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       PRIORITY
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 PAGE 02 OF 02   RHDJGAA 0048 SECTION 02 OF 03       000837       14/0002Z
 IMMUNIZED IN ACCORDANCE WITH SERVICE REOUIREMENTS FOR DEPLOYMENT TO
 THE DEPLOYMENT AREAS.  THE FOLLOWING STANDARD IMMUNIZATIONS ARE  RECOMMENDED:  TETANUS/DIPHTHERIA TOXOID  (TD) - BASIC SERIES WITH 10
YEARS BOOSTER.  POLIOVIRUS VACCINE  (ORAL) - BASIC SERIES PLUS ONE
BOOSTER.  YELLOW FEVER - EVERY 10 YEARS.  IF  IS  NOT  NECESSARY  TO
UNDERGO HIV SCREENING PRIOR TO RECEIVING ORAL POLIO OR YELLOW FEVER VACCINE UNLESS CLINICALLY INDICATED.  TYPHOID - SINGLE DOSE SHOULD BE ADMINISTERED UNLESS IMMUNIZED WITHIN THE PAST 3 YEARS:
RE-IMMUNIZATION IS REQUIRED AT TIME OF DEPLOYMENT TO AOR IF MORE THAN
 3 YEARS HAS ELAPSED SINCE PREVIOUS DOSE, SMALLPOX PLAGUE CHOLERA,  AND
RABIES  (HDCV) VACCINE ARE NOT RECOMMENDED.   IMMUNIZATION CERTIFICATE
MAY BE REQUIRED BY HOST COUNTRY IF PERSONNEL ARRIVE FROM ANOTHER AOR
COUNTRY WHERE CHOLERA IS PRESENT
 (2)  MENINGOCOCCAL VACCINE QUADRIVALENT IS RECOMMENDED TO
 PERSONNEL, NOT VACCINATED WITHIN THE PAST 5 YEARS, WHO EXPECT
 PROLONGED, CLOSE CONTACT WITH LOCAL NATIONALS, ESPECIALLY CHILDREN,
DURING THEIR DEPLOYMENT.  IT MUST  BE  UNDERSTOOD  THAT  OCCASIONAL,
 CASUAL CONTACT IS NOT REPEAT NOT A SUFFICIENT REASON TO VACCINATE.
 CURRENT MEDICAL INTELLIGENCE ANALYSIS INDICATES THAT RISK OF
 MENINGITIS WILL BE EXTREMELY LOW TO DEPLOYED SERVICE MEMBERS DURING
 ANTICIPATED ACTIVITIES.  DISEASE ACTIVITY WILL  BE  MONITORED  UNTIL
 DEPLOYMENT AND RECOMMENDATIONS FOR IMMUNIZATIONS MAY BE SUBJECT TO
 CHANGES AS REQUIRED.
                      K.  CHEMOPROPHYLAXIS  GUIDELINES
                          (1). CHEMOPROPHYLAXIS SHOULD BE CONSIDERED AS
 "SECOND-ECHELON- PREVENTION.  PERSONAL PROTECTIVE  MEASURES  OF  ALL
   TYPES TAKE PRECEDENCE OVER CHEMOPROPHYLAXIS, AND  MUST  BE  PURSUED
   WITH VIGILANCE.
                          (2)   IMMUNE GLOBULIN  (I.  S. G. GAMMA GLOBULIN) IS RECOMMENDED
   FOR DEPLOYMENT TO ALL COUNTRIES IN THE AOR.   IMMUNE GLOBULIN 2.0 CC
   IM SHOULD BE USED FOR SHORT-TERM TRAVEL OF 3 MONTHS OR LES5:   5.0 CC
   IM SHOULD BE USED FOR LONG-TERM TRAVEL  (UP TO 5 MONTHS)
                           (3)   MALARIA CHEMOPROPHYLAXIS SHOULD OCCUR AS FOLLOWS:   NO
   PROPHYLAXIS NECESSARY FOR UNITS  DEPLOYING  TO  EGYPT.  BAHRAIN  OR
   U. A. E.
                           (4)  PERSONNEL DEPLOYING TO OMAN SHOULD USE WEEKLY
   CHLOROQUINE PROPHYLAXIS AND TERMINAL WEEKLY PROPHYLAXIS WITH
   CHLOROQUINE/PRIMAQUINE  (C-P) FOR 8 WEEKS.   THE SAME CHEMOPROPHYLACTIC
   MEASURES ARE REQUIRED IN SAUDI ARABIA ONLY IN  THE  RED  SEA  COAST
   REGION OUTSIDE OF THE URBAN AREAS OF JEDDAH  AND  TAIF  PREGNANT  FEMALES
   AND G-6-PD DEFICIENT PERSONNEL SHOULD NOT USE PRIMAQUINE.   IT IS NOT
   NECESSARY TO ROUTINELY TEST FOR G-6-PD DEFICIENCY PRIOR TO USE OF
   PRIMAQUINE, UNLESS INDIVIDUALS ARE OF MEDITERRANEAN-ANCESTRY OR WILL
   BE EXPOSED TO REPEATED TREATMENTS (THIS  GUIDANCE  APPLIES  TO  ONE
   WEEKLY.TERMINAL PROPHYLAXIS WITH PRIMAQUINE ONLY.)
                      L.   SEXUALLY-TRANSMITTED DISEASES  (STD)
                           (1) HIV AND HEPATITIS  B  ARE  PRESENT,  ESPECIALLY  AMONG
   PROSTITUTES.  STRICT  AVOIDANCE  IS  RECOMMENDED.  AS  HETEROSEXUAL
   TRANSMISSION AMONG NON-PROSTITUTES OCCURS AS WELL.   ABSTINENCE FROM
   SEXUAL ACTIVITY OF ANY KIND IS  RECOMMENDED.  CURRENTLY,  NO  COUNTRY  IN
   THE USCENTCOM AOR REQUIRES CERTIFICATION FROM MILITARY PERSONNEL ON
   OFFICIAL DUTY TO BE DOCUMENTED HIV-NEGATIVE.  HOWEVER.  TRI-SERVICE
   GUIDANCE DICTATES THE FOLLOWING:
                     A.  ARMY ACTIVE DUTY COMPONENTS REQUIRE HIV TESTING
   WITHIN 2 YEARS IF OCONUS DEPLOYMENT IS  LESS  THAN  180  DAYS.  FOR
   DEPLOYMENT GREATER THAN 180 DAYS, HIV TEST WITHIN 6 MONTHS IS
  REQUIRED.  ARMY RESERVE COMPONENTS REQUIRE HIV  TEST  WITHIN  2  YEARS  IF
  DEPLOYMENT IS LESS THAN 30 DAYS, BUT WITHIN 6 MONTHS IF DEPLOYED FOR
  MORE THAN 30 DAYS.
                     B.  AIR FORCE ACTIVE DUTY AND RESERVE COMPONENTS
  REQUIRE HIV TESTING UTILIZING SAME STANDARDS AS ARMY RESERVE
  COMPONENTS.   (CORRECTION:  USE ARMY ACTIVE DUTY STANDARDS PER HQ
  MAC/SGPM)
                    C.  NAVY AND MARINE ACTIVE AND RESERVE FORCES MUST
 HAVE HIV TEST WITHIN 1 YEAR OF OCONUS DEPLOYMENT.
                    D.   HIV TESTING SHOULD OCCUR  PRIOR  TO  RECEIVING
IMMUNE GLOBLIN.  HOWEVER, IF HIV  TESTING  OCCURS  AFTER  IMMUNE  GLOBLIN.
ADMINISTRATION OF IMMUNE GLOBLIN A PERIOD OF 30 DAYS MUST ELA TO
 BT
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                                            UNCLASSIFIED

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