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AHMf FORO3E, PACIFICOGEiISSjAEEAS i*||iif*lil
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RESTRICTED
PREVENTIVE MEDICINE MANUAL No. 2FOR ALL OFFICERS
MILITARY CONTROLof
MALARIAand
INSECT-BORNE DISEASES
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UNITED STATED 4JftViy PACIFIC 'OCEAN AREASkobert C. Richardson, /ts* Lieutenant General, U . S. Army.,
Commanding
MALARIA AND INSECT CONTROL • PACIFIC OCEAN AREASJUNE 1915
The Information in this manual is notto be communicated either directly orindirectly to the press or to any personnot in the Armed Forces (Allied),
DI7CTDM\JLjtD± l\I Lvi jVjU
HEADQUARTERS UNITED STATES ARMYFORCES, PACIFIC OCEAN AREAS
OFFICE OF THE COMMANDING GENERALAPO 958
SUBJECT: Military Control of Malaria and Insect-Borne Diseases.
TO : All Officers, U. S. Army Forces, PacificOcean Areas.
1. This manual on the military control of malariaand insect-borne diseases is published for the informa-tion and guidance of all officers.
2. It is of greatest importance that these diseasesshall not jeopardize the success of a military cam-paign. All commanders are enjoined to assist tneprogram outlined in this manual.
ROBERT C. RICHARDSON, Jr.,Lieutenant General, U. S. Army,
Commanding.
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MILITARY CONTROL OF INSECT-BORNE DISEASES*
SECTION I
Introduction1. Insect-borne diseases of present or potential
military importance in the Pacific Ocean Areas aretransmitted by mosquitoes, mites, flies, fleas and lice.Those which are of immediate and urgent importanceare set in bold type.
a. Mosquito transmitted diseases include mal-aria, dengue fever, filariasis and Japanese B ence-phalitis.
b. Mites transmit mite-borne typhus.c. Fly-borne diseases include the dysenteries.d. Fleas transmit plague and flea-borne typhus.e. Lice transmit louse-borne typhus.
2. Fortunately the measures which prevent onetype of insect-borne disease are effective often againstothers. Thus anti-mosquito work which is done toprevent dengue fever is often effective also in pre-venting filariasis or Japanese B encephalitis.
SECTION II
Malaria1. Military Importance of Malaria.
a. Malaria contributed greatly to the unhappytermination of the defense of Bataan. It is estimatedthat 85 percent of our forces there became infectedwith malaria. Over five times as many casualties inthe South Pacific were due to malaria as were causedby all battle casualties. Heavily seeded troops whowere sent from Guadalcanal to rear bases and ordered
�Revised and extended from Malaria Training ManualsNo. 2 and No. 3, South Pacific Area.
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to stop suppressive atabrine averaged 1-Yz to 2 attacksof malaria per man. Whole divisions were thus ren-dered less effective both in combat and during theirrehabilitation and training periods because of thenumber of men ill with malaria. Similar rates occurredin New Guinea.
b. These early malaria rates followed from theurgency of the situation. It was necessary to beginthe Guadalcanal and New Guinea campaigns beforethe newly-developed repellents and freon aerosolsprays were available, when the supply of quinine wasshort, and when atabrine was a relatively unknowndrug. We had too little knowledge of the danger ofmalaria and how to cope with it. Now we are betterprepared to reduce the malaria hazard; it need nolonger jeopardize the success of a military campaign.
2. Malaria Can Be Effectively Controlled Only ByThe Joint Efforts Of Every Officer and Man.It is urgent to emphasize this point. The present
insect control organization has demonstrated that thedisease can be controlled on established bases. Mos-quito control in newly occupied territory is now aidedby airplanes which are equipped to spray DDT solu-tions. Here it is important to note that too muchreliance is often placed on airplane spraying. Controlwork by ground crews is still the most important andonly proven method. Special spray teams are organ-ized to work behind combat lines, but there is nomosquito control in the area of front line combat.Malaria prevention there becomes a matter of howwell each officer knows what he can do to protect hismen from infected mosquitoes and how well each manuses his clothes, his repellent, and his spray to stopmosquito bites. This is all summed up in two words:malaria discipline.
3. General Information About Malaria.a. t Geographical distribution in Pacific Ocean
Areas. There is no malaria in the Hawaiian Islands,in Saipan or Guam or in the islands between. Thereis malaria in all the target areas; in Formosa, inChina, in the Ryukyus, and in Japan itself.
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b. The malaria mosquito. Malaria is transmittedby only one group of mosquitoes called anophelines.Other groups of mosquitoes do not carry malaria andare commonly called “pest mosquitoes”. The femaleanopheline mosquito lays eggs in water and the cycleof development from eggs through the larval stage toadult requires about ten days. The anopheline (mala-ria) mosquito breeds in open ponds, lagoons, swamps,and streams. She flies over distances of a mile ormore and hence may be thought of as a “field type” ofmosquito in comparison with the “domestic type” ofmosquito which breeds close around camps and dwell-ings and flies only short distances. The “domestictype” of mosquito is discussed under Dengue Fever.Only the female anopheline transmits malaria. She isa shy mosquito which flies and bites only at nightexcept in dark jungle where she may bite in the day-time. Hence protective measures are most importantat night.
c. Variations due to season, control efforts, andbase development. Malaria is more prevalent duringthe rainy season when there are many new pools ofwater where malaria mosquitoes breed. The amountof mosquito control work which has been accomp-lished is another factor in the malariousness of a base.Thus, on entering a new base under combat conditions,little permanent control is possible and reliance mustbe placed on larviciding and on individual protectivemeasures such as the use of repellents, sprays, bednets, and atabrine. As the base develops, better mal-aria control measures are gradually instituted anddestroy more and more mosquitoes until so fewremain that many of the individual protective meas-ures are no longer essential.
d. Man-made malaria, a serious problem. Overfifty per cent of the malaria mosquito breeding duringthe first rainy season on Guadalcanal took place inman-made pools of water which were made by:
(1) Unnecessary ruts, formed by driving“cross country” and on unauthorizedroads and ti’ails.
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(2) Roads which were built without adequateditches and culverts and thus blockednatural drainage courses.
(3) Numerous small borrow pits alongsideroads.
(4) Abandoned foxholes and bomb craterswhich became prolific sources of mos-quitobreeding.
e. Special problems in occupying new bases.Warning should be given of the false security whichtoo often follows a landing during the dry season.Troops who expect mosquitoes and malaria, but findnone, conclude that talk about malaria has been exag-gerated. Thus, the first troops on Guadalcanal inAugust 1942 found few mosquitoes and had littlemalaria in the first weeks. Meanwhile, female anoph-elines were laying countless thousands of eggs inwater which collected in the myriad of ruts and holesmade by the occupying force (man-made malaria).Malaria cases appeared in September and the diseasebecame epidemic in late October.
A similar situation occurred during the NewGeorgia operations where every man was given abottle of repellent and other antimosquito equipment.No mosquitoes were found at the time of landing, andmen discarded their repellent. Meantime, increasingnumbers of mosquito larvae were found in ruts andholes, a warning of malaria to come. Would thesesame troops have thrown away their guns and am-munition if they had not met the enemy during thefirst few days?
4. Nature of Malaria And Suppressive Treatment.a. Three factors must be present at one time and
place if malaria is to be prevalent among troops:Persons infected with malaria. (Natives, Japs
or malaria-infected troops who comprise the “seedbed”.)
Malaria carrying mosquitoes. (Anophelines).Non-infected troops.The chain of transmission from infected persons
to mosquito to healthy troops is described below.
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b. Malaria is a disease caused by a tiny parasitewhich is found in man’s red blood cells. The femaleanopheline, or malaria mosquito, must first becomeinfected before she can spread the disease. This shedoes by biting and sucking up some blood containingparasites from an infected native or other personwho has malaria. The parasites multiply in the mos-quito for about ten days and then wait in her salivaryglands for a chance to infect a well man. Every timethe mosquito drills a hole in a man’s skin for blood,she injects saliva into the opening, and if malariaparasites are in the saliva, they go into the hole andso into the blood. Here they enter a red blood celland multiply until they finally fill the blood cell andburst out, destroying this red cell. They then invadeother cells and repeat the process.
c. Symptoms and diagnosis. Symptoms usuallydevelop about fourteen days after a man is bitten byan infected mosquito. One should suspect malariawhen he has a chill followed by a fever and sweating.The symptoms of malaria may be anything from head-ache to delirious fever or even sudden unconscious-ness. The only way to be certain that one has malariais to find malaria parasites in a blood film examinedwith a microscope. Under field conditions medicalofficers sometimes must diagnose and treat malariafrom symptoms alone, without examining the blood.
d. Treatment and relapse. Atabrine, quinine, orother drugs are used in the treatment of malaria.When given properly, the drugs will usually cure theattack in about a week. But sometimes, even thougha man feels well after treatment, the drugs have notdestroyed all the malaria parasites. A few of them mayhide away in the internal organs. Then, after weeksor months the disease appears again. This is calleda relapse. There may be several such relapses whichhave to be treated each time like a new infection.
e. Atabrine suppressive therapy. There is noknown drug which will prevent malaria infection;but one drug, atabrine, will, when given properly,delay the onset of symptoms of the disease as long
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as it is being taken. This drug is therefore of vitalimportance in keeping men on their feet during urgentmilitary operations. Atabrine blood studies havedemonstrated that failure of the drug to protectagainst malaria is almost always due to not takingthe atabrine regularly as prescribed.
Dosage: Theatre directives prescribe exactdosage schedules.
Supervision: Troops do not take medicine wil-lingly. Blood atabrine studies have shown repeatedlythat atabrine is not taken well when supervision islax. Unit commanders are responsible:
That the drug be given by roster to both officersand men.
That an officer or a competent noncommissionedofficer witness the actual swallowing of the drug byeach individual.
That by checking the roster regularly, all in-dividuals who have not taken the drug be requiredto report and take sufficient dosage to equal thatmissed.
That failure to take atabrine as ordered shouldresult in disciplinary action.
Atabrine is as completely harmless in the recom-mended dosage as is aspirin. It may cause vomitingand diarrhea in a few men when first started. Thisdisappears after the first few days and can be less-ened by taking the tablet on a full stomach. Less thanone in 1000 persons is intolerant of atabrine. For sucha person the medical officer may prescribe quinine.Here it should be noted that atabrine gives bettersuppressive action than quinine and has fewer toxiceffects. A temporary yellowing of the skin may occursince atabrine is a yellow dye. This will disappearafter the drug is stopped and is not harmful. Atabrinewill not cause impotence or sterility.
Eventually when suppressive treatment is dis-continued, most individuals who have been infectedwill become acutely ill with malaria. Recent evidence,however, indicates that suppressive treatment withatabrine will completely stop the development of one
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type of malaria Infection (Plasmodium falciparum).Plasmodium falciparum infections long have beenconsidered the type of malaria most likely to causedeath. It is also probable that suppressive treatmentwith atabrine will lessen the severity of all types ofmalaria infection.
A particularly hazardous aspect of the use ofsuppressive treatment is that it may conceal danger-ously the amount of malaria which may be seeding aunit gradually. The apparent freedom from malariamay lead to carelessness in the enforcement of mal-aria discipline. Commanding officers of such unitsare apt to regard truly preventive measures such asmosquito control and individual protective measuresas not necessary. If the risk of infection is suffici-ently great to necessitate the use of suppressive treat-ment, it is all the more important to stress trulypreventive measures. Failure to employ precautionsagainst mosquitoes to the fullest possible extent isinexusable and is a reflection upon the efficiency ofthe commanding officer concerned.
f. Malaria is a serious disease. It destroys aman’s blood and makes him weak. It may keep himin the hospital for ten days or longer. It may makehim a chronic invalid for a year. It may cost him hislife in combat. It may kill one or two out of everyhundred infected persons if they are not properlytreated.
5. Malaria Preventive Measures Which Are Pri-marily Command Functions.It is the responsibility of all commanders to
initiate and enforce the necessary measures to controlmalaria within their units and unit areas (AppendixI and Circular 223, WD, 1943). These measures in-clude:
a. An organization and program for insect con-trol. Unit commanders will appoint an insect androdent control detail consisting of 1 NCO and 2 en-listed men in each company, battery, squadron, orsimilar unit (see paragraph 3 a. Appendix I). Thesedetails primarily will maintain insect control within
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the camp and in surrounding territory for a distanceof one mile. Their insect control work will includespraying of all standing water once weekly, minorditching to remove such water, smoothing of road rutsand the use of DDT residual effect sprays. This lastmethod is new and is of value because of the per-sistent effect of DDT when sprayed on screens andwalls of tents, quarters, and native dwelling. Spray-ing the latter is particularly profitable because mostmosquitoes become infected with malaria by bitingdiseased natives and often rest on the walls of thedwelling where the blood is obtained. A single spray-ing of these buildings with DDT not only will kill allmosquitoes then present but will continue to kill mos-quitoes as they come in contact with treated surfacesfor one to three months. This may prove one of themost valuable of all antimosquito measures. Insectcontrol officers of units smaller than divisions willbe appointed as provided in Appendix I. For divisionand base insect control groups (see Appendix I).
b. A training program in military control ofinsect-borne diseases for all personnel. The details ofthis program are outlined in Appendix 11. Everyofficer should seek to impress his men with the im-portance of individual protective measures.
c. Supplies and equipment. The commander ischarged with the timely requisitioning of insectcontrol supplies (Appendices 111 and IV). These shouldbe forwarded in divided shipments so that loss ofone shipment will not disrupt the program. It is theresponsibility of unit commanders that each man issupplied with a bed net in good condition and that hehas a bottle of repellent. It is his responsibility thatduring combat insect control supplies reach the frontlines with the same regularity as food.
d. Command responsibilities during the phase ofseaborne troop movements.
(1) Temporary landings of only a few dayson malarious bases (or where dengue is epidemic)may result in large numbers of men contracting thesediseases. Landings made for the purpose of exercise
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should be accomplished during daylight hours, andtroops should be back aboard ship by sunset whenmalaria mosquitoes start biting. Repellent and othermeasures for individual protection should be usedwhen indicated.
(2) When it is known that troops will landand camp on a malarious island, an officer should besent ahead to select, with the aid of the island malariacontrol group, a relatively non-malarious campsite.
(3) All landing movements should be so plan-ned, the military situation permitting, that troops goashore in the morning with sufficient time to set upcamp and be under mosquito nets by night time. Thisrequires that nets, repellents, and other insect controlsupplies be available on the first night ashore.
e. Selection of campsites. The advice of the baseor division malaria and insect control officer shouldbe obtained in selection of camp sites, whenever themilitary situation allows. Camps should be locateda mile or more from native villages and marshes orstreams which are known or suspected to be breedingplaces for mosquitoes.
f. Segregation of natives. Over fifty per cent ofnatives on malarious islands in the Pacific havechronic malaria, and are a serious source, or “seedbed”, of infection. Most of these natives also havefilariasis. Preferably, they should never be allowedin ti’oop areas. In practice, they are often essentialas laborers. When so employed they should be allow-ed in camp areas only between the hours of 0700 and1800. If natives are allowed in or near camp at nightwhen malaria mosquitoes are feeding, the mosquitoesmay become infected and will, in turn, transmit thedisease to troops. Native camps should be “Out ofBounds,” or “Off Limits.”
g. Night exercises and landing drills. Nightmaneuvers, or landing drills, should be held in rela-tively malaria-free regions. The permanently basedmalaria and insect control units will designate suit-able areas for tactical operations and will also markout sectors which should be out of bounds. All anti-
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mosquito precautions should be rigorously enforced,both for protection and as a training measure, evenwhen night exercises are held in authorized sectors.
h. Night working parties in malarious areas.Night working parties should be employed in malari-ous regions only when essential. They should weartheir shirts, use repellents, and take all other protect-ive measures.
1. Screening. Screening is an important pro-tective measure whenever its use is feasible. Menliving inside screened tents and sleeping under bednets have double protection. The specifications anduse of screening are detailed in Appendix 111.
j. Malaria discipline. Unit commanders are re-sponsible for malaria discipline among their troops.This includes the program of suppressive therapywith atabrine described in subparagraph 4e, above,and the enforcement of individual protective meas-ures as outlined in paragraph 6, below.
6. Individual Protective Measures Against Mos-quito Bites. The malaria mosquito bites at
night. The measures which each soldier, sailor, ormarine will take to protect himself are described.(Note: These measures are equally effective againstmosquitoes which transmit dengue fever and otherdiseases, except that they must be carried out duringthe day as well as at night. See Dengue Fever):
a. Ordinary clothing used for protection. Mos-quitoes do not bite through ordinary clothing unlessit is thin or tightly stretched. Shirts will be worn,beginning at sundown, with collars buttoned andsleeves rolled down. Wherever mosquitoes are pres-ent, the bottoms of trousers will be tucked into topsof shoes and socks will be drawn up around trouserbottoms to protect ankles.
b. Repellents. Repellents are chemical solu-tions which, when spread over the skin, will keepmosquitoes from biting for about two hours. Atsunset and every two hours when exposed at night,one should rub fifteen to twenty drops of standardmosquito repellent on hands, wrists, cheeks, neck,
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and lower legs. The repellent must be applied moreoften when men are sweating. Also, apply a fewdrops where clothes are tight, as across shouldersand the seat of trousers and on socks. Repellentshould be taken to fox holes during night alarms.It should be kept close at hand for this purpose byplacing it in steel helmet before retiring. The use ofrepellent is the most important and most neglectedphase of malaria discipline. It is important to em-phasize that there may be times, particularly incombat, when repellents are the best protectionagainst malaria. A man may go through the mostmalarious area and avoid the disease completely ifrepellents are used regularly and well.
c. Spray killing of adult mosquitoes. A sprayer known as a freon aerosol dispenser is available.The spray is highly concentrated. Ten seconds spray-ing is enough for a pyramidal tent, three secondsfor a pup tent. Longer spraying does not increaseeffectiveness and is wasteful. Tents and nets shouldbe sprayed at dusk and at bedtime. A supply of sprayshould be taken to the fox hole at night. Hospitalswith malaria patients should be sprayed regularly,as should mess halls and kitchens.
d. Bed nets and jungle hammocks. Bed netsare one of the most valuable methods of protectionfrom mosquito bites. There are places in the tropicswhere a single night of exposure to mosquito bitesmay result in an infection rate up to twenty per centamong unprotected troops. It is the responsibility ofeach officer to see that these nets are available on thefirst night ashore. They should be regularly inspectedand repaired. Each man should practice setting uphis net before entering a malarious area. The netshould be so supported that it does not sag upon thesleeping man, and so arranged that his elbows andknees do not contact the meshes. In practice, suchcontacts are difficult to prevent. The man is wellrepaid who uses repellent on the knees and elbowswhen he retires. Nets should be ready before dusk,should be tucked in carefully, and a search for mos-
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quitoes should be made preferably with a flash light,after one gets inside. When not in use bed nets shouldbe so arranged that mosquitoes cannot enter.
e. Avoidance of unnecessary exposure to infect-ed mosquitoes. Troops should not be allowed togo swimming or fishing, or to bathe in unscreenedshowers, or otherwise unnecessarily expose them-selves after sundown. It may be feasible to postponereveille until after sunrise in order to avoid earlymorning exposure in highly malarious areas.
SECTION 111
Dengue Fever1. Military Importance. Dengue is usually second
to malaria as a hazard to military operations; but onoccasions it becomes of primary and urgent import-ance. Serious epidemics have occurred on Saipan,Guam, and earlier on Espiritu Santo and New Cale-donia. In some of these epidemics more than 25 percent were non-effectives.
2. Geographical Distribution. Dengue is prevalentin the islands of the Pacific Ocean Areas and particu-larly in Formosa, Ryukyu Islands, Japan, and China.
3. Nature of the Disease. Dengue fever is anacute non-fatal disease caused by a filterable viruswhich is transmitted from an infected man to ahealthy one by a mosquito and by no other means.The symptoms are often much like malaria as isshown in Table I, “Comparison of Malaria and Den-gue.” The importance of blood smears in diagnosisis apparent.
4. Method of Transmission. The Aedes aegyptimosquito is the chief vector of Dengue fever; aedesalbopictus has also been incriminated. Both speciesbite freely during the day as well as at night, differ-ing from anopheline (malaria) mosquitoes which biteat night. The mosquito vector herself must becomeinfected by biting a dengue patient during the first
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three days of the fever as this is the only time thatthe virus is present in the blood. After a short periodof incubation in the mosquito the latter becomes in-effective and is able to transmit dengue at anytimeduring the rest of its life by biting a susceptible man.
5. Life History of Aedes Aegypti. The femaleAedes aegypti lays her eggs in tin cans, flower pots,water tubs, and other artificial water containers closearound a house; and is called a domestic or housetype of mosquito in contrast with the anopheline(malaria) mosquito which breeds in pools and streamsin the fields. A correlary of this is that the adultAedes aegypti mosquitoes fly only short distancesand therefore must lay eggs near the camp or housewhere they are found biting. The Aedes mosquitodevelops from larvae to adult in seven to ten daysin warm climates.
TABLE I
COMPARISON OF MALARIA AND DENGUE
Symptoms or Signs Dengue(100 Cases )
Malaria(100 Gases )
Frontal headaches 88% 96%Chilly sensations 55% 22%True chill 10% 56%Pain in eyes 78% 59%Red Conjunctivae 97% not notedLow backache 74% 79%Pain on eye movement 25% commonAbdominal symptoms 17% 47%Toxic rash 35% noneTemperature 103° F. or over 55% 68%Saddle-back temperature 25% none“Dengue” rash 18% noneJoint aches common 72%
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6. Control of Dengue Depends on Control of Den-gue Carrying Mosquitoes.a. Breeding of this mosquito is controlled by
destroying or emptying the artificial water containerswhere she lays her eggs or by putting oil or DDT onsuch water. This must be done at least once a week.Some of the principal breeding places which must betreated are rain barrels, tubs, cisterns, cans of allsizes, bottles, pots, pails, old shoes, canvas tarpau-lins holding rain water, tires so stacked as to hold rainwater, and slit trenches: anything that will holdwater for ten days.
b. Individual protective measures against den-gue mosquitoes are the same as those already dis-cussed to protect against malaria:
Ordinary clothes used for protection.Repellents.Spray killing of adult mosquitoes.Bed nets and jungle hammocks.Avoidance of unnecessary exposure.Screening.
The only difference is that the dengue mosquitobites both during the day and at night; hence pre-cautions must be taken at all times.
SECTION IV
Mite-Borne Typhus1. Introduction. Mite-borne typhus (scrub typhus,
tsutsugamuchi disease) is a typhus like disease offield mice, rats, and other animals which is trans-mitted by the bite of a mite (chigger or red bug).Man contracts the disease by being accidentally bittenby an infected mite.
2. Military importance. Mite-borne typhus hasnot yet been a disease of great hazard to militaryoperations. There have been less than 4000 cases inthe U. S. Army in the first three years of war. It hashowever been a disease of greatest importance to
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individual organizations who happen to locate in aninfected area. In some organizations nearly 50 percent of the personnel have been infected; the mor-tality rate in restricted localities in the region ofNew Guinea has varied from about 1.5 to almost 30per cent. Small but severe localized epidemics maytherefore give rise to unfounded rumors affectingmorale.
3. Geographical Distribution. The disease occursin scattered areas lying within a rough triangle ofJapan, Eastern India, and Northern Australia. Allfuture target areas are potential sources of mite-bornetyphus.
4. Nature of The Disease. Mite-borne typhus isan acute febrile disease caused by a minute organismwhich usually is found in the blood of infected miceand other rodents and is transmitted from rodent torodent by mites. When man is bitten by an infectedmite the disease becomes manifest after an incubationperiod of about two weeks. The typhus inoculationswhich the army gives are to protect against a moresevere type of typhus which is known as louse-bornetyphus. These inoculations do not protect againstmite-born typhus which is a different and usually amilder disease.
5. Transmission. The six legged larval mite (redbug, chigger) which transmits the disease is so smallthat it is rarely seen. It is red in color. Mites arefrequently described as occurring in open fields ofKunai grass, but they are found equally often inother types of tall grass and in areas overgrown withscrub. Apparently a moist loose humus soil is favor-able for them. It is unknown as yet why one areain a meadow may be highly infected and result innumerous cases in troops encamped there while othertroops a short distance away in the same field mayescape attack. In Japan, mites are common in riverbottom areas and on ground which is subject toflooding.
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6. Control.a. Mite avoidance.
(1) Standing, sitting, or lying in open grassor along jungle margins where mites abound should bereduced to the minimum. Mites remain chiefly in oron the ground but are quick to crawl up the shoesor clothing of a standing or reclining individual.Troops continuously on the march seldom show evi-dence of chigger bites even after traversing heavilyinfested areas.
(2) A vigorous soap and water scrubbing ofthe whole body with a wash cloth is highly desireablefollowing exposure in a potentially mite infested area.
(3) Sleeping in direct contact with theground is necessary under some operational condi-tions but is dangerous. A bare road is to be preferredfor bivouac to sleeping in an adjacent field of kunaigrass. Similarly jungle hammocks are better thancots where there is a choice. Native type beds offreshly cut poles on cross pieces are safer than theground.
b. Repellents. The standard G.I. repellents areall helpful but dimethyl phthalate is the best. Smallamounts in cupped hand should be rubbed thorough-ly into socks, shoe tops, trouser cuffs, trouser fly andwaist, shirt fly, collar, and sleeve cuff. This mustbe repeated weekly. It is not as reliable or practicalfor large bodies of troops as the total impregnationof clothing described below.
(1) Impregnation of clothing and blanketswith a dimethyl phthalate-soap emulsion. An impreg-nated uniform remains mite proof during five weeksof occasional wearing or will protect wearer untillaundry is necessary when worn daily. The treatmentwithstands sun, rain, walking in wet grass, and ex-cessive sweating. Impregnated uniforms are stilleffective after being worn in swiftly running freshwater for fifteen minutes or in the ocean for thirtyminutes. Hard scrubbing with soap and cold wateror laundering in hot water removes the dimethyl
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phthalate. Treated blankets will remain effective fertwo months if unlaundered. Details are given InAppendix VI.
(2) Warning. Repellent impregnated cloth-ing, and DDT should not be used togther. The DDTwhich is insoluble in water is dissolved in the repell-ent and toxic absorption may occur. Each alone issafe.
c. Preparation of bivouac site in area wheremite-borne typhus is prevalent. Locations which areto be used as new camp sites should be prepared asfully as possible before the arrival of a new unit.Native labor should be employed whenever it is avail-able. All grass and scrub should be cut level withthe ground and, after drying, collected and burnedor hauled away. It is desirable to burn over the camparea with a power oil sprayer or flame thrower.Underbrush in adjacent jungle strips should becleared out in a similar manner.
SECTION V
Diseases of Potential MilitaryImportance
1. Filariasis is transmitted by mosquitoes. In theSouth Pacific Area this mosquito is the same onewhich is the chief vector of malaria. In other areasfilariasis is transmitted by the domestic type of mos-quito, one of which has been described in the trans-mission of dengue. In any event, measures againstthese two types of mosquitoes (the field mosquito andthe domestic mosquito) will be equally effectiveagainst filariasis.
2. Japanese B encephalitis. Little is known aboutthis disease. It is probably transmitted by Culexpipiens, a house or domestic type of mosquito withbreeding habits not unlike those described for Aedesaegypti, the vector of dengue. Similar control meas-ures are indicated.
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3. Fly-borne diseases include the dysenteries andare most common during combat operations. Duringthis period fly control measures will be undertakenby special spray teams. See Appendix V, “Exampleof Standard Operating Procedure”.
4. Flea-borne typhus, flea transmitted plague, andlouse-borne typhus are of only potential importanceand are not discussed.
APPENDIX I
Ail Organization for the Military Con-trol of Malaria and Insect Borne
Diseases in all Army Units1. Definition.
Insect-borne diseases of present or potentialmilitary importance in the Pacific Ocean Areas aretransmitted by mosquitoes, mites, flies, fleas andlice. Those of present importance are italicized.
a. Mosquito transmitted diseases include mala-ria, dengue fever, filariasis, and Japanese B enceph-alitis.
b. Mites transmit mite-borne typhus.c. Fly-borne diseases include the dysenteries.d. Fleas transmit plague and flea-borne typhus.e. Lice transmit louse-borne typhus.
2. Responsibility for control of insect-borne dis-eases.It is the responsibility of all commanders to
initiate and enforce the necessary measures to controlinsect-borne diseases within their units and unitareas. The commander or his representative willmake inspections to assure the enforcement of insect-borne disease control in his unit with particularemphasis on the use of individual protective meas-ures. The commander is charged with the timelyrequisitioning of insect control supplies. The ArmyCorps of Engineers will be responsible for the ex-
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ecution of insect control work on real property. TheArmy Air Forces will be responsible for applicationof DDT solutions by airplane to control mosquitoesand flies. See paragraph 5d (4), below.
3. Insect and rodent control details.a. All units will form in each company, battery,
squadron, or similar unit an insect and rodent controldetail to consist of one noncommissioned officer andtwo enlisted men per infantry company or a propor-tionate number for other units and detachments. Innon-medical units these details will be made up ofnon-medical personnel. Additional working partiesas may be required for effective mosquito and rodentcontrol will be assigned to aid these details. Thispersonnel will be given immediate training as detailedin Appendix 11, “A Training Program in Military Con-trol of Insect-Borne Diseases,” to qualify them toperform duties listed in subparagraph b, below.
b. It will be the primary duty of these insectcontrol details to maintain insect control within thecamp and in surrounding territory for a distance ofone mile. Where overlapping occurs between unitsthe commanding officers of these units will decidejointly on the area to be controlled by each group.These details will prepare a map showing all watercollections and places of mosquito breeding in thearea to be covered. In the preparation of this mapthey will be aided by the base or division malariaand insect control group. The following types ofinsect and rodent work will be carried on:
(1) Spray killing of adult mosquitoes includ-ing the use of DDT residual effect sprays.
(2) Larvicidal work directed against mos-quitoes, flies, and mites.
(3) Clearing of stream banks to facilitatelarviciding, minor ditching and filling,and destruction of artificial breedingplaces around camps and dumps.
(4) Minor maintenance repairs of screening.
20
(5) To assist where necessary in the controlof rodents bearing harmful insects anddisease.
4. Malaria and insect disease control officers ofunits smaller than divisions.Unit commanders of all units smaller than
divisions will designate an officer, preferably a medi-cal officer as insect-borne disease control officer. Thisofficer will be responsible for a program of instruc-tion in individual protective measures and for thetraining and work of the insect and rodent controldetails. He will maintain liaison with the base ordivision malaria and insect control group. He willrender to his commander a monthly report, prior tothe third day of the next succeeding month with aninformation copy to the base surgeon, covering thesubjects listed in subparagraph sg, below, but omit-ting subheadings (4), (5), (7), and (10).
5. Division and base malaria and insect controlgroups.Special purpose Medical Department personnel
will be attached to divisions and, as they becomeavailable, to base sections (operating in the PacificOcean Areas west of the 150th degree east longitudeor in the South Pacific Base Command,) as follows:
a. Divisions:One (1) Malariologist, MC, MOS 3138.One (1) Malaria Survey Detachment T/O & E8-500.One (1) Malaria Control Detachment T/O &
E 8-500.This attached personnel constitutes a basic
malaria and insect control group and will accompanythe division in combat and in rehabilitation. Theywill assist in the control of insect-borne diseasesunder combat conditions as well as during the garri-son phase. This personnel is in addition to presentmedical department personnel of a division and doesnot affect existing tables of organization or positionvacancies.
b. Base or garrison forces, other than divisions.
21
(1) For approximately every 20,000 garrisontroops.One (1) Malariologist, MC, MOS 3138.One (1) Malaria Survey Detachment T/O& E 8-500.
(2) For approximately every 7,500 garrisontroops.One (1) Malaria Control Detachment T/O& E 8-500. One control detachmentshould be provided for each importantpost or station.
c. These groups contain officers and enlistedmen trained in preventive medicine, entomology,parasitology, and sanitary engineering. They willwork under the immediate direction of the base ordivision malaria and insect control officer (malari-ologist) who will be responsible through the surgeonto the base or division commander for the preventionand control of insect-borne diseases.
d. The duties of the malariologist, assisted bythis personnel, will include:
(1) Participation in the training program formilitary control of insect-borne diseases(See Appendix II).
(2) Provision of estimates of the insect-bornedisease problem in base and divisionareas and also in areas of anticipatedoperations with recommendations forcontrol.
(3) Provision of specialized services such asmosquito surveys, laboratory diagnosticservice, power sprayer work, and allother measui’es within the scope of thepersonnel and equipment of these groups.
(4) Technical assistance to and integrationand supervision of the work directedagainst disease carrying insects by thefollowing personnel:
Army Engineer Corps.Army AirForces.
22
Insect control details from each com-pany or similar unit.Medical Sanitary Company.Native labor.
(5) Preparation of requisitions for insect con-trol supplies.
e. One or two additional Malaria Survey or Con-trol Detachments may be temporarily attached to adivision for the period of operation when in theopinion of the Commanding General, Pacific OceanAreas, such a measure is indicated.
f. Relation of base and division malaria andinsect control groups. During periods of assault, basemalaria and insect control groups assigned to garrisonforces will render all possible assistance to divisiongroups. After a base has been secured or when adivision is stationed at a base where there is anestablished base malaria and insect control group, theactivities of the division group will be coordinatedwith those of other groups by the base malaria andinsect control officer (malariologist).
g. Monthly and interim reports and recom-mendations of the base or division malaria and insectcontrol officers will be submitted to the base or divis-ion commander through the base or division surgeon.The monthly report will cover the following subjects:
(1) Estimation of the insect-borne diseasesituation with a statistical report andanalysis of malaria, dengue fever, mite-borne typhus, or other insect-borne dis-ease in the division or base.
(2) Status of discipline with regard to indi-vidual protection against insects.
(3) Status of atabrine suppressive therapy(when given) including number and his-tory of troops released from suppression.
(4) Summary of entomologist’s report onmosquito, mite and fly populations, rain-fall and other pertinent data.
23
(5) Summary of sanitary engineer’s report(malaria control detachment).
(6) Activities of training program for mili-tary control of insect-borne diseases.
(7) Estimation of native populations as aseed bed of malaria, dengue, filariasis,and other insect-borne diseases.
(8) Selection of camp sites and related prob-lems.
(9) Status of insect control supplies.(10) Report of investigative work and special
problems.(11) Personnel engaged primarily in malaria
and insect control.(12) Recommendations.
The December report will include in addition tothe data required for the monthly report, a resume ofthe insect-borne disease situation during the year.A copy of these monthly reports will be sent in dupli-cate through command channels to HUSAFPOA.Commanders will indorse these reports indicatingaction taken or contemplated on recommendations.
h. No duties that interfere with primary insectcontrol duties shall be assigned to members of insectand rodent control details or to personnel of base ordivision malaria and insect control groups. Trans-portation and all other authorized equipment assignedto medical composite units (malaria control and sur-vey) and to medical sanitary companies will not bediverted for other uses without approval by the com-mander of the force to which assigned.
6. Direct communication on technical matters be-tween malariologists, scientific commissions, and theSurgeon, Headquarters, United States Army Forces,Pacific Ocean Area, is authorized.
24
APPENDIX II
A Training Program in Military Con-trol of Insect-Borne Diseases
1. Unit commanders will allot in the trainingschedules sufficient time for the proper instruction oftheir troops in the prevention of insect-borne diseases.
2. Instruction for all personnel.Lectures will be given to small groups of men
by their respective medical officers on malaria, denguefever, and mite-borne typhus. Other insect-borne dis-eases will be included as indicated. All personnel willbe given initial instruction in these matters as soonas practicable. Subsequently, a review of the subjectwill be carried out once a month. On maneuvers theuse of individual protective measures will be standardprocedure. These lectures will cover:
a. Military importance of these diseases.b. Nature of these diseases, how transmitted,
and their effects.c. Individual protective measures against mos-
quitoes with emphasis on conditions under whicheach is applicable:
(1) Repellents.(2) Use of ordinary clothing for protection.(3) Bed nets.(4) Spray killing of adult mosquitoes.(5) Avoidance of unnecessary exposure.(6) Atabrine suppressive therapy.
d. Individual protective measures against mitebites.
(1) Impregnation of clothes and blanketswith dimethyl phthalate.
(2) Preparation of bivouac area.(3) Avoidance of mites.
e. Control of mosquito breeding.f. Man-made malaria. How to avoid it.
25
Additional instruction will be given to officersemphasizing command responsibility for selection ofcamp sites, for segregation of natives, and for theenforcement of individual protective measures. Mem-bers of base and division malaria and insect controlgroups will assist.
3. School for insect and rodent control details,a. A school to be conducted by the base and
division malaria and insect control groups will beheld for insect control officers and the members ofinsect and rodent control details from each companyor similar unit. This school will usually occupy threedays and the following subjects will be taught:
(1) Identification of Anopheline (“Malaria”)and Aedes aegypti (“Dengue”) larvaeand adult mosquitoes and characteristicbreeding places.
(2) Use of maps to mark breeding places.(3) Control of mosquito breeding by minor
draining and filling, by spraying withlarvicides, and by emptying or destroyingartificial water containers.
(4) Use of DDT residual sprays to impreg-nate bed nets and to spray quarters.
(5) Assembly and repair of knapsack andcontinuous hand sprayers.
(6) Impregnation of clothes with dimethylphthalate to prevent mite bites.
(7) Control of rodents by trapping and pois-oning.
(8) Fly control by the use of sodium arsenitespray and other measures.
4. A Mobile training center in military control ofinsect-borne diseases.
a. Training centers in military control of in-sect-borne diseases and other aspects of preventivemedicine will be set up from time to time by thisheadquarters at the chief staging bases, preferablyin conjunction with general hospitals or field trainingcenters. The hospitals or field training centers willprovide teaching facilities, and when necessary, quar-
26
ters and rations for faculty and students of theseschools. The following officers of all units will attenda one to two week course at a time to be designatedby this headquarters.
(1) Medical Inspectors of divisions and high-er echelons.
(2) Malaria and insect control officers (ma-lariologists),
(3) Regimental and battalion surgeons asdesignated by division surgeons.
(4) Parasitologists, entomologists and sani-tary engineers as designated by base orArmy surgeons.
The faculties will be under the supervision ofthe Surgeon, Headquarters, United States ArmyForces, Pacific Ocean Areas, and will consist of ma-lariologists, survey units, control units, and otherpersonnel with experience in the prevention of tropic-al disease, as may be available to the base commands.Additional personnel within base commands or Armygarrison forces may be placed on detached servicewith the training center for limited periods, as may-be required.
The curriculum will consist of lectures, fieldtoork, war rounds, and laboratory work.
5. To aid in this program base and division malariaand insect control groups (or base and division sur-geons) will issue the following training manuals.
a. All officers.Preventive Medicine Manual No. 2, “Militarycontrol of malaria and insect-borne diseases.”
b. Enlisted men.Preventive Medicine Manual No. 3, “Mos-quitoes, Mites, and Men.”
Additional training aids such as appropriatetraining films, literature, posters, and material willbe available at base and division malaria and insectdisease control headquarters.
27
Thefollowing
antimalariasuppliesper
1000menper
month(30days)are
authorized(CircularNo.151,
WD,1944,
asamended).Itis
recommendedthat
preparatoryto
enteringa
malariousarea,a
ninety(90)daysupplybeobtained.
Everyeffortshouldbemadeto
securetheitemslistedonthe
followingpagesbefore
leavingrearbasesforundevelopedareas,
dependingon
availabilityof
suppliesand
shipping.These
suppliesshould
alwaysbe
shippedin
dividedlotssothattheloss
ofanyone
shipmentwillnotdisrupttheprogram.
REQUISITIONFROM
MEDICALSUPPLY
APPENDIX111 Supplies
'
Supplyper
ItemNo.
Article
Unit1000
men/moRemarks
1084500Atabrine
100tabletsl-%
gr.
(QuinacrineHCL,USP)
btl
400Units
108440
Atabrine,5
amps,0.2gm,
with10cc
steriledistilled
box
4Units
water.(QuinacrineHCL)
1391000Quininesulphate,1000
tab-
lets;USP;5
gr.
btl
3Units
1389000Quinine
dihydrocholride,12
amps;NP;1
ccamp
containing5
grsolution
box1
Units
28
REQUISITIONFROM
QUARTERMASTER
ItemNo.
Article
UnitSupplyper
1000men/mo
Remarks
27-B-343Bar,insect,field
ea
83
Note1
41-D-3750Duster,
insectpowder,
plungertype
ea
5
Note2
51-1-159Insecticide,aerosol,1
lb
dispenser
ea ea
300
Note3
HawaiianDept
Supply7%/1000
menper
month. 1per10
airplanestobe
disinfectedby
ArmyAir
Forces.
51-1-305Insecticide,
spray,DDT
Residualeffect
gal
60
51-1-169 51-L-122
Insecticide,liquid,fin-
ishedsprayLarvicide,
DDT,powder,
gal
8
Foruseother
thanmos-
quitocontrol.
Note3
HawaiianDept
dusting
lb
50
Supply5/1000
menper
month.
51-1-173Insecticide,powder,
louse,
2ozcan
ea
150
Note3
HawaiianDept
Supply25/1000
menper
month.
51-L-120Larvicide,DDT,powder,
dissolving
lb
200
51-R-265Repellent,
insect,2
ozbtl.
btl
3006
Note3
HawaiianDept
Supply350/1000menper
month(normallyrequir-
edMayto
Octinclusive)
51-R-300Repellent,
insect,spray
clothing
Gal
40
Note3
29
REQUISITIONFROM
QUARTERMASTER(Continued)
REQUISITIONFROM
ARMYENGINEER
CORPS
41-S-4110 to12
Sprayer,liquid,Insect,
pumptype
ea
15
Note2
&
3
HawaiianDeptSupply
10/1000men
permonth.
41-S-4106Sprayer,
liquid,insect,
continuousspray
ea
2
percafeteria
messor
theaterbuilding.
7-0-200Oil,fuel,oil
burner,grade
FS2
gral
150
Note3
HawaiianDept
Supply10/1000
menper
month.
ItemNo.
Article
UnitSupplyper
1000men/mo
Remarks
41-7839.7-7Paris
green,standardlar-
vicide
lb
40
41-3115.5-10Duster,insect,handro-
taryblowertype
ea
3
Sparepartsfor
above
duster
set
3
Note2
&
3
41-7839.5-5Sprayers,
insect,knapsack
type,3
galcapacity
ea
10
Note2
&
3
HawaiianDeptSupply
1/1000men
permonth.
Sprayers,insect,
knapsack
type,spare
parts
set
10
Note2
&
3
HawaiianDepartmentof
Supply
1/1000menper
month.
30
�Allowancesforscreeningarenot
available.These
recommendationsare
basedon
plans
toscreen
nearlyall
tents.Enoughto
screenfieldhospitals,caringformalariaand
dengue
patientsshould
comeashorewithhospitalunits,tobefollowedassoonas
possibleby
screen
forkitchens,
messhalls,offices,
latrines,andlateralltents,inthatorderof
priority.Cloth
bobbinetteis
preferredtowireforfielduse.Wireor
plasticscreeningis
preferredwhenever
woodenmess
halls,or
otherstablesemi-permanent
buildingsaretobescreened.
Note1:
Replacementfactorper1000menper
month,appliestoArmyGround
Forcesonly.
Note2:Initial
supplyonly.
Note3:
ExceptHawaiian
Department
Note4:
Maybeissuedinlieuofcloth
bobbinettewhen
useof
permanentbuildingsis
anticipated.Replacementrate
shouldbehalfthatofclothscreening.
REQUISITIONFROM
ARMYENGINEER
CORPS(Continued)
40-9030.6-3Sprayer,insect,
portable,
gasoline,enginedrivenfor
larvicidewithfour50ft
lengthsof%
inchoilre-
sistenthoseand
spray
nozzle Parts,sparefor
above
set set
% %
Note Note2&
3
2&
3
•Screening,cloth-bobin-
ette,18-20
mesh,bar3ft
wide
ft
16,000lin.ft
Note2
•Screening,cloth-bobin-
ette,18-20
mesh,bar3ft
wide
ft
4,000lin.ft
Note1
•Screen,wire,heavy
grade,16
meshestoinch
Note4
�Screen,standardgrade,
18meshesto
inch
Note4
�Saran-plasticscreening
(DowChemicalCo.)
Note4
31
APPENDIX IV
Supplies for Insect and RodentControl Details
The following equipment should be available tothe insect and rodent control details of each battalionfrom the T/BA equipment of the unit. Smaller unitsshould have similar equipment in amount proportionalto their strength. Items not included in unit T/BA’sshould be requisitioned as indicated below (Initialissue). A motor vehicle is needed for use in bivouacarea to haul oil and other supplies, labor details, etc.
Item No. Article Unit AmountEngineer Equipment
Compass ea 174-70005-22 Machetes, w/scabbard ea 8
Paper, overlay or trac-ing, for maps Roll 1
41-3780.43-02 Funnel, iron, galvanized,plain, 2 qt ea 4Quartermaster equipmentSpigot, (valve, molasses)with approximately 2%inch male thread connec-tion to fit bung of 55 galdrum ea 4
41-A-1277 Axe, single bit, w/handle ea 370-H-1180 Brush hook, w/handle ea 2
Note book, field ea 641-M-720 Mattocks, w/handles ea 541-S-3170 Shovel, D-handles, round
No. 2 ea 341-S-3220 Shovel, long handle,
round point, No. 2 ea 3
7263000
Medical suppliesClass 7
Dipper, 1 pt ea 3
32
APPENDIX V
Example of Standing OperatingProcedure
This S.O.P. is merely a sample plan adapted toand used during one operation. All such plans shouldbe flexible. Several general plans should be preparedby each division malaria and insect control group.The exact plan and details will be determined bycurrent requirements of the particular military situa-tion.
Standing Operating ProcedureFor Control of Malaria and Other Insect-
Borne Diseases During X Operation1. Statement of Problem.
“X” operation will take place in an area wheremalaria is the fourth cause of death, where denguefever is prevalent, and where mite-borne typhus andfly-borne intestinal diseases are potent hazards. Anative population which averages over 500 per squaremile is a seed bed of disease.
2. Mounting Phase.a. All personnel will again be trained in indi-
vidual measures to protect against mosquito and mitebites. Officers will review the importance of campsiteselection to avoid proximity to infected natives andto breeding places of disease carrying insects.
b. Suppressive atabrine will be given to allpersonnel as outlined in TB Med 65, 3 July 1944,beginning three weeks before D day.
c. Bed nets of all personnel will be sprayedwith a five (5) per cent solution of DDT in keroseneas outlined in Appendix VI.
33
d. Each man will be provided with two uniformsand one blanket impregnated with dimethyl-phthalateas outlined in TB Med 121, Dec. 1944, (see AppendixVI). Measures in this and preceding subparagraphwill be carried out as short a time before embarkationas possible.
e. Each organization will be issued thirty dayssupply of the following items which will be conspicu-ously marked and carried with the organization so asto be readily available:
Sprayer, oil knapsack 1 per 100 mentypeDiesel oil No. 2, 55 gal- 1 per sprayer, oillon drum knapsack type
Repellent, 2 oz bottles 300 per 100 men
Atabrine tablets 0.1 Gm. 4000 per 100 men
Insecticide, freon-aero- 30 per 100 mensol 1 lb dispenser
A further sixty day supply of insect controlitems should be shipped in divided lots so that theloss of any one shipmentwill not disrupt the program.(See Appendix 111, Insect Control Manual No. 2).
Each individual will be provided with:Bar, mosquito or hammock, jungle, complete 1Repellent insect, 2 oz. bottle 2Atabrine tablets, 0.1 Gm. 30
3. Combat Phase.
a. Anti-mosquito measures will be carried outby airplanes and temporary spray teams as outlinedin paragraph 5, against both “malaria” and “Dengue”mosquitoes. The application of DDT solution to nativedwellings will be emphasized. This method is ofvalue because most mosquitoes become infected bybiting diseased natives and then rest in or near the
34
buildings where the blood meal is obtained. A singlespraying of such buildings with DDT not only willkill all mosquitoes in the building but will continueto kill mosquitoes as they come in contact with treat-ed walls for several months.
b. Fly control will be done when feasible byhand spraying of dead bodies and by proper care ofgarbage dumps and human waste.
c. The malariologist, with the entomologist andparasitologist, will provide the surgeon with a mos-quito survey and an estimate of the malaria anddengue hazard as rapidly as feasible after D day,with subsequent estimates as determined by currentconditions and needs.
4. The personnel to carry out malaria and epidem-ic control work during “X” operation is as fol-lows:a. Division malaria and insect control group
(attached medical department personnel).4 officers.22 enlisted men.
b. Pilots of L4B cub airplanes.2 pilots.
c. Troop unit insect and rodent control details.Enlisted men: Insect and rodent control
details of three enlisted men, including one NCO,from each of the 75 companies, batteries, or similarunits in the division.
5. Four temporary spray teams, chart I, will bedrawn from the above personnel for the periodof “X” operation as follows:a. Division headquarters spray team.
(1) Personnel4 officers.1 malariologist from attached divisionmalaria and insect control group.1 entomologist from attached divisionmalaria and insect control group.2 pilots L4B cub airplanes.
35
21 enlisted men.10 technicians from attached divisionmalaria and insect control group.11 men drawn from insect and rodentcontrol details of division Hq. Co., SignalCo., QM Co., Ord. Co., and similar units.
(2) This spray team will be attached to divis-ion headquarters company for period of operation.
b. Temporary spray team attached to each regi-ment.
(1) Personnel of each spray team will com-prise:1 officer.*24 enlisted men.4 technicians from attached divisioninsect control group.20 men: 1 from each insect and rodentcontrol detail in the regiment. Theremaining men of each insect and rodentcontrol detail will remain with theircompanies.
(2) Each regimental spray team will bequartered with its regimental headquart-ers company for the period of “X” opera-tion.
c. Duties of these spray teams.In amphibious operations these spray teams
will go ashore with the headquarters to which theyare attached and begin antimalaria and insect controlwork when the beachhead is about one mile deep. Itwill often be necessary to arm some of the men inthe spray teams to protect the remainder againstsnipers. Each team will carry out the following meas-ures in the rear of combat lines.
* The engineer and parasitologist will each beattached to a regiment for the operation. The divisionsanitary officer or other officer designated by thedivision surgeon will be attached to the third regi-ment.
36
(1) Spraying of dwellings and other tempor-ary mosquito control measures in area of headquart-ers, medical facilities, supply stations and alongcommunication lines. Fly control measures will becarried out when feasible.
(2) Initial survey and map work.(3) The division headquarters spray team
will have additional duties:(a) General supervision of malaria and
insect control program.(b) Relocation of insect control person-
nel and supplies as necessary to meetchanging conditions.
(c) Airplane spraying.d. Equipment of these spray teams.
(1) Every man will be equipped with a spray-er for DDT solution. Technicians fromdivision malaria and insect controlgroups will carry a dipper for samplinglarvae populations and preliminary spotmaps. All other men will carry a onepound aerosol dispenser. Each sprayteam will be equipped with a powersprayer.
6. Insect and Rodent Control Details EachCompany or Battery.These details are temporarily reduced in size;
one man being drawn from each detail to form thetemporary spray team (See paragraph 3). It is rarelyfeasible to do antimosquito work in frontline combat.These smaller insect and rodent control details willwork as directed by the unit insect control officer(usually the battalion surgeon) and will aid in thedistribution of repellent and other antimalaria sup-plies to the front lines. Spraying and other anti-mosquito work will be done when practicable.
7. A rear echelon insect control group will be form-ed, if indicated, by one NCO technician from division
37
insect control group and by insect and rodent controldetails in rear echelon. This group will continuelarviciding and other control work in rear echelonarea.
8. Procedure:Exact procedures will depend on local condi-
tions, the speed of the operation, and the relativeimportance of malaria, dengue, and of fly-borne dis-eases. In rear areas emphasis probably will be onlarviciding, which is worthwhile in territory to beoccupied for two weeks or more and of decreasingvalue as time of occupancy is shortened. Emphasisin more forward areas probably will be on spraykilling of adult mosquitoes and larviciding will be ofsecondary importance. The need for flexibility in thismalaria and insect control program is apparent.
a. The malariologist will supervise the entireinsect control program and will be particularly con-cerned that personnel and supplies are allocatedaccording to changing needs.
b. The entomologist will be directly in chargeof spraying and other control work in territory assign-ed to division headquarters spray team. He will beresponsible for initial survey and map work in theentire area of operation.
c. The airplane pilots will work under thedirection of the malariologist. They will beginairplane spraying as soon as it is feasible for air-planes attached to the artillery regiment to operate.
d. The temporary spray teams are formed forthe period of active operation only. As soon as con-ditions become stabilized and when designated by thedivision malariologist this personnel will return toroutine control measures. The engineer will thenresume his normal duties to supervise control activi-ties in the entire division area, the other officers willresume their usual work, and the enlisted personnelwill return to their company insect and rodent con-trol details.
38
9. Shipping and supplies.a. Each spray team will take one power sprayer,
one additional vehicle, adequate hand sprayers forall personnel, one weeks supply of DDT solutionprepared in advance, and three weeks supply of DDTpowder, dissolving, and other necessary supplies.Deck loading of these supplies will be arranged.
b. The division headquarters malaria and insectcontrol group will be responsible for shipment ofadditional DDT, the remaining vehicles, one or morepower sprayers, and all other equipment. This groupwill be responsible to have a detail to assist in storingand distribution of insect control supplies when isnecessary.
c. Supplies will go in divided shipments. Checklist of insect control supplies is given in Appendix111 and IV, Preventive Medicine Manual No. 2.
d. The L4B cub airplanes will be shipped withother planes of division artillery observation group.
10. No duties that interfere with their malaria andinsect control functions will be assigned to the abovepersonnel.
11. Individual protective measures against mos-quito-borne diseases and mite-borne typhus will becarried out by all division personnel as directed inmemorandum . . . this headquarters.
12. Regimental commanders will immediately for-ward to this headquarters a roster of enlisted menwho are assigned to temporary spray teams.
CHARTI
TEMPORARYORGANIZATIONOF
DIVISIONINSECTCONTROL
PERSONNEL
INTOFOUR
SPRAYTEAMS
FOR"X"
OPERATIONDIVISION
HEADQUARTERSSPRAYTEAM
4Officers 1
Div
Malariologist1
Div
Entomologist2
Pilotsof
L4BCub
Planes
21Enlisted
Men9
MalariaControl
Technicians12
Mendrawn
frominsectand
rodentcontroldetails
ofDivHq.Co..SignalCo.,QMCo.,etc.
I
n
1stRegiment
RegimentalSprayTeam
1
Officer(Engineer)fromDiv.Mai.Con-
trolGroup.
24Enlisted
men4
Mai.Con.
Technicians20Men:1
drawnfrom
eachinsect
and
rodentcontroldetailin
regiment.
2ndRegiment
RegimentalSprayTeam
1
Officer(Parasitologist)
fromDiv.Mai.
ControlGroup.
24Enlisted
men4
Mai.Con.
Technicians20Men.1
drawnfrom
eachinsectand
rodentcontroldetailin
regiment.
3rdRegiment
RegimentalSprayTeam
t
Officer(DivisionSanitaryOfficer)
24Enlisted
men4Mai.Con.
Technicians20Men;1
drawnfromeach
insectand
rodentcontroldetailin
regiment
I
I
.i
|
1stBattalion|
|
2ndBattalion|
|
3rdBattalion
I
T
L_
L
i
ECo
InsectAnd
RodentControl
Detail3
EnlistedMen
(1MantoReg.
SprayTeam).
PCo
InsectAnd
RodentControl
Detail3
EnlistedMen
(1MantoReg
SprayTeam).
G
Co
insectAnd
RodentControl
Detail3
EnlistedMen
(1MantoReg.
SprayTeam)
HCo
InsectAnd
RodentControl
Detail3
EnlistedMen
(1MantoReg
SprayTeam)
40
APPENDIX VI
Treatment of Uniforms with Dime-thylphthalate; Treatment of Bed Netswith D.D.T.; and Other Data on DDT,
Sodium Arsenite, and PDBI. Impregnation of uniforms with dimethylphthal-
ate.1. Materials.
The materials required to prepare sufficientemulsion to impregnate approximately 100 uniformsinclude: TVz quarts dimethylphthalate, 6 pounds GIlaundry soap (about 7 cakes), 35 gallons of water,one 55 gallon oil drum, one 32 gallon GI can or similarcontainer, a water bucket, and a GI egg-whip (wire)or suitable improvised devise for mixing.
2. To prepare emulsion.a. Cut 6 pounds of GI laundry soap (7 cakes)
into small pieces and dissolve in 10 gallons of waterby boiling in an oil drum. Then add 25 gallons ofcool water. Do not boil entire 35 gallons.
b. Pour 3 gallons of this soap solution into aGI can, and to it slowly add 7% quarts of dimethyl-phthalate, whipping vigorously to make a creamyconcentrate. Return this concentrate to the drumof soap solution and stir to make the finished emul-sion. The final product represents a 5 percent emul-sion of dimethylphthalate in a 2 percent soap solution,measuring about 37 gallons.
3. Impregnation of clothing.a. Only dry materials should be treated and
the emulsion should be stirred while garments arebeing dipped.
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b. Completely immerse clothing, shirt and trous-ers or coverall, socks (placed in trouser pockets) andleggings, in the emulsion. Wring out over a secondcontainer to save excess liquid. Hang up to dry. Theclothing is ready to be worn when dry. To facilitateinspection of personnel, a system of marking clothingto indicate impregnation and date of treatment ofthe clothing should be employed.
c. Blankets and mosquito bars may also betreated In the above manner,
d. For protection against mites, impregnationof clothing should be repeated after each laundering.For blankets, treatment at two months intervals issufficient.
e. Thorough impregnation withstands sun, rain,and excessive sweating. Vigorous scrubbing withsoap and cold water or laundering with hot waterremoves the dimethylphthalate.
4. Impregnation of clothing by spraying.When the preparation of the above emulsion is
not practicable, dimethylphthalate, undiluted, may beapplied to clothing with a “flit-gun”, knapsack spray-er, or paint-spray gun, delivering a large dropletspray. Clothing may be treated off the body andbuttoned. To apply, insert the sprayer inside thereversed garment and hold the sleeves, neck of shirt,and bottoms of trousers closed while the spray isdelivered. The clothing may be sprayed while beingworn, provided care is taken to protect the eyes andmcuth and not to breathe the spray materials. Twoto three ounces of dimethylphthalate is sufficient totreat one uniform. It is necessary to repeat theapplication after each laundering.
5. Precautions.a. Untreated shorts should be worn under treat-
ed uniforms to prevent skin irritation in the groins.No other precautions are necessary. No ill effectshave been reported from wearing treated clothing.
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b. It should be emphasized that clothing im-pregnated with dimethylphthalate does not protectexposed body surfaces from insect bites. For pro-tection of these areas, application of repellent to theskin must supplement the use of impregnated clothing.The standard two ounce bottle of insect repellent(QM Item 51-E-265) should be employed for thispurpose.
11. Treatment of bed nets with DDT,
1. Materials.The materials required to impregnate approxi-
mately 100 bed nets with DDT include:5 percent DDT in kerosene 14 gallonsPower sprayer 1or hand sprayers (knapsacktype or C. W. decontaminationtype) 3
QM Item 51-1-305 Insecticide, spray, DDT, resid-ual effect is a 5% solution of DDT in kerosene, orthis solution may be prepared by dissolving 6 lbs of51-L-120 Larvicide, DDT, powder, dissolving in 14gallons of kerosene. DDT goes into solution slowlyand all solutions should be prepared 1 to 3 days inadvance of use. Solution is aided by agitation and byplacing kerosene in warm sun.
2. Procedure.a. The bed nets should be arranged in piles.
Spray the top net on one side, reverse it to start a newpile and then spray it on the other side. Hang netsin the sun to dry.
b. Six to eight men are able to spray 150 to 200nets per hour with a power driven sprayer with twooutlets, and half this number of nets with handsprayers.
c. Mosquitoes which come in contact with atreated bed net cease to attempt to bite after a fewminutes and die after an hour or more. The durationof this residual effect is still to be determined. Wash-ing or exposure to heavy rain removes the DDT from
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the bed net. Present information is that under nor-mal conditions bed nets should be retreated every3 months. Large scale impregnation may be doneby Chemical Warfare Processing Companies.
111. Technical data on DDT.1. DDT is usually dissolved in diesel oil No. 2 or
kerosene. The amount of DDT used depends uponthe skill of labor, the type of equipment available,and on other local conditions. DDT is so effectivewhen applied by airplane sprayer that only 2 quartsper acre of a 5 per cent solution are needed. Otherequipment is less effective. Table II shows thatordinary labor applies an average minimum of 2gallons per acre of water surface with a “flit gun”type sprayer and 6 gallons per acre of water surfacewith a knapsack sprayer. This table also shows therecommended maximum and minimum concentrationsof DDT for various types of equipment. QuartermasterCorps item (51-L-120) Larvicide, DDT, powder, dis-solving, is used in these solutions.
TABLE IIRECOMMENDED CONCENTRATION OF DDT
RELATED TO OUTPUT OF EQUIPMENT
# Acre of water surface.
Recommended ConcentrationMaximum Minimum
Lbs LbsAverage DDT DDTOutput per per per per
Equipment Gal/acre # cent acre cent acre
Knapsack or C. W.DecontaminationSprayer 6.0 2.5 1.2 1.0 0.48“Flit gun” typeSprayer 2.0 5.0 0.8 2.5 0.4Airplane 0.5 10.0 0.4 5.0 0.2
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Unskilled oiling crews use larger amounts ofspray and should be given DDT solutions which ap-proach the minimum. They use smaller amounts ofspray as they become moi’e skilled and may then begiven more concentrated solutions.
2. Preparation of DDT Solutions.Table 111 shows the amount of DDT to be used
in obtaining approximate concentrations.TABLE 111
PREPARATIONS OF VARIOUS DDTCONCENTRATIONS
Measuring equipment is often scarce in the for-ward areas and the following approximations may behelpful. A number 10 food can filled to % of itstop is the equivalent of 2 lbs of DDT. DDT is usuallysupplied in 10 lb cans. Diesel oil No. 2 and keroseneare usually in 55 gallon drums from which about 5gallons may be removed before adding the DDT.Solutions should be prepared a minimum of 24 hoursand preferably several days in advance of use tofacilitate dissolving. Rolling of barrels in the sun oragitation with mechanical equipment aids in prepar-ing solutions. Agitation can be obtained by blowingair through a solution with an air compressor. Itshould be emphasized that only Larvicide, DDT,powder, dissolving is used for making oil solutions.
3. The choice of diesel oil No. 2or kerosene.Diesel oil No. 2 is used in solutions for killing
mosquito larvae and against adult mosquitoes andflies in the open. Kerosene does not leave a stickyfilm of oil and is preferable for spraying bed nets,tents, and dwellings for residual effect.
DesiredSolutionPer-cent
Number LbsLarvicide DDT,
Powder Dissolving
NumberGallons Diesel
Oil or Kerosene5 2 55 20 502.5 10 501.0 5 50
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4. DDT for insect and larvicidal dusting.Quartermaster item (51-L-122) Larvicide, DDT,
powder, dusting is a 10 per cent DDT powder. Itmay be used in the field undiluted but is usuallydiluted with 4 parts of waste flour, road dust, or otherdiluent to make a 2 per cent dust. Mixing shouldbe carefully and thoroughly done. A home mademechanical mixer is easily improvised. The nearestmalaria control unit will usually be set up to provideready mixed dust when this is indicated. Larvicide,DDT, powder, dusting is not suitable for making oilsolutions.
5. DDT louse powder for dusting individuals andbedding.
DDT louse powder is supplied as Quartermasteritem (51-1-173) Insecticide, powder, louse, 2 ouncecan. It is also supplied in bulk for mass treatment ofa louse infested population. Individual treatment isaccomplished by rubbing about V 2 ounce of lousepowder into the seams of underwear and outer cloth-ing and then dusting the bedding. Mass treatment isdone with a small plunger type duster as follows:
a. Dust the hat and replace it on the head.b. With arms extended pump the dust between
the skin and inner garments, then between all layersof clothing.
c. Insert the pump behind the neck and spraypowder between all layers of clothing.
d. Unbutton the shirt and other clothing downto the skin. Blow powder to right and left towardthe armpits and then dust the center portion of thechest,
e. Loosen the trousers at the waist, insert theduster to contact the skin and then spray into theseams and crotch. Do this to both front and back oftrousers.
Approximately iy2 ounce of Insecticide, powder,louse is required per individual by this procedure. Ateam of 2 men can dust 35 to 40 individuals and their
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bedding per hour if the individual after being sprayedhelps with his own bedding. Treated clothes mustbe worn for one week in order to kill all lice andthose which will hatch out. Otherwise the dustingmust be repeated after one week.
6. Warning.Repellent impregnated clothing and DDT should
not be used together. The DDT which is insoluble inwater is dissolved in the repellent and toxic absorp-tion may occur. Each alone is safe.
IV. Use of sodium arsenate for fly control duringcombat.A 1% per cent solution of sodium arsenite is
an effective temporary expedient for fly control whenproperly applied to dead bodies, to unburned garbage,to damaged latrines and to other sources of fly breed-ing. Sodium arsenite is supplied in a 54 per centsolution (Penite). This concentrated solution is adangerous poison and should be handled with care.One part of this solution is mixed with 40 parts offresh or salt water to make the finished spray (ap-proximately IVz per cent). A total of 1 to quartsof this dilute solution is sprayed evenly over theentire surface of each dead body and on the groundbeneath. The solution should also be sprayed ondamaged rations and on the ground of pill boxes thathave contained dead bodies. Only trained personnelshould be assigned to this work. Rubber glovesshould be worn by those working with these solutions.Spraying should be done from the windward side.V. Paradichlorobenzene (PDB) for fiy control in
covered latrines.Paradichlorobenzene is effective by virtue of a
vapor of gas which is deadly to flies and maggots. Itis most efficient in tightly closed latrine boxes. Three(3) pounds of paradichlorobenzene per 8 hole latrineshould be evenly scattered on the feces twice aweek. Further details are available in Circular No. 42,HUSAFPOA, 1944.
