r.~UT~NEOUS LEl M~NI~SIS IN S~U!OI ~R~8IH'//.

File: 970805_DOC_222_CUTANEOUS_LEISHMAN_01.txt
Page: 01
Total Pages: 2
                                THIS DOCUMENT MAY BE RELEASE IN ENTIRETY


                           `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K V
  PRIORITY                             U N C   ~ S S I F T E fl           ~   TOfl
                           `K'K'K'K'K'K'K'K'K'K'K'K'K'K~ `K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K 

  RH~4U~YUt4 RHIR~~~ . I? ~~~i755----UUUI..i---RHTHn~~ PHI IMr~~ RHI1JFH~4 RUflCH~~
  Pl.IHOO~f~
   r~R iJIJtJUU
  P 29~4S.~7.: t\rr. 9C'
  FM USCINCCENT//CCSO//
  TO RUE)~..,H~Pi/~~OMUS~RCENT 4 - U.'.'~:.~.,/
  RH II M~~/COMUSMr~RCENT / /MEOt'
  P'.JHOO~~/COMUSN~&'r.ENT.//Sr-,~'y
  RH I UFr~~/UD..CENT~~F FWfl Hfl:~S ELEMENT/ /50/
  PHIHDP~H/SOCCEN T DEPLOYr-nY /`--~r~
  8T
  UNCL~S
  ORER/~ESERT SHIELD//
  MSO I D/SYS RRM/USCENTCOM CCSct --P!- -
  ~MPN/SUBJECT:      r.~UT~NEOUS LEl      M~NI~SIS IN S~U!OI ~R~8IH'//.
  RMklS/1    THE FIRST L~BOR~TORY CONFIRMED C~SE OF ClJTP1NFOt.lS
  LEISHM~NI~SIS H~S BEEN REPORTED BY THE USNS COMFORT IN ~ 27 YF~R
  OLD M~LE PILOT ~SSIONED TO THE 1ST C~Y~LRY DIVISION                  SIX
  CUT~NEOUS LESIONS DEVELOPED ON THE LEFT ELBOW r~ND ~RM. LEFT
  CHEEF::: ~ND RIOHT FORE~RM ~PPROXIM~TELY-TWo MONTHS ~FTER ~RRIVHL
  IN COUNTRY.    HE IS BEINO TRE~TED WITH SODIUM STIBOGLUCONflTE
  (PENTOST~M)    ~ PENT~V~LENT ~NTIMONI~L. ~T c?C) MO/I--O/D~Y ron TEN
  D~YS ~ND IS EXPECTED TO RETURN TO DUTY
  2.  EPIDEt4IOLO0Y:     E~STERN PROVINCE:       ~N EPIDEMIC OF        .OONOTIC
  CUT~NEOUS LEISHM~NI~SIS     (~CL        ~PP~RENTLY STH~RTED IN THE ~L H~Ss'~i
- OHSIS IN THE EHr.RLY TO MID 1?.-7O~5.        OIL COMPHN.i! REPORTS SHOW ONLY'
    I?- Crr~SES OF Im!.~JTH~NEOUS LLISHM~NI~SiS FROM i95~ TO ir~..4.65 BUT IN


  p~~r C)-~ RHIP~~~\\.\.\. 1JNCLt~S

  .~9B2 EXPERIENCED MORE TH~N 60 C~SES.          THE CUM(JL~TIVE TOT~L C~SFS
  IN 1988 NHS 66 C~SES WITH ~ F: YE~R ME~W (19S4--1980) or ~i C~aSES.
  THE PPINCIP~L FORM OF ORO~NISM ISOL~TED FROM M~N IN THE FINODOM OF
  S~UDI ~R~BI~ IS LEISHM~NI~ M~JOP (Y~r;IWOFF (~ND SCHOrHOR 191.4)
    F WHICH ::YMODEME LON.-4 IS THE MOST COMMON.         IT IS PROB~BLE TH~T
  PHLEBOTOMUS P~PHTHSI IS THE PRINCIP~~~~L. OR MORE LIi-:ELY.            THE SO.I~E
  VECTOR OF    CL.    S~NDFLIES BREED IN CR~CF:.S IN THE Wr'?~LLS OF DWELLINOS.
  IN RUBBISH. OR IN RUBBLE PILES.           THEY ~RE WE~F::: FLYERS ~ND TEND TO
  REM~IN CLOSE TO THE CROiINr NEH~R THE BREEDING SIDE.               ONLY FEM~LES
  SUC!-. BLOG . ~ND MOST SPECIES HRE NOCTl!RN~L FEEDERS.             SOME M~Y FEED
  DURING THE    -~ -  IN D~'r--;.~ ROOMS. P5~MMOMYS OBESUS.  (.CPET~SCHM~P 1828)
  ~ DESERT - -   -IL. HH'S BEEN' IMPLIC~-TEfl ~S THE PRINCTP~iL PE~.-Pk~OIP
  HOCT       . NTR~L ~-   --~PTHERN .C~RE~S:    RIY~DH ~~N1D ~L      ~RJ H~VE
  REPORTED SEVER----------- -S OF      CL WITH H~TL ~l-.4D Nor---------~R~FThs-
   IMPLIC~TED.   TH~ -- r-TOP PHLEBOTOMUS P~P~T~SI Hr'~S            -EN IDENTIFIED IN
  PIN!~~DK. r~L lH~~~rj. ~rn ~~j~s..IM.   LEIS.HM(:1-NI~ BODIES-. H    BEEN FflUND IN
  LESIONS OF TWO G-ERETLS ~ND ONE DOC FROM THE ~L ~H~RJ ~REH.                WEST
  SOUTHWEST H~r:E~S--    BIS.H~. C,I'~I!.   (-~ĽID H-SIR H~~-'E ~LL DOCt.Jl4E!-iTED CHSES:. OF
           PHELPflTflNtJS PH~~PH-~T~-SI He~S-. BEEN DOCUMENTED IN r~~LL OF THEr~,E
    - e~S (~ND SUP--ES :N THE- ~s:R H~VE CONCLUDED TH~-iT THE DISE(-~s:E

                            V- `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K `K'K'K'K `K `K `K `K

  PRIORIT"                                1-4 C L ~ S S I F I E D          `K
                            `K'K'K'K'K'K~'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K'K