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Appendix A

Contents

APPENDIX A

Standard Operating Procedure for Control of Malaria and Other Insect-Borne Diseases During a Combat Operation1

    This Standard Operating Procedure is merely a sample plan adapted to and used during one operation. All such plans should be flexible. One division malaria control group had 4 general plans calling for various degrees of decentralization, the exact plan and details used to he determined by the particular situation.

1. STATEMENT OF PROBLEM

    The target for the operation is an area where a flea, louse, and parasite infested native population of several hundred persons per square mile is a seed-bed of disease. Fly-borne and water-borne intestinal diseases are likely to be the most immediate disease hazards. Native food is contaminated by the use of human feces for fertilizer and should not be eaten. Dengue fever, malaria and mite-borne typhus are potential dangers. Schistosomiasis (blood fluke disease) adds to the risk of drinking or bathing in untreated water.

2. MOUNTING PHASE

    a. All personnel will again be trained in individual measures to protect against mosquito and mite bites. Water and food discipline will be emphasized. Fly control measures will be reviewed, particularly the use of DDT solutions and of sodium arsenite solutions to spray corpses. Officers will review the importance of campsite selection to avoid proximity to infected natives and to breeding places of disease carrying insects.

    b. Bednets of all personnel will be sprayed with a five (5) percent solution of DDT in kerosene.

    c. Each man will be provided with 2 uniforms and 1 blanket impregnated with dimethyl phthalate as outlined in TB Med 121, dated December 1944. Measures in b and c will be carried out in as short a time before embarkation as possible.

    d. Immunization records will be checked and the necessary booster doses will be given.

    e. Suppressive atabrine will be given to all personnel as outlined in TB Med 65, dated 3 July 1944, beginning 3 weeks before D-day.

    f. Each individual will be provided with:
            Bar, mosquito or hammock, jungle, complete..................................1
            Repellent insect, 2 oz. bottle............................................................2
            Atabrine tablets, 0.1 Gm...............................................................30
            Insecticide, powder, louse, 2 oz. can...............................................1

1 Variations of this SOP were published three times in the South Pacific Area Malaria Training Manual No. 2. revised October 1944; in Preventive Medicine Manual No. 2, HUSAFPOA March 1945; and in the Journal of Military Medicine in the Pacific, September 1945--of which the last and simplest is reproduced

    g. Each organization will be issued 30 days supply of the following items which will be conspicuously marked and carried with the organization so as to be readily available:
            Insecticide, powder, louse, 2 oz. can.................................................100 per 100 men
            Repellent, 2 oz. bottles......................................................................800 per 100 men
            Sprayer, liquid, insecticide, continuous spray, 2 quart.............................1 per 100 men
            Sprayer, oil knapsack type....................................................................1 per 100 men
            Diesel oil, No. 2, 55 gallon drum with 5% DDT added...........................1 per sprayer oil knapsack type
            Atabrine tablets, 0.1 Gm..................................................................4000 per 100 men
            Insecticide, freon-aerosol, 1 lb. dispenser.............................................30 per 100 men

3. COMBAT PHASE

    a. The malariologist, with the entomologist and parasitologist will provide the surgeon with an insect survey and an estimate of the malaria and insect-borne disease hazard as rapidly as feasible after D-day, with subsequent estimates as determined by current conditions and needs.

    b. Fly control will be done by hand spraying of dead bodies, with 5 per cent DDT solution or with 1 per cent sodium arsonite solution, and by proper care of human waste and garbage.

    c. Anti-mosquito measures will be carried out by temporary spray teams as outlined in par. 4. The application of DDT residual effect solution to native dwellings will be emphasized.

    d. Airplane spraying of DDT will be available about D plus 10. Requests for airplane spraying will be forwarded to the surgeon and will describe the area to he sprayed with an accompanying contour map or grid map. The nature of the insect problem with exact entomological data should be given and an estimate of the need for repeat spraying.

4. TEMPORARY SPRAY TEAMS FOR EACH REGIMENT

    a. Each regimental commander will immediately form a temporary spray team comprising 20 men, one man drawn from the insect and rodent control detail of each company. These spray teams will be assisted by 2 technicians, who will be temporarily attached from the Malaria Survey and Control Detachment assigned to Army, Corps or Division. Each regimental spray team will be quartered with its regimental company for the combat period. The work of these spray teams will be supervised by the Divisional Medical Inspector and by personnel from Malaria and Insect-Borne Disease Control Groups.

    b. Duties of These Spray Teams:

    In amphibious operations these spray teams will go ashore with the headquarters to which they are attached and begin fly and mosquito control work. Each team will carry out the following measures in the rear of combat lines.

            (1) Fly Control. Dead bodies will he sprayed with 5 percent DDT solution or 1 percent sodium arsenite solution. Straddle trenches and pit latrines will be sprayed with 5 per cent DDT at the rate of 1 pint per-hole twice a week.
            (2) Spraying of dwellings and other temporary mosquito control measures in areas of headquarters, medical- facilities, supply stations and along communication lines.

    c. Equipment of These Spray Teams.

    Every man will he equipped with a sprayer for DDT solution. Technicians from Division malaria and insect control groups will carry a dipper for sampling larva populations and preliminary spot maps. Each spray team will carry one weeks supply of DDT solution prepared in advance and 3 weeks supply of DDT powder, dissolving. Each spray team should be equipped with a power sprayer.

    d. The Temporary Spray Teams are formed for the period of active operation only. As soon as conditions become stabilized and when designed by the division surgeon, this personnel will return to routine control measures of the company insect and rodent control details.

    e. No duties that interfere with their malaria and insect control functions will be assigned to the above personnel.

    Individual protective measures against mosquito-borne diseases, mite-borne typhus, and schistosomiasis will he carried out by all division personnel as directed.

    1Variations of this SOP were published three times--in the South Pacific Area Malaria Training Manual No. 2, revised October 1944; in Preventive Medicine Manual No. 2, HUSAFPOA, March 1945; and in the Journal of Military Medicine in the Pacific, September 1945--of which the last and simplest is reproduced.