One of the most significant modern day efforts to prevent and control an arthropod-borne disease during a military deployment occurred when a team of U.S. military entomologists led efforts to characterize, prevent, and control leishmaniasis at Tallil Air Base (TAB), Iraq, during Operation Iraqi Freedom. Soon after arriving at TAB on 22 March 2003, military entomologists determined that 1) high numbers of sand flies were present at TAB, 2) individual soldiers were receiving many sand fly bites in a single night, and 3) Leishmania parasites were present in 1.5% of the female sand flies as determined using a real-time (fluorogenic) Leishmania-generic polymerase chain reaction assay. The rapid determination that leishmaniasis was a specific threat in this area allowed for the establishment of a comprehensive Leishmaniasis Control Program (LCP) over 5 mo before the first case of leishmaniasis was confirmed in a U.S. soldier deployed to Iraq. The LCP had four components: 1) risk assessment, 2) enhancement of use of personal protective measures by all personnel at TAB, 3) vector and reservoir control, and 4) education of military personnel about sand flies and leishmaniasis. The establishment of the LCP at TAB before the onset of any human disease conclusively demonstrated that entomologists can play a critical role during military deployments.

One of the most signiÞcant modern day efforts to prevent and control an arthropodborne disease during a military deployment occurred when a team of U.S. military entomologists led efforts to characterize, prevent, and control leishmaniasis at Tallil Air Base (TAB), Iraq, during Operation Iraqi Freedom. Soon after arriving at TAB on 22 March 2003, military entomologists determined that 1) high numbers of sand ßies were present at TAB, 2) individual soldiers were receiving many sand ßy bites in a single night, and 3) Leishmania parasites were present in 1.5% of the female sand ßies as determined using a real-time (ßuorogenic) Leishmania-generic polymerase chain reaction assay. The rapid determination that leishmaniasis was a speciÞc threat in this area allowed for the establishment of a comprehensive Leishmaniasis Control Program (LCP) over 5 mo before the Þrst case of leishmaniasis was conÞrmed in a U.S. soldier deployed to Iraq. The LCP had four components: 1) risk assessment, 2) enhancement of use of personal protective measures by all personnel at TAB, 3) vector and reservoir control, and 4) education of military personnel about sand ßies and leishmaniasis. The establishment of the LCP at TAB before the onset of any human disease conclusively demonstrated that entomologists can play a critical role during military deployments. KEY WORDS sand ßies, leishmaniasis, Iraq, surveillance, controlIn this article, we provide an overview of the general situation that the U.S. Military encountered at Tallil Air Base (TAB), Iraq, in March 2003 and discuss the factors that led to the establishment of a Leishmaniasis Control Program (LCP) at TAB. We also describe each of the four main components of the LCP (vector surveillance, personal protective measures [PPM], sand ßy and reservoir control, and soldier education). Although brief summaries of this program have been published separately (Coleman et al. 2004;2005), we believe that it is important to provide a comprehensive overview of one of the most signiÞcant modern day efforts to prevent and control an arthropod-borne disease during a military deployment. Although much of this article relies on anecdote, we believe that this information has both scientiÞc as well as historical value. In the series of articles to follow, we will provide detailed results about the speciÞc components of the program, including: 1) the general biology of phlebotomine sand ßies at TAB, 2) our evaluation of a variety of surveillance devices for the collection of sand ßies, 3) the impact of environmental conditions on sand ßy activity, 4) the efÞcacy of a variety of area spray measures on sand ßy abundance, 5) the efÞcacy of a variety of residual spray measures on sand ßy abundance, 6) testing of sand ßy populations for the presence of Leishmania parasites and the genetics of Leishmania parasites isolated from sand ßies, 7) our evaluation of PPM as a means of protecting soldiers from sand ßy bites, and 8) our overall evaluation of the risk of leishmaniasis at TAB and the efÞcacy of the ...

CDC miniature light traps were used to evaluate the general biology of phlebotomine sand ßies from April 2003 to November 2004 at Tallil Air Base, Iraq. Factors evaluated include species diversity and temporal (daily and seasonal) and geographic distribution of the sand ßies. In addition, the abundance of sand ßies inside and outside tents and buildings was observed. In total, 61,630 sand ßies were collected during 1,174 trap nights (mean 52 per trap, range 0 Ð1,161), with 90% of traps containing sand ßies. Sand ßy numbers were low in April, rose through May, were highest from mid-June to early September, and dropped rapidly in late September and October. More than 70% of the sand ßies were female, and of these sand ßies, 8% contained visible blood. Phlebotomus alexandri Sinton, Phlebotomus papatasi Scopoli, Phlebotomus sergenti Parrot, and Sergentomyia spp. accounted for 30, 24, 1, and 45% of the sand ßies that were identiÞed, respectively. P. alexandri was more abundant earlier in the season (April and May) than P. papatasi, whereas P. papatasi predominated later in the season (August and September). Studies on the nocturnal activity of sand ßies indicated that they were most active early in the evening during the cooler months, whereas they were more active in the middle of the night during the hotter months. Light traps placed inside tents with and without air conditioners collected 83 and 70% fewer sand ßies, respectively, than did light traps placed outside the tents. The implications of these Þndings to Leishmania transmission in the vicinity of Tallil Air Base are discussed.

We evaluated the effectiveness of commercially available light traps and sticky traps baited with chemical light sticks for the collection of phlebotomine sand flies. Evaluations were conducted at Tallil Air Base, Iraq, in 2003. In an initial study, a Centers for Disease Control and Prevention (CDC)-style trap with UV bulb collected significantly more sand flies than did an up-draft CDC trap, a standard down-draft CDC trap (STD-CDC), or a sticky strap with a green chemical light stick. In a subsequent study, we found that the addition of chemical light sticks to sticky traps resulted in a significant increase in the number of sand flies collected compared with sticky traps without the light sticks. These data indicate that 1) the CDC light trap with an UV bulb is an effective alternative to the standard CDC light trap for collecting phlebotomine sand flies in Iraq, and 2) that the addition of a chemical light stick to a sticky trap can result in a field-expedient tool for the collection of sand flies.

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