Medical Briefing:

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Medical Briefing

• Afghanistan

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OVERVIEW

• Mission
• Medical Threats
• Medical Recommendations

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MISSION

• Primary Provide medical and preventive medicine
  support to deployed US Forces in Afghanistan
• Secondary Provide information and
  recommendations to Local National Health Care
  Providers

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(No Transcript)
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WEATHER

• Rain and snow October to April
• Rainfall 15 inches/year
• Wind of 120 days June to Sept up to 110 mph
• Temperature extremes
• Winter 37 F to -3F
• Summer 118o to 68o F

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MEDICAL THREATS

• Diseases
• Environmental injuries and illnesses
• Flora/fauna

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DISEASESFood/Water Borne

• !!!HIGH Risk!!!
• Diarrhea
• High risk caused by bacterial, amoeba, viral
• In Afghanistan war, Soviets had an entire
  mechanized unit of 3,000 men, out of combat
• Resistance to standard treatment TMX/SMX
• Typhoid Fever- Highly endemic
• Hepatitis A- Almost 20 of Russian personnel
  hospitalized

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DISEASES Vector Borne

• Malaria (Primarily Plasmodium vivax)
• May through November
• West Nile fever (Mosquito)
• Sand fly fever
• Leishmaniasis ( sand fly)
• Scrub typhus (mite)

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DISEASES Other

• Tuberculosis- Highly endemic
• Cholera
• Meningococcal Meningitis
• Helminthic infections- 95 of population infected

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DISEASES Other Cont

• Leptospirosis
• Rabies
• Anthrax (animal-borne cutaneous)
• Flea-borne Typhus

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DISEASES Recreational

• Sexually Transmitted Diseases
• HIV/AIDS low 0.01 of population 15-49 y/o
• Hepatitis B/C found in 6.7 of women
• Fresh water recreation
• Leptospirosis

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ENVIRONMENTAL INJURIES AND ILLNESSES

• Water shortages
• Water contamination with sewage
• Temperature extremes heat/cold injuries
• Dust storms 110 mph
• High altitude

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FLORA/FAUNA

• Venomous land snakes
• Insects
• Plants

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LOCAL MEDICAL FACILITIES

• Civil war has disrupted health care
• Operated by international humanitarian
  organizations.
• Local blood supply is not safe

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MEDICAL SHOW STOPPERS

• Infectious disease epidemic
• Food/water borne
• Potable water availability
• Heat/cold casualties
• Mass casualty/evacuation

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RECOMMENDATIONSPre-Deployment

• Vaccinations
• Hepatitis A, influenza, typhoid, yellow fever,
  Td, polio,MMR
• Verify status HIV, PPD, G6PD
• Begin malaria prophylaxis Mefloquine or
  doxycycline (mefloquine not approved for flight
  status)
• Preventive medicine brief

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RECOMMENDATIONSDeployment Location

• DEET
• Malaria prophylaxis-
• Mefloquine 250 mg/week or doxycycline 100
  mg/day. Post exposure primaquine required.
• Treat BDUs/bed nets with permethrin
• Clothing discipline
• Monitor environmental conditions
• Field sanitation equipment/water discipline

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SUMMARY

• Mission
• Food/Water threats
• Other Infectious Diseases
• Environmental
• Safety