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11 diapositives · 293 Views · Aug 21, 2014

Vector-borne and zoonotic pathogen diagnostic needs for U.S. Navy Entomologists Deployed in support of the U.S. Marine Corps Craig A. Stoops LCDR MSC USN Navy Entomology Center of Excellence. Disclaimer.

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  1. Vector-borne and zoonotic pathogen diagnostic needs for U.S. NavyEntomologists Deployed in support of the U.S. Marine CorpsCraig A. StoopsLCDR MSC USNNavy Entomology Center of Excellence

  2. Disclaimer The views expressed in this presentation are those of the author and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the U. S. Government

  3. Testing Needs - Pathogens Malaria Dengue Chikungunya Leishmaniasis Rickettsia Schistosomiasis

  4. Importance Value Timeliness Impact on decision loop Contractors/Local Nationals/TCNs Humanitarian Missions (coordinating with host nation governments)

  5. Issues Division/Group/Regimental/Battalion Surgeons Will not impact combat operations Varying levels of trust in rapid diagnostics within physician community Will not be used for diagnosis in most cases Could be used to screen

  6. Camp Ramadi Would leish or sand fly fever rapid tests been helpful on Camp Ramadi? 81st Regimental Combat Team Regimental Combat Team 6 Combat Logistics Battalion 4 Rogues gallery of HTT/Special OPS/OGA KBR LNs and TCNs

  7. Hypothetical Example Patients with symptoms were screened with test kit Positives were placed on SIQ status. Number of patients set to trigger full quarantine Big risk of quarantining healthy patients taking them out of the fight Big risk of waiting too long and not being able to contain the outbreak

  8. Example What to do about the Contractors, Local Nationals and TCNs? Communication up and down chain of command from Division and Group of how to solve local problems is difficult

  9. Positives/Negatives Would a negative result stop surveillance and control OPS? What is worse – False Positive or Negative? Presenting a negative result to the chain of command. Guidance needed.

  10. False Positives Must rigorously test kits in areas of low endemicity where chance of a false positive is greater NAMRU-2 tested 6681Anopheles spp. From across Indonesia Five positives confirmed with ELISA Confident that there were no false positives

  11. Conclusion Entomologists should continue surveillance and control ops even without diagnostics Regional intelligence estimates or published reports are not enough. Since vector-borne diseases are focal – information on what is happening on your base or in your battlespace will be essential Diagnostics will provide area specific information on very focal pathogen presence/absence