U.S. Department of Defense Surveillance Recommendations for Management of Chikungunya and Dengue Vectors

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U.S. Department of Defense Surveillance
Recommendations for Management of Chikungunya and
Dengue Vectors

• James E. Cilek

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The views expressed in this presentation are
those of the author and do not necessarily
reflect the official policy or position of the
Department of the Navy, Department of Defense,
nor the U. S. Government.
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In early 2014, the Department of Defense (DoD)
Armed Forces Health Surveillance Center/Division
of Integrated Biosurveillance formed a Working
Group of representative key DoD communities and
external organizations to address strengthening
DoD surveillance and detection for chikungunya
(CHIK) and dengue (DENV) on CONUS
installations. The Center is the central
epidemiological resource and a global health
surveillance proponent for the U.S. Armed Forces.
It provides timely, relevant, actionable, and
comprehensive health surveillance information in
order to promote, maintain, and enhance the
health of military and military-associated
populations. On July 15, 2014, this group of
about 20 people met in Silver Spring, MD at the
headquarters of the Walter Reed Army Institute
for Research (WRAIR).
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• The ambitious objectives of the working group
  were to
• Assess current DoD capability to detect and
  characterize CHIK and DENV infection in DoD
  personnel.
• Recommend specific human surveillance efforts to
  enhance CHIK and DENV detection.
• Assess and recommend specific entomological
  surveillance efforts to enhance risk assessment
  for CHIK and DENV transmission on military
  installations.

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• The ambitious objectives of the working group
  were to
• Recommend science and technology initiatives to
  improve CHIK and DENV surveillance and detection
  in DoD.
• Propose policy, guidance, or other resources for
  issuance by appropriate DoD organizations to
  improve CHIK and DENV surveillance and detection
  in DoD.

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I will address

1. Assess and recommend specific entomological
   surveillance efforts to enhance risk assessment
   for CHIK and DENV transmission on military
   installations.

• Currently, Department of Defense DODI 4150.07
  implements policy, assigns responsibilities, and
  prescribes procedures for the DoD Integrated Pest
  Management (IPM) Program.
• The Navy is committed to maintaining an
  integrated pest management (IPM) program
  consistent with DoDI 4150.07 through OPNANINST
  6250.4C.

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Departments of the Navy and Marine Corps
Commanders of all shore activities bear the
responsibility for maintenance of an adequate
vector and economic pest control program
(OPNAVINST 6250.4). The Medical Department of
each installation is required to plan and
recommend vector control measures and to
determine that all pesticides are applied safely
(NAVMED P-5010). Pest control operations as a
scheduled part of performed services can be
conducted through the operations department on
base (NAVFAC) or contracted to outside vendors
but still monitored by the medical department.
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The objective of the plan is to give general
guidance for Navy and Marine Corps installations
regarding surveillance and control of CHIK
vectors for their installations.
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Moreover, the CHIK plan is used to complement an
Installations Pest Management Plan that contains
an Emergency Vector Control Plan for disease
vector surveillance and control during a disease
epidemic.
The CHIK plan also lists options for vector
surveillance on each Navy and Marine Corps
installations 1. Local Public Health and/or
Mosquito Control Agencies If local, county, or
state agencies are currently performing
surveillance and control measures that meet or
exceed US DoD CHIK recommendations then
arrangements may be made to include the military
installation as part of the agencys operations.
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• The CHIK plan also lists options for vector
  surveillance on each Navy and Marine Corps
  installations
• Private Contractor Installation may have
  contract with civilian mosquito pest control
  professionals that meet or exceed the DoD CHIK
  recommendations.
• DoD Personnel DoD medical personnel and
  equipment should be implemented to augment
  available civilian support. In the absence of
  civilian support, DoD personnel will provide
  support for their respective installations.

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The Armed Forces Pest Management Boards mission
is to ensure that environmentally sound and
effective programs are present to prevent pests
and disease vectors from adversely affecting DoD
operations.
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• Although a unified report by the Workshop on
  Strengthening DoD Surveillance and Detection for
  CHIK and DENV has yet to be officially released,
  below are some of the informal suggestions
  provided by the group
• DHA should consider developing policy for
  mosquito-borne disease preparedness in the DoD,
  including recommended responses to human cases on
  military installations, vector surveillance, risk
  communication, and other related measures.
• Armed Forces Health Surveillance Center should
  consider collaborating with the Armed Forces Pest
  Management Board and Service Public Health
  Centers to identify ways of improving Aedes
  surveillance on military installations.

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It was suggested that a model guideline could be
adapted by the DoD is CDC, Preparedness and
Response for Chikungunya Virus Introduction in
the Americas, 2011.
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THANK YOU