ARMY MEDICAL RESEARCH DEVELOPMENT CENTER MEMO

File: 970101_sep96_decls65_0002.txt
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Subject: ARMY MEDICAL RESEARCH DEVELOPMENT CENTER MEMO                   

Unit: OTSG        

Parent Organization: HSC         

Box  ID: BX003205

Folder Title: 4TH USAMRDC LEISHMANIASIS VARIOUS LEVELS                                                        

Document Number:          1

Folder Seq  #:         11





             BGRD.-UWZ-P                                                           14 Sep 90

             MEMORANDUM FOR: INTERESTED PARTIES

             SUBJECT: OPERATION DESERT SHIELD AND LEISHMANIASIS: MEMORANDUM OF FOURTH
                          USAMRDC LEISHMANIASIS STEERING COMMITTEE MEETING

             1The -Committee met on 14 Sept 90. Committee members were:

                 COL S. -Schuster.
                 COL J. Berman, chair.
                 LTC 0. Moore.
                 CF?T (P) M Grog[.
                 Dr. M. Heiffer.

             2. The Threat:

               The Department of Advanced Preventive Medicine, WRAIR, has listed Lalshmaniasis as #7
             out of 20 on their 23 Aug 90 prioritized list of major d!sease threats for Operation Desert
             Shield. There are three forms of felshmaniasis endemic in the region.
                    I
                 L. major: L major cutaneous disease la the most prevalent. The Iranians were sufficiently
             concerned about the potential problem of cutaneous leishmanissis (mostly L major) that they
             Inoculated all their troops (-300,000 per year) with a strain that gave mild disease In the
             index case, to protect tne troops against Dossible more severe future Infection. The prevalence
             of cutaneous loishmaniasis was tabulated by the Lalshmanis Department of the Saudi Arabian
             Ministry of Health for the years 1978-1985. There were 13000-18000 cases per yea., for
             i983-1985. These cases were Identified clinically rather than parasitologicalty, but most are
             thought to be L. major. There were approximately 3000 cases per year in the central provinces
             Including. the cjty o4 Riyadh, and 1600 cases In the Eastern province. [ Peters and Al-Zahranl.
             1987. The Leishmanlases--a Public Health Problem In Saudi Arable. Saudi Medical Journal
             8-.333-343.1

in south-west Saudi Arabia, where the
             Incidence is fully 1/3 the Incidence of L. major elsewhere [Al-Zahranl et at, TRSTMH
             83:621-628, 1989], and near the Iraq-Kuwalt-Saucii border.
                 L. djnovani: visceral lelshmaniasls is endemic In the Mid-East, particularly In the Central
             region of Iraq.

             3@ Diagnosis of Lelahmanias7is In the Persian Gulf region:

                 Clinical diagnosis: Cutaneous loishmaniasis presents as a no.,i-nealing skin ulcer,
             frequently,.wlth bacterial superinfootion and sometimes with metestasis to the proximal lymph
             nodes, Other skin diseases such as Infected Insect bites are frequently misdiagnosed as
             lelshmaniasis. Visceral loishmenlasts presents with fever, hepatospienomegaly, and the
             sequalla of pancytopenla. Other retteuloendothelial diseases including leukemia are easily
             confused with visceral laishmaniasls.

                 Parasitological diagnosis: lntaot6d lesions are aspirated or blopsied. To visualize the
             organisms,, lesion specimens are stained with Glemsa and, for greater sensitivity, with a
             genus-specific monoclonal developed at WRAIR. Lesion specimens are also cultured for 3 weeks
             on:Schnaider's madlum, MMI madlum, and NNN medlum so that leishmanla may grow out.
             Successful culture on these unusual media requires training by experts.

Document 4 f:/Week-36/BX003205/4TH USAMRDC LEISHMANIASIS VARIOUS LEVELS/army medical research development center memo:12249609314566
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003205
Unit = OTSG
Parent Organization = HSC
Folder Title = 4TH USAMRDC LEISHMANIASIS VARIOUS LEVELS
Folder Seq # = 11
Subject = ARMY MEDICAL RESEARCH DEVELOPMENT CENTER MEMO
Document Seq # = 1
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 = 24-DEC-1996