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Appendix B

Contents

APPENDIX B

Directive on Malaria Control

HEADQUARTERS

UNITED STATES ARMY FORCES IN THE FAR EAST

FEMC: 710
A.P.O. 501
18 APRIL 1943

SUBJECT: Sanitary and Prevention Measures for the Control of Malaria

TO:     Commanding General, Sixth Army, APO 442.
           Commanding General, Fifth Air Force, APO 925.
           Commanding General, U.S.A. S.O.S., APO 501.

    1. The following anti-malaria measures are published for the information and guidance of all United States Army troops now serving in or destined for malarious areas:

        a. Prior to movement of a command into a malarious area the following anti-malaria measures will be made effective:

            (1) All available information bearing on health in the area will be collected and evaluated in order to determine the probable effect of these factors on the sickness rate of the troops. Special note will be made of the prevalence of malaria and other insect and water-borne diseases.

            (2) Where the military situation permits, especially trained medical personnel will be dispatched in advance of the troops to make a health survey of the area. Results of this survey will form a basis for estimating the relative health hazards of different locations under consideration for occupation or proposed tactical operations.

            (3) There will he attached to the staff of the commander, a malariologist or a medical officer especially qualified in tropical diseases, to advise the commander concerning the relative malaria hazards of various proposed camp and bivouac sites, and to inspect and supervise the anti-malaria work and discipline throughout the command.

            (4) When the nature of the tactical operation permits, the organization will have attached to it malaria survey and control units.

           (5) All commanding officers will take measures to form anti-malaria details in each company, squadron or smaller unit and will provide for the training of these details in anti-malaria work. Details will be made up on the basis of one (1) N.C.O. and two (2) enlisted men per infantry company, and a suitable proportionate number for each smaller unit or detachment. The routine anti-malaria work in each unit area will be done by these details, augmented, if necessary, by additional personnel. The unit commander will be responsible for the anti-malaria work as advised by the attached medical officer.

            (6) All military personnel will he thoroughly trained prior to departure in carrying out the anti-malaria measures.

            (7) Each individual will have in his possession the following items of anti-malaria supplies and equipment:

                    Bar, mosquito, or hammock, jungle complete
                    Headnet, mosquito
                    Gloves, Mosquito
                    Repellent, mosquito--2 oz. bottle
                    Atabrine, tablets, 0.1 gm. (1 1/2 grams) --30

        (8) Each organization will be issued the following one months maintenance stocks:
                    Bars, mosquito.......................................................................25 per 100 men
                    Headnets, mosquito................................................................10 per 100 men
                    Gloves, mosquito....................................................................10 prs per 100 men
                    Repellent mosquito................................................................400 2-oz. bottles per 100 men
                    Atabrine, tablets.....................................................................0.1 gm. - (1 1/2 grams) 3,000 tablets per 100 men for suppressive treatment

    Equipment:
                Sprayer, hand, insecticide                                                            10 per each 100 men
                Sprayer, knapsack type                                                                1 per each 200 or less men
                Malariol (or Diesel Oil No.2)                                                        1 drum 50 gallon U.S. per sprayer, knapsack
                Insecticide, for use in hand sprayers                                              5 gallons U.S. per 100 men

    These unit anti-malaria supplies will be conspicuously marked and must be carried in a readily accessible place on the ship, to be available immediately upon arrival.

        (9) Suppressive Treatment (see b.(3)).

    b. Anti-Malaria Measures for Military Personnel in Malarious Areas.

        (1) Unit commanders will be held responsible for the enforcement of anti-malaria measures in their command. They will direct the attached medical officers to, give regular and frequent instructions to the personnel of the command on malaria control measures as well as other phases of hygiene and sanitation. The dates, number of hours, and subjects covered in all instructions will be reported in the monthly sanitary reports.

        (2) In these units in which anti-malaria details have not been organized, steps will he taken promptly to designate and train such details in accordance with the provisions of paragraph a. (5).

        (3) Suppressive treatment will be taken commencing one week prior to arrival in a malarious area and will continue under careful supervision while in the area and for four weeks after return to a non-malarious area. Treatment in highly malarious areas will consist of one tablet of atabrine 0.1 gm. once daily, six days a week, taken at mealtime with a drink of water. For troops stationed in areas specifically designated by the Chief Malariologist as mildly malarious, the suppressive dose of atabrine will be one tablet 0.1 gm. (1½ grains) twice daily on two days a week, allowing a two or three day interval between days of medication. Suppressive treatment will be supervised by a commissioned officer to insure that each soldier actually swallows the medication.

        (4) The selection of camp and bivouac sites will be made so as to avoid if possible:
                (a.) Proximity to native villages or camps.
                (b.) Areas known to have a heavy population of malaria-carrying mosquitoes.

        (5) Individual protective measures will be carried out as follows:

                a.) The wearing of shorts, and shirts without sleeves is prohibited. Work details may during daylight hours work without shirts when so authorized by the officer in charge of the detail. All troops will wear their shirt sleeves rolled down from sunset to sunrise. Leggings will be worn to protect ankles and legs from mosquito bites and from injuries leading to tropical sores.

                b.) All personnel will be required to sleep under mosquito nets. Unit commanders or their representatives will instruct the troops in the proper use of sleeping nets; and by frequent inspections at night will see that the nets are efficiently used.

                c.) Mosquito headnets and gloves will be worn while on guard duty or other night work whenever this is possible. Officers and men who, because of their work are unable to wear gloves and headnets, will cover all exposed skin surfaces with repellent. The repellent must be re-applied every few hours to be effective.

            (6) Anti-mosquito measures as follows, will be initiated upon arrival in malarious area
 
                (a) Hand killing of engorged mosquitoes will be done daily in each tent and hut within the area.
                (b) Each tent, hut, or sleeping place will be sprayed daily with insecticide to kill the infected mosquitoes.
                (c) Breeding places for mosquito larvae within half a mile radius of the camp site will be drained, filled or oiled by the unit anti-malaria detail. Especial attention will be directed to standing water in man-made excavations, wheel ruts, coconut shells, cans, and other containers. It is the responsibility of the commanding officer to see that the program for the destruction of breeding places is efficiently carried out.

    2. Existing instructions issued by the U.S. Army commands will be revised to conform in detail to the above.

By command of General MACARTHUR.

s/ L. S. OSTRANDER
t/ L. S. OSTRANDER
        Adjutant General.

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