COVER SHEET FOR DOCUMENT TRANSMISSION

File: 970101_sep96_decls6_0002.txt
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Total Pages: 8

Subject: COVER SHEET FOR DOCUMENT TRANSMISSION                           

Unit: OTSG        

Parent Organization: HSC         

Box  ID: BX003205

Folder Title: VACCINES TO PREVENT DIARRHEA IN OPERATION DESERT SHIELD                                         

Document Number:          1

Folder Seq  #:         14










                                                                    28 November 1990


                    Memorandum to Peter Collis, MD, MPH, Deputy Assistant Secretary of Defense,
                    (Medical Readiness), OASD (Health Affairs), The Pentagon

                    From: COL Jerald Sadoff, Director, Div. Communicable Diseases
                                        and Immunology, WRAIR
                         LTC David N. Taylor, Enteric Infections Br, DCD&I
                         202-576-@

                    Subject: Vaccines to Prevent Diarrhea In Operation Desert Shield

                    1. THE DIARRHEA PROBLEM. Army and Navy preventive medicine units In the
                    Persian Gulf have reported that 2-5 percent of visits to troop health care facilities per
                    week have been for diarrhea. Thus, a conservative estimate of diarrhea cases
                    presenting to health facilities Is 4000 cases per week among the 200,000 troops
                    deployed. In previous maneuvers only 20% of persons with diarrhea went to clinics
                    for treatment. This has also been true in Desert Shield where diarrhea rates of over
                    50% were experienced In many of the units under surveillance. To date, diarrhea Is
                    the most important medical problem encountered during Desert Shield.

                    2. Bacteriological studies show that 55% of diarrhea is caused by enterotoxigenic
                    Esr,herichfa MU (ETEC) and 20% is caused by Shicelia species. A pathogen was not
                    found in the remaining 25% of specimens, although                  and
                    @ have been rarely isolated. Among r>4 cases of ETEC diarrhea diagnosed thus
                    far, 69% are caused by ETEC which produce the heal-labile toxin (LT) and 31% were
                    caused by ETEC producing the heat-stable toxin (ST). Known colonization factor
ed in 59% of ETEC isolates. CFA 1 (6%), CFA 11 (36%),
                    and CFA IV (i 7%).
                          Among the 5higelia, -S. @nnel (29 isolates) was the predominant species.
                    There were 3 s9. flexneri isolates (i .5. flpxneri 2a, 1 @. flexned 2b, and 1 $. flexnerl
                    4a). One Isolate was a.S. @. Although no @ @ferae has been Isolated In a
                    U.S. servicemember, cholera has been reported in this area and has at times been
                    epidemic. Typhoid fever Is also endemlc In the region and recent reports from
                    Bahrain suggest that strains In the region are often resistant to antibiotics commonly
                    used for treatment of typhoid fever.

                    3. PREVENTION OF ETEC INFECTIONS. A safe, oral cholera vaccine tested In
                    Bangladesh prevented 67% of LT and LTST ETEC infections for 3 months. The
                    vaccine consists of a combination of the B subunit of cholera toxin and killed whole
                    cells cholera organisms (BSMC). Three oral doses of this vaccine was given to

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Document 8 f:/Week-36/BX003205/VACCINES TO PREVENT DIARRHEA IN OPERATION DESERT SHIELD/cover sheet for document transmission:1224960931177
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003205
Unit = OTSG
Parent Organization = HSC
Folder Title = VACCINES TO PREVENT DIARRHEA IN OPERATION DESERT SHIELD
Folder Seq # = 14
Subject = COVER SHEET FOR DOCUMENT TRANSMISSION
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