/2 months, and
         water discipline was stressed via briefings and notices easy in the deployment.
         No ssignificant precipitation has occured to date, although about 1/4 inch per
         month is expected for February and March

         2. WATER
            All drinking water is provided via a desalinization plant and shipped to
         hardened facilities on the RAFO (Royal Air Force of Oman) Base. The
         desalinization plant is a reverse osmosis unit with two distillation units.  Maximum
         capacity is 1,220 tons per day, and is delivered with a source provided 0.5 ppm
         chlorine content.  Water sampling on an every other week basis from all hardened
         facilities has yielded no positive bacterial cultures; average chlorine content has
         been 0.3 ppm, and ph 6.8.  Since the initiation of hostilities, chemical agent water
         testing has been initiated as well.
	
        3.  MALARIA
            Low to moderate malaria risk exists in the whole of Oman, with a 20%
         prevelance in rural areas, and less than 5% in the capital, Muscat. Most  are P.
         Falciparum (80%), with P. Virax responsible for the remainder.  No chloroquine
         resistance is reported.  Having said this, the risk on Masirah is assessed to be
         neglible; the only cases reported on Masirah by the local medical authority within
         the past 3 to 5 years were cases contracted by people returning from the
         mainland.  The RAFO Base including USAF tent city are fogged for mosquitoes
         weekly by the host nation.  During aggressive mosquito sampling in September
         and October (using small Army mosquito trap), only two mosquitos (both Aedes)
         were found. There have been no complaints of mosquito bites since October.
         MAC aircrews and others who leave Masirah regularly are instructed to take
         weekly Chloroquine prophyloxis.

        4. GASTROINTESTINAL DISEASES
             As an mainland Oman, a moderate risk exists.   Low levels of local sanitation
         outside the RAFO Base suggest that local food (unless throughly cooked), water
         and ice should  be avoided. Enteric Diseases on the mainland are assessed to
         exist locally (typhoid, paratyphoid fever, Hepatitis, Amebiasis, Salmonellosis,
         Shigella, and Helminthiasis). Moreover,a polio outbreak occurred on the mainland
         in 1986. One suspected pointt source outbreak of a food borne illness occurred
         early  in the deployment. 68 cases of diarrheal disease were seen from 20 to 24
         August. The illness was characterized by modest cramps and frequent loose
         stools, however presentation ranged from mild cramps without diarrhea, to fever,
         severe cramps, diarrhea and dehydration. Intravenous fluilds were administered
         in a minority (about 5) of cases. No blood or mucus to suggest an enteroinvasine
         organism were seen, and the incubation period was 12 to 24 hours (range 6 to
   

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