Department of the Navy
Navy Medical Department Guide to
Malaria Prevention and Control
Bureau of Medicine and Surgery
Peer Review Status:
Internally Peer Reviewed
This section presents measures that prevent mosquitoes from biting and
transmitting malaria. Applications of
personal protective measures are effective against a wide range of disease
vectors, not solely for prevention of malaria. In many military operations,
they will be the only means of
protection against biting arthropods. They are the first line of defense, are
simple to teach and perform, and enable personnel to remain in endemic areas
while maintaining their operational capabilities. The major drawback of
personal protective measures is dependence on service member compliance.
Persuasion by medical personnel, and enforcement by NCOs and commanders is
necessary for their continuous proper application. Medical personnel must
circulate among units teaching, examining, and improving personal protective
measure practice, and also reporting their findings to those in charge.
Commanders and NCOs must ensure compliance and lead via personal example.
Topical repellents are natural or synthetic compounds that repel arthropods.
The use of vapor-active skin repellents by U.S. Armed Forces has a long
history. It began with the use of oil of citronella in 1910, continued with the
discovery of dimethyl phthalate during WW II, and led to the development of
diethyl toluamide or "DEET" in 1957. The duration of a repellent's
effectiveness decreases with activity, heat, and humidity. Since Anopheles
mosquitoes inhabit warm tropical environments, military personnel need to
re-apply repellent frequently to prevent biting. These products were selected
based on their effectiveness. Contrary to public opinion, Avon Skin So SoftR
and flea collars are not effective. As
with all repellents and insecticides, carefully read and comply with the label
requirements.
Available Military Supplies: Insect/Arthropod
Repellent Lotion (NSN 6840-01-284-3982) is a 33 % DEET lotion developed to
last 12 hours, has low odor, and less damaging to plastics than previous
formulations. Apply in the same manner as skin lotion; neglected skin is not
protected.
Insect Repellent, Clothing and Personal Application (NSN
6840-00-753-4963) is a 75% DEET, 25% alcohol liquid that must be applied
every 1-2 hours in warm, humid conditions. It may cause skin irritation, is
corrosive to plastics and paint, and is very flammable. Apply in the same
manner as skin lotion; neglected skin is not protected. The liquid can also be
used as a fabric impregnant, with effectiveness of up to 2 days if not removed
by laundering, rain, or perspiration.
Impregnants are compounds very similar to topical repellents. They are
longer lasting, and cannot be applied to skin. Permethrin is an impregnant for
fabric only, used by the military to treat tents and clothing. It is also a
contact insecticide capable of reducing the biting population and attack rate
in the immediate area of use. Permethrin is a synthetic compound modeled from a
naturally occurring insecticide found in certain plants. It is quick acting,
long lasting (12 years in unwashed, stored clothing), nearly odorless, and
non-staining. Permethrin is resistant to degradation when exposed to heat,
sunlight, wear, laundering, rinsing, and immersion in water. It is effective
against crawling arthropods such as ticks, and flying insects such as
mosquitoes and biting flies.
Available Military Supplies: Permanone Aerosol Spray "Insect Repellent,
Clothing Application" (NSN 6840-01-278-1336) is a formulation of 0.5% permethrin in 6 oz.
aerosol cans for use on uniforms and mosquito netting. It is odorless,
non-irritating, and can last through 3-5 washings. Apply the same way as spray
paint (slow sweeping motion 6-8 inches from object) until the surface of the
fabric appears moistened. Allow to dry for 2 hours before wearing. Do
not apply to caps, socks or undergarments or while clothing is being worn.
IDAA Kit, "Insect Repellent, Clothing Application" (NSN
6840-01-345-0237) is a field kit in which shirt and trousers are treated in
separate plastic bags containing a 1% permethrin and water mixture. Treatment
lasts through about 30 washings.
Protective Clothing and Netting
The basic utility or camouflage uniform treated with permethrin and worn
with sleeves down, collars closed and trousers bloused over boots offers
excellent protection from mosquitoes. Other types of protective clothing and
netting are also available.
Available : DEET net jacket,
known as Parka, Fabric Mesh, Insect Repellent, (NSN 8415-01-035-0848) is
a waist length mesh jacket with extra long sleeves and a hood designed to cover
a combat helmet. The fabric is polyester netting interwoven with cotton strands
designed to absorb DEET. It is issued with a ziplock plastic bag and a bottle
of the 75% DEET liquid (NSN 6840-00-753-4963). Before wearing, saturate
the coat with the supplied DEET and store in the plastic bag for 24 hours.
Protection should last 6 weeks if the jacket is stored in the ziplock pouch
when not being worn. Impregnation with permethrin is also an option, which provides
longer, more effective protection.
Insect Head Net (NSN 8415-00-935-3130) is a fine mesh nylon screen
and cover that can be worn over a helmet, cap, or bare head. It is designed to
be fastened to the uniform shirt collar and breast pocket buttons. For maximum
protection, impregnate with permethrin or DEET liquid.
Mosquito Bed Nets, (NSN 7210-00-266-9736), and poles (NSN
7210-00-267-5641) are a protective measure with a long history of use in
tropical areas. They are designed for use with cots, bedrolls, hammocks, steel
beds, and shelter half tents. Personnel should receive bed nets and be trained
in their use before entry into an endemic area. If set up properly, they will
not interfere with quick night exits. Bed nets should be treated with
permethrin, set up before dusk and checked for tears or other spots where
mosquitoes can enter. A training team to coach, inspect, and advise on the
application of personal protective measures including bed net use should be
established for each unit.
