MEDICAL REPORTING 14 AUG 90

File: 072496_may96_decls9_0023.txt
Page: 0023
Total Pages: 79

Subject: MEDICAL REPORTING  14 AUG 90                                    

Unit: 24TH ID     

Parent  Organization: XVIII CORPS 

Box ID: BX001433

Folder Seq #:          5

Document Number:         17






            SAUDI ARABIA



             ARBOVIRAL FEVERS (3-12 days)
                   Sandfly fever may be present in the ooriliwcst where scrological studies have found 20 pctcetkt or
                        those sampled scropositivc for the Sicilian virus and 5 percent scroposfdvc for die Naples
                        vi.@ Phlebotomuspqpalasi, the potential sandily vector, occurs ffimughout the central and
                        eastern provinces.
                   Dengue fever could occur. The mosquito vectorAcdesae8ypti, Ls present In some areas, and historic
                        rcr-ords exist of dengue fever occurring in the eastern coastal areas.
                   Shadbis Y@ reportedly has caused viral cnccphali@ In coastal areas of Fmtem Province, but no rcrent
                        incidents of human disease have been reported and the vim may no longer be circulating.
                        Potential mosquito vectors (Culcx spp.) arc prcscnl

                   DISEASES WTIII LONG INCU13ATION PERIODS (USUALLY MORE- -n@ 15 DAYS)

             VIRAL IIEPATMS (15-180 days)
                   Transmission: Hepatic A (HAV) - person to person by the fecal-oral route. Hermflils 13 OIBV) -
                        contact with causative agent through blood transfusions, contaminated needles, sexual confac4
                        and contaminated pcrinr-al wounds. Non-A non-B hcpauds (NANB) - may be cntcrically
                        transmitted (A-like) or parentcr-dily transmitted (B-Iikc).
                   Risk Peri"D@bution: Y@r-round, with risk elevated from October through December. Occurs
                        countrywide, with risk greatest in the sotitliwestem provinces, followed by the western provinces.
                   Remarks: Highly endcmic; presents a major health hnurd to jionlildigenous personnel. Infection will,
                        hcpatitis A virus GIAV) accounts for more than 50 pctretit of the annual average of 6,000 cases
icpa(i@, followed by hcpa(i@ B vi'r'us- (I IBV) and parentcrally transmitted hcpgd(fs
                        (hcpatitis C - HVC), 25 percent each. Antibodies to I LAV occur in an cstlmntcd 90 percent of
                        children by age 10 and in almost 100 percent of adults. The annual Incidence of acute hepatitis
                        A @ was increasing during Uic late 1980s, possibly related to a slightly larger nonimmunc child
                        population subsequent to improvements in environmental sanitation. Approximately 70 percent of
                        the adult population express antibodies to HBV, and (lie I IBV carrier rate is estimatcd at neatly 8
                        pcrrcnl 'Me delta agent (hcpaUUs D virus - liDV) has been found In approximatcly 15 percent of
                        HBV carriers. Entcrically transmitted NANB hepatitis Oic@tdtis E - I IFV) ha.,; not been reported,
                        but may occur.

              Lrisiim"@is (I week to many months)
                   Trnnsruission/Vector Ecology: Bitc of an infective sandny (Piticbotottius spp.). Most sandnies are
                        active from sunset on through the night and have very limited flight rtngcs. The primary vectors
                        for cutaneous Icishmaniasis (CL) are P. papatasi for Lcislitittviia nialor (the wct/rural form) and
                        P. sergeant (found at the higher elevations - up to 2,OW mciets) rot L. fropica (the dry/urban form).
                        No specific vecto- for visceral Icislimaniasis (VL), caused by L doiiovaiii, has been Identified in
                        Saudi Arabia.
                   Risk Per@Distribtition: Transmission of CL occurs year-round, 1=Uiig in July through September.
                        L. '@'aroccurscommonlylathcoascsofOicemtcmandccntralprovinccs,wliliaL.tropicaoccurs
                        commonly in the mountains of the western provinces. Transmission of VL occurs year-round and
 to die Southwestern provinces.
                   Remarks: The annual number of CL cases rcpori@ increased to about 15,0()O during tire late 1980s,
                        partially attributed to improved reporting. Clinical cases most rotnmonly are seen from October
                        (hrougli January. Most cases of the we(/ruml form occur In notdtiimune individuals, either
                        children or nonindigcnous adults (an annual attack rate iiii to 50 percent among unprotected
                        individuals has been reported). Also called wonotic CL, this form occurs in onscs foci based
                        on the distribution of arc primary reservoir liosi, fire fat-tailcd sand rat (Psaninloinys obesus).
                        Tlc dry/urban form, also called aniltroj@notic CL, Is less widely distributed, with most cases
                        reported from the western and Southwestern areas. (Appmxfinatcly 80 percent oral[ cases are
                        reported from Jizan Province.) @scs occur in all nge groups. no annual incidence of VL had


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Document 79 f:/Week-22/BX001433/MEDICAL REPORTING-DIVISION SURGEON/medical reporting 14 aug 90:07199610201768
Control Fields 17
File Room = may96_declassified
File Cabinet = Week-22
Box ID = BX001433
Unit = 24TH ID
Parent Organization = XVIII CORPS
Folder Title = MEDICAL REPORTING-DIVISION SURGEON
Folder Seq # = 5
Subject = MEDICAL REPORTING 14 AUG 90
Document Seq # = 68
Document Date =
Scan Date =
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 19-JUL-1996