AHMf FORO3E, PACIFIC 
OGEiISSjAEEAS i*||iif*lil 
I illSi RESTRICTED 
PREVENTIVE MEDICINE MANUAL No. 2 
FOR ALL OFFICERS 
MILITARY CONTROL 
of 
MALARIA 
and 
INSECT-BORNE DISEASES 
wv, f ~~ ' 
UNITED STATED 4JftViy PACIFIC'OCEAN AREAS 
kobert C. Richardson, /ts* Lieutenant General, U. S. Army., 
Commanding 
MALARIA AND INSECT CONTROL • PACIFIC OCEAN AREAS 
JUNE 1915 
The Information in this manual is not 
to be communicated either directly or 
indirectly to the press or to any person 
not in the Armed Forces (Allied), 
DI7CTD 
M\JLjtD± l\ I Lvi jVjU HEADQUARTERS UNITED STATES ARMY 
FORCES, PACIFIC OCEAN AREAS 
OFFICE OF THE COMMANDING GENERAL 
APO 958 
SUBJECT: Military Control of Malaria and Insect- 
Borne Diseases. 
TO : All Officers, U. S. Army Forces, Pacific 
Ocean Areas. 
1. This manual on the military control of malaria 
and insect-borne diseases is published for the informa- 
tion and guidance of all officers. 
2. It is of greatest importance that these diseases 
shall not jeopardize the success of a military cam- 
paign. All commanders are enjoined to assist tne 
program outlined in this manual. 
ROBERT C. RICHARDSON, Jr., 
Lieutenant General, U. S. Army, 
Commanding. MILITARY CONTROL OF INSECT- 
BORNE DISEASES* 
SECTION I 
Introduction 
1. Insect-borne diseases of present or potential 
military importance in the Pacific Ocean Areas are 
transmitted by mosquitoes, mites, flies, fleas and lice. 
Those which are of immediate and urgent importance 
are set in bold type. 
a. Mosquito transmitted diseases include mal- 
aria, dengue fever, filariasis and Japanese B ence- 
phalitis. 
b. Mites transmit mite-borne typhus. 
c. Fly-borne diseases include the dysenteries. 
d. Fleas transmit plague and flea-borne typhus. 
e. Lice transmit louse-borne typhus. 
2. Fortunately the measures which prevent one 
type of insect-borne disease are effective often against 
others. Thus anti-mosquito work which is done to 
prevent dengue fever is often effective also in pre- 
venting filariasis or Japanese B encephalitis. 
SECTION II 
Malaria 
1. Military Importance of Malaria. 
a. Malaria contributed greatly to the unhappy 
termination of the defense of Bataan. It is estimated 
that 85 percent of our forces there became infected 
with malaria. Over five times as many casualties in 
the South Pacific were due to malaria as were caused 
by all battle casualties. Heavily seeded troops who 
were sent from Guadalcanal to rear bases and ordered 
♦Revised and extended from Malaria Training Manuals 
No. 2 and No. 3, South Pacific Area. 
1 to stop suppressive atabrine averaged 1-Yz to 2 attacks 
of malaria per man. Whole divisions were thus ren- 
dered less effective both in combat and during their 
rehabilitation and training periods because of the 
number of men ill with malaria. Similar rates occurred 
in New Guinea. 
b. These early malaria rates followed from the 
urgency of the situation. It was necessary to begin 
the Guadalcanal and New Guinea campaigns before 
the newly-developed repellents and freon aerosol 
sprays were available, when the supply of quinine was 
short, and when atabrine was a relatively unknown 
drug. We had too little knowledge of the danger of 
malaria and how to cope with it. Now we are better 
prepared to reduce the malaria hazard; it need no 
longer jeopardize the success of a military campaign. 
2. Malaria Can Be Effectively Controlled Only By 
The Joint Efforts Of Every Officer and Man. 
It is urgent to emphasize this point. The present 
insect control organization has demonstrated that the 
disease can be controlled on established bases. Mos- 
quito control in newly occupied territory is now aided 
by airplanes which are equipped to spray DDT solu- 
tions. Here it is important to note that too much 
reliance is often placed on airplane spraying. Control 
work by ground crews is still the most important and 
only proven method. Special spray teams are organ- 
ized to work behind combat lines, but there is no 
mosquito control in the area of front line combat. 
Malaria prevention there becomes a matter of how 
well each officer knows what he can do to protect his 
men from infected mosquitoes and how well each man 
uses his clothes, his repellent, and his spray to stop 
mosquito bites. This is all summed up in two words: 
malaria discipline. 
3. General Information About Malaria. 
a. tGeographical distribution in Pacific Ocean 
Areas. There is no malaria in the Hawaiian Islands, 
in Saipan or Guam or in the islands between. There 
is malaria in all the target areas; in Formosa, in 
China, in the Ryukyus, and in Japan itself. 
2 b. The malaria mosquito. Malaria is transmitted 
by only one group of mosquitoes called anophelines. 
Other groups of mosquitoes do not carry malaria and 
are commonly called “pest mosquitoes”. The female 
anopheline mosquito lays eggs in water and the cycle 
of development from eggs through the larval stage to 
adult requires about ten days. The anopheline (mala- 
ria) mosquito breeds in open ponds, lagoons, swamps, 
and streams. She flies over distances of a mile or 
more and hence may be thought of as a “field type” of 
mosquito in comparison with the “domestic type” of 
mosquito which breeds close around camps and dwell- 
ings and flies only short distances. The “domestic 
type” of mosquito is discussed under Dengue Fever. 
Only the female anopheline transmits malaria. She is 
a shy mosquito which flies and bites only at night 
except in dark jungle where she may bite in the day- 
time. Hence protective measures are most important 
at night. 
c. Variations due to season, control efforts, and 
base development. Malaria is more prevalent during 
the rainy season when there are many new pools of 
water where malaria mosquitoes breed. The amount 
of mosquito control work which has been accomp- 
lished is another factor in the malariousness of a base. 
Thus, on entering a new base under combat conditions, 
little permanent control is possible and reliance must 
be placed on larviciding and on individual protective 
measures such as the use of repellents, sprays, bed 
nets, and atabrine. As the base develops, better mal- 
aria control measures are gradually instituted and 
destroy more and more mosquitoes until so few 
remain that many of the individual protective meas- 
ures are no longer essential. 
d. Man-made malaria, a serious problem. Over 
fifty per cent of the malaria mosquito breeding during 
the first rainy season on Guadalcanal took place in 
man-made pools of water which were made by: 
(1) Unnecessary ruts, formed by driving 
“cross country” and on unauthorized 
roads and ti’ails. 
3 (2) Roads which were built without adequate 
ditches and culverts and thus blocked 
natural drainage courses. 
(3) Numerous small borrow pits alongside 
roads. 
(4) Abandoned foxholes and bomb craters 
which became prolific sources of mos- 
quito breeding. 
e. Special problems in occupying new bases. 
Warning should be given of the false security which 
too often follows a landing during the dry season. 
Troops who expect mosquitoes and malaria, but find 
none, conclude that talk about malaria has been exag- 
gerated. Thus, the first troops on Guadalcanal in 
August 1942 found few mosquitoes and had little 
malaria in the first weeks. Meanwhile, female anoph- 
elines were laying countless thousands of eggs in 
water which collected in the myriad of ruts and holes 
made by the occupying force (man-made malaria). 
Malaria cases appeared in September and the disease 
became epidemic in late October. 
A similar situation occurred during the New 
Georgia operations where every man was given a 
bottle of repellent and other antimosquito equipment. 
No mosquitoes were found at the time of landing, and 
men discarded their repellent. Meantime, increasing 
numbers of mosquito larvae were found in ruts and 
holes, a warning of malaria to come. Would these 
same troops have thrown away their guns and am- 
munition if they had not met the enemy during the 
first few days? 
4. Nature of Malaria And Suppressive Treatment. 
a. Three factors must be present at one time and 
place if malaria is to be prevalent among troops: 
Persons infected with malaria. (Natives, Japs 
or malaria-infected troops who comprise the “seed 
bed”.) 
Malaria carrying mosquitoes. (Anophelines). 
Non-infected troops. 
The chain of transmission from infected persons 
to mosquito to healthy troops is described below. 
4 b. Malaria is a disease caused by a tiny parasite 
which is found in man’s red blood cells. The female 
anopheline, or malaria mosquito, must first become 
infected before she can spread the disease. This she 
does by biting and sucking up some blood containing 
parasites from an infected native or other person 
who has malaria. The parasites multiply in the mos- 
quito for about ten days and then wait in her salivary 
glands for a chance to infect a well man. Every time 
the mosquito drills a hole in a man’s skin for blood, 
she injects saliva into the opening, and if malaria 
parasites are in the saliva, they go into the hole and 
so into the blood. Here they enter a red blood cell 
and multiply until they finally fill the blood cell and 
burst out, destroying this red cell. They then invade 
other cells and repeat the process. 
c. Symptoms and diagnosis. Symptoms usually 
develop about fourteen days after a man is bitten by 
an infected mosquito. One should suspect malaria 
when he has a chill followed by a fever and sweating. 
The symptoms of malaria may be anything from head- 
ache to delirious fever or even sudden unconscious- 
ness. The only way to be certain that one has malaria 
is to find malaria parasites in a blood film examined 
with a microscope. Under field conditions medical 
officers sometimes must diagnose and treat malaria 
from symptoms alone, without examining the blood. 
d. Treatment and relapse. Atabrine, quinine, or 
other drugs are used in the treatment of malaria. 
When given properly, the drugs will usually cure the 
attack in about a week. But sometimes, even though 
a man feels well after treatment, the drugs have not 
destroyed all the malaria parasites. A few of them may 
hide away in the internal organs. Then, after weeks 
or months the disease appears again. This is called 
a relapse. There may be several such relapses which 
have to be treated each time like a new infection. 
e. Atabrine suppressive therapy. There is no 
known drug which will prevent malaria infection; 
but one drug, atabrine, will, when given properly, 
delay the onset of symptoms of the disease as long 
5 as it is being taken. This drug is therefore of vital 
importance in keeping men on their feet during urgent 
military operations. Atabrine blood studies have 
demonstrated that failure of the drug to protect 
against malaria is almost always due to not taking 
the atabrine regularly as prescribed. 
Dosage: Theatre directives prescribe exact 
dosage schedules. 
Supervision: Troops do not take medicine wil- 
lingly. Blood atabrine studies have shown repeatedly 
that atabrine is not taken well when supervision is 
lax. Unit commanders are responsible: 
That the drug be given by roster to both officers 
and men. 
That an officer or a competent noncommissioned 
officer witness the actual swallowing of the drug by 
each individual. 
That by checking the roster regularly, all in- 
dividuals who have not taken the drug be required 
to report and take sufficient dosage to equal that 
missed. 
That failure to take atabrine as ordered should 
result in disciplinary action. 
Atabrine is as completely harmless in the recom- 
mended dosage as is aspirin. It may cause vomiting 
and diarrhea in a few men when first started. This 
disappears after the first few days and can be less- 
ened by taking the tablet on a full stomach. Less than 
one in 1000 persons is intolerant of atabrine. For such 
a person the medical officer may prescribe quinine. 
Here it should be noted that atabrine gives better 
suppressive action than quinine and has fewer toxic 
effects. A temporary yellowing of the skin may occur 
since atabrine is a yellow dye. This will disappear 
after the drug is stopped and is not harmful. Atabrine 
will not cause impotence or sterility. 
Eventually when suppressive treatment is dis- 
continued, most individuals who have been infected 
will become acutely ill with malaria. Recent evidence, 
however, indicates that suppressive treatment with 
atabrine will completely stop the development of one 
6 type of malaria Infection (Plasmodium falciparum). 
Plasmodium falciparum infections long have been 
considered the type of malaria most likely to cause 
death. It is also probable that suppressive treatment 
with atabrine will lessen the severity of all types of 
malaria infection. 
A particularly hazardous aspect of the use of 
suppressive treatment is that it may conceal danger- 
ously the amount of malaria which may be seeding a 
unit gradually. The apparent freedom from malaria 
may lead to carelessness in the enforcement of mal- 
aria discipline. Commanding officers of such units 
are apt to regard truly preventive measures such as 
mosquito control and individual protective measures 
as not necessary. If the risk of infection is suffici- 
ently great to necessitate the use of suppressive treat- 
ment, it is all the more important to stress truly 
preventive measures. Failure to employ precautions 
against mosquitoes to the fullest possible extent is 
inexusable and is a reflection upon the efficiency of 
the commanding officer concerned. 
f. Malaria is a serious disease. It destroys a 
man’s blood and makes him weak. It may keep him 
in the hospital for ten days or longer. It may make 
him a chronic invalid for a year. It may cost him his 
life in combat. It may kill one or two out of every 
hundred infected persons if they are not properly 
treated. 
5. Malaria Preventive Measures Which Are Pri- 
marily Command Functions. 
It is the responsibility of all commanders to 
initiate and enforce the necessary measures to control 
malaria within their units and unit areas (Appendix 
I and Circular 223, WD, 1943). These measures in- 
clude: 
a. An organization and program for insect con- 
trol. Unit commanders will appoint an insect and 
rodent control detail consisting of 1 NCO and 2 en- 
listed men in each company, battery, squadron, or 
similar unit (see paragraph 3 a. Appendix I). These 
details primarily will maintain insect control within 
7 the camp and in surrounding territory for a distance 
of one mile. Their insect control work will include 
spraying of all standing water once weekly, minor 
ditching to remove such water, smoothing of road ruts 
and the use of DDT residual effect sprays. This last 
method is new and is of value because of the per- 
sistent effect of DDT when sprayed on screens and 
walls of tents, quarters, and native dwelling. Spray- 
ing the latter is particularly profitable because most 
mosquitoes become infected with malaria by biting 
diseased natives and often rest on the walls of the 
dwelling where the blood is obtained. A single spray- 
ing of these buildings with DDT not only will kill all 
mosquitoes then present but will continue to kill mos- 
quitoes as they come in contact with treated surfaces 
for one to three months. This may prove one of the 
most valuable of all antimosquito measures. Insect 
control officers of units smaller than divisions will 
be appointed as provided in Appendix I. For division 
and base insect control groups (see Appendix I). 
b. A training program in military control of 
insect-borne diseases for all personnel. The details of 
this program are outlined in Appendix 11. Every 
officer should seek to impress his men with the im- 
portance of individual protective measures. 
c. Supplies and equipment. The commander is 
charged with the timely requisitioning of insect 
control supplies (Appendices 111 and IV). These should 
be forwarded in divided shipments so that loss of 
one shipment will not disrupt the program. It is the 
responsibility of unit commanders that each man is 
supplied with a bed net in good condition and that he 
has a bottle of repellent. It is his responsibility that 
during combat insect control supplies reach the front 
lines with the same regularity as food. 
d. Command responsibilities during the phase of 
seaborne troop movements. 
(1) Temporary landings of only a few days 
on malarious bases (or where dengue is epidemic) 
may result in large numbers of men contracting these 
diseases. Landings made for the purpose of exercise 
8 should be accomplished during daylight hours, and 
troops should be back aboard ship by sunset when 
malaria mosquitoes start biting. Repellent and other 
measures for individual protection should be used 
when indicated. 
(2) When it is known that troops will land 
and camp on a malarious island, an officer should be 
sent ahead to select, with the aid of the island malaria 
control group, a relatively non-malarious campsite. 
(3) All landing movements should be so plan- 
ned, the military situation permitting, that troops go 
ashore in the morning with sufficient time to set up 
camp and be under mosquito nets by night time. This 
requires that nets, repellents, and other insect control 
supplies be available on the first night ashore. 
e. Selection of campsites. The advice of the base 
or division malaria and insect control officer should 
be obtained in selection of camp sites, whenever the 
military situation allows. Camps should be located 
a mile or more from native villages and marshes or 
streams which are known or suspected to be breeding 
places for mosquitoes. 
f. Segregation of natives. Over fifty per cent of 
natives on malarious islands in the Pacific have 
chronic malaria, and are a serious source, or “seed 
bed”, of infection. Most of these natives also have 
filariasis. Preferably, they should never be allowed 
in ti’oop areas. In practice, they are often essential 
as laborers. When so employed they should be allow- 
ed in camp areas only between the hours of 0700 and 
1800. If natives are allowed in or near camp at night 
when malaria mosquitoes are feeding, the mosquitoes 
may become infected and will, in turn, transmit the 
disease to troops. Native camps should be “Out of 
Bounds,” or “Off Limits.” 
g. Night exercises and landing drills. Night 
maneuvers, or landing drills, should be held in rela- 
tively malaria-free regions. The permanently based 
malaria and insect control units will designate suit- 
able areas for tactical operations and will also mark 
out sectors which should be out of bounds. All anti- 
9 mosquito precautions should be rigorously enforced, 
both for protection and as a training measure, even 
when night exercises are held in authorized sectors. 
h. Night working parties in malarious areas. 
Night working parties should be employed in malari- 
ous regions only when essential. They should wear 
their shirts, use repellents, and take all other protect- 
ive measures. 
1. Screening. Screening is an important pro- 
tective measure whenever its use is feasible. Men 
living inside screened tents and sleeping under bed 
nets have double protection. The specifications and 
use of screening are detailed in Appendix 111. 
j. Malaria discipline. Unit commanders are re- 
sponsible for malaria discipline among their troops. 
This includes the program of suppressive therapy 
with atabrine described in subparagraph 4e, above, 
and the enforcement of individual protective meas- 
ures as outlined in paragraph 6, below. 
6. Individual Protective Measures Against Mos- 
quito Bites. The malaria mosquito bites at 
night. The measures which each soldier, sailor, or 
marine will take to protect himself are described. 
(Note: These measures are equally effective against 
mosquitoes which transmit dengue fever and other 
diseases, except that they must be carried out during 
the day as well as at night. See Dengue Fever): 
a. Ordinary clothing used for protection. Mos- 
quitoes do not bite through ordinary clothing unless 
it is thin or tightly stretched. Shirts will be worn, 
beginning at sundown, with collars buttoned and 
sleeves rolled down. Wherever mosquitoes are pres- 
ent, the bottoms of trousers will be tucked into tops 
of shoes and socks will be drawn up around trouser 
bottoms to protect ankles. 
b. Repellents. Repellents are chemical solu- 
tions which, when spread over the skin, will keep 
mosquitoes from biting for about two hours. At 
sunset and every two hours when exposed at night, 
one should rub fifteen to twenty drops of standard 
mosquito repellent on hands, wrists, cheeks, neck, 
10 and lower legs. The repellent must be applied more 
often when men are sweating. Also, apply a few 
drops where clothes are tight, as across shoulders 
and the seat of trousers and on socks. Repellent 
should be taken to fox holes during night alarms. 
It should be kept close at hand for this purpose by 
placing it in steel helmet before retiring. The use of 
repellent is the most important and most neglected 
phase of malaria discipline. It is important to em- 
phasize that there may be times, particularly in 
combat, when repellents are the best protection 
against malaria. A man may go through the most 
malarious area and avoid the disease completely if 
repellents are used regularly and well. 
c. Spray killing of adult mosquitoes. A spray 
er known as a freon aerosol dispenser is available. 
The spray is highly concentrated. Ten seconds spray- 
ing is enough for a pyramidal tent, three seconds 
for a pup tent. Longer spraying does not increase 
effectiveness and is wasteful. Tents and nets should 
be sprayed at dusk and at bedtime. A supply of spray 
should be taken to the fox hole at night. Hospitals 
with malaria patients should be sprayed regularly, 
as should mess halls and kitchens. 
d. Bed nets and jungle hammocks. Bed nets 
are one of the most valuable methods of protection 
from mosquito bites. There are places in the tropics 
where a single night of exposure to mosquito bites 
may result in an infection rate up to twenty per cent 
among unprotected troops. It is the responsibility of 
each officer to see that these nets are available on the 
first night ashore. They should be regularly inspected 
and repaired. Each man should practice setting up 
his net before entering a malarious area. The net 
should be so supported that it does not sag upon the 
sleeping man, and so arranged that his elbows and 
knees do not contact the meshes. In practice, such 
contacts are difficult to prevent. The man is well 
repaid who uses repellent on the knees and elbows 
when he retires. Nets should be ready before dusk, 
should be tucked in carefully, and a search for mos- 
11 quitoes should be made preferably with a flash light, 
after one gets inside. When not in use bed nets should 
be so arranged that mosquitoes cannot enter. 
e. Avoidance of unnecessary exposure to infect- 
ed mosquitoes. Troops should not be allowed to 
go swimming or fishing, or to bathe in unscreened 
showers, or otherwise unnecessarily expose them- 
selves after sundown. It may be feasible to postpone 
reveille until after sunrise in order to avoid early 
morning exposure in highly malarious areas. 
SECTION 111 
Dengue Fever 
1. Military Importance. Dengue is usually second 
to malaria as a hazard to military operations; but on 
occasions it becomes of primary and urgent import- 
ance. Serious epidemics have occurred on Saipan, 
Guam, and earlier on Espiritu Santo and New Cale- 
donia. In some of these epidemics more than 25 per 
cent were non-effectives. 
2. Geographical Distribution. Dengue is prevalent 
in the islands of the Pacific Ocean Areas and particu- 
larly in Formosa, Ryukyu Islands, Japan, and China. 
3. Nature of the Disease. Dengue fever is an 
acute non-fatal disease caused by a filterable virus 
which is transmitted from an infected man to a 
healthy one by a mosquito and by no other means. 
The symptoms are often much like malaria as is 
shown in Table I, “Comparison of Malaria and Den- 
gue.” The importance of blood smears in diagnosis 
is apparent. 
4. Method of Transmission. The Aedes aegypti 
mosquito is the chief vector of Dengue fever; aedes 
albopictus has also been incriminated. Both species 
bite freely during the day as well as at night, differ- 
ing from anopheline (malaria) mosquitoes which bite 
at night. The mosquito vector herself must become 
infected by biting a dengue patient during the first 
12 three days of the fever as this is the only time that 
the virus is present in the blood. After a short period 
of incubation in the mosquito the latter becomes in- 
effective and is able to transmit dengue at anytime 
during the rest of its life by biting a susceptible man. 
5. Life History of Aedes Aegypti. The female 
Aedes aegypti lays her eggs in tin cans, flower pots, 
water tubs, and other artificial water containers close 
around a house; and is called a domestic or house 
type of mosquito in contrast with the anopheline 
(malaria) mosquito which breeds in pools and streams 
in the fields. A correlary of this is that the adult 
Aedes aegypti mosquitoes fly only short distances 
and therefore must lay eggs near the camp or house 
where they are found biting. The Aedes mosquito 
develops from larvae to adult in seven to ten days 
in warm climates. 
TABLE I 
COMPARISON OF MALARIA AND DENGUE 
Symptoms or Signs 
Dengue 
(100 Cases) 
Malaria 
(100 Gases) 
Frontal headaches 
88% 
96% 
Chilly sensations 
55% 
22% 
True chill 
10% 
56% 
Pain in eyes 
78% 
59% 
Red Conjunctivae 
97% 
not noted 
Low backache 
74% 
79% 
Pain on eye movement 
25% 
common 
Abdominal symptoms 
17% 
47% 
Toxic rash 
35% 
none 
Temperature 103° F. or over 
55% 
68% 
Saddle-back temperature 
25% 
none 
“Dengue” rash 
18% 
none 
Joint aches 
common 
72% 
13 6. Control of Dengue Depends on Control of Den- 
gue Carrying Mosquitoes. 
a. Breeding of this mosquito is controlled by 
destroying or emptying the artificial water containers 
where she lays her eggs or by putting oil or DDT on 
such water. This must be done at least once a week. 
Some of the principal breeding places which must be 
treated are rain barrels, tubs, cisterns, cans of all 
sizes, bottles, pots, pails, old shoes, canvas tarpau- 
lins holding rain water, tires so stacked as to hold rain 
water, and slit trenches: anything that will hold 
water for ten days. 
b. Individual protective measures against den- 
gue mosquitoes are the same as those already dis- 
cussed to protect against malaria: 
Ordinary clothes used for protection. 
Repellents. 
Spray killing of adult mosquitoes. 
Bed nets and jungle hammocks. 
Avoidance of unnecessary exposure. 
Screening. 
The only difference is that the dengue mosquito 
bites both during the day and at night; hence pre- 
cautions must be taken at all times. 
SECTION IV 
Mite-Borne Typhus 
1. Introduction. Mite-borne typhus (scrub typhus, 
tsutsugamuchi disease) is a typhus like disease of 
field mice, rats, and other animals which is trans- 
mitted by the bite of a mite (chigger or red bug). 
Man contracts the disease by being accidentally bitten 
by an infected mite. 
2. Military importance. Mite-borne typhus has 
not yet been a disease of great hazard to military 
operations. There have been less than 4000 cases in 
the U. S. Army in the first three years of war. It has 
however been a disease of greatest importance to 
14 individual organizations who happen to locate in an 
infected area. In some organizations nearly 50 per 
cent of the personnel have been infected; the mor- 
tality rate in restricted localities in the region of 
New Guinea has varied from about 1.5 to almost 30 
per cent. Small but severe localized epidemics may 
therefore give rise to unfounded rumors affecting 
morale. 
3. Geographical Distribution. The disease occurs 
in scattered areas lying within a rough triangle of 
Japan, Eastern India, and Northern Australia. All 
future target areas are potential sources of mite-borne 
typhus. 
4. Nature of The Disease. Mite-borne typhus is 
an acute febrile disease caused by a minute organism 
which usually is found in the blood of infected mice 
and other rodents and is transmitted from rodent to 
rodent by mites. When man is bitten by an infected 
mite the disease becomes manifest after an incubation 
period of about two weeks. The typhus inoculations 
which the army gives are to protect against a more 
severe type of typhus which is known as louse-borne 
typhus. These inoculations do not protect against 
mite-born typhus which is a different and usually a 
milder disease. 
5. Transmission. The six legged larval mite (red 
bug, chigger) which transmits the disease is so small 
that it is rarely seen. It is red in color. Mites are 
frequently described as occurring in open fields of 
Kunai grass, but they are found equally often in 
other types of tall grass and in areas overgrown with 
scrub. Apparently a moist loose humus soil is favor- 
able for them. It is unknown as yet why one area 
in a meadow may be highly infected and result in 
numerous cases in troops encamped there while other 
troops a short distance away in the same field may 
escape attack. In Japan, mites are common in river 
bottom areas and on ground which is subject to 
flooding. 
15 6. Control. 
a. Mite avoidance. 
(1) Standing, sitting, or lying in open grass 
or along jungle margins where mites abound should be 
reduced to the minimum. Mites remain chiefly in or 
on the ground but are quick to crawl up the shoes 
or clothing of a standing or reclining individual. 
Troops continuously on the march seldom show evi- 
dence of chigger bites even after traversing heavily 
infested areas. 
(2) A vigorous soap and water scrubbing of 
the whole body with a wash cloth is highly desireable 
following exposure in a potentially mite infested area. 
(3) Sleeping in direct contact with the 
ground is necessary under some operational condi- 
tions but is dangerous. A bare road is to be preferred 
for bivouac to sleeping in an adjacent field of kunai 
grass. Similarly jungle hammocks are better than 
cots where there is a choice. Native type beds of 
freshly cut poles on cross pieces are safer than the 
ground. 
b. Repellents. The standard G.I. repellents are 
all helpful but dimethyl phthalate is the best. Small 
amounts in cupped hand should be rubbed thorough- 
ly into socks, shoe tops, trouser cuffs, trouser fly and 
waist, shirt fly, collar, and sleeve cuff. This must 
be repeated weekly. It is not as reliable or practical 
for large bodies of troops as the total impregnation 
of clothing described below. 
(1) Impregnation of clothing and blankets 
with a dimethyl phthalate-soap emulsion. An impreg- 
nated uniform remains mite proof during five weeks 
of occasional wearing or will protect wearer until 
laundry is necessary when worn daily. The treatment 
withstands sun, rain, walking in wet grass, and ex- 
cessive sweating. Impregnated uniforms are still 
effective after being worn in swiftly running fresh 
water for fifteen minutes or in the ocean for thirty 
minutes. Hard scrubbing with soap and cold water 
or laundering in hot water removes the dimethyl 
16 phthalate. Treated blankets will remain effective fer 
two months if unlaundered. Details are given In 
Appendix VI. 
(2) Warning. Repellent impregnated cloth- 
ing, and DDT should not be used togther. The DDT 
which is insoluble in water is dissolved in the repell- 
ent and toxic absorption may occur. Each alone is 
safe. 
c. Preparation of bivouac site in area where 
mite-borne typhus is prevalent. Locations which are 
to be used as new camp sites should be prepared as 
fully as possible before the arrival of a new unit. 
Native labor should be employed whenever it is avail- 
able. All grass and scrub should be cut level with 
the ground and, after drying, collected and burned 
or hauled away. It is desirable to burn over the camp 
area with a power oil sprayer or flame thrower. 
Underbrush in adjacent jungle strips should be 
cleared out in a similar manner. 
SECTION V 
Diseases of Potential Military 
Importance 
1. Filariasis is transmitted by mosquitoes. In the 
South Pacific Area this mosquito is the same one 
which is the chief vector of malaria. In other areas 
filariasis is transmitted by the domestic type of mos- 
quito, one of which has been described in the trans- 
mission of dengue. In any event, measures against 
these two types of mosquitoes (the field mosquito and 
the domestic mosquito) will be equally effective 
against filariasis. 
2. Japanese B encephalitis. Little is known about 
this disease. It is probably transmitted by Culex 
pipiens, a house or domestic type of mosquito with 
breeding habits not unlike those described for Aedes 
aegypti, the vector of dengue. Similar control meas- 
ures are indicated. 
17 3. Fly-borne diseases include the dysenteries and 
are most common during combat operations. During 
this period fly control measures will be undertaken 
by special spray teams. See Appendix V, “Example 
of Standard Operating Procedure”. 
4. Flea-borne typhus, flea transmitted plague, and 
louse-borne typhus are of only potential importance 
and are not discussed. 
APPENDIX I 
Ail Organization for the Military Con- 
trol of Malaria and Insect Borne 
Diseases in all Army Units 
1. Definition. 
Insect-borne diseases of present or potential 
military importance in the Pacific Ocean Areas are 
transmitted by mosquitoes, mites, flies, fleas and 
lice. Those of present importance are italicized. 
a. Mosquito transmitted diseases include mala- 
ria, dengue fever, filariasis, and Japanese B enceph- 
alitis. 
b. Mites transmit mite-borne typhus. 
c. Fly-borne diseases include the dysenteries. 
d. Fleas transmit plague and flea-borne typhus. 
e. Lice transmit louse-borne typhus. 
2. Responsibility for control of insect-borne dis- 
eases. 
It is the responsibility of all commanders to 
initiate and enforce the necessary measures to control 
insect-borne diseases within their units and unit 
areas. The commander or his representative will 
make inspections to assure the enforcement of insect- 
borne disease control in his unit with particular 
emphasis on the use of individual protective meas- 
ures. The commander is charged with the timely 
requisitioning of insect control supplies. The Army 
Corps of Engineers will be responsible for the ex- 
18 ecution of insect control work on real property. The 
Army Air Forces will be responsible for application 
of DDT solutions by airplane to control mosquitoes 
and flies. See paragraph 5d (4), below. 
3. Insect and rodent control details. 
a. All units will form in each company, battery, 
squadron, or similar unit an insect and rodent control 
detail to consist of one noncommissioned officer and 
two enlisted men per infantry company or a propor- 
tionate number for other units and detachments. In 
non-medical units these details will be made up of 
non-medical personnel. Additional working parties 
as may be required for effective mosquito and rodent 
control will be assigned to aid these details. This 
personnel will be given immediate training as detailed 
in Appendix 11, “A Training Program in Military Con- 
trol of Insect-Borne Diseases,” to qualify them to 
perform duties listed in subparagraph b, below. 
b. It will be the primary duty of these insect 
control details to maintain insect control within the 
camp and in surrounding territory for a distance of 
one mile. Where overlapping occurs between units 
the commanding officers of these units will decide 
jointly on the area to be controlled by each group. 
These details will prepare a map showing all water 
collections and places of mosquito breeding in the 
area to be covered. In the preparation of this map 
they will be aided by the base or division malaria 
and insect control group. The following types of 
insect and rodent work will be carried on: 
(1) Spray killing of adult mosquitoes includ- 
ing the use of DDT residual effect sprays. 
(2) Larvicidal work directed against mos- 
quitoes, flies, and mites. 
(3) Clearing of stream banks to facilitate 
larviciding, minor ditching and filling, 
and destruction of artificial breeding 
places around camps and dumps. 
(4) Minor maintenance repairs of screening. 
19 (5) To assist where necessary in the control 
of rodents bearing harmful insects and 
disease. 
4. Malaria and insect disease control officers of 
units smaller than divisions. 
Unit commanders of all units smaller than 
divisions will designate an officer, preferably a medi- 
cal officer as insect-borne disease control officer. This 
officer will be responsible for a program of instruc- 
tion in individual protective measures and for the 
training and work of the insect and rodent control 
details. He will maintain liaison with the base or 
division malaria and insect control group. He will 
render to his commander a monthly report, prior to 
the third day of the next succeeding month with an 
information copy to the base surgeon, covering the 
subjects listed in subparagraph sg, below, but omit- 
ting subheadings (4), (5), (7), and (10). 
5. Division and base malaria and insect control 
groups. 
Special purpose Medical Department personnel 
will be attached to divisions and, as they become 
available, to base sections (operating in the Pacific 
Ocean Areas west of the 150 th degree east longitude 
or in the South Pacific Base Command,) as follows: 
a. Divisions: 
One (1) Malariologist, MC, MOS 3138. 
One (1) Malaria Survey Detachment T/O & E 
8-500. 
One (1) Malaria Control Detachment T/O & 
E 8-500. 
This attached personnel constitutes a basic 
malaria and insect control group and will accompany 
the division in combat and in rehabilitation. They 
will assist in the control of insect-borne diseases 
under combat conditions as well as during the garri- 
son phase. This personnel is in addition to present 
medical department personnel of a division and does 
not affect existing tables of organization or position 
vacancies. 
b. Base or garrison forces, other than divisions. 
20 (1) For approximately every 20,000 garrison 
troops. 
One (1) Malariologist, MC, MOS 3138. 
One (1) Malaria Survey Detachment T/O 
& E 8-500. 
(2) For approximately every 7,500 garrison 
troops. 
One (1) Malaria Control Detachment T/O 
& E 8-500. One control detachment 
should be provided for each important 
post or station. 
c. These groups contain officers and enlisted 
men trained in preventive medicine, entomology, 
parasitology, and sanitary engineering. They will 
work under the immediate direction of the base or 
division malaria and insect control officer (malari- 
ologist) who will be responsible through the surgeon 
to the base or division commander for the prevention 
and control of insect-borne diseases. 
d. The duties of the malariologist, assisted by 
this personnel, will include: 
(1) Participation in the training program for 
military control of insect-borne diseases 
(See Appendix II). 
(2) Provision of estimates of the insect-borne 
disease problem in base and division 
areas and also in areas of anticipated 
operations with recommendations for 
control. 
(3) Provision of specialized services such as 
mosquito surveys, laboratory diagnostic 
service, power sprayer work, and all 
other measui’es within the scope of the 
personnel and equipment of these groups. 
(4) Technical assistance to and integration 
and supervision of the work directed 
against disease carrying insects by the 
following personnel: 
Army Engineer Corps. 
Army Air Forces. 
21 Insect control details from each com- 
pany or similar unit. 
Medical Sanitary Company. 
Native labor. 
(5) Preparation of requisitions for insect con- 
trol supplies. 
e. One or two additional Malaria Survey or Con- 
trol Detachments may be temporarily attached to a 
division for the period of operation when in the 
opinion of the Commanding General, Pacific Ocean 
Areas, such a measure is indicated. 
f. Relation of base and division malaria and 
insect control groups. During periods of assault, base 
malaria and insect control groups assigned to garrison 
forces will render all possible assistance to division 
groups. After a base has been secured or when a 
division is stationed at a base where there is an 
established base malaria and insect control group, the 
activities of the division group will be coordinated 
with those of other groups by the base malaria and 
insect control officer (malariologist). 
g. Monthly and interim reports and recom- 
mendations of the base or division malaria and insect 
control officers will be submitted to the base or divis- 
ion commander through the base or division surgeon. 
The monthly report will cover the following subjects: 
(1) Estimation of the insect-borne disease 
situation with a statistical report and 
analysis of malaria, dengue fever, mite- 
borne typhus, or other insect-borne dis- 
ease in the division or base. 
(2) Status of discipline with regard to indi- 
vidual protection against insects. 
(3) Status of atabrine suppressive therapy 
(when given) including number and his- 
tory of troops released from suppression. 
(4) Summary of entomologist’s report on 
mosquito, mite and fly populations, rain- 
fall and other pertinent data. 
22 (5) Summary of sanitary engineer’s report 
(malaria control detachment). 
(6) Activities of training program for mili- 
tary control of insect-borne diseases. 
(7) Estimation of native populations as a 
seed bed of malaria, dengue, filariasis, 
and other insect-borne diseases. 
(8) Selection of camp sites and related prob- 
lems. 
(9) Status of insect control supplies. 
(10) Report of investigative work and special 
problems. 
(11) Personnel engaged primarily in malaria 
and insect control. 
(12) Recommendations. 
The December report will include in addition to 
the data required for the monthly report, a resume of 
the insect-borne disease situation during the year. 
A copy of these monthly reports will be sent in dupli- 
cate through command channels to HUSAFPOA. 
Commanders will indorse these reports indicating 
action taken or contemplated on recommendations. 
h. No duties that interfere with primary insect 
control duties shall be assigned to members of insect 
and rodent control details or to personnel of base or 
division malaria and insect control groups. Trans- 
portation and all other authorized equipment assigned 
to medical composite units (malaria control and sur- 
vey) and to medical sanitary companies will not be 
diverted for other uses without approval by the com- 
mander of the force to which assigned. 
6. Direct communication on technical matters be- 
tween malariologists, scientific commissions, and the 
Surgeon, Headquarters, United States Army Forces, 
Pacific Ocean Area, is authorized. 
23 APPENDIX II 
A Training Program in Military Con- 
trol of Insect-Borne Diseases 
1. Unit commanders will allot in the training 
schedules sufficient time for the proper instruction of 
their troops in the prevention of insect-borne diseases. 
2. Instruction for all personnel. 
Lectures will be given to small groups of men 
by their respective medical officers on malaria, dengue 
fever, and mite-borne typhus. Other insect-borne dis- 
eases will be included as indicated. All personnel will 
be given initial instruction in these matters as soon 
as practicable. Subsequently, a review of the subject 
will be carried out once a month. On maneuvers the 
use of individual protective measures will be standard 
procedure. These lectures will cover: 
a. Military importance of these diseases. 
b. Nature of these diseases, how transmitted, 
and their effects. 
c. Individual protective measures against mos- 
quitoes with emphasis on conditions under which 
each is applicable: 
(1) Repellents. 
(2) Use of ordinary clothing for protection. 
(3) Bed nets. 
(4) Spray killing of adult mosquitoes. 
(5) Avoidance of unnecessary exposure. 
(6) Atabrine suppressive therapy. 
d. Individual protective measures against mite 
bites. 
(1) Impregnation of clothes and blankets 
with dimethyl phthalate. 
(2) Preparation of bivouac area. 
(3) Avoidance of mites. 
e. Control of mosquito breeding. 
f. Man-made malaria. How to avoid it. 
24 Additional instruction will be given to officers 
emphasizing command responsibility for selection of 
camp sites, for segregation of natives, and for the 
enforcement of individual protective measures. Mem- 
bers of base and division malaria and insect control 
groups will assist. 
3. School for insect and rodent control details, 
a. A school to be conducted by the base and 
division malaria and insect control groups will be 
held for insect control officers and the members of 
insect and rodent control details from each company 
or similar unit. This school will usually occupy three 
days and the following subjects will be taught: 
(1) Identification of Anopheline (“Malaria”) 
and Aedes aegypti (“Dengue”) larvae 
and adult mosquitoes and characteristic 
breeding places. 
(2) Use of maps to mark breeding places. 
(3) Control of mosquito breeding by minor 
draining and filling, by spraying with 
larvicides, and by emptying or destroying 
artificial water containers. 
(4) Use of DDT residual sprays to impreg- 
nate bed nets and to spray quarters. 
(5) Assembly and repair of knapsack and 
continuous hand sprayers. 
(6) Impregnation of clothes with dimethyl 
phthalate to prevent mite bites. 
(7) Control of rodents by trapping and pois- 
oning. 
(8) Fly control by the use of sodium arsenite 
spray and other measures. 
4. A Mobile training center in military control of 
insect-borne diseases. 
a. Training centers in military control of in- 
sect-borne diseases and other aspects of preventive 
medicine will be set up from time to time by this 
headquarters at the chief staging bases, preferably 
in conjunction with general hospitals or field training 
centers. The hospitals or field training centers will 
provide teaching facilities, and when necessary, quar- 
25 ters and rations for faculty and students of these 
schools. The following officers of all units will attend 
a one to two week course at a time to be designated 
by this headquarters. 
(1) Medical Inspectors of divisions and high- 
er echelons. 
(2) Malaria and insect control officers (ma- 
lariologists), 
(3) Regimental and battalion surgeons as 
designated by division surgeons. 
(4) Parasitologists, entomologists and sani- 
tary engineers as designated by base or 
Army surgeons. 
The faculties will be under the supervision of 
the Surgeon, Headquarters, United States Army 
Forces, Pacific Ocean Areas, and will consist of ma- 
lariologists, survey units, control units, and other 
personnel with experience in the prevention of tropic- 
al disease, as may be available to the base commands. 
Additional personnel within base commands or Army 
garrison forces may be placed on detached service 
with the training center for limited periods, as may- 
be required. 
The curriculum will consist of lectures, field 
toork, war rounds, and laboratory work. 
5. To aid in this program base and division malaria 
and insect control groups (or base and division sur- 
geons) will issue the following training manuals. 
a. All officers. 
Preventive Medicine Manual No. 2, “Military 
control of malaria and insect-borne diseases.” 
b. Enlisted men. 
Preventive Medicine Manual No. 3, “Mos- 
quitoes, Mites, and Men.” 
Additional training aids such as appropriate 
training films, literature, posters, and material will 
be available at base and division malaria and insect 
disease control headquarters. 
26 The following antimalaria supplies per 1000 men per month (30 days) are 
authorized (Circular No. 151, WD, 1944, as amended). It is recommended that 
preparatory to entering a malarious area, a ninety (90) day supply be obtained. 
Every effort should be made to secure the items listed on the following pages before 
leaving rear bases for undeveloped areas, depending on availability of supplies and 
shipping. These supplies should always be shipped in divided lots so that the loss 
of any one shipment will not disrupt the program. 
' 
Supply per 
Item No. 
Article 
Unit 
1000 men/mo 
Remarks 
1084500 
Atabrine 100 tablets l-% 
gr. (QuinacrineHCL, USP) 
btl 
400 Units 
108440 
Atabrine, 5 amps, 0.2 gm, 
with 10 cc sterile distilled 
box 
4 Units 
water. (Quinacrine HCL) 
1391000 
Quinine sulphate, 1000 tab- 
lets; USP; 5 gr. 
btl 
3 Units 
1389000 
Quinine dihydrocholride, 
12 amps; NP; 1 cc amp 
containing 5 gr solution 
box 
1 Units 
REQUISITION FROM MEDICAL SUPPLY 
APPENDIX 111 
Supplies 
27 Item No. 
Article 
Unit 
Supply per 
1000 men/mo 
Remarks 
27-B-343 
Bar, insect, field 
ea 
83 
Note 1 
41-D-3750 
Duster, insect powder, 
plunger type 
ea 
5 
Note 2 
51-1-159 
Insecticide, aerosol, 1 lb 
dispenser 
ea 
ea 
300 
Note 3 Hawaiian Dept 
Supply 7%/1000 men per 
month. 
1 per 10 airplanes to be 
disinfected by Army Air 
Forces. 
51-1-305 
Insecticide, spray, DDT 
Residual effect 
gal 
60 
51-1-169 
51-L-122 
Insecticide, liquid, fin- 
ished spray 
Larvicide, DDT, powder, 
gal 
8 
For use other than mos- 
quito control. 
Note 3 Hawaiian Dept 
dusting 
lb 
50 
Supply 5/1000 men per 
month. 
51-1-173 
Insecticide, powder, louse, 
2 oz can 
ea 
150 
Note 3 Hawaiian Dept 
Supply 25/1000 men per 
month. 
51-L-120 
Larvicide, DDT, powder, 
dissolving 
lb 
200 
51-R-265 
Repellent, insect, 2 oz btl. 
btl 
3006 
Note 3 Hawaiian Dept 
Supply 350/1000 men per 
month (normally requir- 
ed May to Oct inclusive) 
51-R-300 
Repellent, insect, spray 
clothing 
Gal 
40 
Note 3 
REQUISITION FROM QUARTER MASTER 
28 41-S-4110 
to 12 
Sprayer, liquid, Insect, 
pump type 
ea 
15 
Note 2 & 3 Hawaiian 
Dept Supply 10/1000 men 
per month. 
41-S-4106 
Sprayer, liquid, insect, 
continuous spray 
ea 
2 per cafeteria mess or 
theater building. 
7-0-200 
Oil, fuel, oil burner, grade 
FS2 
gral 
150 
Note 3 Hawaiian Dept 
Supply 10/1000 men per 
month. 
Item No. 
Article 
Unit 
Supply per 
1000 men/mo 
Remarks 
41-7839.7-7 
Paris green, standard lar- 
vicide 
lb 
40 
41-3115.5-10 
Duster, insect, hand ro- 
tary blower type 
ea 
3 
Spare parts for above 
duster 
set 
3 
Note 2 & 3 
41-7839.5-5 
Sprayers, insect, knapsack 
type, 3 gal capacity 
ea 
10 
Note 2 & 3 Hawaiian 
Dept Supply 1/1000 men 
per month. 
Sprayers, insect, knapsack 
type, spare parts 
set 
10 
Note 2 & 3 Hawaiian 
Department of Supply 
1/1000 men per month. 
REQUISITION FROM QUARTERMASTER (Continued) 
REQUISITION FROM ARMY ENGINEER CORPS 
29 ♦Allowances for screening are not available. These recommendations are based on plans 
to screen nearly all tents. Enough to screen field hospitals, caring for malaria and dengue 
patients should come ashore with hospital units, to be followed as soon as possible by screen 
for kitchens, mess halls, offices, latrines, and later all tents, in that order of priority. Cloth 
bobbinette is preferred to wire for field use. Wire or plastic screening is preferred whenever 
wooden mess halls, or other stable semi-permanent buildings are to be screened. 
Note 1: Replacement factor per 1000 men per month, applies to Army Ground Forces only. 
Note 2: Initial supply only. 
Note 3: Except Hawaiian Department 
Note 4: May be issued in lieu of cloth bobbinette when use of permanent buildings is 
anticipated. Replacement rate should be half that of cloth screening. 
40-9030.6-3 
Sprayer, insect, portable, 
gasoline, engine driven for 
larvicide with four 50 ft 
lengths of % inch oil re- 
sistent hose and spray 
nozzle 
Parts, spare for above 
set 
set 
% 
% 
Note 
Note 
2 & 3 
2 & 3 
•Screening, cloth-bobin- 
ette, 18-20 mesh, bar 3 ft 
wide 
ft 
16,000 
lin. ft 
Note 
2 
•Screening, cloth-bobin- 
ette, 18-20 mesh, bar 3 ft 
wide 
ft 
4,000 
lin. ft 
Note 
1 
•Screen, wire, heavy 
grade, 16 meshes to inch 
Note 
4 
♦Screen, standard grade, 
18 meshes to inch 
Note 
4 
♦Saran-plastic screening 
(Dow Chemical Co.) 
Note 
4 
REQUISITION FROM ARMY ENGINEER CORPS (Continued) 
30 APPENDIX IV 
Supplies for Insect and Rodent 
Control Details 
The following equipment should be available to 
the insect and rodent control details of each battalion 
from the T/BA equipment of the unit. Smaller units 
should have similar equipment in amount proportional 
to their strength. Items not included in unit T/BA’s 
should be requisitioned as indicated below (Initial 
issue). A motor vehicle is needed for use in bivouac 
area to haul oil and other supplies, labor details, etc. 
Item No. 
Article Unit 
Amount 
Engineer Equipment 
Compass 
ea 
1 
74-70005-22 
Machetes, w/scabbard 
ea 
8 
Paper, overlay or trac- 
ing, for maps 
Roll 
1 
41-3780.43-02 
Funnel, iron, galvanized, 
plain, 2 qt 
ea 
4 
Quartermaster equipment 
Spigot, (valve, molasses) 
with approximately 2% 
inch male thread connec- 
tion to fit bung of 55 gal 
drum 
ea 
4 
41-A-1277 
Axe, single bit, w/handle 
ea 
3 
70-H-1180 
Brush hook, w/handle 
ea 
2 
Note book, field 
ea 
6 
41-M-720 
Mattocks, w/handles 
ea 
5 
41-S-3170 
Shovel, D-handles, round 
No. 2 
ea 
3 
41-S-3220 
Shovel, long handle, 
round point, No. 2 
ea 
3 
7263000 
Medical supplies 
Class 7 
Dipper, 1 pt 
ea 
3 
31 APPENDIX V 
Example of Standing Operating 
Procedure 
This S.O.P. is merely a sample plan adapted to 
and used during one operation. All such plans should 
be flexible. Several general plans should be prepared 
by each division malaria and insect control group. 
The exact plan and details will be determined by 
current requirements of the particular military situa- 
tion. 
Standing Operating Procedure 
For Control of Malaria and Other Insect- 
Borne Diseases During X Operation 
1. Statement of Problem. 
“X” operation will take place in an area where 
malaria is the fourth cause of death, where dengue 
fever is prevalent, and where mite-borne typhus and 
fly-borne intestinal diseases are potent hazards. A 
native population which averages over 500 per square 
mile is a seed bed of disease. 
2. Mounting Phase. 
a. All personnel will again be trained in indi- 
vidual measures to protect against mosquito and mite 
bites. Officers will review the importance of campsite 
selection to avoid proximity to infected natives and 
to breeding places of disease carrying insects. 
b. Suppressive atabrine will be given to all 
personnel as outlined in TB Med 65, 3 July 1944, 
beginning three weeks before D day. 
c. Bed nets of all personnel will be sprayed 
with a five (5) per cent solution of DDT in kerosene 
as outlined in Appendix VI. 
32 d. Each man will be provided with two uniforms 
and one blanket impregnated with dimethyl-phthalate 
as outlined in TB Med 121, Dec. 1944, (see Appendix 
VI). Measures in this and preceding subparagraph 
will be carried out as short a time before embarkation 
as possible. 
e. Each organization will be issued thirty days 
supply of the following items which will be conspicu- 
ously marked and carried with the organization so as 
to be readily available: 
Sprayer, oil knapsack 1 per 100 men 
type 
Diesel oil No. 2, 55 gal- 1 per sprayer, oil 
lon drum knapsack type 
Repellent, 2 oz bottles 300 per 100 men 
Atabrine tablets 0.1 Gm. 4000 per 100 men 
Insecticide, freon-aero- 30 per 100 men 
sol 1 lb dispenser 
A further sixty day supply of insect control 
items should be shipped in divided lots so that the 
loss of any one shipment will not disrupt the program. 
(See Appendix 111, Insect Control Manual No. 2). 
Each individual will be provided with: 
Bar, mosquito or hammock, jungle, complete 1 
Repellent insect, 2 oz. bottle 2 
Atabrine tablets, 0.1 Gm. 30 
3. Combat Phase. 
a. Anti-mosquito measures will be carried out 
by airplanes and temporary spray teams as outlined 
in paragraph 5, against both “malaria” and “Dengue” 
mosquitoes. The application of DDT solution to native 
dwellings will be emphasized. This method is of 
value because most mosquitoes become infected by 
biting diseased natives and then rest in or near the 
33 buildings where the blood meal is obtained. A single 
spraying of such buildings with DDT not only will 
kill all mosquitoes in the building but will continue 
to kill mosquitoes as they come in contact with treat- 
ed walls for several months. 
b. Fly control will be done when feasible by 
hand spraying of dead bodies and by proper care of 
garbage dumps and human waste. 
c. The malariologist, with the entomologist and 
parasitologist, will provide the surgeon with a mos- 
quito survey and an estimate of the malaria and 
dengue hazard as rapidly as feasible after D day, 
with subsequent estimates as determined by current 
conditions and needs. 
4. The personnel to carry out malaria and epidem- 
ic control work during “X” operation is as fol- 
lows: 
a. Division malaria and insect control group 
(attached medical department personnel). 
4 officers. 
22 enlisted men. 
b. Pilots of L4B cub airplanes. 
2 pilots. 
c. Troop unit insect and rodent control details. 
Enlisted men: Insect and rodent control 
details of three enlisted men, including one NCO, 
from each of the 75 companies, batteries, or similar 
units in the division. 
5. Four temporary spray teams, chart I, will be 
drawn from the above personnel for the period 
of “X” operation as follows: 
a. Division headquarters spray team. 
(1) Personnel 
4 officers. 
1 malariologist from attached division 
malaria and insect control group. 
1 entomologist from attached division 
malaria and insect control group. 
2 pilots L4B cub airplanes. 
34 21 enlisted men. 
10 technicians from attached division 
malaria and insect control group. 
11 men drawn from insect and rodent 
control details of division Hq. Co., Signal 
Co., QM Co., Ord. Co., and similar units. 
(2) This spray team will be attached to divis- 
ion headquarters company for period of operation. 
b. Temporary spray team attached to each regi- 
ment. 
(1) Personnel of each spray team will com- 
prise: 
1 officer.* 
24 enlisted men. 
4 technicians from attached division 
insect control group. 
20 men: 1 from each insect and rodent 
control detail in the regiment. The 
remaining men of each insect and rodent 
control detail will remain with their 
companies. 
(2) Each regimental spray team will be 
quartered with its regimental headquart- 
ers company for the period of “X” opera- 
tion. 
c. Duties of these spray teams. 
In amphibious operations these spray teams 
will go ashore with the headquarters to which they 
are attached and begin antimalaria and insect control 
work when the beachhead is about one mile deep. It 
will often be necessary to arm some of the men in 
the spray teams to protect the remainder against 
snipers. Each team will carry out the following meas- 
ures in the rear of combat lines. 
* The engineer and parasitologist will each be 
attached to a regiment for the operation. The division 
sanitary officer or other officer designated by the 
division surgeon will be attached to the third regi- 
ment. 
35 (1) Spraying of dwellings and other tempor- 
ary mosquito control measures in area of headquart- 
ers, medical facilities, supply stations and along 
communication lines. Fly control measures will be 
carried out when feasible. 
(2) Initial survey and map work. 
(3) The division headquarters spray team 
will have additional duties: 
(a) General supervision of malaria and 
insect control program. 
(b) Relocation of insect control person- 
nel and supplies as necessary to meet 
changing conditions. 
(c) Airplane spraying. 
d. Equipment of these spray teams. 
(1) Every man will be equipped with a spray- 
er for DDT solution. Technicians from 
division malaria and insect control 
groups will carry a dipper for sampling 
larvae populations and preliminary spot 
maps. All other men will carry a one 
pound aerosol dispenser. Each spray 
team will be equipped with a power 
sprayer. 
6. Insect and Rodent Control Details Each 
Company or Battery. 
These details are temporarily reduced in size; 
one man being drawn from each detail to form the 
temporary spray team (See paragraph 3). It is rarely 
feasible to do antimosquito work in frontline combat. 
These smaller insect and rodent control details will 
work as directed by the unit insect control officer 
(usually the battalion surgeon) and will aid in the 
distribution of repellent and other antimalaria sup- 
plies to the front lines. Spraying and other anti- 
mosquito work will be done when practicable. 
7. A rear echelon insect control group will be form- 
ed, if indicated, by one NCO technician from division 
36 insect control group and by insect and rodent control 
details in rear echelon. This group will continue 
larviciding and other control work in rear echelon 
area. 
8. Procedure: 
Exact procedures will depend on local condi- 
tions, the speed of the operation, and the relative 
importance of malaria, dengue, and of fly-borne dis- 
eases. In rear areas emphasis probably will be on 
larviciding, which is worthwhile in territory to be 
occupied for two weeks or more and of decreasing 
value as time of occupancy is shortened. Emphasis 
in more forward areas probably will be on spray 
killing of adult mosquitoes and larviciding will be of 
secondary importance. The need for flexibility in this 
malaria and insect control program is apparent. 
a. The malariologist will supervise the entire 
insect control program and will be particularly con- 
cerned that personnel and supplies are allocated 
according to changing needs. 
b. The entomologist will be directly in charge 
of spraying and other control work in territory assign- 
ed to division headquarters spray team. He will be 
responsible for initial survey and map work in the 
entire area of operation. 
c. The airplane pilots will work under the 
direction of the malariologist. They will begin 
airplane spraying as soon as it is feasible for air- 
planes attached to the artillery regiment to operate. 
d. The temporary spray teams are formed for 
the period of active operation only. As soon as con- 
ditions become stabilized and when designated by the 
division malariologist this personnel will return to 
routine control measures. The engineer will then 
resume his normal duties to supervise control activi- 
ties in the entire division area, the other officers will 
resume their usual work, and the enlisted personnel 
will return to their company insect and rodent con- 
trol details. 
37 9. Shipping and supplies. 
a. Each spray team will take one power sprayer, 
one additional vehicle, adequate hand sprayers for 
all personnel, one weeks supply of DDT solution 
prepared in advance, and three weeks supply of DDT 
powder, dissolving, and other necessary supplies. 
Deck loading of these supplies will be arranged. 
b. The division headquarters malaria and insect 
control group will be responsible for shipment of 
additional DDT, the remaining vehicles, one or more 
power sprayers, and all other equipment. This group 
will be responsible to have a detail to assist in storing 
and distribution of insect control supplies when is 
necessary. 
c. Supplies will go in divided shipments. Check 
list of insect control supplies is given in Appendix 
111 and IV, Preventive Medicine Manual No. 2. 
d. The L4B cub airplanes will be shipped with 
other planes of division artillery observation group. 
10. No duties that interfere with their malaria and 
insect control functions will be assigned to the above 
personnel. 
11. Individual protective measures against mos- 
quito-borne diseases and mite-borne typhus will be 
carried out by all division personnel as directed in 
memorandum . . . this headquarters. 
12. Regimental commanders will immediately for- 
ward to this headquarters a roster of enlisted men 
who are assigned to temporary spray teams. 
38  
DIVISION HEADQUARTERS SPRAY TEAM 
4 Officers 
1 Div Malariologist 
1 Div Entomologist 
2 Pilots of L4B Cub Planes 
21 Enlisted Men 
9 Malaria Control Technicians 
12 Men drawn from insect and rodent control details 
of Div Hq. Co.. Signal Co., QM Co., etc. 
I 
n 
1st Regiment 
Regimental Spray Team 
1 Officer (Engineer) from Div. Mai. Con- 
trol Group. 
24 Enlisted men 
4 Mai. Con. Technicians 
20 Men: 1 drawn from each insect and 
rodent control detail in regiment. 
2nd Regiment 
Regimental Spray Team 
1 Officer (Parasitologist) from Div. Mai. 
Control Group. 
24 Enlisted men 
4 Mai. Con. Technicians 
20 Men. 1 drawn from each insect and 
rodent control detail in regiment. 
3rd Regiment 
Regimental Spray Team 
t Officer (Division Sanitary Officer) 
24 Enlisted men 
4 Mai. Con. Technicians 
20 Men; 1 drawn from each insect and 
rodent control detail in regiment 
I 
I 
. i 
| 1st Battalion | 
| 2nd Battalion | 
| 3rd Battalion 
I 
T 
L_ 
L 
i 
E Co 
Insect And Rodent Control 
Detail 
3 Enlisted Men 
(1 Man to Reg. 
Spray Team). 
P Co 
Insect And Rodent Control 
Detail 
3 Enlisted Men 
(1 Man to Reg 
Spray Team). 
G Co 
insect And Rodent Control 
Detail 
3 Enlisted Men 
(1 Man to Reg. 
Spray Team) 
H Co 
Insect And Rodent Control 
Detail 
3 Enlisted Men 
(1 Man to Reg 
Spray Team) 
CHART I 
TEMPORARY ORGANIZATION OF DIVISION INSECT CONTROL PERSONNEL 
INTO FOUR SPRAY TEAMS 
FOR "X" OPERATION APPENDIX VI 
Treatment of Uniforms with Dime- 
thylphthalate; Treatment of Bed Nets 
with D.D.T.; and Other Data on DDT, 
Sodium Arsenite, and PDB 
I. Impregnation of uniforms with dimethylphthal- 
ate. 
1. Materials. 
The materials required to prepare sufficient 
emulsion to impregnate approximately 100 uniforms 
include: TVz quarts dimethylphthalate, 6 pounds GI 
laundry soap (about 7 cakes), 35 gallons of water, 
one 55 gallon oil drum, one 32 gallon GI can or similar 
container, a water bucket, and a GI egg-whip (wire) 
or suitable improvised devise for mixing. 
2. To prepare emulsion. 
a. Cut 6 pounds of GI laundry soap (7 cakes) 
into small pieces and dissolve in 10 gallons of water 
by boiling in an oil drum. Then add 25 gallons of 
cool water. Do not boil entire 35 gallons. 
b. Pour 3 gallons of this soap solution into a 
GI can, and to it slowly add 7% quarts of dimethyl- 
phthalate, whipping vigorously to make a creamy 
concentrate. Return this concentrate to the drum 
of soap solution and stir to make the finished emul- 
sion. The final product represents a 5 percent emul- 
sion of dimethylphthalate in a 2 percent soap solution, 
measuring about 37 gallons. 
3. Impregnation of clothing. 
a. Only dry materials should be treated and 
the emulsion should be stirred while garments are 
being dipped. 
40 b. Completely immerse clothing, shirt and trous- 
ers or coverall, socks (placed in trouser pockets) and 
leggings, in the emulsion. Wring out over a second 
container to save excess liquid. Hang up to dry. The 
clothing is ready to be worn when dry. To facilitate 
inspection of personnel, a system of marking clothing 
to indicate impregnation and date of treatment of 
the clothing should be employed. 
c. Blankets and mosquito bars may also be 
treated In the above manner, 
d. For protection against mites, impregnation 
of clothing should be repeated after each laundering. 
For blankets, treatment at two months intervals is 
sufficient. 
e. Thorough impregnation withstands sun, rain, 
and excessive sweating. Vigorous scrubbing with 
soap and cold water or laundering with hot water 
removes the dimethylphthalate. 
4. Impregnation of clothing by spraying. 
When the preparation of the above emulsion is 
not practicable, dimethylphthalate, undiluted, may be 
applied to clothing with a “flit-gun”, knapsack spray- 
er, or paint-spray gun, delivering a large droplet 
spray. Clothing may be treated off the body and 
buttoned. To apply, insert the sprayer inside the 
reversed garment and hold the sleeves, neck of shirt, 
and bottoms of trousers closed while the spray is 
delivered. The clothing may be sprayed while being 
worn, provided care is taken to protect the eyes and 
mcuth and not to breathe the spray materials. Two 
to three ounces of dimethylphthalate is sufficient to 
treat one uniform. It is necessary to repeat the 
application after each laundering. 
5. Precautions. 
a. Untreated shorts should be worn under treat- 
ed uniforms to prevent skin irritation in the groins. 
No other precautions are necessary. No ill effects 
have been reported from wearing treated clothing. 
41 b. It should be emphasized that clothing im- 
pregnated with dimethylphthalate does not protect 
exposed body surfaces from insect bites. For pro- 
tection of these areas, application of repellent to the 
skin must supplement the use of impregnated clothing. 
The standard two ounce bottle of insect repellent 
(QM Item 51-E-265) should be employed for this 
purpose. 
11. Treatment of bed nets with DDT, 
1. Materials. 
The materials required to impregnate approxi- 
mately 100 bed nets with DDT include: 
5 percent DDT in kerosene 14 gallons 
Power sprayer 1 
or hand sprayers (knapsack 
type or C. W. decontamination 
type) 3 
QM Item 51-1-305 Insecticide, spray, DDT, resid- 
ual effect is a 5% solution of DDT in kerosene, or 
this solution may be prepared by dissolving 6 lbs of 
51-L-120 Larvicide, DDT, powder, dissolving in 14 
gallons of kerosene. DDT goes into solution slowly 
and all solutions should be prepared 1 to 3 days in 
advance of use. Solution is aided by agitation and by 
placing kerosene in warm sun. 
2. Procedure. 
a. The bed nets should be arranged in piles. 
Spray the top net on one side, reverse it to start a new 
pile and then spray it on the other side. Hang nets 
in the sun to dry. 
b. Six to eight men are able to spray 150 to 200 
nets per hour with a power driven sprayer with two 
outlets, and half this number of nets with hand 
sprayers. 
c. Mosquitoes which come in contact with a 
treated bed net cease to attempt to bite after a few 
minutes and die after an hour or more. The duration 
of this residual effect is still to be determined. Wash- 
ing or exposure to heavy rain removes the DDT from 
42 the bed net. Present information is that under nor- 
mal conditions bed nets should be retreated every 
3 months. Large scale impregnation may be done 
by Chemical Warfare Processing Companies. 
111. Technical data on DDT. 
1. DDT is usually dissolved in diesel oil No. 2 or 
kerosene. The amount of DDT used depends upon 
the skill of labor, the type of equipment available, 
and on other local conditions. DDT is so effective 
when applied by airplane sprayer that only 2 quarts 
per acre of a 5 per cent solution are needed. Other 
equipment is less effective. Table II shows that 
ordinary labor applies an average minimum of 2 
gallons per acre of water surface with a “flit gun” 
type sprayer and 6 gallons per acre of water surface 
with a knapsack sprayer. This table also shows the 
recommended maximum and minimum concentrations 
of DDT for various types of equipment. Quartermaster 
Corps item (51-L-120) Larvicide, DDT, powder, dis- 
solving, is used in these solutions. 
RECOMMENDED CONCENTRATION OF DDT 
RELATED TO OUTPUT OF EQUIPMENT 
TABLE II 
Recommended Concentration 
Maximum 
Minimum 
Lbs 
Lbs 
Average 
DDT 
DDT 
Output 
per 
per 
per 
per 
Equipment 
Gal/acre # 
cent 
acre 
cent 
acre 
Knapsack or C. W. 
Decontamination 
Sprayer 
6.0 
2.5 
1.2 
1.0 
0.48 
“Flit gun” type 
Sprayer 
2.0 
5.0 
0.8 
2.5 
0.4 
Airplane 
0.5 
10.0 
0.4 
5.0 
0.2 
# Acre of water surface. 
43 Unskilled oiling crews use larger amounts of 
spray and should be given DDT solutions which ap- 
proach the minimum. They use smaller amounts of 
spray as they become moi’e skilled and may then be 
given more concentrated solutions. 
2. Preparation of DDT Solutions. 
Table 111 shows the amount of DDT to be used 
in obtaining approximate concentrations. 
PREPARATIONS OF VARIOUS DDT 
CONCENTRATIONS 
TABLE 111 
Desired 
Solution 
Per-cent 
Number Lbs 
Larvicide DDT, 
Powder Dissolving 
Number 
Gallons Diesel 
Oil or Kerosene 
5 
2 
5 
5 
20 
50 
2.5 
10 
50 
1.0 
5 
50 
Measuring equipment is often scarce in the for- 
ward areas and the following approximations may be 
helpful. A number 10 food can filled to % of its 
top is the equivalent of 2 lbs of DDT. DDT is usually 
supplied in 10 lb cans. Diesel oil No. 2 and kerosene 
are usually in 55 gallon drums from which about 5 
gallons may be removed before adding the DDT. 
Solutions should be prepared a minimum of 24 hours 
and preferably several days in advance of use to 
facilitate dissolving. Rolling of barrels in the sun or 
agitation with mechanical equipment aids in prepar- 
ing solutions. Agitation can be obtained by blowing 
air through a solution with an air compressor. It 
should be emphasized that only Larvicide, DDT, 
powder, dissolving is used for making oil solutions. 
3. The choice of diesel oil No. 2or kerosene. 
Diesel oil No. 2 is used in solutions for killing 
mosquito larvae and against adult mosquitoes and 
flies in the open. Kerosene does not leave a sticky 
film of oil and is preferable for spraying bed nets, 
tents, and dwellings for residual effect. 
44 4. DDT for insect and larvicidal dusting. 
Quartermaster item (51-L-122) Larvicide, DDT, 
powder, dusting is a 10 per cent DDT powder. It 
may be used in the field undiluted but is usually 
diluted with 4 parts of waste flour, road dust, or other 
diluent to make a 2 per cent dust. Mixing should 
be carefully and thoroughly done. A home made 
mechanical mixer is easily improvised. The nearest 
malaria control unit will usually be set up to provide 
ready mixed dust when this is indicated. Larvicide, 
DDT, powder, dusting is not suitable for making oil 
solutions. 
5. DDT louse powder for dusting individuals and 
bedding. 
DDT louse powder is supplied as Quartermaster 
item (51-1-173) Insecticide, powder, louse, 2 ounce 
can. It is also supplied in bulk for mass treatment of 
a louse infested population. Individual treatment is 
accomplished by rubbing about V 2 ounce of louse 
powder into the seams of underwear and outer cloth- 
ing and then dusting the bedding. Mass treatment is 
done with a small plunger type duster as follows: 
a. Dust the hat and replace it on the head. 
b. With arms extended pump the dust between 
the skin and inner garments, then between all layers 
of clothing. 
c. Insert the pump behind the neck and spray 
powder between all layers of clothing. 
d. Unbutton the shirt and other clothing down 
to the skin. Blow powder to right and left toward 
the armpits and then dust the center portion of the 
chest, 
e. Loosen the trousers at the waist, insert the 
duster to contact the skin and then spray into the 
seams and crotch. Do this to both front and back of 
trousers. 
Approximately iy2 ounce of Insecticide, powder, 
louse is required per individual by this procedure. A 
team of 2 men can dust 35 to 40 individuals and their 
45 bedding per hour if the individual after being sprayed 
helps with his own bedding. Treated clothes must 
be worn for one week in order to kill all lice and 
those which will hatch out. Otherwise the dusting 
must be repeated after one week. 
6. Warning. 
Repellent impregnated clothing and DDT should 
not be used together. The DDT which is insoluble in 
water is dissolved in the repellent and toxic absorp- 
tion may occur. Each alone is safe. 
IV. Use of sodium arsenate for fly control during 
combat. 
A 1% per cent solution of sodium arsenite is 
an effective temporary expedient for fly control when 
properly applied to dead bodies, to unburned garbage, 
to damaged latrines and to other sources of fly breed- 
ing. Sodium arsenite is supplied in a 54 per cent 
solution (Penite). This concentrated solution is a 
dangerous poison and should be handled with care. 
One part of this solution is mixed with 40 parts of 
fresh or salt water to make the finished spray (ap- 
proximately IVz per cent). A total of 1 to quarts 
of this dilute solution is sprayed evenly over the 
entire surface of each dead body and on the ground 
beneath. The solution should also be sprayed on 
damaged rations and on the ground of pill boxes that 
have contained dead bodies. Only trained personnel 
should be assigned to this work. Rubber gloves 
should be worn by those working with these solutions. 
Spraying should be done from the windward side. 
V. Paradichlorobenzene (PDB) for fiy control in 
covered latrines. 
Paradichlorobenzene is effective by virtue of a 
vapor of gas which is deadly to flies and maggots. It 
is most efficient in tightly closed latrine boxes. Three 
(3) pounds of paradichlorobenzene per 8 hole latrine 
should be evenly scattered on the feces twice a 
week. Further details are available in Circular No. 42, 
HUSAFPOA, 1944. 
46