| Lyme Disease Risk Assessment, Fort Jackson, South Carolina, 24-29 August 1992 DEPARTMENT OF THE ARMY U.S. Army Environmental Hygiene Activity - South Fort McPherson, Georgia 30330-5000 [Seal of Department of Defense, United States of America] REPLY TO ATTENTION OF: HSHB-AS-P (40-5f) 22 October 1992 MEMORANDUM FOR Commander, U.S. Army Training and Doctrine Command, ATTN: ATBO-M, Fort Monroe, VA 23651-5451 Commander, U.S. Army Health Services Command, ATTN: HSCL-P, Fort Sam Houston, TX 78234-6000 SUBJECT: Lyme Disease Risk Assessment No. 16-62-AL21-92, Fort Jackson, Fort Jackson, South Carolina, 24-29 August 1992 1. Tick-borne diseases can present a serious health threat to personnel in the field. This Lyme Disease Risk Assessment was performed to gather additional data on possible reservoirs for the Lyme disease spirochete at Fort Jackson for use in developing a definitive risk assessment. Implementation of a sound integrated tick management program is strongly encouraged. 2. No spirochetes were detected in any of the ticks collected during this assessment. However, they were found in 1990 and 1991 in ticks collected in the field and from hunter-killed white-tailed deer. The high incidence of Lyme disease and Rocky Mountain spotted fever in humans in Richland and surrounding counties indicates that personnel at Fort Jackson should be encouraged to obtain and use repellents and other personal protective measures to reduce the threat from tick-borne diseases. 3. Copies of the report with Executive Summary are enclosed. The USAEHA-S will respond to requests for additional information on this risk assessment or provide direct support in the areas of occupational and environmental enhancement. Assistance may be obtained by contacting the Survey Officers or the Chief, Entomological Sciences Division, MAJ Michael Collyer at DSN 572-2564 or 572-2578. [signature] JOSEPH A. JAKUBOWSKI LTC, MS Commanding DEPARTMENT OF THE ARMY U.S. Army Environmental Hygiene Activity - South Fort McPherson, Georgia 30330-5000 [Seal of Department of Defense, United States of America] REPLY TO ATTENTION OF: HSHB-AS-P LYME DISEASE RISK ASSESSMENT NO. 16-62-AL21-92 FORT JACKSON, FORT JACKSON, SOUTH CAROLINA 24-29 AUGUST 1992 1. REFERENCES. See Appendix A. 2. AUTHORITY. The scheduling of this assessment was based on the following: a. AEHA Form 250, Request for USAEHA Field Services, 7 August 1991. b. Conference Report on the National Defense Authorization Act for Fiscal Years 92 and 93, House Report 102-311, 102nd Congress, 1st Session, November 1991, P. 422. 3. PURPOSE. Lyme disease (LD) is one of several severe tick-borne diseases which pose health threats at military installations. These diseases, while seldom life-threatening, reduce the efficiency of affected military personnel and diminish the overall quality of life at installations. The purpose of this risk assessment was to obtain blood serum from hunter-killed white-tailed deer and ticks from deer, wild rodents and reptiles in order to provide a portion of the baseline data needed in the preparation of a definitive Lyme Disease Risk Assessment (LDRA) for Fort Jackson. The completed assessment can be used by supervisory personnel to minimize risks of LD to military and civilian personnel at the installation. 4. GENERAL. a. Description of the Installation. Fort Jackson is located in Richland County near Columbia, South Carolina. Columbia is a city of about 100,000 inhabitants situated in the central portion of the state. Major drainages in the area consist of the Broad, Saluda and the Congaree Rivers and Gills Creek. Fort Jackson was established in 1917. It consists of approximately 52,000 acres of gently rolling sandy to clay soils. Vegetation consists of a mixture of various species of pines and hardwoods. The installation's function is that of training approximately 67,000 soldiers in both basic and advanced individual training annually. b. Abbreviations and Terms. A listing of abbreviations and terms is included in Appendix B. c. Survey Personnel. This risk assessment was conducted by CPT Kelly Loftin, Survey Officer, Entomologist, U.S. Army Environmental Hygiene Activity-South (USAEHA-S), Entomological Sciences Division (ESD), and Jack H. Chandler, Entomologist, USAEHA-S, ESD. d. Personnel Contacted. A list of the personnel contacted is in Appendix C. e. Background. The total number of reported South Carolina cases of LD and of Rocky Mountain spotted fever (RMSF) from 1987 to 1991 were 48 and 179, respectively. Richland County was responsible for about 17 percent of the total LD cases for this period and about 5 percent of the RMSF cases. Forty percent of the 1991 reported State cases of LD were from Richland County. No cases of LD have been reported for 1992 to date. South Carolina was fifth in the nation in the number of reported cases of RMSF, another tick-borne disease. Since 1987 there have been 179 cases with about 5 percent of these occurring in Richland County. 5. FINDINGS AND DISCUSSION. a. Small Mammal Trapping. One hundred Sherman collapsible small-mammal traps were placed in a variety of habitats at three locations to capture native rodents in order to remove parasitic ticks. Only three white-footed mice (Peromyscus leucopus) and one Hispid Cotton Rat (Sigmodon hispidus) were captured. No ticks were found on any of these specimens. No ticks were observed on either of these species during the 1990 study. b. Drift Fence Trapping. Eight drift fences were operated for four days in order to capture small mammals and other vertebrates. The drift fences were very efficient in capturing amphibians. The total capture included 30 young carpenter frogs (Rana virgatipes), 12 wood frogs (Rana sylvatica), 2 Fowler's toads (Bufo woodhousei), and one southern toad (B. terrestris). No ticks were found on any of these amphibians. One white- footed mouse was captured by a drift fence. No ticks were removed from this specimen. A skink, either the five-lined (Eumeces fasciatus) or the southeastern five-lined (E. inexpectatus) was captured in one of the traps. Five nymphal, black-legged ticks Ixodes scapularis ticks were removed from the fore-arm and the pleural region of this reptile. Three were tested by direct immunofluorescent assay (DIFA) at Fort McPherson and were found to be negative for the Lyme spirochete. The remaining two ticks were sent to the Centers for Disease Control at Fort Collins, Colorado for testing. One six-lined racerunner lizard (Cnemidophorus sexlineatus), an eastern fence lizard (Sceloporus undulatus) and two green anoles (Anolis carolinensis) were captured by hand in the vicinity of the drift fences. No ticks were observed on any of these specimens. c. Dragging for Ticks. About 5.2 percent of the Lone Star ticks captured by tick drags and dry-ice (carbon dioxide) traps during the 1990 study were positive for Borrelia burgdorferi when tested by indirect, immunofluorescent assay. No ticks were captured by dragging during this LDRA. d. Dry Ice Trapping. Twelve dry-ice traps were operated throughout this LDRA. No ticks were obtained from any of these traps. e. Examination of Deer. (1) Collection of Ticks. Hunter-killed, white-tailed deer were examined for parasitic ticks. Collected ticks were tansported to the laboratory at Fort McPherson where they were identified and processed by DIFA to determine if they harbored Borrelia spirochetes. Three species were captured from deer during the 1991 LDRA. The species and the percent determined to harbor spirochetes were, respectively, Amblyomma americanum (26%), Ixodes scapularis (27%) and Dermacentor albipictus (30%). Only the Lone Star tick (Amblyomma americanum) was collected from deer during this LDRA. Twenty-nine percent of them were adults and the remainder were in the nymphal stage. The mid-gut contents of all of the ticks were negative for the Lyme spirochete when tested by DIFA. Eighteen deer keds (Hippoboscidae, Lipoptena), a wingless, parasitic fly were collected from the deer, evaluated by DIFA and found to be negative for the spirochete causing LD. Ticks will be collected along with blood from hunter-killed deer throughout the 1992 season. The results of DIFA tests with these ticks will be furnished in an addendum to this report. (2) Collection of Deer Sera. During the 1991 LDRA 43 deer sera samples were obtained. These were evaluated by the Regional Veterinary Laboratory at Fort George G. Meade, Maryland. All samples were seronegative for exposure to Borrelia burgdorferi. Blood from deer will be obtained throughout the 1992 season and sent to the Regional Laboratory. Laboratory results will be included in the addendum. 6. CONCLUSIONS. Although no spirochetes were found in ticks collected during this survey, they have been identified during previous surveys. Significant numbers of human cases of LD and RMSF have occurred in Richland and surrounding counties. Personnel training or recreating at Fort Jackson should make full use of personal protective measures to minimize their risks to tick-borne diseases. 7. RECOMMENDATIONS. Recommendations are based on the findings of this and prior reports and on conversations with public health officials. They are made to ensure good Preventive Medicine (PVNTMED) practices which will reduce Lyme and other tick-borne disease risks to military and civilian personnel at Fort Jackson. General tick-borne disease reduction measures can be found at Appendix D. a. Fort Jackson - U.S. Army Training and Doctrine Command. (1) Proper wearing of clothing and the use of repellents will minimize the threat to tick-borne diseases to installation personnel. It is recommended that commanders at all levels emphasize the use of repellents to minimize potential exposure to tick and other arthropod-borne diseases (Appendix D). When possible avoid utilizing those habitats identified as having exceptionally high tick populations. (2) When practical, remove dense brush and leaf litter which may serve as tick habitats. Controlled burning in training/bivouac areas is often effective in controlling ticks. However, care must be exercised not to threaten endangered/threatened species habitats. (3) Effective management of the white-tailed deer populations will contribute to the reduction of tick populations. Follow the installation professional wildlife biologist's recommendations to achieve annual deer harvest quotas to ensure that the deer population is kept in check in those areas where tick populations are high. (4) Continue to post warning signs (DA Poster 40-5) at entrances to training/bivouac areas to inform potential users that the threat of contracting LD exists. b. PVNTMED Service (Svc), Fort Jackson - U.S. Army Health Services Command. (1) Continue to emphasize public awareness programs to educate installation personnel and visitors to behavioral and personal protective measures available to reduce their exposure to tick-borne diseases. Encourage the use of a VHS .5-inch audio-visual tape entitled "Lyme Disease - A growing threat" (PIN 504494) by activities to educate their personnel. The Heise Pond Hunting and Fishing Center has the equipment necessary to view the tape. Consider obtaining a copy of this tape and making it available during peak hunting and recreating months. Copies of the "Fact Sheet, Protection from Ticks and Lyme Disease" appearing at Appendix E can be obtained from USAEHA-S for distribution during tick-borne disease months. (2) Continue with the excellent pest surveillance program already in place at Fort Jackson. U.S. Army Environmental Hygiene Activity - South will continue to identify/test any live ticks collected on the installation. 8. TECHNICAL ASSISTANCE. The USAEHA-S will continue to identify and test any ticks sent to this Activity for the presence/absence of spirochetes. A Reserve Entomologist will be present at the hunter check-in station at Heise Pond Hunting and Fishing Center throughout the 1992 deer hunting season. He will collect ticks and deer sera and send these to USAEHA-S for testing. [signature] KELLY M. LOFTIN CPT, MS Entomologist Entomological Sciences Division [SIGNATURE] JACK H. CHANDLER Entomologist Entomological Sciences Division APPROVED: [signature] MICHAEL R. COLLYER MAJ, MS Chief, Entomological Sciences Division APPENDIX A REFERENCES 1. Technical Information Memorandum No. 26, March 1990, Lyme Disease- Vector Surveillance and Control. 2. Technical Guide No. 174, June 1991, Personal Protective Techniques Against Insects and Other Arthropods of Military Significance. 3. Technical Bulletin Medical 561, June 1992, Occupational and Environmental Health and Pest Surveillance. 4. Pest Management Study No. 16-62-0537-91, Fort Jackson, South Carolina, 24-27 April 1990. 5. Lyme Disease Risk Assessment and Addendum, No. 16-62-0505-92, Fort Jackson, Fort Jackson, South Carolina, 8-10 November 1991. APPENDIX B ABBREVIATIONS AND TERMS DIFA direct immunofluorescent assay DSN Defense Switched Network ESD Entomological Sciences Division LD Lyme disease LDRA Lyme Disease Risk Assessment PVNTMED Preventive Medicine RMSF Rocky Mountain spotted fever Svc Service USAEHA-S U.S. Army Environmental Hygiene Activity-South APPENDIX C PERSONNEL CONTACTED COL John A. Bass, Reserve Entomologist, Salley, South Carolina, Commercial (803)648-7563. Mr. Chuck Belcher, Supervisor, Pest Management Branch, Directorate of Engineering and Housing, Fort Jackson, DSN 734-6722. Mr. Bill Gates, Wildlife Biologist, Environmental and Natural Resources Division, Fort Jackson, DSN 734-6856. SSG Ronald Grow, Region 2, Noncommissioned Officer in Charge (NCOIC), Eastover, South Carolina, Commercial (803)695-2363. Mr. Richard Hendrick, Wildlife Technician, Environmental and Natural Resources Division, Fort Jackson, DSN 734-6856. Mr. Jeffery Jones, MD, Director, Disease Control and Epidemiology, State Epidemiologist, South Carolina Department of Health, Commercial (803)737- 4165. CPT Gregory McKee, Environmental Science Officer, Environmental Health Section, PVNTMED Svc, Fort Jackson, DSN 734-6081. Mr. Doug Morrow, Administrator/Wildlife Biologist, Environmental and Natural Resources Division, Fort Jackson, DSN 734-6856. Mr. Jim Moseley, Environmental Health Technician, PVNTMED Svc, Fort Jackson, DSN 734-6081. SSG Steve Nickelson, Game Warden, Law Enforcement Activity, Provost Marshal Office, Fort Jackson, DSN 734-3114. SSG Jose Ortiz, Range Control, Fort Jackson, DSN 734-7171. Mr. Ken Streeter, Manager, Nonappropriated Funds, Fort Jackson, DSN 751- 4948. SPC Gary Walker, PVNTMED Specialist, PVNTMED Technician, PVNTMED Svc, Fort Jackson, DSN 734-4552. SFC Whitely, Range NCOIC, Range Control, Fort Jackson, DSN 734-7171. APPENDIX D TICK-BORNE DISEASE RISK REDUCTION MEASURES 1. Emphasize public awareness programs to educate installation personnel and visitors on the potential for contracting tick-borne diseases such as Lyme disease and Rocky Mountain spotted fever and on personal protective measures which can be employed to minimize these risks. The USAEHA-S can provide brochures and other display materials. An informative VHS 0.5-inch audio-visual tape entitled "Lyme Disease - A growing threat" (PIN 504494) is available from the supporting Training and Audiovisual Support Activity. Copies of a small card entitled "Tick-Borne Diseases" (U.S. Army Medical Department, 7819) make excellent handouts. Additional cards are available from USAEHA-S. 2. Submit any collected tick specimens (both field collected or ticks that have been removed from individuals) alive for identification and DFA testing to USAEHA-S, Building 180, Fort McPherson, GA 30330-5000. The USAEHA-S can provide directions and supplies for shipments of ticks. 3. Encourage individuals displaying LD symptoms such as febrile illness and rashes, to obtain prompt medical attention. 4. Stock Permethrin Arthropod Repellent (NSN 6840-01-278-1336, box of 12 cans), Insect Repellent Fabric Treatment (NSN 6840-01-334-2666, box of 12 bottles) and 3M Trademark Insect Repellent (NSN 6840-01-284-3982, box of 12 tubes) for distribution. Emphasize tick habitat avoidance and the proper wearing of clothing and use of repellents. 5. Identify high risk foci in cantonment areas via tick dragging/flagging, small mammal trapping, deer checks and the assaying of collected ticks for B. burgdorferi. Sampling should be performed in early summer when the ticks are active. Post DA Poster 40-5, and thereby identify high risk areas. 6. Avoid high tick population areas for troop training or recreation. Such areas can be identified by tick dragging or flagging prior to use. 7. Eliminate tick habitat in heavily used, infested areas (e.g., wooded recreation areas) by removing leaf litter and keeping grass mowed. Clearing should be performed during low-risk months (January/February) when the ticks are the least active. These measures will also discourage small mammals which may serve as hosts for the ticks. Thinning of trees and removal of brush will allow more sun penetration which will reduce the humidity level necessary for optimum tick survival. Prepare, as a contingency, to employ chemical control (use only approved pesticides) in the event that non-chemical control measures fail to reduce the tick population. 8. Follow installation professional wildlife biologist's recommendations to achieve annual deer harvest quotas in all training areas to ensure that the deer population is kept in check. Effective management of the deer population will reduce the associated tick population. - Trademark 3M is a registered trademark of Minnesota Mining and Manufacturing Co., St. Paul, MN 55133. Use of trademarked name does not imply endorsement by the U.S. Army but is intended only to assist in identification of a specific product. APPENDIX E U.S. Army Environmental Hygiene Agency Entomological Sciences Division [picture of tick] Aberdeen Proving Ground, MD 21010-5422 FACT SHEET - PROTECTION FROM TICKS AND LYME DISEASE WHAT IT'S ALL ABOUT Soldiers and other personnel and dependents who live, train, work, or play in the field, share their environment with many forms of animal and insect life. Ticks may be abundant in both wooded and grassy areas. Several tick species are vectors or "transmitters" of Lyme disease. They include the deer tick, Ixodes dammini, in the Northeast and Midwest, and the western black-legged tick, Ixodes pacificus, in the West. Two other species, the Lone Star tick, Amblyomma americanum, and the black-legged tick, Ixodes scapularis, are prevalent across the South, and are potential vectors of Lyme disease. BE CONCERNED - BUT NOT ALARMED. Not all ticks carry Lyme disease, so a tick bite does not necessarily mean that disease will follow. In addition, prompt removal of a tick will lessen the chance of disease transmission. BUDDY UP When in the field, buddy up and routinely check for ticks every few hours or as frequently as possible. After returning indoors, remove your clothing and check your body carefully. Pay special attention to the hairy and/or warm, moist parts of the body. You can greatly reduce your chance of tick bite by following the DOD REPELLENT SYSTEM of wearing proper clothing and using both skin and clothing repellents: WEAR CLOTHING PROPERLY Blouse or tuck your uniform legs into your boots and wear your sleeves down. Civilians should tuck their pant legs into their socks, and their shirt into their pants. Light colored clothing makes it easier to spot ticks. USE REPELLENTS Apply deet repellent, NSN 6840-01-284-3982, to any exposed skin surfaces, and apply permethrin repellent spray, NSN 6840-01-278-1336, to your uniform or field clothing. Remember that permethrin is only for use on clothing, NEVER on skin. This combined use of repellents and proper wearing of clothing will provide nearly complete protection from tick bites. IF YOU ARE BITTEN If you find a tick embedded in your skin, DO NOT SQUASH OR BURN IT. Report to medical personnel to have the tick removed, or follow these guidelines: Use tweezers to grasp the tick's mouthparts as close to the skin as possible, and pull it straight outward. Pull slowly, firmly, and steadily. Be patient. The ticks central mouthpart called the hypostome is long and covered with barbs. This can make it difficult to remove. Wash the wound site and apply an antiseptic. Save the tick either in alcohol or frozen in a pill vial or plastic bag in case symptoms arise and identification of the tick becomes necessary. BE AWARE Be aware of the symptoms of Lyme disease. IF YOU HAVE BEEN IN AN AREA WHERE TICKS ARE FOUND AND YOU DEVELOP A RASH AROUND THE SITE OF THE TICK BITE OR FLU-LIKE SYMPTOMS (ACHES AND PAINS, HEADACHE, FEVER, EXTREME FATIGUE), ESPECIALLY DURING THE PERIOD FROM MAY THROUGH EARLY FALL, PROMPTLY SEE A PHYSICIAN FOR EVALUATION. REMEMBER... Wear trousers inside boots and sleeves down; use skin (deet) and clothing (permethrin) repellents; check your clothing and body as frequently as possible; remove attached ticks as soon as they are discovered; seek medical attention if symptoms develop. U.S. Army Environmental Hygiene Activity-South Entomological Sciences Division Fort McPherson, GA 30330-5000 FOR FURTHER INFORMATION CALL DSN: 572-2564/2578 or Commercial: (404)752-2564/2578 | |
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