Enclosure (2) to COMDTINST 6220.9A
These diseases include: scabies, lice infestation, arboviral encephalitides, dengue fever, malaria,
yellow fever and plague. Zoonotic and insect and arthropod-related diseases are generally not
spread from person-to-person. They can be transmitted to humans by certain vectors (e.g., mites,
fleas, lice, mosquitoes and ticks). Most Coast Guard personnel involved in boardings, inspections
and AMIO are at negligible risk of contracting these diseases.
2. Risk Factors.
a) Zoonotic diseases. Rabies is a preventable viral disease of mammals most often transmitted
through the bite of a rabid animal. Hanatavirus pulmonary syndrome is a potentially deadly
disease transmitted by infected rodents through urine, droppings or saliva. Humans can contract
the disease when they breathe in aerosolized virus. Lyme disease is caused by a bacteria
(Borrelia burgdorferi) and is transmitted to humans by the bite of infected blacklegged ticks.
b) Scabies. Scabies is an infestation of the skin by a microscopic mite (Sarcoptes scabei). Scabies
spreads rapidly under crowded conditions where there is frequent skin-to-skin contact between
people. To contract scabies, contact must be prolonged (a quick handshake or hug will usually
not spread infestation). Infestation may also occur by sharing towels, clothing and bedding.
c) Lice infestation. Lice infestation spreads rapidly under crowded conditions where hygiene is
poor and there is frequent contact among people. Lice are found on the body, clothing or
bedding of infested individuals. Lice can cause typhus and/or louse-borne relapsing fever.
d) Arboviral encephalitides. There are several types of arboviral encephalitides (e.g., Eastern
equine encephalitides, Japanese encephalitides, La Cross encephalitides, St. Louis
encephalitides, West Nile virus and Western equine encephalitides). Most of these
encephalitides are caused by infected mosquitoes.
e) Dengue fever. Dengue fever and dengue hemorrhagic fever (DHF) involve the Aedes aegypti
mosquito. Dengue fever and DHF are primarily diseases of tropical and sub-tropical regions.
f) Malaria. Malaria sometimes is a fatal disease caused by a parasite. Four kinds of parasites can
infect humans: Plasmodium falciparum, P. vivax, P. ovale, and P. malariae. Malaria is typically
found in warmer regions around the world. Individuals get malaria by being bitten by an
infected Anopheles mosquito. Malaria, however, is not passed directly from person-to-person
and the circumstances of most boardings, inspections and AMIO situations make the risk of
malaria remote. Coast Guard personnel engaged in Coast Guard operations may make port visits
or travel to land regions where malaria is endemic. These situations are not specific to
boardings, inspections and AMIO and are covered by provisions of reference (h). Additional
references on malaria include - http://www.cdc.gov/malaria/diagnosis_treatment/clinicians2.htm.
g) Yellow fever. Yellow fever is a viral disease transmitted between humans by a mosquito.
Yellow fever is endemic to Africa and South America.
h) Plague. Plague is transmitted by fleas infected with bacteria (Yersinis pestis). Fleas transmit the
plague bacteria to humans. Individuals can spread plague (plague pneumonia) to other
individuals by coughing droplets containing the bacteria.
3. Prevention and Control Measures. The transmission of various zoonotic and insect and arthropod-
related diseases to Coast Guard personnel can be prevented. Personal protective measures outlined
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