TRI SERVICE VACCINE TASK FORCE 7 DEC 90

File: 102596_sep96_decls2_0005.txt
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Total Pages: 8

Subject: TRI SERVICE VACCINE TASK FORCE 7 DEC 90                         

Unit: OTSG        

Parent Organization: HSC         

Box ID: BX003202

Folder Title: DESERT SHIELD MEDICAL ISSUES REVIEW AND AD HOC WORKING GROUP                                    

Document Number:          3

Folder SEQ  #:         31




                                                     UNCLASSIFIED

                                DEPARTMENT OF THE ARMY
                               WALTER REED ARMY INS@ OF RESEARCH
                                 WALTER REED ARMY MEDICAL CENTER
                                    W@TON. 0,C @-SIOD

                                    Appendix B


            IN FTFPLY REFER TO.

        SGRD-UWF-J                               7 December 1990


        MEMORANDUM FOR Head, Tri-Service Vaccine Task Force

        SUBJECT:   Vaccines to Prevent Diarrhea and Typhoid Fever in
        Operation Desert Shield


        1.  THE DIARRHEA PROBLEM.    To date, diarrhea has been the most
        common medical problem encountered during Desert Shield. Between
        2-5 percent of troops in Desert Shield visit health care facilities
        every week for diarrhea.      However, only 20% of persons are
        presenting themselves for treatment. Thus, about 20,000 cases per
        week are occurring.

        2. 55% (11,000 cases/wk) of diarrhea are caused by enterotoxigenic
        Escherichia coli (ETEC), 20% (4,000 cases/wk) are caused by
        shigella species, and the remaining 25% are unknown. 69% of ETEC
        diarrhea diagnosed thus far were caused by ETEC which produce the
        heat-labile toxin (LT) and 31% were caused by ETEC producing the
        heat-stable toxin (ST) . The problem will become worse as more new
        forces are deployed and the present cool weather subsides. over
        90% of the Shigella isolated thus far are Shigella sonnei; but
        other serotypes, most commonly S. flexneri, are endemic in the area
        and are likely to become a significant problem. Shigella from this
        area are resistant to all commonly used antibiotics except
        ciprofloxacin.   Resistance to this drug has been documented in
        Africa and will result in Desert Shield from widespread use of this
        antibiotic.  Although no Vibrio cholerae have been isolated in a
.S. service member thus far, cholera has been reported in this
        area and has at times been epidemic.    Salmmella tvrhoid (typhoid
        fever) is also endemic in this region and recent reports from
        Bahrain indicate that strains in the region are often resistant to
        antibiotics commonly used for treatment of typhoid fever.
        Presently used parenteral vaccines are protective but give
        unsatisfactory high incidence of side effects.

        3. PREVENTION OF CHOLERA. A safe, oral cholera vaccine tested in
        Bangladesh in over 25,000 children and young adults provided highly
        significant protection against cholera and was completely safe (80%
        protection over 6 months, 60% protection over 12 months).       This
        oral vaccine afforded more protection against cholera and for
        longer periods of time than the parenteral cholera vaccine used
        previously.


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Document 8 f:/Week-36/BX003202/DESERT SHIELD MEDICAL ISSUES REVIEW AND AD HOC WORKING GROUP/tri service vaccine task force 7 dec 90:1018961354253
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Box ID = BX003202
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Folder Title = DESERT SHIELD MEDICAL ISSUES REVIEW AND AD HOC WORKING GROUP
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Subject = TRI SERVICE VACCINE TASK FORCE 7 DEC 90
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