Dr. Gissella Vasquez, deputy director of the Entomology Department at the U.S. Naval Medical Research Unit No. 6 inspects a vector trap at Soto cano Air Base, Honduras, Aug. 11, 2017. The Joint Task Force-Bravo Medical Element,NAMRU- 6 and the Uniformed Service University of the Health Sciences partnered for an ongoing tropical disease study in Trujillo and Soto Cano Air Base early August, testing live samples and collecting vectors that could be potential carriers for diseases. (Photo by Maria Pinel )
Malaria, leishmaniasis, dengue, chikungunya and zika are infectious diseases affecting millions in South, Central America and the Caribbean where hundreds of service members are deployed to yearly.
The Joint Task Force-Bravo Medical Element, the U.S. Naval Medical Research Unit No. 6 and the Uniformed Service University of the Health Sciences partnered for an ongoing tropical disease study in Trujillo and Soto Cano Air Base early August, testing live samples and collecting vectors that could be potential carriers for diseases.
The team, comprised of preventive medicine personnel, entomologists and students of the tropical medicine program, collected samples from August 6-11 in Trujillo, a red zone for malaria and leishmaniasis in Honduras, and later continued their gathering at Soto Cano Air Base the following week.
“These are diseases that could potentially impact broad population segments,” said 1st Lt. Isavelita Goodearly, public health nurse with JTF-Bravo MEDEL. “When we test those individuals we are not only directly impacting that group of people; the indirect impact from studying these diseases could affect millions.”
Trujillo, Colon and the Misquito Coast have the highest incidence of malaria in the country. These are also areas where JTF-Bravo participates in multiple humanitarian missions. These areas represent an important interest for NAMRU-6, whose mission is to detect infectious disease threats of military and public health importance.
“We have a lot of service members coming through these areas classified as red zones for these types of illnesses,” said Dr. Ricardo Aviles, medical liaison, JTF-Bravo MEDEL. “For the preventive medicine portion of MEDEL, this mission and training is crucial because we are in this environment; we face these illnesses all the time.”
Currently there are no specific medications for the treatment of these vector-borne diseases and the entomologists at NAMRU-6 work diligently to help develop vector control strategies against them.
“What we are doing is simultaneously collecting vectors and teaching the group of medics everything about the different methods we use to gather specimens and the habitat of vectors in endemic areas,” said Dr. Gissella Vasquez, deputy director of the Entomology Department at NAMRU-6.
Dr. Vasquez and her team from Peru visited malaria and leishmaniasis prone areas and taught the doctors, students and host nation entomology technicians how to identify breeding sites, adults and larvae. The team also worked with MEDEL preventive medicine personnel on base to prepare them on how to collect samples, as well.
Live case studies
While deployed in the Trujillo area, the multi-faceted team performed rapid malaria tests, collected blood samples and created blood smear slides for analysis at the national Ministry of Health Laboratory, screening a total of 108 patients.
While on location they also tested an ill Marine who was working on a humanitarian mission.
“He looked critically ill,” said Goodearly. “My mission was to bring his blood back to Soto Cano so it could get tested and we are currently trying to identify what he has and are also working with the lab results.”
The service member’s blood tested positive for dengue and is receiving medical treatment. From the patients tested in the community only one person tested positive.
After collecting hundreds of samples both on base and on location, the next step for NAMRU-6 is to morphologically identify mosquito vectors from the diversity of vector species since not all of them carry diseases.
“What we are trying to determine is what species are present in these endemic areas, and with this information we will determine if you have a certain vector and potential risk of an outbreak,” said Vasquez.
The NAMRU- 6 representative expressed how the organization is interested in developing capacities and working in collaboration with the Task Force to aid them in their research of tropical diseases in support of military readiness and public health worldwide.
“The plan is to work together and for them to use the techniques that we have taught them to continue with this entomological risk assessment,” said Vasquez.
Dr. Vasquez also specified that the continued collaboration extends to the Walter Reed Army Institute of Research who will detect human pathogens from the collected samples by performing a molecular screening to know if there are infected specimens among them.
This combination of efforts, field experience and onsite learning in a tropical environment will provide a better understanding of infectious diseases that directly impact medical readiness.
“Studying these diseases gives us the potential to find cures, find ways to treat, find ways to prevent and minimize incidences from occurring,” said Goodearly. “We are in a place where malaria is prevalent so we have to be aware and take our vaccines and malaria prophylaxis.”