BUMEDINST 6230.16 Flashcards
Malaria is one of the most deadly diseases in tropical and subtropical regions.
Forty
percent of the world is endemic for malaria leading to approximately 500 million cases and over one million deaths annually, per references (b).
(b) World Health Organization. World Malaria Report. Geneva: World Health
Organization, 2012
In 2003, a Marine Expeditionary Unit (MEU) on emergent tasking to
Liberia suffered a 44% attack rate (69 of 157 spending nights ashore) and an attack rate of 28%
overall (80 of 290 who went ashore).
All cases should be reported through the chain of command in order
to ensure Command Surgeons/Operational Commanders are aware of any developing malaria
threats to their operations and forces.
Medical personnel deploying or preparing to deploy should refer to the
relevant plans for locality specific malaria prevention and control guidance.
Medical planners or unit medical personnel should obtain access to the
National Center for Medical
Intelligence (NCMI) website for current Department of Defense (DoD) risk estimates of the malaria burden in
planned area of operations or deployments.
The Navy Marine Corps Public Health Center (NMCPHC) Pocket Guide to Malaria
Prevention and Control, reference (d), provides a compact reference for medical support to Navy
and Marine Corps operations in malarious zones.
Commanders are responsible for protecting the health of the persons in their charge and to obtain advice from their medical
personnel.
Command enforcement is best conducted at the junior officer and petty officer/staff
noncommissioned officer (SNCO) level, with the support of the senior enlisted, executive officer
(XO) and CO.
MTF’s may issue 30 to 60 day supplies of
standard malaria chemoprophylaxis for individual travel or small detachment unit travel on a
case by case basis (as medical treatment facility (MTF) pharmaceutical funding allows).
To the greatest extent possible medical record should document malaria
chemoprophylaxis, pharmaceutical issue, adverse reactions, or malaria treatment.
Prior to deployment, Medical Department shall screen the records of all deployers in
order to identify and evaluate all G-6-PD deficient individuals and determine their need for
special chemoprophylaxis and treatment protocols when traveling, transiting through, or deploying to malaria-risk areas.
Provide a Medical Event Report (MER) for all suspect or confirmed malaria cases to the Navy
and Marine Corps Public Health Center using the Disease Reporting System internet (DRSi).
A malaria MER should include information on
chemoprophylaxis (medication(s) ordered, number of pills ordered), length of travel in malaria
risk area, potential countries of exposure, and circumstances surrounding exposure (whether duty
related, personal protective measures used, etc).
Obtain a complete history of travel for the 6 months prior to illness.
Individuals that live in malarious areas for several years may develop “limited” immunity.
Mefloquine (Lariam) may cause psychiatric symptoms when used for malaria prophylaxis.
Only use Mefloquine (Lariam) if malarone and doxycycline have been ruled out.
It is a contraindication for use with those who have a history of seizure disorder and specific neurologic /behavioral disorder.
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