RTAUZYUW RUENMED0299 3311850-UUUU--RHMFIUU. ZNR UUUUU R 271850Z NOV 03 ZYB FM BUMED WASHINGTON DC//M11// TO AIG 7783 INFO RUENAAA/CNO WASHINGTON DC//N931// RUCBCLF/COMLANTFLT NORFOLK VA//N02M// RHHMHAA/COMPACFLT PEARL HARBOR HI//N01M// RUCCNOM/COMNAVRESFOR NEW ORLEANS LA//JJJ// RUEACMC/CMC WASHINGTON DC//HS// RHMFIUU/CMC WASHINGTON DC//HS// RUCBLFB/COMMARFORLANT RHMFIUU/COMMARFORLANT RUHEHMS/COMMARFORPAC RHMFIUU/COMMARFORPAC RHMFIUU/COMMARFORRES RUWICBN/CG I MEF RHMFIUU/CG I MEF RUCKMEA/CG II MEF RHMFIUU/CG II MEF RHVAUJW/CG III MEF RHMFIUU/CG III MEF PAGE 02 RUENMED0299 UNCLAS RULSMCC/CG MCCDC QUANTICO VA//JJJ// RHMFIUU/CG MCCDC QUANTICO VA//JJJ// RUWICBN/CG FIRST MARDIV RHMFIUU/CG FIRST MARDIV RUCKDDA/CG SECOND MARDIV RHMFIUU/CG SECOND MARDIV RUHBABA/CG THIRD MARDIV RHMFIUU/CG THIRD MARDIV RUCCNOP/CG FOURTH MARDIV RHMFIUU/CG FOURTH MARDIV RUHBANB/CG FIRST MAW RHMFIUU/CG FIRST MAW RUCKFCA/CG SECOND MAW RHMFIUU/CG SECOND MAW RUWIKBC/CG THIRD MAW RHMFIUU/CG THIRD MAW RUCCNOQ/CG FOURTH MAW RHMFIUU/CG FOURTH MAW RHMFIUU/CG FIRST FSSG RUCKMOB/CG SECOND FSSG RHMFIUU/CG SECOND FSSG PAGE 03 RUENMED0299 UNCLAS RUHBANA/CG THIRD FSSG RHMFIUU/CG THIRD FSSG RUCCNOO/CG FOURTH FSSG RHMFIUU/CG FOURTH FSSG RUCKPIC/CG MCRD ERR PARRIS ISLAND SC//JJJ// RHMFIUU/CG MCRD ERR PARRIS ISLAND SC//JJJ// RUWDNAA/CG MCRD WRR SAN DIEGO CA//JJJ// RHMFIUU/CG MCRD WRR SAN DIEGO CA//JJJ// RUCKALC/CO MCLB ALBANY GA//JJJ// RHMFIUU/CO MCLB ALBANY GA//JJJ// RUWIBNA/CO MCLB BARSTOW CA//JJJ// RHMFIUU/CO MCLB BARSTOW CA//JJJ// RUCKSAG/FLDMEDSERVSCOL CAMP LEJEUNE NC//JJJ// RHMFIUU/FLDMEDSERVSCOL CAMP LEJEUNE NC//JJJ// RUWICBF/FLDMEDSERVSCOL CAMP PENDLETON CA//JJJ// RHMFIUU/FLDMEDSERVSCOL CAMP PENDLETON CA//JJJ// RULSMJA/MARCORSUPACT KANSAS CITY MO//JJJ// RHMFIUU/MARCORSUPACT KANSAS CITY MO//JJJ// RUWIBHA/MCAS YUMA AZ//JJJ// RHMFIUU/MCAS YUMA AZ//JJJ// PAGE 04 RUENMED0299 UNCLAS RUWIDAA/MCMWTC BRIDGEPORT CA//JJJ// RHMFIUU/MCMWTC BRIDGEPORT CA//JJJ// RUCBACM/JFHQ HLS NORFOLK VA//JJJ// RUCOFAE/NAVENVIRHLTHCEN PORTSMOUTH VA//JJJ// RHMFIUU/CHPPMDCSOPSOPNSBRCH ABERDEEN PROVING GROUND MD//JJJ// BT UNCLAS //N00000// MSGID/GENADMIN/BUMED WASHINGTON DC/M11/NOV// SUBJ/MEDICAL SITREP ONE: LEISHMANIASIS CY 03// REF/A/DOC/ASD (HA)/12SEP2003// REF/B/GENADMIN/NEHC/101750ZOCT2003// REF/C/DOC/CDC/24OCT2003// REF/D/DOC/BUMED WASHINGTON DC/21OCT1998// NARR/REF A IS MEMO FROM ASST SEC DEF (HEALTH AFFAIRS): MEDICAL ADVISORY-LEISHMANIASIS, AVAILABLE AT HTTP://WWW-NEHC.MED.NAVY.MIL/DOWNLOADS/PREVMED/ASDLEISHMAN.PDF REF B IS PREVIOUS RMG ON TOPIC AND AVAILABLE AT HTTP:(DOUBLE SLASH) WWW-NEHC.MED.NAVY.MIL/PREVMED/EPI/NEHCLEISHGUIDE.TXT REF C IS MMWR: CUTANEOUS LEISHMANIASIS IN U.S. MILITARY PERSONNEL SOUTHWEST/CENTRAL ASIA, 2002-2003. AVAILABLE AT HTTP:(DOUBLE PAGE 05 RUENMED0299 UNCLAS SLASH)WWW.CDC.GOV/MMWR/PREVIEW/MMWRHTML/MM5242A1.HTM REF D IS BUMEDINST 6220.12A ON MEDICAL EVENT REPORTING, AVAILABLE AT HTTP:(DOUBLE SLASH) WWW-NEHC.MED.NAVY.MIL/PREVMED/INDEX.HTM// RMKS/1. UPDATING REF A AND B, WE ARE TRACKING SEVEN MARINES AND THREE SAILORS WITH THE DIAGNOSIS OF LEISHMANISIS, EITHER PRESUMED OR CONFIRMED. REF C PROVIDES ADDITIONAL SURVEILLANCE INFORMATION FROM CDC. 2. LEISHMANISIS CONTINUES TO BE A CONCERN FOR SAILORS AND MARINES WHO HAVE SERVED IN IRAQ AND NEARBY COUNTRIES. LEISHMANIASIS IS A SERIOUS DISEASE, AND DIAGNOSIS AND TREATMENT CAN BE DIFFICULT. AS AN UPDATE TO REF B, REQUEST AT LEAST TELEPHONE CONSULTATION WITH THE APPROVED TREATMENT CENTER AT WALTER REED ARMY MEDICAL CENTER FOR PRESUMED CASES OF CUTANEOUS LEISHMANIASIS (BAGHDAD BOIL) OR VISCERAL DISEASE. ACTUAL OR PRESUMED CASES OF LEISHMANIASIS ARE REPORTABLE PER REF D. THE CHAIN OF COMMAND SHOULD BE MADE AWARE OF PRESUMED CASES. AS NOTED IN THE SURGEON GENERALS GUIDANCE OF 10 NOVEMBER, IT IS IMPERATIVE TO KEEP THE MAIN THING, THE MAIN THING: FORCE HEALTH PROTECTION. VIGILANCE TO ENDEMIC DISEASES AND THEIR PREVENTION ARE CRITICAL TO MISSION SUCCESS. PREVENTION IS THE BEST COURSE OF ACTION. IF PAGE 06 RUENMED0299 UNCLAS PREVENTION FAILS, ENSURE ENDEMIC DISEASES ARE AT THE TOP OF YOUR DIFFERENTIAL DIAGNOSIS LIST. TREAT EARLY AND TREAT PRESUMPTIVELY IF IN DOUBT. ADDITIONAL INFORMATION ON LEISHMANIASIS IS AVAILABLE FROM THE DEPLOYMENT HEALTH CLINICAL CENTER WEBSITE, HTTP://WWW.PDHEALTH.MIL/LEISH.ASP, TEL 1-800-796-9699. EMAIL: PDHEALTH@AMEDD.ARMY.MIL. 3. EDUCATION OF ALL PERSONNEL DEPLOYING TO ENDEMIC AREAS ON PREVENTION OF LEISHMANIASIS REMAINS IMPORTANT. AVOIDING SAND FLY BITES, MOST OF WHICH OCCUR AT NIGHT, IS IMPORTANT. LEADERSHIP ATTENTION SHOULD BE GIVEN TO ENFORCING PROCEDURES THAT REDUCE EXPOSURE TO SAND FLIES AND ENHANCE AWARENESS OF THE DISEASE. USE OF STANDARD PERSONAL PROTECTIVE MEASURES AGAINST MALARIA WILL ALSO HELP PREVENT LEISHMANIASIS. MEDICAL PERSONNEL IN GENERAL, AND PREVENTIVE MEDICINE PERSONNEL IN PARTICULAR, SHOULD TAKE THE INITIATIVE FOR ENSURING THAT MARINES AND SAILORS USE PERSONAL PROTECTIVE MEASURES (PPMS). 4. PERSONNEL REDEPLOYING FROM ENDEMIC AREAS SHOULD RECEIVE INFORMATION ON THE DISEASE PRESENTATION AS WELL AS ACCESSING THE HEALTH CARE SYSTEM IF THEY DEVELOP SKIN LESIONS OR BECOME ILL. PAGE 07 RUENMED0299 UNCLAS 5. FOR INFORMATION ON AREAS AT RISK, REVIEW AFMIC WEB SITE AT HTTP://MIC.AFMIC.DETRICK.ARMY.MIL/ OR SIPRNET EMAIL TO AFMICOPS@AFMIC.DIA.SMIL.MIL ADDITIONAL INFORMATION RESOURCES: A. NAVY ENVIRONMENTAL HEALTH CENTER (WWW-NEHC.MED.NAVY.MIL) (757) 953-0700, DSN 377-0700, AFTER HOURS (757) 621-1967, EPI@NEHC.MAR.MED.NAVY.MIL B. NAVY ENVIRONMENTAL AND PREVENTIVE MEDICINE UNIT TWO (757) 444-7671, DSN 564-7671, EPI-NEPMU2-NOR@MAR.MED.NAVY.MIL C. NAVY ENVIRONMENTAL AND PREVENTIVE MEDICINE UNIT FIVE (619) 556-7070, DSN 526-7070, NEPMU5@NEPMU5.MED.NAVY.MIL D. NAVY ENVIRONMENTAL AND PREVENTIVE MEDICINE UNIT SIX (808) 473-0555, DSN 473-0555, EPI@NEPMU6.MED.NAVY.MIL E. NAVY ENVIRONMENTAL AND PREVENTIVE MEDICINE UNIT SEVEN 39-095-86-9251, DSN 624-9251, NEPMU7@NEPMU7.SICILY.NAVY.MIL// BT #0299