REPORTING OF COMMUNICABLE DISEASES
An important step in the control of communicable disease is proper reporting. Instructions and requirements for reporting to local, state, national, and international health authorities are found in the preface of Control of Communicable Diseases in Man (NAVMED P-5038). In addition, cases in the Navy and Marine Corps must be reported as required by NAVMEDCOMINST 6220.2 series, Disease Alert Reports.
Navy references concerning prevention, control, diagnosis, treatment, etc., include Control of Communicable Diseases in Man (NAVMED P-5038), Technical Information Manual for Medical Corps Officers (NAVMED P-5052), and Manual of Naval Preventive Medicine (NAVMED P-5010). Selected communicable diseases are discussed in NAVMEDCOM/BUMED instructions.
Assistance with communicable disease investigation, reporting, and prevention may be obtained by contacting the area Navy Environmental and Preventive Medicine Unit.
Disease Alert Reports
The Disease Alert Report provides responsible commands with information necessary to minimize interruption of Navy and Marine Corps operations and to protect the health of personnel in the communities and areas in which they live. These reports are particularly applicable for reporting outbreaks of selected diseases that may affect operational readiness; be hazardous to the community; be spread through transfer of personnel; be an international quarantinable disease; or be of such significance that inquiry may be made of the Naval Medical Command or higher authority.
The initial Disease Alert Report will be submitted by the commanding officer with primary responsibility for the health and welfare of the affected individual. These reports are submitted either by speedletter or routine message. However, for all diagnoses indicated by an asterisk (*) in NAVMEDCOMINST 6220.2, or if, in the judgment of the commanding officer, more timely notification of the diagnosis is necessary to ensure expeditious implementation of preventive measures, submit a priority message. For more detailed information, refer to NAVMEDCOMINST 6220.2 series.
COMMUNICABLE DISEASES OF INTERNATIONAL IMPORTANCE
Acquired Immune Deficiency Syndrome (AIDS)
The onset of AIDS is gradual and presents symptoms that are nonspecific, e.g., fatigue, fever, chronic diarrhea, loss of appetite, weight loss, and involvement of the lymph nodes. Underlying deficiency of the body’s immune system allows for secondary “opportunistic” diseases (bacterial, viral, or parasitic secondary infections) to develop. On some occasions, the first presentation is a severe, life-threatening opportunistic disease. Detection of AIDS may depend on the surveillance of certain diseases, which may be predictive of a body immune deficiency in the absence of a known immune deficiency.
A serologic test for antibodies to the AIDS virus is available and is now used for screening for evidence of past or present infection among civilian and military personnel.
The infectious agent is a virus designated as either human immune virus (HIV), human Tlymphotropic virus, type III (HTLV-3), or lymphadenopathy-associated virus (LAV). These are considered to be the same virus. The reservoir is man. The incubation period is unknown; evidence suggests from 6 months to 5 years with an average of about 2 years for transfusion associated cases.
Epidemiologic evidence indicates that AIDS is primarily transmitted by promiscuous sexual contact (especially homosexual intercourse), sharing unclean needles, through contaminated blood transfusions or blood products, and transplacental transfer. It also may occur with heterosexual contact with high risk populations, e.g., prostitutes in the United States and overseas. This is not to say that only these populations are at risk; all personnel who engage in sexual activity with an unknown partner are at some level of risk.
The period of communicability for AIDS is unknown. It may extend from the asymptomatic period until the appearance of opportunistic diseases.
There is no specific treatment for the immune deficiency. Treatment is directed toward the opportunistic diseases that result from AIDS. Patients are treated in hospitals with blood and body fluid precautions. They require intensive medical support and prognosis for long-term survival is poor.