1. Jessica Turner, USAPH Region North, LT Kirk Mundal USN, LCDR Craig Stoops USN, Melissa Miller USAPH Region-North,

2. VECTOR-BORNE DISEASE SURVEILLANCE KIT  Kit based presentation Detailed instructions Collection materials Pre-printed return envelope PHR-N

3. UPON RECEIPT BY USAPHR-North  Blood prepared and tested for appropriate organism based on animal species ○ PCR  Ticks, fleas, etc. Identified Prepared and tested for appropriate organism ○ PCR  Test results provided to submitter and other appropriate recipients.

4. ANIMALS SAMPLED 2007-2009 Bagram, AFKandahar, AFRamadi, IQBagdad, IQ Dogs382461 Cats6219172 Foxes01101 Jackals52561 Coyotes13000 Jungle Cats0113 Hedgehogs0201 Mouse0100 Cow1000 Sheep1000 Goats3000 TOTAL123244309

5. Ectoparasites Identified 2007-2009 Kandahar, AFBagram, AFRamadi, IQBagdad, IQ Xenopsylla astia 3600 Ctenocephalides canis 6909 Ctenocephalides felis 3000 Pulex irritans 52570 Synosternus pallidus 0030 Rhipicephalus turanicus 373214430 R. sanguineus 00400 Hyalomma anatolicum 02700 Ixodes rubicundus 0060

6. Analysis Performed PathogenTest Type AnaplasmaReal-time PCR BabesiaConventional PCR BorreliaReal-time PCR EhrlichiaReal-time PCR RickettsiaReal-time PCR

7. Results of Analysis Kandahar, AFBagram, AF Babesia # POSITIVE/# tested % POSITIVE CAT R. turanicus3 /19 16%3 /6 50% Whole Blood13 /187 7%3 /60 5% JACKAL R. turanicus1/12 8%0/4 Whole Blood3/25 12%0/5 DOG R. turanicusnone1/14 7% Whole Blood2/24 8%0/16

8. Results of Analysis cont. Kandahar, AFBagram, AF Babesia # POSITIVE/# tested %POSITIVE HEDGEHOG R. turanicus2/10 20%none C. canis1/1 100%none Whole Bloodnone

9. Results of Analysis cont. Ramadi, IQ Baghdad, IQ Babesia # POSITIVE/# tested % POSITIVE CAT R. turanicus1/26 4%0/3 JACKAL R. turanicus1/12 8%2/8 25%

10. Kandahar, AF 2008

11. CONCLUSIONS  Babesia species circulating in the animal and ectoparasite populations  Vector-borne diseases information can be gained with this type of surveillance

12. FUTURE  Conclude analysis of 2009 Iraq samples  Receive samples from Iraq and Afghanistan in 2010 Several cooperators have requested supplies  Refine capability to employ serological analysis on blood samples  Update analysis platform to allow concise results for multiple pathogens in one test run

13. FUTURE cont.  Apply epidemiological information to the data  Receive samples from livestock Can analyze for other potential pathogens of importance

14. THANK YOU By Cpl. Matthew K. Hacker from USA War Dogs