Vector-borne diseases (VBDs) are transmitted primarily or exclusively by invertebrates, mainly insects and arachnids. Ticks and mosquitoes are the key vectors, while VBDs are one of the principal causes of morbidity and mortality worldwide, and account for 17% of all infections. Vector-borne diseases are also a major concern for military deployments; they can lead to the non-combat depletion of strength and even cancellation or failure of military operations.
Emerging and recently introduced VBDs have spread across the globe, creating hotspots for disease transmission. VBDs are of considerable concern for military personnel deployed internationally. In many parts of the world, including Pakistan, soldiers are the most vulnerable professionals, serving in parts with varying climatic and sanitary conditions, where they remain for months in a specific place. Therefore, military personnel are particularly prone to VBDs, due to more frequent encounters with vectors during out-of-door training exercises, military-response operations, and occupational-specific exposures.
Disease outbreaks during combat have momentously brought down the contesting power of militaries, leading to the suspension or termination of military missions
The threat of VBDs has also been altered with advances in hygiene and disease control within militaries. Some diseases have lost their military worth, such as bubonic plague, yellow fever, and epidemic typhus; others remain of concern, such as malaria and dengue fever. Novel potential threats have also emerged, such as West Nile encephalitis and chikungunya fever. Malaria, arbovirus and, more recently, leishmaniasis are of particular concern. Vaccine-preventable diseases are also important globally.
Certain vector-borne diseases also signify a potential public health concern upon returning home. Recently, in Europe, attention has been drawn to emerging mosquito-borne infectious diseases, including malaria, dengue fever, West Nile fever and chikungunya fever. Malaria, a mosquito-borne disease, is the most important VBD problem facing militaries worldwide.
Mosquitoes are the utmost important vectors for humans. Geographical expansion of vector mosquitoes may lead to the proliferation of disease in new areas. Troops exercise in the field, take part in missions, or are deployed to military units in various climatic conditions, are directly related to exposure to mosquito-borne diseases.
Over the ages, disease outbreaks during combat have momentously brought down the contesting power of militaries, leading to the suspension or termination of military missions. The current findings reiterate that the threat to militaries from VBDs is real and will vary depending upon the prevalence of endemic diseases in specific geographic areas, the accessibility to protective vaccines, and the execution of preventive measures individually and as a military community.
Standard malaria control measures shall be part of operational deployment planning built on existing policy and disease patterns in the zones of missions. Recent malaria control measures comprise the use of malarial chemoprophylaxis, personal protection, environmental management against disease vectors, early detection and treatment, and malaria eradication strategies.
Vectors and their accompanying diseases have also changed their geographical distribution qualitatively and quantitatively over time, and are, among other factors, an increasing problem for armed forces stationed outside the homeland. Armed forces around the globe are persistently being compelled to develop novel infectious disease vector control strategies for deploying troops. The burden of VBDs on soldiers can be extraordinary, and a majority of Western militaries have established vector control approaches.
To reduce soldiers’ risk of acquiring VBDs, various preventive and unit protection measures should be implemented. Preventive measures include the correct wearing of uniforms, the use of repellents on uncovered skin, and the use of tents, curtains, and insecticide-treated nets. Additionally, collective protection measures take in site selection for army bases, environmental management, space spraying of suspected areas of mosquito habitats, and indoor residual spraying. On a battlefield, personal protective measures are mostly the last resort of protection for troops.
Militaries have sought to avert the spreading of disease via the adoption of proactive public health measures, like the formation of vector control programs at garrisons, and international research-based partnerships aimed at enhancing prevention skills. A military entomology infrastructure consisting of medical entomologists and epidemiologists is needed to collect precise entomological and epidemiological data at military installations. Such data is important for predicting vector population trends and monitoring vector-borne diseases in these areas.
The adoption of Pre-Exercise Vector Surveillance (PEVS) programs is also critical to mitigate the risk of VBDs. Such programs can recommend timely and concrete actions to ensure the health and security of soldiers. It also has the potential to provide fighting commanders with useful intelligence on disease threat levels in different ecological regions.
Scientific advances have reduced the impact of VBDs on militaries, but the risk still exists, and it must be remembered that lapses in vector control or the usage of personal protective equipment may result in these diseases posing the same threat to tactical military missions as they once used to.