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File: 123096_may96_decls3_0023.txt
Subject: MEDICAL REPORT 14 AUG 90
Unit: 24TH ID
Parent Organization: XVIII CORPS
Box ID: BX001433
Folder Title: MEDICAL REPORTING-DIVISION SURGEON
Document Number: 17
Folder Seq #: 456
SAUDI ARA131A
ARBovilzAL @ (3-12 days)
Sandfly feyer may be present in the nordtwcs@ wherc. sctological studies have found 20 percent of
those sampled scropositive for the Sicilian virus and 5 pemcnt sztioposfdvc for ate Naplcs
,virus. Phlebotomuspqpatasi, the potential sand(ly vector, occurs throughout the central and
eastern provinces.
Dengue tevercould occur. The mosquito vector, Acdeyac8ypil, Is present In some areas, and historic
records @t of dengue [ever occurring In the =tcm coastal arms.
Sindbis v@ reportedly has caused viral encephalitis in coastal arm ofp-astern Province, but no recent
incidents of human disease have been reported and the virus may no longer be circulating.
Potential mosquito vectors (Culex spp.) arc present
DISEASES WTrll LONG INCUBATION PEIUODS (USUALLY MORR,, -nlAN 15 DAYS)
VLRAL IIEPATYNS (15-180 days)
Trunsm@ion: Hepati@ A (.MV) - person to person by the reml-oral route. Hcimdtis 13 O ]DV) -
contact with causative agent through blood transfusions, cojitaml;Ltted needier, sexual contac@
and contaminated lxrincal wounds. Non-A non-B hepatitis (NANB) - may be cntcrically
transmitted (A-like) or parenterally transmitted (B-like).
Risk Pe@Distribittion: Yc3r-round, with risk elevated from October through December. Occurs
countrywide, with risk greatest in the Southwestern provinces, followed by tire western provinces.
Remarks: Mgbiy endcnuc; presents a major health h@rd to iionindigcrious r4rsonnct. Inrccdon with
hcpatilis A virus OIAV) accounts for more than 50 pctrctit of the annual average of 6,OW cases
ca followed by hcp3(i@ B vt'rt'LS- (I IB%o and ratcnicrally trnnstnilled bepadtls
(hcpaGUs C - HVC), 2.5 percent each. AnUbodics to IIAV occur in an estimated 90 percent of
children by age 10 and in almost 100 percent of adults. Ilia annual incidence of acute ficpat(6
A @ was increasing during Oic lnte 198N, possibly related to a slightly larger nonimmune child
population subs@uc,,it to improvements in environmental sanitation. Approximately 70 percent of
the adult population exp-css antibodies to FIBV, and Ilia I IOV carrier rate is esilmated at nearly 8
pcrccnl The delta agent (hepa6ds D virus - liDV) has been found In approximatcly 15 percent of
HBV @rricrs. Entcrically transmitted NAN13 hepatitis Oicpadils E - I IP-V) has not been reported,
but may occur.
LT.:ISIIMANIASIS (I week to many months)
Trnnsru@on/Vector Ecology- Bite of an infective sandfly (Plilcbotonius spp.). Most sandnics are
acuvc from sunset on through die night and have very limited flight ringes. Tire primrtty vectors
for cutaneous Icishmariasis (CL) arc P. popotasi for Lcishiiiattia niajor (the wct/ruml form) and
P. sergeant (found at the higher elevations - up to 2,OW melets) for L. tropics (Ilia dry/urban form).
No specific vector for visceral lcislitnaniasis (VL), caused by L. doiiovaiti, has been Identified in
Saudi Arabia.
Risk Perio 'd/Distribtition: Trans,-mssion of CL occurs year-round, lxakiiig in July through September.
L. m'aj'or occurs commonly in die cases of ate cistcm and central proanccs, white L. tropics occurs
commonly in die mountains of die western provinces. Transmission of VL occurs year-round and
is restricted to die Southwestern provinces.
Remarks: 'De annual number of CL cases reported inct=ed to about 15,000 during the late 198031
partially 3tUibutcd to improved reporting. Clinical cases most commonly ate seen from October
through January. Most cases of the wcL/rural farm occur In nordr?imune individuals, either
children or nonindigcnous adults (an annual attack late up to 50 pcmcnt among unprotected
individuals has been reported). Also cilled zmnotic CL, this form occurs in onscs foci based
on the distribution of the primary reservoir )rest, the fat-tailcd sand rat (Psanitnoinys obesus).
The dry/urb3n form, also called antliroponotic CL, Is less widely distributed, with most cases
reported from the western and Southwestern areas. (Approximately 80 percent of all cases are
reported from jizan Province.) Ca= occur in all nge gmups.,no annual incidence of VL had
SA-6
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Document 79 f:/Week-22/BX001433/MEDICAL REPORTING-DIVISION SURGEON/medical report 14 aug 90:12179611151420
Control Fields 17
File Room = may96_declassified
File Cabinet = Week-22
Box ID = BX001433
Unit = 24TH ID
Parent Organization = XVIII CORPS
Folder Title = MEDICAL REPORTING-DIVISION SURGEON
Folder Seq # = 456
Subject = MEDICAL REPORT 14 AUG 90
Document Seq # = 17
Document Date =
Scan Date =
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 17-DEC-1996