USS PONCE, At Sea -- When one thinks of the dangers to military members, the kinetics of battle are what first comes to mind. Marines with 26th Marine Expeditionary Unit learned that one of the greatest dangers they may face is smaller than the eraser on a number two pencil.
The mosquito, or more specifically the cyclic disease malaria the insect can carry, kills between one and three million people annually, according to a study published in a March 2005 edition of Nature. It's a lesson well-learned by today's 26th MEU Marines. In 2003, following a Joint Task Force operation in Liberia, almost 70 Marines from 26th MEU were treated for Malaria.
“It only takes one bite,” said Cmdr. Gidget Peterson, the Combat Logistics Battalion 26 surgeon.
The vector-borne (spread by insects) disease is preventable, if certain measures are taken by each individual.
“If you are going to an area where you might get shot at, you would wear your flak and Kevlar,” said Peterson, a physician assistant. “Your DEET and pills are like individual armor for malaria.”
There are three specific instructions which prepare Marines for areas that would be likely hunting grounds for malaria-carrying mosquitoes.
Medications
The first step is taking anti-malaria medication. Depending on the anticipated time ashore, 26th MEU medical issues either doxycycline or mefloquine prior to Marines going ashore. If doxycycline is used, Marines must take it daily and continue that regimen for four weeks after they have returned to their home base or ship, according to Peterson. Mefloquine is taken weekly ashore and for four weeks upon returning. There is an additional medication, Primaquine, which they must take daily for two weeks after they have returned, regardless if doxycycline or mefloquine is taken.
Barriers
Military uniforms must be treated with Permethrin, a repellant that lasts about 30 washes. 26th MEU Marines turned in sets of uniforms for Permethrin treatment before deployment. Peterson also explained that how the uniform is worn is also extremely important.
“It’s crucial to create a physical barrier to insects by wearing your uniform properly,” she said. “Cover as much skin as possible by wearing your sleeves down. Close all openings in your clothing, tucking your undershirt into your pants, and buttoning your shirt at the neck and wrists. Lace up boots completely. Wear your uniform loosely, as mosquitoes can bite through untreated fabric that is taut against the skin.”
Another important barrier for Marines is mosquito netting. Unable to swat insects while sleeping, a Marine can rest in relative ease under a protective net issued from his Supply section.
DEET (Diethyl-meta-toluamide)
“DEET is a vapor-active repellent, so it helps to prevent insects from actually landing on your skin and subsequently biting you,” said Peterson. “The standard military DEET lotion product contains only 33-percent DEET, yet one application lasts up to 12 hours or more, depending on the climate and other environmental conditions.”
She explained that Marines should apply DEET only to exposed skin. DEET can be safely used with camouflage face paint; Marines just need to apply the DEET first, followed by the face paint. DEET can also be safely used with sunscreen. Marines need to apply sunscreen approximately one half hour to one hour prior to applying the DEET. This gives the sunscreen time to bind to the skin first. DEET may reduce the sun protection time of the sunscreen.
“One thing Marines need to remember is where they applied the DEET,” said Peterson. “If they decide to take their blouse off, Marines need to apply DEET to the newly exposed skin.”
Peterson explained that the most important aspect to prevention is for Marines to continue taking their pills after they return, as proven by Marines' experience in the past.
During Operation Restore Hope, in Somalia in 1993, there were 290 cases in U.S. Forces. Of those, 242 occurred after return to U.S., and 53 of these cases were Marines after 30 days of exposure. Malaria affected 10.6 percent of their total forces.
“Malaria is preventable," said Peterson, "and we should work to ensure that everyone is safe.”