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         reinspected and disapproved by the US Army. Units should have
        reported these Army food establishment inspection problems to
        CENTAF for resolution. Locally listed establishments approved by
        EH personnel did not require Army Veterinary Service inspection.

             5. Site Selection: Additional efforts need to be exerted to
        ensure medical concerns are considered in site selection. One
        ATH, located beside water storage tanks, was evacuated on at
        least two occasions because of a chlorine leak. Another ATH, in
        a flood zone, flooded. It is understood that security or other
        conce.ns may override medical recommendations.

             6. Food Safety: Foodborne illness was the most significant
        public health problem for deployed air force personnel. Most
        foodborne illness outbreaks would have been avoided if the USAF
        had its own deployable food service. TAC/SG should work with
        TAC/DE to make this happen. EH should inspect food and food
        service facilities during OREs and ORIs. This would provide
        necessary training for EH and demonstrate their mission to
        supervisors and commanders. It will also demonstrate the need
        for a government vehicle. Inadequate transportation was a common
        problem for EH and BEE. In some cases foodborne illness
       outbreaks were not followed by good reports. CENTAF/SGPM should
       have requested more complete reports when incomplete information
       was received. Some facilities didn't use ratings or route
       reports through the chain of command as they should have.
       Procedures that worked during peacetime and on previous
       deployments should not have been abandoned. Foodhandler training
       would have been difficult, but EH should have exerted more effort
       to train foodhandlers.
            7. Disease Reporting and Epidemiology: A very good disease
       reporting system was established after the deployment began,
       although not without difficulty. At least two changes were made
       to the reporting system during the deployment. It would be
       better to have the reporting system ready for use before a
       deployment. Lt Col Weiland will draft minor changes to this
      system to eliminate grouping conditions into a single category
       and reduce the number of non-communicable diseases reported. It
       was proposed that this program be presented to the preventive
       medicine officer of CENTCOM, SOCOM, and others as the system for
       future conflicts. It was difficult to investigate foodborne
       illness outbreaks without menus from food service facilities. An
       attempt should be made to require food service facilities to
       maintain menus.
                 8. Communicable Disease Issues: Services provided by the
       ATH laboratory were too limited. The laboratory needs a
       microbiology incubator and appropriate media to identify fecal
       pathogens such as Shigella, Salmonella, and Campylobacter. The
       laboratory also needs to be able to do fecals for ova and            
       parasites. They need a micrometer for their microscope to be
       able to measure the size of ova and parasites. The high level of
       resoiratory disease was expected and no recommendations were

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