Medical Entomology in the U.S. Army: A Historical Perspective

Military Entomology History

• Armies in the field often lived in squalor with inadequate shelter, food, and water.

• Many conflicts were brought to a halt not by superior force but by insects and the diseases they transmit.

• 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 Army

Battle Injuries (BI) Disease Non Battle Injuries (DNBI)

Arthropod Borne Diseases

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

Spanish American War

280,564 369 2,061 Typhoid, malaria

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

• Military medical entomology got its start when MAJ Walter Reed showed that yellow fever was transmitted by mosquitoes.

• With the identification of insects as the cause of disease the need to find ways to mitigate their impact became a military issue.

• Major William Gorgas was the first to successfully control mosquitoes with his efforts in Havana and the Panama Canal.

Military Entomology World War I

• By World War I, the connection between insects and disease was well established.

• Entomologists (6-8) were commissioned as officers in the Sanitary Corps.

• Over 9,600 cases of malaria occurred in troops training in the southern U.S.

• 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

• Sanitary Corps moved to the Organized Reserves from Active Duty.

• 14 entomologist were commissioned in the Sanitary Corps.

• The War Department recognized the need for malaria control and began efforts to develop improved control methods and a true malaria prophylactic.

• 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

• 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.

• The Army recognized the importance of controlling vector-borne disease and began commissioning entomologists, with many more serving as enlisted soldiers.

• 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 Fever

130 12 92.3

Epidemic typhus 100 0 0.0

Post WWII

• The Army continues to commission entomologists with around 60 serving on Active Duty and around 35 in the Reserves.

• Entomologist serve in many capacities and have many unique opportunities.

Army Entomology Today

• Mission: To prevent arthropod-borne disease in Soldiers, their families, and other individuals for whom the Army is responsible.

• Plan, direct, and evaluate comprehensive integrated pest control programs.

• Conduct surveillance for medically important pests.

• Identify insects and other zoological specimens.• Provide disease vector risk assessments for

geographical areas.

Recent Disease and non-Battle Injuries Rates (DNBI)

• 1991 Gulf War 6.5 %• OJE (Bosnia) 7.1%• OJG (Kosovo) 8.1%• OEF (Afghanistan) 5%• 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

• Provide support across the entire public health spectrum to service members during field operations.

• Units composed of 13 soldiers who support a large area.

• Entomologist can serve as the Executive Officer (XO) or Commander.

• Lieutenant and Captains serve as XO’s• Senior Captains and Majors are Commanders

Center for Health Promotion and Public Health (CHPPM)

• CHPPM provides health promotion and public health leadership and services in support of the Military.

• Entomologists are located at all 6 CHPPM locations worldwide.

• Junior entomologists gain valuable experience in a variety of entomology areas and provide support services to requesting customers.

• Senior entomologist provide experience and expertise to customers while mentoring the junior entomologists.

Entomology Teaching

• Entomologists serve as instructors at the AMEDDC&S where they help train preventive medicine technicians, pest control personnel, and incoming AMEDD officers.

• Entomologists maybe assigned to the AMEDDC&S after obtaining experience as an Army entomologist.

• 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

• There are opportunities for Army entomologist to conduct research to protect the war fighter from arthropod borne-disease threats.

Staff Positions

• 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

• Army entomology is by no means a narrow specialty. You will be challenged by unique situations:– Providing entomological support during disaster relief efforts in

both the United States and foreign countries.– Providing technical assistance for civil affairs agricultural

projects in nation building efforts.– Assisting in developing vector surveillance and pest control

programs in developing nations.– Assisting in an arthropod-borne disease outbreak investigation.

• You will be afforded many opportunities expand personally and professionally as you meet new challenges.

Questions?