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Medical Entomology in the U.S.
Army: A Historical Perspective
Military Entomology History
โ€ข Armies in the field often lived in squalor
  with inadequate shelter, food, and water.
โ€ข Many conflicts were brought to a halt not
  by superior force but by insects and the
  diseases they transmit.
โ€ข Typhoid fever, louse borne typhus,
  malaria, yellow fever, and diarrheal
  disease ran rampant degrading an armies
  ability to fight.
Cause of War Deaths
War                 Number Serving in   Battle Injuries (BI)   Disease Non       Arthropod Borne
                    Army                                       Battle Injuries   Diseases
                                                               (DNBI)



Civil War (Union)   2,128,948           138,154                221,374           Yellow fever,
                                                                                 typhoid, malaria

Spanish American    280,564             369                    2,061             Typhoid, malaria
War

World War I         4,057,101           50,510                 55,868            Trench fever,
                                                                                 malaria, louse
                                                                                 borne typhus

World War II        11,260,000          234,874                83,400            Malaria, scrub
                                                                                 typhus

Vietnam             4,368,000           30,922                 7,273             Malaria

Desert Shield       246,682             98                     105               Leishmaniasis
Military Entomology History
โ€ข Military medical entomology got its start when
  MAJ Walter Reed showed that yellow fever was
  transmitted by mosquitoes.
โ€ข With the identification of insects as the cause of
  disease the need to find ways to mitigate their
  impact became a military issue.
โ€ข Major William Gorgas was the first to
  successfully control mosquitoes with his efforts
  in Havana and the Panama Canal.
Military Entomology
               World War I
โ€ข By World War I, the connection between insects
  and disease was well established.
โ€ข Entomologists (6-8) were commissioned as
  officers in the Sanitary Corps.
โ€ข Over 9,600 cases of malaria occurred in troops
  training in the southern U.S.
โ€ข Trench fever and louse-borne typhus were the
  primary arthropod-borne diseases in Europe as
  troops were often infested with lice.
Army Entomology Between the
           World Wars
โ€ข Sanitary Corps moved to the Organized
  Reserves from Active Duty.
โ€ข 14 entomologist were commissioned in the
  Sanitary Corps.
โ€ข The War Department recognized the need for
  malaria control and began efforts to develop
  improved control methods and a true malaria
  prophylactic.
โ€ข Extensive mosquito control programs were
  initiated in the camps located in the southern
  U.S. to prevent malaria outbreaks in training
  soldiers.
Army Entomology in World War II
โ€ข The prevention and control of malaria in the Southern
  U.S. and in possible overseas areas was one of the
  problems facing the military at the beginning of WWII.
โ€ข The Army recognized the importance of controlling
  vector-borne disease and began commissioning
  entomologists, with many more serving as enlisted
  soldiers.
โ€ข Army entomologists staffed malaria control and survey
  units in the Pacific theater; served as advisors in all
  theaters; and conducted research to develop better
  methods of control and prevention of arthropod-borne
  disease.
Arthropod Disease Incidence and
          Death Rate 1942-45
Disease                 Incidence (number)   Deaths (number)   Fatality Rate/100,000 cases

Malaria                       378,000               302                         0.8

Dengue                        91,000                 4                          0.0

Sand fly fever                19,000                 0                          0.0

Scrub typhus                   5,400                283                        52.4

Filariasis                     2,500                 1                          0.4

Murine typhus                  800                  15                         18.8

Lesihmaniasis                  500                   0                          0.0

Encephalitis                   400                  21                         52.5

Tularemia                      200                   4                         20.0

Relapsing fever                170                   0                          0.0

Rock Mountain spotted          130                  12                         92.3
Fever
Epidemic typhus                100                   0                          0.0
Post WWII
โ€ข The Army continues to commission
  entomologists with around 60 serving on
  Active Duty and around 35 in the
  Reserves.
โ€ข Entomologist serve in many capacities
  and have many unique opportunities.
Army Entomology Today
โ€ข Mission: To prevent arthropod-borne disease in
  Soldiers, their families, and other individuals for
  whom the Army is responsible.
โ€ข Plan, direct, and evaluate comprehensive
  integrated pest control programs.
โ€ข Conduct surveillance for medically important
  pests.
โ€ข Identify insects and other zoological specimens.
โ€ข Provide disease vector risk assessments for
  geographical areas.
Recent Disease and non-Battle
         Injuries Rates (DNBI)
โ€ข   1991 Gulf War         6.5 %
โ€ข   OJE (Bosnia)          7.1%
โ€ข   OJG (Kosovo)          8.1%
โ€ข   OEF (Afghanistan)     5%
โ€ข   OIF (Iraq)            4%

    Reduction in DNBI rate is a true force multiplier.
    Leads to less demand for healthcare and lower
    requirement for replacements!
Preventive Medicine Detachments
โ€ข Provide support across the entire public health
  spectrum to service members during field
  operations.
โ€ข Units composed of 13 soldiers who support a
  large area.
โ€ข Entomologist can serve as the Executive Officer
  (XO) or Commander.
โ€ข Lieutenant and Captains serve as XOโ€™s
โ€ข Senior Captains and Majors are Commanders
Center for Health Promotion and
      Public Health (CHPPM)
โ€ข CHPPM provides health promotion and public
  health leadership and services in support of the
  Military.
โ€ข Entomologists are located at all 6 CHPPM
  locations worldwide.
โ€ข Junior entomologists gain valuable experience in
  a variety of entomology areas and provide
  support services to requesting customers.
โ€ข Senior entomologist provide experience and
  expertise to customers while mentoring the
  junior entomologists.
Entomology Teaching
โ€ข Entomologists serve as instructors at the
  AMEDDC&S where they help train preventive
  medicine technicians, pest control personnel,
  and incoming AMEDD officers.
โ€ข Entomologists maybe assigned to the
  AMEDDC&S after obtaining experience as an
  Army entomologist.
โ€ข Entomologists serve as Assistant Professors at
  the Uniformed Services University of Health
  Sciences where they teach classes to a variety
  of programs that train future military health care
  providers.
Research
โ€ข There are opportunities for Army
  entomologist to conduct research to
  protect the war fighter from arthropod
  borne-disease threats.
Staff Positions
โ€ข Senior Entomologists (MAJ, LTC, COL)
  serve on a variety of staffs to provide the
  Commands with recommendations on
  arthropod-borne disease threats, personal
  protective measures, pesticide usage, and
  a variety of other issues.
Unique Opportunities
โ€ข Army entomology is by no means a narrow specialty.
  You will be challenged by unique situations:
   โ€“ Providing entomological support during disaster relief efforts in
     both the United States and foreign countries.
   โ€“ Providing technical assistance for civil affairs agricultural
     projects in nation building efforts.
   โ€“ Assisting in developing vector surveillance and pest control
     programs in developing nations.
   โ€“ Assisting in an arthropod-borne disease outbreak investigation.
โ€ข You will be afforded many opportunities expand
  personally and professionally as you meet new
  challenges.
Questions?

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Army entomology a_historical_perspective

  • 1. Medical Entomology in the U.S. Army: A Historical Perspective
  • 2. Military Entomology History โ€ข Armies in the field often lived in squalor with inadequate shelter, food, and water. โ€ข Many conflicts were brought to a halt not by superior force but by insects and the diseases they transmit. โ€ข Typhoid fever, louse borne typhus, malaria, yellow fever, and diarrheal disease ran rampant degrading an armies ability to fight.
  • 3. Cause of War Deaths War Number Serving in Battle Injuries (BI) Disease Non Arthropod Borne Army Battle Injuries Diseases (DNBI) Civil War (Union) 2,128,948 138,154 221,374 Yellow fever, typhoid, malaria Spanish American 280,564 369 2,061 Typhoid, malaria War World War I 4,057,101 50,510 55,868 Trench fever, malaria, louse borne typhus World War II 11,260,000 234,874 83,400 Malaria, scrub typhus Vietnam 4,368,000 30,922 7,273 Malaria Desert Shield 246,682 98 105 Leishmaniasis
  • 4. Military Entomology History โ€ข Military medical entomology got its start when MAJ Walter Reed showed that yellow fever was transmitted by mosquitoes. โ€ข With the identification of insects as the cause of disease the need to find ways to mitigate their impact became a military issue. โ€ข Major William Gorgas was the first to successfully control mosquitoes with his efforts in Havana and the Panama Canal.
  • 5. Military Entomology World War I โ€ข By World War I, the connection between insects and disease was well established. โ€ข Entomologists (6-8) were commissioned as officers in the Sanitary Corps. โ€ข Over 9,600 cases of malaria occurred in troops training in the southern U.S. โ€ข Trench fever and louse-borne typhus were the primary arthropod-borne diseases in Europe as troops were often infested with lice.
  • 6. Army Entomology Between the World Wars โ€ข Sanitary Corps moved to the Organized Reserves from Active Duty. โ€ข 14 entomologist were commissioned in the Sanitary Corps. โ€ข The War Department recognized the need for malaria control and began efforts to develop improved control methods and a true malaria prophylactic. โ€ข Extensive mosquito control programs were initiated in the camps located in the southern U.S. to prevent malaria outbreaks in training soldiers.
  • 7. Army Entomology in World War II โ€ข The prevention and control of malaria in the Southern U.S. and in possible overseas areas was one of the problems facing the military at the beginning of WWII. โ€ข The Army recognized the importance of controlling vector-borne disease and began commissioning entomologists, with many more serving as enlisted soldiers. โ€ข Army entomologists staffed malaria control and survey units in the Pacific theater; served as advisors in all theaters; and conducted research to develop better methods of control and prevention of arthropod-borne disease.
  • 8. Arthropod Disease Incidence and Death Rate 1942-45 Disease Incidence (number) Deaths (number) Fatality Rate/100,000 cases Malaria 378,000 302 0.8 Dengue 91,000 4 0.0 Sand fly fever 19,000 0 0.0 Scrub typhus 5,400 283 52.4 Filariasis 2,500 1 0.4 Murine typhus 800 15 18.8 Lesihmaniasis 500 0 0.0 Encephalitis 400 21 52.5 Tularemia 200 4 20.0 Relapsing fever 170 0 0.0 Rock Mountain spotted 130 12 92.3 Fever Epidemic typhus 100 0 0.0
  • 9. Post WWII โ€ข The Army continues to commission entomologists with around 60 serving on Active Duty and around 35 in the Reserves. โ€ข Entomologist serve in many capacities and have many unique opportunities.
  • 10. Army Entomology Today โ€ข Mission: To prevent arthropod-borne disease in Soldiers, their families, and other individuals for whom the Army is responsible. โ€ข Plan, direct, and evaluate comprehensive integrated pest control programs. โ€ข Conduct surveillance for medically important pests. โ€ข Identify insects and other zoological specimens. โ€ข Provide disease vector risk assessments for geographical areas.
  • 11. Recent Disease and non-Battle Injuries Rates (DNBI) โ€ข 1991 Gulf War 6.5 % โ€ข OJE (Bosnia) 7.1% โ€ข OJG (Kosovo) 8.1% โ€ข OEF (Afghanistan) 5% โ€ข OIF (Iraq) 4% Reduction in DNBI rate is a true force multiplier. Leads to less demand for healthcare and lower requirement for replacements!
  • 12. Preventive Medicine Detachments โ€ข Provide support across the entire public health spectrum to service members during field operations. โ€ข Units composed of 13 soldiers who support a large area. โ€ข Entomologist can serve as the Executive Officer (XO) or Commander. โ€ข Lieutenant and Captains serve as XOโ€™s โ€ข Senior Captains and Majors are Commanders
  • 13.
  • 14. Center for Health Promotion and Public Health (CHPPM) โ€ข CHPPM provides health promotion and public health leadership and services in support of the Military. โ€ข Entomologists are located at all 6 CHPPM locations worldwide. โ€ข Junior entomologists gain valuable experience in a variety of entomology areas and provide support services to requesting customers. โ€ข Senior entomologist provide experience and expertise to customers while mentoring the junior entomologists.
  • 15.
  • 16. Entomology Teaching โ€ข Entomologists serve as instructors at the AMEDDC&S where they help train preventive medicine technicians, pest control personnel, and incoming AMEDD officers. โ€ข Entomologists maybe assigned to the AMEDDC&S after obtaining experience as an Army entomologist. โ€ข Entomologists serve as Assistant Professors at the Uniformed Services University of Health Sciences where they teach classes to a variety of programs that train future military health care providers.
  • 17.
  • 18. Research โ€ข There are opportunities for Army entomologist to conduct research to protect the war fighter from arthropod borne-disease threats.
  • 19.
  • 20. Staff Positions โ€ข Senior Entomologists (MAJ, LTC, COL) serve on a variety of staffs to provide the Commands with recommendations on arthropod-borne disease threats, personal protective measures, pesticide usage, and a variety of other issues.
  • 21.
  • 22. Unique Opportunities โ€ข Army entomology is by no means a narrow specialty. You will be challenged by unique situations: โ€“ Providing entomological support during disaster relief efforts in both the United States and foreign countries. โ€“ Providing technical assistance for civil affairs agricultural projects in nation building efforts. โ€“ Assisting in developing vector surveillance and pest control programs in developing nations. โ€“ Assisting in an arthropod-borne disease outbreak investigation. โ€ข You will be afforded many opportunities expand personally and professionally as you meet new challenges.
  • 23.

Editor's Notes

  1. Alexander the Great is suspected to have died of malaria Napoleons campaign to conquer Russia was stopped by the Russian winter and louse borne typhus.
  2. Malaria was not considered to be a serious threat in France and areas of Europe in 1914 and little attention was given to the protection of troops from mosquitoes, lice and other pests. Malaria was a problem in training camps in the southern U.S. with over 9600 cases of malaria reported in the training troops. There is little information on what the entomologist did during WWI, although it is known that they did not supervise the drainage of mosquito breeding areas in the southern training areas.
  3. Medical Department, United States Army. Preventive Medicine in World War II. Volume VII. Communicable Diseases: Introduction. Washington: U.S. Government Printing Office 1964.
  4. The key metric of all our work is whether we have been able to keep the DNBI rate low, particularly those diseases caused by arthropods and other pests. By doing so we free up medical assets for other uses and reduce the number of personnel that are taken off mission.