SCOTT KUBICA
Ground Directorate
U.S. Army Combat Readiness Center
Fort Rucker, Alabama
Now that we’re firmly entrenched in the Army’s most active training period — the spring and summer months — our focus is on heat illness prevention, and rightly so. However, there are other things lurking in the training and recreation environments that also demand our attention, such as certain plants, insects and snakes, so Soldiers don’t fall victim to a preventable injury.
Plants
In most areas of the country, the woods are now covered in green foliage. Soldiers must be aware there are a few of those leafy green specimens they need to avoid; or, if they do come in contact with them, how to alleviate their effects. The three most common offenders are poison ivy, poison oak and poison sumac.
Poison ivy and poison oak are the three-leafed ground dwellers Soldiers often walk through, lay in or rub up against on a tree. Poison sumac looks like a shrub or small tree and grows in damp areas. The results of an encounter with one of these plants can render a Soldier incapacitated for a few days.
The oily sap from these plants, called urushiol, rubs off on the skin or sometimes onto the clothes. The oil is then typically transferred when rubbing sweat from the face or eyes. Urushiol can cause itching, redness, slight swelling and blisters on the skin, which tend to appear 24 to 48 hours after contact. Although the blisters can break and ooze, the fluid cannot spread the rash.
There are several ways to prevent contact with these plants. First, leaders should provide an information brief explaining how to identify hazardous plants so Soldiers can try to avoid them. Second, when in areas of known plant growth, Soldiers should refrain from rubbing their faces with their hands. Finally, if a Soldier comes into contact with one of these plants, they should change their clothes and bathe to remove the oils from their skin. Those unfortunate Soldiers who have an acute allergic reaction due to these plants should visit their medics. They will probably give them calamine lotion to dry up the blisters and prevent spreading. In severe cases, a Soldier may have to be taken to the hospital and given treatment via topical steroids such as clobetasol, or systemic steroids and antihistamines or other allergy medicines.
Insects
From the less harmful black flies, chiggers and mosquitoes to the more threatening ticks, insects become more active in the spring and summer months. Protection from these pests can come by way of different DEET-containing lotions and sprays to uniforms impregnated with permethrin. Most of these insects can cause minor itching due to the reaction to the bite, which can be treated with topical Benadryl or other anti-itching creams. There are some cases where people get numerous bites and then scratch them until they become raw and infected, resulting in the need for medical treatment.
Mosquitoes are known carriers of West Nile Virus. Fortunately, most people infected with WNV will have no symptoms. However, about 1 in 5 people will develop a fever with other symptoms. Less than 1 percent of those infected develop a serious, sometimes fatal, neurologic illness. For the most part, though, these insects are little more than just a nuisance.
On the other hand, the tick can cause much more of an issue if you are bitten by an infected vector. Ticks can carry Colorado tick fever, ehrlichiosis, Lyme disease, Rocky Mountain spotted fever, southern tick-associated rash illness and tularemia. While not all ticks are infectious, it’s better to be safe than sorry. If you find an embedded tick on your body, see your medical personnel and have them remove it and send it to the lab for diagnosis. If the diagnosis comes back positive, a doctor will then prescribe the proper medical treatment.
With the introduction of the permethrin-treated ACU, the Army has provided a product that will enhance force health protection and readiness. A single factory treatment with permethrin offers significant benefits to the wearer, including increased protection against the bites of mosquitoes, flies, midges, ticks and chiggers for the life of the uniform. The permethrin-treated ACU protects Soldiers from insect- and tick-borne diseases while in garrison, training and noncombat deployed environments worldwide.
Wearing permethrin-treated uniforms is a key component of the DOD Insect Repellent System. Soldiers wearing the uniform should continue to properly protect themselves against insect bites and diseases by wearing it with the sleeves rolled down, closing all openings that might let in insects, tucking pants into boots and the undershirt into pants, and keeping the uniform loose. For more than 20 years, the DOD Insect Repellent System has been proven to be highly effective in preventing biting insects from becoming an annoyance or making Soldiers sick.
Snakes
Lastly, there are those creatures that slither on the ground. Snakes become more active as the days heat up. Ensure Soldiers get briefed to avoid snakes and are taught to identify poisonous varieties that may frequent training areas. In the event a Soldier is bitten, it’s a good idea to identify the snake if at all possible. This will greatly assist medical personnel in their treatment plan. Most snake bites won’t kill a person, but they can make them sick, so it’s best to get treated immediately in order to minimize the severity.
Some poisonous snakes found in North America, such as the copperhead, rattlesnake and water moccasin, have venom consisting of neurotoxins that affect the nervous system and brain. The coral snake, the most poisonous, has hemotoxin, which affects the heart and cardiovascular system. The bottom line is if you see a snake, leave it alone! Soldiers must be proactive and check sleeping areas and sleeping bags before settling in for the night. “Jake the snake” has been known to slither into sleeping bags during the day to escape the heat.
Conclusion
As the temperatures warm up and you get out to train or enjoy some much-needed recreation, make sure to take those preventive measures to keep everyone safe from those warm weather woes!
Zika Virus: What is it? What can you do?
KIRK FRADY
U.S. Army Medical Command
Fort Sam Houston, Texas
What is it, where is it and how is it spread?
Zika is a mosquito-borne virus closely related to yellow fever, dengue and West Nile viruses. A Zika virus outbreak was identified in Brazil in early 2015. Since then, it has spread to more than 25 other countries in Central and South America and the Caribbean. The Centers for Disease Control and Prevention issued a Level 2 Travel Alert (Practice Enhanced Precautions) for areas where Zika virus transmission is ongoing. This includes the recommendation that women who are pregnant, or trying to become pregnant, consider postponing travel to any area where Zika virus transmission is ongoing.
What can I do to prevent catching it?
The best way to prevent diseases spread by mosquitoes is to avoid being bitten. There is currently no vaccine for Zika. Mosquitoes that spread Zika bite mostly during the daytime and prefer to bite people; they live indoors and outdoors near humans. The best prevention is to minimize standing water in items like buckets, bowls, animal dishes, flower pots and vases.
What if I am pregnant or want to become pregnant?
If you are pregnant and plan to travel to an area with ongoing Zika virus transmission, consider postponing travel until after delivery. If you are pregnant and traveled to an area with ongoing Zika virus transmission, your provider can arrange for testing to see if you were infected, even if you never experienced symptoms. If you are not yet pregnant, there is no evidence that Zika infection prior to conception poses a risk for any future pregnancies.
If you think you've been infected, what should you do?
If you think you may be infected, see your primary care provider immediately. If you have recently traveled abroad, tell your healthcare provider when and where you traveled. Your healthcare provider may order blood tests to look for Zika or other similar viruses like dengue or chikungunya.
What are the symptoms?
- About 1 in 5 people infected with Zika virus become ill (i.e., develop Zika).
- The most common symptoms of Zika are fever, rash, joint pain or conjunctivitis (red eyes). Other common symptoms include muscle pain and headache. The incubation period (the time from exposure to symptoms) for Zika virus disease is not known, but is likely to be a few days to a week.
- The illness is usually mild with symptoms lasting for several days to a week.
- Zika virus usually remains in the blood of an infected person for a few days but it can be found longer in some people.
- Severe disease requiring hospitalization is uncommon.
- Deaths are rare.
Treatment
- There is no current vaccine available to prevent Zika infections.
- There is no specific treatment for Zika infections; instead, treat the symptoms.
- Your healthcare provider will recommend supportive treatment such as rest and rehydration.
- If you have Zika, prevent mosquito bites for the first week of your illness.
- During the first week of infection, Zika virus can be found in the blood and passed from an infected person to another mosquito through mosquito bites.
- An infected mosquito can then spread the virus to other people.
What are the Army and DOD doing?
Department of Defense labs are enhancing techniques to test mosquitoes for Zika. Southern Command is offering voluntary relocation out of affected areas to all pregnant DOD employees and beneficiaries, and all Army medical facilities have been notified of the concerns surrounding Zika infections and are prepared to assist patients who may have been infected. The Armed Forces Pest Management Board recommends wear of permethrin-treated uniforms/clothing, use of approved insect repellent and removal of standing water that may serve as mosquito breeding sites to prevent bites.
Editor’s note: This article is being republished with permission from the author.