IIR 2 201 0094 9I/DESERT SHIELD - DISEASE OCCURRENCE (U). Filename:22010094.91r PATHFINDER RECORD NUMBER: 33189 GENDATE: 950504 NNNN TEXT: ENVELOPE CDSN = LGX236 MCN = 90292/43262 TOR = 902922222 PTTCZYUW RUEKJCS3022 2922223- --RUEALGX. ZNY HEADER P 192223Z OCT 90 FM JOINT STAFF WASHINGTON DC INFO RUEAHQA/CSAF WASHINGTON DC RUEDADA/AFIS AMHS BOLLING AFB DC RUEALGX/SAFE P 191202Z OCT 90 FM CDR[ (b)(1) sec 1.3(a)(4) ]USAOPSGP INSCOM ALEX VA //[ (b)(1) sec 1.3(a)(4) ]// TO RUEKJCS/DIA WASH DC//DC-4A/DAH-3/DAH-6/DB-8// RUEADWD/DA WASHDC //DAMI-POH/DAMI-FII/DALO-ZC// RUDHAAA/CDRINSCOM FT BELVOIR VA//IAOPS-H-C// RUFDAAA/CINCUSAREUR HEIDELBERG GE//AEAGB-PD-CURIN/ AEAGB-C-HO// RHIVHAA/CDRXVIIIABNCORPSFWD//G2// RHCGSRB/COMUSARCENT FT MCPHERSON GA//AFRD-DSO// RUDCAAA/ARCENT SPT CMD//J2// RUHQHQA/CINCPAC HONOLULU HI//J2// RUDOECA/USAORG LINDSEY AS GE//ED// RHCGSRB/CDRFORSCOM FT MCPHERSON GA//FCJ2// RHIUFAA/USCENTAF FWD//IN// RHIIMAA/COMUSMARCENT//G2// RHEPAAB/TAC IDHS LANGLEY AFB VA//INPC// RUKGNBA/HQ AFSAC FT BELVOIR VA//INO// RUCBSAA/USCINCLANT NORFOLK VA//J24// RUDHSIC/CDRUSASOIC WASH DC//DI// RHIHDAA/SOCCENT DEPLOYED//J2// RUDMNIC/COMNAVINTCOM WASHINGTON DC RUEBLEA/NAVSENT RIYADH SA RULKNIS/COMNISCOM WASHINGTON DC RUENAAA/CNO WASH DC//OP-009// RHHMBRA/CINCPACFLT PEARL HARBOR HI RUFGAID/USEUCOM AIDES VAIHINGEN GE RUCJACC/USCINCCENT MACDILL AFB FL//CCJ2-CH/J2/CCCS-F/SUPR// RUCJACC/USCENTCOM REAR MACDILL AFB FL//JIC/CCJ2-CH// RUCJAAA/USCINCSOC MACDILL AFB FL//SOJ2-PP/SOJ2-O/SOJ2-MC// RUEOFAA/COMJSOC FT BRAGG NC//J2// RUETIAA/NSACSS FT MEADE MD//T5232// RUEAIIA/CIA WASH DC RUEHC/STATE DEPT WASHDC //INR-IC-CD// RUEKJCS/JCS WASHDC //J33(JOG)/J5// RUEACMC/CMC WASHINGTON DC RUEBJFA/CDRUSAOPSGP FT MEADE MD//IAGPC-CM/IAGPC-S// BT CONTROLS QQQQ SERIAL: (U) IIR 2 201 0094 91. X- BODY OUNTRY: (U) SAUDI ARABIA (SA). X- SUBJ: IIR 2 201 0094 9I/DESERT SHIELD - DISEASE OCCURRENCE (U). X- WARNING: (U) THIS IS AN INFO REPORT, NOT FINALLY EVALUATED INTELLIGENCE. REPORT CLASSIFIED X - - - - - - - - - - - - - - - DEPARTMENT OF DEFENSE X - - - - - - - - - - - - - - - DOI: (U) 900913. X- REQS: (U) T-8C2-2650-0I-90; G-OSG-2520-25-90; (INITIATIVE). X- SOURCE: //OTS 2 20I 0216 90//[ (b)(7)(D) ] X- SUMMARY: LESHMANIASIS IS BECOMING AN INCREASING PROBLEM IN SAUDI ARABIA DUE TO CHANGING ECONOMIC AND ECOLOGIC CONDITIONS. X- TEXT: (U) I. THERE HAS BEEN AN INCREASE IN THE NUMBERS OF PEOPLE, IN SAUDI ARABIA, REPORTED AS HAVING CUTANEOUS LESHMANIASIS DUE TO BETTER RECORD KEEPING AND ALSO THE SIGNIFICANT NUMBERS OF FOREIGN WORKERS APPEARING AT TREATMENT FACILITIES WHO HAVE CONTRACTED THE DISEASE. ZOONOTIC CUTANEOUS LESHMANIASIS (CL) IS FOUND IN FOUR WIDELY SEPARATED GEOGRAPHIC AREAS OF THE KINGDOM. A. RIYADH - AL KHARJ AREA//GEOCOORDS 2408N--04724E//. THE DISEASE VECTOR IS P. PAPATASI WHICH IS NORMALLY FOUND ASSOCIATED WITH RODENT BURROWS. IN THIS CASE THE RESERVOIR OF THE DISEASE IS THE GERBIL, PSAMMOMY OBESUS. IT HAS BEEN DETERMINED THAT THERE IS A CLOSE ASSOCIATION BETWEEN THE GERBIL, PAPATASI, AND A DESERTIC BUSH KNOWN AS THE HALOPHILUS PLANT. THE GERBILS BUILD THEIR BURROWS BENEATH THE PLANT, EAT THE PLANT, AND THE PAPATASI SANDFLY LIVES ON THE PLANT. B. BISHA AREA//GEOCOORDS - 2001N--04239E//. THE MAJORITY OF THE INFECTIONS IN THIS AREA ARE OF THE CLASSICAL TYPE OF CL KNOWN AS DRY LESHMANIASIS, OR ANTHROPONOTIC CUTANEOUS LESHMANIASIS. THE PARASITE CAUSING THIS FORM OF CL IS VERY HARD TO TREAT AND THE CLINICAL PRESENTATION IS TOTALLY DIFFERENT THAN THAT FOUND 1N ZOONOTIC CUTANEOUS LESHMANIASIS. SCAR RATES FOR THE POPULATION IN THIS AREA ARE 30 PERCENT. SIX POINT FIVE (6.5) PERCENT OF THE POPULATION HAVE ACTIVE LESIONS. C. TABUK AREA//GEOCOORDS - 2822N--03632E//. TABUK IS ON THE ROAD THAT RUNS FROM JORDAN TO MEDINA//GEOCOORDS - 2430N--03935E//SAUDI ARABIA. INFECTIONS IN THIS AREA ARE CHARACTERIZED BY MULTIPLE LESIONS, BUT THOSE INFECTED ALL RESPONDED TO TREATMENT. D. AL HOFUF AREA//GEOCOORDS UNKNOWN//. THIS IS THE CAPITAL OF THE AL HASSA OASIS IN THE EASTERN PROVINCE OF THE KINGDOM. THERE HAD BEEN A RECENT OUTBREAK OF CL IN THIS AREA AMONG EUROPEANS, MOSTLY WORKERS, BUT NO FURTHER INFORMATION IS AVAILABLE. AMONG THE INDIGENOUS PEOPLE OF THE REGION, OUT OF 171 TESTED WITH THE LESHMANIA SKIN TEST, 65 PERCENT SHOWED POSITIVE REACTIONS FOR CL. THIS IS AN AVERAGE OF 65 PERCENT OF THE POPULATION HAVING BEEN EXPOSED TO THE DISEASE AT SOME TIME. P.PAPATASI IS AGAIN THE VECTOR. 2. NEARLY ALL CL HAS BEEN ASSOCIATED WITH THE DESERTIC AREAS OF THE KINGDOM. THE INCUBATION PERIOD FOR THE DISEASE IN THE AL HOFUF AREA HAS BEEN ANYWHERE FROM SEVERAL WEEKS TO TWO OR MORE MONTHS. THE AVERAGE HAS BEEN 8 WEEKS. IN ADDITION TO THE BISHA AREA, ANTHROPONOTIC CL IS ENDEMIC TO THE SOUTHWESTERN PART OF THE COUNTRY, MAINLY IN ABHA//GEOCOORDS - 1814N--04231E//SAUDI ARABIA. APPROXIMATELY TWO MONTHS AGO, THERE WERE SIX PEOPLE TREATED FOR CL FROM THE BORDER AREA BETWEEN SAUDI ARABIA AND IRAQ CENTERED ON THE TOWN OF NISAB//GEOCOORDS-- 29I4N--04442E//SAUDI ARABIA. THESE PEOPLE WERE ALL TREATED BY THE SAME DOCTOR AND IT IS BELIEVED THE OUTBREAK IS VERY LARGE. 3. VISCERAL LESHMANIASIS IS ENDEMIC IN THE MOUNTAINOUS AREAS OF THE SOUTHWESTERN PORTION OF THE KINGDOM. THE VECTOR IS PHLEBOTOMIS ORIENTALIS. THERE HAVE BEEN SPORADIC REPORTS OF THE DISEASE OCCURRING IN THE CENTRAL PORTION OF THE KINGDOM BUT IT IS NOT KNOWN WHERE THE ACTUAL CONTRACTION OF THE DISEASE OCCURRED. 4. THE SAUDIS HAVE A PROGRAM TO STUDY LESHMANIASIS. THE POINT OF CONTACT IN COUNTRY FOR INFORMATION IS DR. ABDULAZIZ ((AL-KHAWAJAH)), PHARMACOLOGY DEPARTMENT, COLLEGE OF MEDICINE, P.O. BOX 2114, DAMMAN - 31451, SAUDI ARABIA, TEL. 8577000/8575307. ACCORDING TO SAUDI OFFICIALS, IN 1983 THEY HAD A TOTAL OF 18,000 CASES OF CL THROUGHOUT THE KINGDOM. OVER THE LAST FEW YEARS THEY HAVE REPORTED 12,000-17,000 CASES OF CL PER YEAR AT KING FAHAD HOSPITAL ALONE. X- COMMENTS: (U) GEOCOORDS USED WERE FROM THE TIMES ATLAS OF THE WORLD, SEVENTH COMPREHENSIVE EDITION. X- //IPSP: (U) PGW2650; PG 2520//. //COMSOBJ: (U) 211; 170//. ADMIN PROJ: (U) 202019. INSTR: (U) US NO. PREP: (U) 2-10446. ACQ: (U) ALEXANDRIA, VA (901018). DISSEM: (U) NONE FIELD: NONE SENT TO: NONE. X- WARNING: (U)