Attachment 19 Mod 10 to USCENTCOM Indiv Protectection Indiv Unit Deployment.pdf

PDF ATTACHMENT TO MSG / SEE DATE TIME GROUP OF BASE MSG

UNCLASSIFIED//

OPERS/ENDURING FREEDOM/IRAQI FREEDOM//

MSGID/GENADMIN/CDRUSCENTCOM/SG/MAR10//

SUBJ/MOD TEN TO USCENTCOM INDIVIDUAL PROTECTION AND INDIVIDUAL/UNIT DEPLOYMENT

POLICY//

REF/A/MSG/CDRUSCENTCOM/SG/032024ZOCT2001//

AMPN/ORIGINAL USCINCCENT INDIVIDUAL PROTECTION AND INDIVIDUAL UNIT

DEPLOYMENT POLICY MESSAGE//

REF/B/MSG/CDRUSCENTCOM/SG/101925ZSEP2008//

AMPN/MOD NINE TO USCENTCOM INDIVIDUAL PROTECTION AND UNIT DEPLOYMENT POLICY

MESSAGE. MOD NINE IS NO LONGER VALID AND IS SUPERSEDED BY MOD TEN//

REF/C/ DOC/DOD USD (P AND R)/11AUG2006//

AMPN/DODI 6490.03/DEPLOYMENT HEALTH//

REF/D/DOC/DOD USD (P AND R)/03AUG2006

AMPN/DODI 6025.19/INDIVIDUAL MEDICAL READINESS//

REF/E/ DOC/COMDT CG/VARIOUS, AS UPDATED//

AMPN/COMDTINST M6000.1B/MEDICAL MANUAL//

REF/F/ DOC/SECAF/05JUN2006//

AMPN/AFI 48-123/MEDICAL EXAMINATIONS AND STANDARDS, VOLUME 4 - SPECIAL STANDARDS

AND REQUIREMENTS//

REF/G/ DOC/HQDA/14DEC2007//

AMPN/AR 40-501/STANDARDS OF MEDICAL FITNESS//

REF/H/ DOC/BUMED/14JAN2009//

AMPN/NAVMED P-117/MANUAL OF THE MEDICAL DEPARTMENT//

REF/I/DOC/ASD (HA)/20JUN2009//

AMPN/ASSISTANT SECRETARY OF DEFENSE MEMO/REVISED SERVICE GUIDELINES FOR

REPORTABLE MEDICAL EVENTS//

REF/J/DOC/USD (P AND R)/03OCT2005//

AMPN/DODI 3020.41/CONTRACTOR PERSONNEL AUTHORIZED TO ACCOMPANY THE U.S.

ARMED FORCES//

REF/K/ ORD/CFC/010458ZJUL2006//

AMPN/CFC FRAGO 09-1038/CONTRACTOR CARE IN THE USCENTCOM AOR//

REF/L/DOC/USD (P AND R)/23JAN2009//

AMPN/DODD 1401.10/DOD CIVILIAN EXPEDITIONARY WORKFORCE//

REF/M/DOC/ASD(FMP)/11MAR2006//

AMPN/DODI 1100.21/VOLUNTARY SERVICES IN THE DEPARTMENT OF DEFENSE//

REF/N/ DOC/DEPSECDEF/12OCT2006//

AMPN/DEPUTY SECRETARY OF DEFENSE MEMO/ANTHRAX VACCINE IMMUNIZATION

PROGRAM//

REF/O/DOC/USD (P AND R)/09FEB2006//

AMPN/UNDER SECRETARY OF DEFENSE MEMO/POLICY GUIDANCE FOR MEDICAL DEFERRAL

PENDING DEPLOYMENT TO THEATERS OF OPERATION//

REF/P/RESERVED FOR FUTURE USE

REF/Q/RESERVED FOR FUTURE USE

REF/R/RESERVED FOR FUTURE USE

REF/S/ DOC/HQDA/BUMED/SECAF/29OCT2006//

AMPN/AR 40-562/BUMEDINST 6230.15A/AFJI 48-110/IMMUNIZATIONS AND CHEMOPROPHYLAXIS//

REF/T/DOC/DEPSECDEF/28JUN2004//

AMPN/DEPUTY SECRETARY OF DEFENSE MEMO/EXPANSION OF FORCE HEALTH PROTECTION

ANTHRAX AND SMALLPOX IMMUNIZATION PROGRAMS FOR DOD PERSONNEL//

REF/U/DOC/USD (P AND R)/22SEP2004//

AMPN/UNDER SECRETARY OF DEFENSE MEMO/EXPANSION OF FORCE HEALTH PROTECTION

ANTHRAX AND SMALLPOX IMMUNIZATION PROGRAMS FOR EMERGENCY-ESSENTIAL AND

Modification 10 to USCENTCOM Individual Protection & Individual/Unit Deployment Policy

ATTACHMENT 19

EQUIVALENT DEPARTMENT OF DEFENSE CIVILIAN EMPLOYEES//

REF/V/DOC/USD (P AND R)/6DEC2006//

AMPN/UNDER SECRETARY OF DEFENSE MEMO/IMPLEMENTATION OF THE ANTHRAX VACCINE

IMMUNIZATION PROGRAM (AVIP)//

REF/W/DOC/ASD (HA)/01APR2008//

AMPN/ASSISTANT SECRETARY OF DEFENSE MEMO/UPDATE TO CLINICAL POLICY FOR THE

DEPARTMENT OF DEFENSE SMALLPOX VACCINATION PROGRAM//

REF/X/DOC/USD (P AND R)/ 10SEP2007//

AMPN/UNDER SECRETARY OF DEFENSE MEMO/CHANGE IN POLICY FOR PRE-DEPLOYMENT

ADMINISTRATION OF ANTHRAX AND SMALLPOX VACCINES//

REF/Y/DOC/USD (P AND R)/17OCT2006//

AMPN/DODI 6485.01/HUMAN IMMUNODEFICIENCY VIRUS//

REF/Z/DOC/ASD(HA)/14MAR2006//

AMPN/ASSISTANT SECRETARY OF DEFENSE MEMO/POLICY FOR PRE AND POST DEPLOYMENT

SERUM COLLECTION//

REF/AA/DOC/ASD(HA)/29JUL1981//

AMPN/DODI 6465.1/HEMOGLOBIN S AND ERYTHROCYTE GLUCOSE-6-PHOSPHATE

DEHYDROGENASE DEFICIENCY TESTING PROGRAM//

REF/BB/DOC/ASD(HA)/18MAR2003//

AMPN/DODI 5154.30/ARMED FORCES INSTITUTE OF PATHOLOGY OPERATIONS//

REF/CC/DOC/ASD (HA)/18MAY2007//

AMPN/ASSISTANT SECRETARY OF DEFENSE MEMO/UPDATED POLICY FOR PREVENTION OF

ARTHROPOD-BORNE DISEASES AMONG DEPARTMENT OF DEFENSE PERSONNEL DEPLOYED

TO ENDEMIC AREAS//

REF//DD/USD(I)/20MAR2009//

AMPN/DODI 6420.01/NATIONAL CENTER MEDICAL INTELLIGENCE (NCMI)

REF/EE/ASD(HA)/04SEP2009//

AMPN/ASSISTANT SECRETARY OF DEFENSE MEMO/POLICY MEMORANDUM ON THE USE OF

MEFLOQUIN (LARIAM®) IN MALARIA PROPHYLAXIS//

REF/FF/DPC/ASD (HA)/28MARY2008//

AMPN/ASSISTANT SECRETARY OF DEFENSE MEMO/BASELINE PRE DEPLOYMENT

NEUROCOGNITIVE FUNCTIONAL ASSESSMENT - INTERIM GUIDANCE//

REF/GG/DOC/J4/02NOV2007//

AMPN/MCM-0028-07/PROCEDURES FOR DEPLOYMENT HEALTH SURVEILLANCE//

REF/HH/DOC/ASD(HA)/07NOV2006//

AMPN/ASSISTANT SECRETARY OF DEFENSE MEMO/POLICY GUIDANCE FOR DEPLOYMENT

LIMITING PSYCHIATRIC CONDITIONS AND MEDICATIONS//

REF/II/DOC/ASD (HA)/15OCT2008//

AMPN/ASSISTANT SECRETARY OF DEFENSE MEMO/GUIDANCE FOR CONTAINMENT OF

VARICELLA OUTBREAKS//

RMKS/1. (U) THIS IS MODIFICATION TEN TO USCENTCOM INDIVIDUAL PROTECTION AND

INDIVIDUAL, UNIT DEPLOYMENT POLICY. IN SUMMARY, MODIFICATIONS HAVE BEEN MADE TO

PARAGRAPH 15 FROM MOD 9, REF B.

1.A. PARAGRAPH 15 REQUIRED NUMEROUS CHANGES; THEREFORE, IT IS BEING REPUBLISHED

IN ITS ENTIRETY.

1.B. PARAGRAPH 15 OF REF A HAS BEEN TOTALLY REWRITTEN AS FOLLOWS:

15.A. DEFINITIONS.

15.A.1. DEPLOYMENT. FOR MEDICAL PURPOSES, THE DEFINITION OF DEPLOYMENT IS TRAVEL

TO OR THROUGH THE USCENTCOM AREA OF RESPONSIBILITY (AOR), WITH TIME IN COUNTRY

(BOOTS ON GROUND) FOR A PERIOD OF GREATER THAN 30 DAYS IAW REF C.

15.A.2. TEMPORARY DUTY (TDY). MISSIONS WITH TIME IN COUNTRY (BOOTS ON GROUND) OF

30 DAYS OR LESS,

15.A.3. PERMANENT CHANGE OF STATION (PCS). PCS PERSONNEL (E.G. EMBASSY

PERSONNEL AND DEPENDENTS) WILL COORDINATE WITH THEIR RESPECTIVE COMPONENT

Modification 10 to USCENTCOM Individual Protection & Individual/Unit Deployment Policy

MEDICAL PERSONNEL AND COMPLY WITH THE MEDICAL DEPLOYABILITY GUIDANCE IN

PARAGRAGH 15.C. AND IMMUNIZATION REQUIREMENTS IN PARAGRAGH 15.F. THE

EXCEPTIONAL FAMILY MEMBER PROGRAM (EFMP) APPLIES AND REQUIRES A WAIVER FROM

THE COMPONENT SURGEON.

15.B. APPLICABILITY. THIS MOD APPLIES TO MILITARY PERSONNEL, DOD CIVILIANS, DOD

CONTRACTORS, DEPENDENTS AND VOLUNTEERS TRAVELING OR DEPLOYING TO THE

CENTCOM AOR.

15.C. MEDICAL DEPLOYABILITY. DEPLOYED HEALTH SERVICE SUPPORT INFRASTRUCTURE

PROVIDES ONLY LIMITED MEDICAL CARE. THERE ARE LIMITED FIXED FACILITIES (DHP-

FUNDED) IN THE AOR. ALL PERSONNEL (MILITARY, CIVILIAN AND CONTRACTOR) SHOULD BE

MEDICALLY EVALUATED AND IF DEEMED UNABLE TO COMPLY WITH CENTCOM DEPLOYMENT

REQUIREMENTS ON A CONTINUING BASIS, DISQUALIFIED FOR DEPLOYMENT IAW SERVICE

POLICY AND MOD 10. PERSONNEL FOUND NON-DEPLOYABLE WHILE OUTSIDE OF THE

CENTCOM AOR WILL NOT ENTER OR RE-ENTER THE THEATER. FOR EXAMPLE, A SERVICE

MEMBER WHO BECOMES MEDICALLY NON-DEPLOYABLE WHILE IN ANY LEAVE STATUS WILL

NOT RE-ENTER THE AOR UNTIL THE NON-DEPLOYABLE CONDITION IS CLEARED OR A WAIVER

FOR THE NON-DEPLOYABLE CONDITION IS APPROVED. SEE REF D, E, F, G AND H.

15.C.1. RESPONSIBILITY. DEPLOYMENT ELIGIBILITY DETERMINATION, IAW MOD 10 AND

SERVICE STANDARDS, LIES WITH THE CLINICIAN PROVIDERS ASSIGNED TO THE MEDICAL

SECTION OF THE DEPLOYMENT SCREENING SITE. DEPLOYING PERSONNEL WITH

POTENTIALLY DISQUALIFYING MEDICAL CONDITIONS MAY NEED TO BE EVALUATED BY A

DOCTORAL LEVEL SPECIALIST TO ASSIST IN THE DETERMINATION OF ELIGIBILITY.

15.C.2. MEDICAL FITNESS.

15.C.2.A. UNFIT PERSONNEL. CASES OF IN-THEATER/DEPLOYED PERSONNEL IDENTIFIED AS

UNFIT IAW THIS MOD 10, DUE TO CONDITIONS THAT EXISTED PRIOR TO DEPLOYMENT, WILL BE

FORWARDED TO THE COMPONENT SURGEON (THE APPROPRIATE SURGEON WHO WOULD

HAVE RECEIVED A WAIVER REQUEST HAD ONE BEEN SUBMITTED) FOR INVESTIGATION AND

POTENTIAL REDEPLOYMENT DETERMINATION. FINDINGS/ACTIONS WILL BE FORWARDED NO

LESS THAN MONTHLY TO THE CENTCOM SURGEON AT EMAIL: CCSG-WAIVER@CENTCOM.MIL.

COMPLY WITH RME REPORTING CRITERIA AS REQUIRED. SEE REF I.

15.C.2.B. ALL PERSONNEL (UNIFORMED SERVICE MEMBERS, GOVERNMENT CIVILIAN

EMPLOYEES, VOLUNTEERS, AND DOD CONTRACTOR EMPLOYEES) TRAVELING TO THEATER

MUST BE MEDICALLY (TO INCLUDE DENTAL) AND PSYCHOLOGICALLY FIT FOR DEPLOYMENT.

FITNESS INCLUDES, BUT IS NOT LIMITED TO, THE ABILITY TO ACCOMPLISH THE TASKS AND

DUTIES UNIQUE TO A PARTICULAR OPERATION, AND ABILITY TO TOLERATE THE

ENVIRONMENTAL AND OPERATIONAL CONDITIONS OF THE DEPLOYED LOCATION, INCLUDING

WEAR OF PROTECTIVE EQUIPMENT AND USE OF REQUIRED PROPHYLACTIC MEDICATIONS.

SEE TAB A AND REF D, J, K AND L FOR FURTHER GUIDANCE.

15.C.2.C. SPECIALIZED GOVERNMENT CIVILIAN EMPLOYEES WHO MUST MEET SPECIFIC

PHYSICAL STANDARDS (E.G., FIREFIGHTERS, SECURITY GUARDS AND POLICE, AVIATORS,

AVIATION CREW MEMBERS AND AIR TRAFFIC CONTROLLERS, DIVERS, MARINE CRAFT

OPERATORS AND COMMERCIAL DRIVERS) MUST MEET THOSE STANDARDS WITHOUT WAIVER

OR EXCEPTION, IN ADDITION TO BEING FOUND FIT FOR THE SPECIFIC DEPLOYMENT BY A

MEDICAL AND DENTAL EVALUATION PRIOR TO DEPLOYMENT.

15.C.2.D. OTHER GOVERNMENT CIVILIAN EMPLOYEES AND VOLUNTEERS. MUST BE FOUND FIT

FOR DUTY AND FIT FOR THE SPECIFIC DEPLOYMENT WITHOUT LIMITATIONS OR NEED FOR

ACCOMMODATION BY A MEDICAL AND DENTAL EVALUATION IAW SERVICE OR DOD

REGULATION PRIOR TO DEPLOYMENT. CIVILIAN PERSONNEL, WHO DEPLOY FOR MULTIPLE

TOURS, FOR MORE THAN 12 MONTHS TOTAL, MUST BE RE-EVALUATED FOR FITNESS TO

DEPLOY. AN EXAMINATION WILL REMAIN VALID FOR 15 MONTHS FROM THE DATE OF THE

PHYSICAL. MINIMUM STANDARDS INCLUDE ABILITY TO WEAR RESPIRATORY PROTECTIVE

EQUIPMENT AND OTHER CHEMICAL/BIOLOGICAL PERSONAL PROTECTIVE EQUIPMENT. SEE

TAB A AND REF L AND M FOR FURTHER GUIDANCE.

15.C.2.E. DOD CONTRACTOR EMPLOYEES. MUST BE DOCUMENTED TO BE FIT FOR THE

Modification 10 to USCENTCOM Individual Protection & Individual/Unit Deployment Policy

PERFORMANCE OF THEIR DUTIES WITHOUT LIMITATIONS OR NEED FOR ACCOMMODATION BY

A MEDICAL AND DENTAL EVALUATION PRIOR TO DEPLOYMENT. COMPLY WITH REF V AND

SPECIFICALLY ENCLOSURE 3 FOR MEDICAL REQUIREMENTS. ENSURE COMPLIANCE WITH

IMMUNIZATION, DNA AND PANOGRAPH REQUIREMENTS. CONTRACTOR PERSONNEL, WHO

DEPLOY FOR MULTIPLE TOURS, FOR MORE THAN 12 MONTHS TOTAL, MUST BE RE-EVALUATED

FOR FITNESS TO DEPLOY. AN EXAMINATION WILL REMAIN VALID FOR 15 MONTHS FROM THE

DATE OF THE PHYSICAL. MINIMUM STANDARDS INCLUDE ABILITY TO WEAR RESPIRATORY

PROTECTIVE EQUIPMENT AND OTHER CHEMICAL/BIOLOGICAL PERSONAL PROTECTIVE

EQUIPMENT. PREDEPLOYMENT AND/OR TRAVEL MEDICINE SERVICES FOR CONTRACTOR

EMPLOYEES, INCLUDING IMMUNIZATIONS AND EVALUATION OF FITNESS ARE THE

RESPONSIBILITY OF THE CONTRACTOR. CONTRACTORS MUST MEET THE SAME STANDARDS

OF FITNESS AS OTHER MILITARY AND DOD CIVILIAN PERSONNEL; QUESTIONS SHOULD BE

SUBMITTED TO THE SUPPORTED COMMAND'S MEDICAL AUTHORITY. SEE TAB A AND REF J

FOR FURTHER GUIDANCE.

15.C.2.E.1. CONTRACTOR EXPENSE. IAW REF J, CONTRACTORS WILL PROVIDE THE MEDICAL

AND DENTAL EVALUATIONS. THE REQUIRED IMMUNIZATIONS OUTLINED IN THE FOREIGN

CLEARANCE GUIDE (HTTPS://WWW.FCG.PENTAGON.MIL) FOR THE COUNTRIES TO BE VISITED,

AS WELL AS THOSE OUTLINED IN PARAGRAPH 15.F.2. OF THIS MOD, WILL BE GIVEN AT

CONTRACTOR EXPENSE. A DISQUALIFYING MEDICAL CONDITION AS DETERMINED BY AN IN-

THEATER COMPETENT MEDICAL AUTHORITY WILL BE IMMEDIATELY REPORTED TO THE

CONTRACTOR EMPLOYEE'S CONTRACTING OFFICER WITH A RECOMMENDATION THAT THE

CONTRACTOR BE IMMEDIATELY REDEPLOYED AND REPLACED AT CONTRACTOR EXPENSE.

15.C.2.E.2. MILITARY EXPENSE. THE MILITARY WILL PROVIDE THEATER SPECIFIC ANTHRAX

AND SMALLPOX VACCINES. SEE REF C, J AND N.

15.C.2.F. WOMEN'S HEALTH. THERE IS LIMITED WOMEN'S HEALTH SUPPORT THROUGHOUT

THE THEATER. PRE-DEPLOYMENT PAP SMEARS, MAMMOGRAMS, CONTRACEPTIVE

COUNSELING AND PRESCRIPTION MANAGEMENT SHOULD BE RECENT ENOUGH SO AS TO

REMAIN CURRENT THROUGH THE DEPLOYMENT PERIOD. FOR SERVICEMEMBERS, COMPLY

WITH SERVICE-SPECIFIC GUIDELINES.

15.C.2.F.1. WOMEN WHO ARE NOT SERVICEMEMBERS MUST HAVE A WOMEN'S HEALTH

EVALUATION WITHIN THE GUIDELINES SPECIFIED BY THE AMERICAN SOCIETY FOR

COLPOSCOPY AND CERVICAL PATHOLOGY (ASCCP) AND THE U.S. PREVENTIVE SERVICES

TASK FORCE. FURTHER EVALUATION OF ABNORMAL PAP SMEARS SHOULD BE IAW CURRENT

ASCCP GUIDELINES. WOMEN REQUIRING FURTHER EVALUATION AND/OR TREATMENT

DURING THE ANTICIPATED DEPLOYMENT WILL BE CONSIDERED NON-DEPLOYABLE.

QUESTIONS REGARDING FURTHER EVALUATION AND/OR DEPLOYABILITY DETERMINATION

SHOULD BE REFERRED TO THE SUPPORTED COMMAND'S COMPONENT SURGEON (I.E. THE

SURGEON TO WHOM A WAIVER REQUEST WOULD BE SUBMITTED).

15.C.2.F.1.A. NON-SERVICEMEMBER WOMEN MUST HAVE A DOCUMENTED PAP SMEAR WITHIN

1 YEAR OF DEPLOYMENT, UNLESS THEY MEET ONE OF THE FOLLOWING CRITERIA:

15.C.2.F.1.A.1. THEY ARE 30 YEARS OF AGE OR OLDER WITH NO HISTORY OF DYSPLASIA AND

HAVE HAD THREE CONSECUTIVE NORMAL PAP SMEARS. THESE WOMEN MUST HAVE HAD A

PAP SMEAR WITHIN 2 YEARS OF DEPLOYMENT.

15.C.2.F.1.A.2. THEY HAVE HAD A TOTAL HYSTERECTOMY (I.E. CONFIRMED ABSENCE OF A

CERVIX) FOR BENIGN DISEASE (E.G., NO EVIDENCE OF CERVICAL NEOPLASIA OR CANCER).

THESE WOMEN ARE PERMANENTLY EXEMPT FROM THE PAP SMEAR REQUIREMENT.

15.C.2.F.1.B. NON-SERVICEMEMBER WOMEN ≥ 50 YEARS OF AGE MUST HAVE A DOCUMENTED

MAMMOGRAM WITHIN 1 YEAR OF DEPLOYMENT.

15.C.2.G. HOST NATION (HN) AND THIRD COUNTRY NATIONAL (TCN) EMPLOYEES. MINIMUM

SCREENING REQUIREMENTS FOR HN AND TCN EMPLOYEES FOLLOW.

15.C.2.G.1. ALL CONTRACTORS ARE RESPONSIBLE TO PROVIDE THE APPROPRIATE LEVEL OF

MEDICAL SCREENING FOR THEIR EMPLOYEES BASED ON THE JOB THEY ARE HIRED TO

PERFORM. THE SCREENING MUST BE COMPLETED BY A LICENSED MEDICAL PROVIDER AND A

COPY OF THE COMPLETED MEDICAL SCREENING DOCUMENTATION MUST BE MAINTAINED BY

Modification 10 to USCENTCOM Individual Protection & Individual/Unit Deployment Policy

THE CONTRACTOR. SUCH DOCUMENTATION MAY BE REQUESTED BY BASE OPERATIONS

CENTER PERSONNEL PRIOR TO ISSUANCE OF ACCESS BADGES AS WELL AS BY MEDICAL

PERSONNEL FOR COMPLIANCE REVIEWS. PRE-EMPLOYMENT MEDICAL SCREENING OF HN

AND TCN EMPLOYEES IS NOT TO BE PERFORMED IN MTFS.

15.C.2.G.2. ALL HN AND TCN EMPLOYEES WHOSE JOB REQUIRES CLOSE OR FREQUENT

CONTACT WITH NON-HN/TCN PERSONNEL (E.G., DINING FACILITY WORKERS, SECURITY

PERSONNEL, ETC.) MUST BE SCREENED FOR TUBERCULOSIS (TB) USING A CHEST X-RAY.

ONLY CLOSE CONTACTS OF AN ACTIVE TB CASE REQUIRE A TUBERCULIN SKIN TEST (TST) AS

DISCUSSED IN SECTION 15.G.6. SPECIFIC QUESTIONS REGARDING WHICH HN/TCN

PERSONNEL REQUIRE SCREENING PRIOR TO EMPLOYMENT SHOULD BE REFERRED TO LOCAL

PREVENTIVE MEDICINE / FORCE HEALTH PROTECTION PERSONNEL.

15.C.2.G.3. HN AND TCN EMPLOYEES INVOLVED IN FOOD SERVICE, WATER AND ICE

PRODUCTION MUST BE SCREENED FOR SIGNS AND SYMPTOMS OF INFECTIOUS DISEASES.

CONTRACTORS MUST ENSURE EMPLOYEES RECEIVE TYPHOID AND HEPATITIS A

VACCINATIONS AND THIS INFORMATION MUST BE DOCUMENTED IN THE EMPLOYEES MEDICAL

RECORD / SCREENING DOCUMENTATION.

15.C.3. MEDICAL WAIVERS.

15.C.3.A. MEDICAL WAIVER APPROVAL AUTHORITY.

15.C.3.A.1. MEDICAL WAIVER APPROVAL AUTHORITY LIES AT THE COMBATANT COMMAND

SURGEON LEVEL IAW REF O.

15.C.3.A.2. DELEGATION TO COMPONENTS. WAIVER AUTHORITY IS DELEGATED TO THE

USCENTCOM COMPONENT SURGEONS FOR ALL DEPLOYING PERSONNEL WITHIN THEIR

RESPECTIVE COMPONENT FOR ALL NON-BEHAVIORAL HEALTH CONDITIONS. (E.G., ARMY,

ARMY COMPONENT AGENCIES, AND ARMY CONTRACTORS WILL FIRST CONSULT WITH THE

ARCENT SURGEON; AF WITH THE AFCENT SURGEON, ETC. ALSO, WAIVERS FOR SPECIAL

OPERATIONS PERSONNEL DEPLOYING WITH A SOCCENT UNIT SHOULD BE SENT TO THE

SOCCENT SURGEON). THE CENTCOM SURGEON REMAINS THE APPROVAL AUTHORITY FOR

ALL BEHAVIORAL HEALTH WAIVER REQUESTS. IF THE SERVICE WISHES TO DEPLOY A

MEMBER WHO IS DETERMINED TO BE NOT FIT FOR DEPLOYMENT, THE SERVICE MUST OBTAIN

A WAIVER FROM THE CENTCOM COMMAND SURGEON OR CENTCOM COMPONENT SURGEON

AS OUTLINED ABOVE. SENDING UNIT COMMANDERS MUST OBTAIN A MEDICAL WAIVER AND

ARE NOT AUTHORIZED TO OVERRIDE THE LOCAL MEDICAL DEPLOYABILITY DETERMINATION.

UNLIKE THE MILITARY PROFILE SYSTEM, UNIT COMMANDERS CANNOT OVERRIDE THE

DEPLOYABILITY WAIVER AUTHORITY.

15.C.3.A.3. WHILE AN INDIVIDUAL MAY BE DENIED DEPLOYMENT BY THE LOCAL MEDICAL

AUTHORITY OR CHAIN OF COMMAND, AUTHORITY TO APPROVE DEPLOYMENT WITH MEDICAL

CONDITIONS OUTLINED IN THIS MODIFICATION AND THE ACCOMPANYING AMPLIFICATION LIES

SOLELY WITH THE CENTCOM SURGEON AND THE CENTCOM SERVICE COMPONENT

SURGEONS WHO HAVE BEEN DELEGATED THIS AUTHORITY BY THE CENTCOM SURGEON.

THEREFORE, IF THE LOCAL COMMAND APPROVES A WAIVER TO DEPLOY WITH A NON-

DEPLOYABLE CONDITION AS OUTLINED IN THIS MODIFICATION AND AMPLIFICATION, A WAIVER

REQUEST MUST STILL BE SUBMITTED TO, AND APPROVED BY, THE APPROPRIATE CENTCOM

WAIVER AUTHORITY BEFORE THAT SERVICEMEMBER IS DEPLOYABLE.

15.C.3.A.4. ALL ADJUDICATING SURGEONS WILL MAINTAIN A WAIVER DATABASE AND RECORD

ALL WAIVER REQUESTS.

15.C.3.A.5. THE ADJUDICATING SURGEON MAY CONSIDER CONSULTING THE RECEIVING

MEDICAL AUTHORITY WITH ANY QUESTIONS REGARDING THE DEPLOYABILITY OF THE

PATIENT. THE COMPONENT SURGEON WILL RETURN THE SIGNED WAIVER FORM TO THE

REQUEST ORIGINATOR FOR INCLUSION IN THE PATIENT'S DEPLOYMENT MEDICAL RECORD

AND THE ELECTRONIC MEDICAL RECORD (EMR).

15.C.3.B. WAIVER PROCESS. IF A MEDICAL WAIVER IS DESIRED, LOCAL MEDICAL PERSONNEL

WILL INFORM THE NON-DEPLOYABLE INDIVIDUAL AND THE UNIT COMMAND ABOUT THE

WAIVER PROCESS.

15.C.3.B.1. LOCAL MEDICAL PROVIDERS WILL FORWARD A MEDICAL WAIVER REQUEST FORM

Modification 10 to USCENTCOM Individual Protection & Individual/Unit Deployment Policy

(TAB B), OR LIKE DOCUMENT, AT THE REQUEST OF THE PATIENT'S COMMANDER/SUPERVISOR

OR REPRESENTATIVE. THE MEDICAL WAIVER WILL BE SENT TO AND ADJUDICATED BY THE

APPROPRIATE SURGEON IAW PARAGRAPH 15.C.4.F.

15.C.3.B.2. DOCUMENTED DISAPPROVALS FOR VALID CONDITIONS ARE NECESSARY AND

SHOULD NOT BE GIVEN TELEPHONICALLY.

15.C.3.B.3. A CENTCOM WAIVER DOES NOT PRECLUDE THE NEED FOR A PSYCHOTROPIC

MEDICATION SMALL ARMS WAIVER IAW SERVICE POLICY (E.G., US NAVY SMALL ARMS

WAIVER).

15.C.3.B.4. WAIVERS FOR NON-SERVICE AFFILIATED PERSONNEL. THE CENTCOM SURGEON

IS THE WAIVER AUTHORITY FOR ORGANIZATIONS SUCH AS DEFENSE INTELLIGENCE AGENCY

AND AMERICAN RED CROSS, ETC, WHO ARE NOT DIRECTLY ASSOCIATED WITH A PARTICULAR

CENTCOM COMPONENT.

15.C.3.B.5. APPEAL PROCESS. IF THE SENDING UNIT DISAGREES WITH THE COMPONENT

SURGEON'S DECISION, AN APPEAL MAY BE SUBMITTED TO THE CENTCOM SURGEON. IF THE

DISAGREEMENT IS WITH THE CENTCOM SURGEON'S DECISION, AN APPEAL MAY BE

SUBMITTED THROUGH THE CHAIN OF COMMAND TO THE CENTCOM CHIEF OF STAFF.

15.C.3.C. CONTACTS FOR WAIVERS

15.C.3.C.1. CENTCOM SURGEON. CCSG-WAIVER@CENTCOM.MIL;

CML: 813.827.6397; DSN: 312.651.6397

15.C.3.C.2. AFCENT SURGEON. USAFCENTSG.ORGBOX@SHAW.AF.MIL;

CML: 813.895.4373; DSN: 312.965.4373 / 4380

15.C.3.C.3. ARCENT SURGEON. ARCENT-WAIVER@ARCENT.ARMY.MIL;

CML: 404.464.3378; DSN: 312.367.3367 / 3378

15.C.3.C.4. MARCENT SURGEON. MARCENTFSURG@MARCENT.USMC.MIL;

CML: 813.827.7175; DSN: 312.651.7175

15.C.3.C.5. NAVCENT SURGEON. CUSNC.MEDWAIVERS@ME.NAVY.MIL;

CML: 011.973.1785.4032; DSN: 318.439.4032

15.C.3.C.6. SOCCENT SURGEON. CFSOCCGMEDOP@CFSOCC.SOCCENT.CENTCOM.MIL;

CML: 813.828.4351; DSN: 312.968.4351

15.D. PHARMACY.

15.D.1. SUPPLY. PERSONNEL WHO REQUIRE MEDICATION AND WHO ARE DEPLOYING FOR A

YEAR WILL DEPLOY WITH NO LESS THAN A 180 DAY SUPPLY OF THEIR MAINTENANCE

MEDICATIONS WITH ARRANGEMENTS TO OBTAIN A 180 DAY SUPPLY FOLLOW-ON REFILL

PRESCRIPTION. TRICARE ELIGIBLE PERSONNEL WILL HAVE A FOLLOW-ON REFILL

PRESCRIPTION ENTERED INTO THE MAIL ORDER PHARMACY PER THE DEPLOYMENT

PRESCRIPTION PROGRAM IAW REF Q. PERSONNEL DEPLOYING FOR LESS THAN A YEAR WILL

DEPLOY WITH NO LESS THAN A 180 DAY SUPPLY, OR A SUFFICIENT SUPPLY TO COVER THE

ENTIRE DEPLOYMENT, OR FOLLOW SERVICE SPECIFIC GUIDANCE.

15.D.2. EXCEPTIONS. EXCEPTIONS TO THE 180 DAY PRESCRIPTION QUANTITY REQUIREMENT

INCLUDE:

15.D.2.A. PERSONNEL REQUIRING MALARIA CHEMOPROPHYLACTIC MEDICATIONS (E.G.

DOXYCYCLINE, MEFLOQUINE, ETC.) WILL DEPLOY WITH ENOUGH MEDICATION FOR THEIR

ENTIRE DEPLOYMENT. THE DEPLOYMENT PERIOD SHOULD BE CONSIDERED TO INCLUDE AN

ADDITIONAL 4 WEEKS OF NECESSARY TERMINAL PROPHYLAXIS WITH THE PRIMARY AGENT

USED.

15.D.2.B. PSYCHOTROPIC MEDICATION (EXCEPT CII) AND ALL CIII-V CONTROLLED SUBSTANCE

PRESCRIPTIONS MAY BE DISPENSED FOR UP TO A 180 DAY SUPPLY WITH NO REFILL.

15.D.2.B.1. IF REQUIRED, THE PROVIDER MAY PRESCRIBE A LIMITED QUANTITY (I.E. AT LEAST

A 90 DAY SUPPLY) WITH NO REFILLS TO FACILITATE CLINICAL FOLLOW-UP IN THEATER.

15.D.2.B.2. PSYCHOTROPIC MEDICATIONS INCLUDE, BUT ARE NOT LIMITED TO, CONTROLLED

AND NON-CONTROLLED SUBSTANCE ANTI-DEPRESSANTS, ANTI-ANXIETY, QUETIAPINE

(SEROQUEL) FOR SLEEP, CII AND NON-CII STIMULANTS, ANTI-SEIZURE MEDICATIONS USED FO

MOOD DISORDERS, AND BENZODIAZEPINE AND NON-BENZODIAZEPINE SEDATIVE-HYPNOTIC

MEDICATIONS. THIS TERM ALSO ENCOMPASSES THE GENERIC EQUIVALENTS OF THE ABOVE

Modification 10 to USCENTCOM Individual Protection & Individual/Unit Deployment Policy

MEDICATION CATEGORIES WHEN USED FOR NON-PSYCHOTROPIC INDICATIONS.

15.D.2.C. ALL CII CONTROLLED SUBSTANCES (TO INCLUDE CII PSYCHOTROPIC MEDICATIONS)

QUANTITIES ARE LIMITED TO A 90 DAY SUPPLY WITH NO REFILLS. CLINICAL FOLLOW-UP IN

THEATER SHOULD BE SOUGHT AT THE EARLIEST OPPORTUNITY TO OBTAIN MEDICATION

REFILLS.

15.D.3. PRESCRIPTION MEDICATION ANALYSIS AND REPORTING TOOL (PMART). SOLDIER

READINESS PROCESSING (SRP) AND OTHER DEPLOYMENT PLATFORM PROVIDER/PHARMACY

AND UNIT MEDICAL OFFICER PERSONNEL WILL MAXIMIZE THE USE OF THE PRESCRIPTION

MEDICATION ANALYSIS AND REPORTING TOOL (PMART) TO SCREEN DEPLOYING PERSONNEL

FOR HIGH-RISK MEDICATIONS, IDENTIFY MEDICATIONS NOT AVAILABLE ON THE CENTCOM

FORMULARY, AND OVER-THE-COUNTER AND TEMPERATURE-SENSITIVE MEDICATIONS NOT

AVAILABLE THROUGH THE MAIL ORDER PHARMACY. CONTACT THE DOD PHARMACY

OPERATIONS CENTER AT 1.866.275.4732 OR P-MART@AMEDD.ARMY.MIL FOR INFORMATION

ON HOW TO OBTAIN A PMART REPORT. INFORMATION REGARDING PMART AS WELL AS THE

CENTCOM FORMULARY CAN BE FOUND AT THE DOD PHARMACOECONOMIC CENTER WEBSITE

AT: HTTP://PEC.HA.OSD.MIL/PMART/DEFAULT.PHP. SEE REF R.

15.D.4. TRICARE MAIL ORDER PHARMACY (MOP). PERSONNEL REQUIRING ONGOING

PHARMACOTHERAPY WILL MAXIMIZE USE OF THE MAIL-ORDER PHARMACY (MOP) SYSTEM (TO

INCLUDE MEDICATIONS LISTED IN 15.D.2.B AND 15.D.2.C) WHEN POSSIBLE. THOSE ELIGIBLE

FOR MOP WILL COMPLETE ON-LINE ENROLLMENT AND REGISTRATION PRIOR TO

DEPLOYMENT TO THE MAXIMUM EXTENT POSSIBLE.

15.E. MEDICAL EQUIPMENT.

15.E.1. PERMITTED EQUIPMENT. PERSONNEL WHO REQUIRE MEDICAL EQUIPMENT (E.G.,

CORRECTIVE EYEWEAR, HEARING AIDS, ORTHODONTIC EQUIPMENT) MUST DEPLOY WITH ALL

REQUIRED ITEMS IN THEIR POSSESSION TO INCLUDE TWO PAIRS OF EYEGLASSES,

PROTECTIVE MASK EYEGLASS INSERTS, BALLISTIC EYEWEAR INSERTS, AND HEARING AID

BATTERIES. SEE REF C.

15.E.2. NON-PERMITTED EQUIPMENT. PERSONAL DURABLE MEDICAL EQUIPMENT (E.G., CPAP,

TENS, ETC) IS NOT PERMITTED. MEDICAL MAINTENANCE, LOGISTICAL SUPPORT, AND

INFECTION CONTROL PROTOCOLS FOR PERSONAL MEDICAL EQUIPMENT ARE NOT AVAILABLE

AND ELECTRICITY IS OFTEN UNRELIABLE. A WAIVER FOR A MEDICAL CONDITION REQUIRING

PERSONAL DURABLE MEDICAL EQUIPMENT WILL ALSO BE CONSIDERED APPLICABLE TO THE

EQUIPMENT.

15.E.3. CONTACT LENSES.

15.E.3.A. ARMY, NAVY AND MARINE PERSONNEL WILL NOT DEPLOY WITH CONTACT

LENSES EXCEPT IAW SERVICE POLICY.

15.E.3.B. AIR FORCE PERSONNEL (NON-AIRCREW) WILL NOT DEPLOY WITH CONTACT LENSES

UNLESS WRITTEN AUTHORIZATION IS PROVIDED BY THE DEPLOYED UNIT COMMANDER.

CONTACT LENSES ARE LIFE SUPPORT EQUIPMENT FOR USAF AIRCREWS AND THEREFORE

ARE EXEMPT IAW SERVICE GUIDELINES. AIR FORCE PERSONNEL DEPLOYING WITH CONTACT

LENSES MUST RECEIVE PRE-DEPLOYMENT EDUCATION IN THE SAFE WEAR AND

MAINTENANCE OF CONTACT LENSES IN THE DEPLOYED ENVIRONMENT. THEY MUST ALSO

DEPLOY WITH TWO PAIRS OF EYEGLASSES AND A SUPPLY OF CONTACT LENS MAINTENANCE

ITEMS (E.G. CLEANSING SOLUTION) ADEQUATE FOR THE DURATION OF THE DEPLOYMENT.

15.E.4. MEDICAL ALERT TAGS. DEPLOYING PERSONNEL REQUIRING MEDICAL ALERT TAGS

(E.G. MEDICATION ALLERGIES, G6PD DEFICIENCY) WILL DEPLOY WITH RED MEDICAL ALERT

TAGS WORN IN CONJUNCTION WITH THEIR PERSONAL IDENTIFICATION TAGS.

15.F. IMMUNIZATIONS.

15.F.1. ADMINISTRATION. ALL IMMUNIZATIONS WILL BE GIVEN IAW REF S. REFER TO THE

MILITARY VACCINE AGENCY WEBSITE (HTTP://WWW.VACCINES.MIL).

15.F.2. REQUIREMENTS. ALL PERSONNEL (TO INCLUDE PCS PERSONNEL) TRAVELING FOR

ANY PERIOD OF TIME TO THE THEATER WILL BE CURRENT WITH ACIP IMMUNIZATION

GUIDELINES AND SERVICE IMR REQUIREMENTS. IN ADDITION, ALL TDY PERSONNEL MUST

COMPLY WITH THE FOREIGN CLEARANCE GUIDE FOR THE COUNTRIES TO WHICH THEY ARE

Modification 10 to USCENTCOM Individual Protection & Individual/Unit Deployment Policy

TRAVELING. MANDATORY VACCINES FOR DOD PERSONNEL (MILITARY, CIVILIAN &

CONTRACTORS) TRAVELING FOR ANY PERIOD OF TIME IN THEATER ARE:

15.F.2.A. TETANUS/DIPTHERIA (ONE-TIME DOSE OF TDAP REQUIRED IF NOT PREVIOUSLY

RECEIVED AND IF ≥ 5 YEARS SINCE LAST TETANUS BOOSTER).

15.F.2.B. VARICELLA. REQUIRED DOCUMENTATION OF ONE OF THE FOLLOWING: HISTORY OF

DISEASE, SUFFICIENT VARICELLA TITER, OR ADMINISTRATION OF VACCINE. SEE REF II.

15.F.2.C. MEASLES / MUMPS / RUBELLA. IT IS TO BE ASSUMED THAT ALL POST-ACCESSION

MILITARY PERSONNEL ARE IMMUNE TO THESE DISEASES AND DO NOT REQUIRE THE

IMMUNIZATIONS. DOCUMENTATION OF IMMUNITY OR IMMUNIZATION REQUIRED FOR ALL

CIVILIAN DEPLOYERS.

15.F.2.D. POLIO - IPV. SINGLE ADULT BOOSTER IS REQUIRED FOR TRAVEL TO AFGHANISTAN

OR PAKISTAN. IT IS TO BE ASSUMED THAT ALL POST-ACCESSION MILITARY PERSONNEL ARE

IMMUNE AND DO NOT REQUIRE THIS BOOSTER. DOCUMENTATION OF IMMUNITY OR

IMMUNIZATION REQUIRED FOR ALL CIVILIAN DEPLOYERS.

15.F.2.E. SEASONAL INFLUENZA (INCLUDING EVENT-SPECIFIC INFLUENZA, E.G. H1N1).

15.F.2.F. HEPATITIS A.

15.F.2.G. HEPATITIS B.

15.F.2.H. TYPHOID. BOOSTER DOSE IF GREATER THAN TWO YEARS SINCE LAST VACCINATION

WITH INACTIVATED / INJECTABLE VACCINE OR GREATER THAN FIVE YEARS SINCE RECEIPT OF

LIVE / ORAL VACCINE.

15.F.3. ANTHRAX. ALL MEDICALLY ELIGIBLE PERSONNEL (I.E. WITHOUT A MEDICAL

CONTRAINDICATION) TRAVELING IN THE CENTCOM THEATER FOR 15 DAYS OR MORE WILL

COMPLY WITH THE DOD ANTHRAX REQUIREMENTS. SEE REF N, T, U AND V.

15.F.3.A. MILITARY PERSONNEL. REQUIRED.

15.F.3.B. DOD CIVILIANS: REQUIRED AT GOVERNMENT EXPENSE.

15.F.3.C. DOD CONTRACTORS: REQUIRED AT GOVERNMENT EXPENSE PER CONTRACT.

15.F.3.D. DEPENDENTS AND VOLUNTEERS: VOLUNTARY AT GOVERNMENT EXPENSE.

15.F.4. SMALLPOX. ALL MEDICALLY ELIGIBLE PERSONNEL IN THE CENTCOM THEATER FOR 15

DAYS OR MORE WILL COMPLY WITH THE DOD SMALLPOX REQUIREMENTS. WARNING:

VARICELLA AND SMALLPOX VACCINATIONS MUST BE GIVEN 28 DAYS APART TO

DIFFERENTIATE BETWEEN POTENTIAL ADVERSE EVENTS. SEE REF T, U AND W. ADDITIONAL

INFORMATION AVAILABLE AT HTTP://WWW.SMALLPOX.MIL.

15.F.4.A. MILITARY PERSONNEL. REQUIRED.

15.F.4.B. DOD CIVILIANS: REQUIRED.

15.F.4.C. DOD CONTRACTORS: REQUIRED AT GOVERNMENT EXPENSE PER CONTRACT.

15.F.4.D. DEPENDENTS AND VOLUNTEERS: VOLUNTARY AT GOVERNMENT EXPENSE.

15.F.4.E. MEDICAL TEMPORARY VACCINATION WAIVER. EVERY ATTEMPT WILL BE MADE TO

ADMINISTER THE SMALLPOX VACCINATION PRIOR TO DEPLOYMENT WITHOUT INCREASING

RISK TO PERSONNEL AND THEIR CLOSE CONTACTS. HOWEVER, PERSONNEL HAVING A CLOSE

CONTACT WITH CONTRAINDICATIONS FOR THE SMALLPOX (VACCINIA) VACCINATION MAY BE

GIVEN UP TO A 30 DAY MEDICAL TEMPORARY WAIVER FOR SMALLPOX VACCINATION AND

WILL BE VACCINATED AT THE DEPLOYED LOCATION. INCLUDE THE SMALLPOX SCREENING

QUESTIONNAIRE AS PART OF THEIR DD FORM 2766, DEPLOYED MEDICAL RECORD AND EMR.

15.F.5. EXCEPTIONS. REQUIRED IMMUNIZATIONS WILL BE ADMINISTERED PRIOR TO

DEPLOYMENT, WITH THE FOLLOWING POSSIBLE EXCEPTIONS:

15.F.5.A. THE FIRST VACCINE IN A REQUIRED SERIES MUST BE ADMINISTERED PRIOR TO

DEPLOYMENT WITH ARRANGEMENTS MADE FOR SUBSEQUENT IMMUNIZATIONS TO BE GIVEN

IN THEATER.

15.F.5.B. IAW REF X, ANTHRAX AND SMALLPOX VACCINATIONS MAY BE ADMINISTERED UP TO

120 DAYS PRIOR TO DEPLOYMENT. IT IS HIGHLY ADVISABLE TO GET THE FIRST TWO

ANTHRAX IMMUNIZATIONS OR SUBSEQUENT DOSE/BOOSTER PRIOR TO DEPLOYMENT IN

ORDER TO AVOID UNNECESSARY STRAIN ON THE DEPLOYED HEALTHCARE SYSTEM.

15.G. MEDICAL / LABORATORY TESTING.

15.G.1. HIV TESTING. HIV LAB TESTING, WITH DOCUMENTED NEGATIVE RESULT, WILL BE

Modification 10 to USCENTCOM Individual Protection & Individual/Unit Deployment Policy

WITHIN 120 DAYS PRIOR TO DEPLOYMENT. IAW REF Y, HIV IS A NON-DEPLOYABLE CONDITION.

15.G.2. SERUM SAMPLE. SAMPLE WILL BE TAKEN WITHIN THE PREVIOUS 365 DAYS. IF THE

INDIVIDUAL'S HEALTH STATUS HAS RECENTLY CHANGED OR HAS HAD AN ALTERATION IN

OCCUPATIONAL EXPOSURES THAT INCREASES HEALTH RISKS, A HEALTH CARE PROVIDER

MAY CHOOSE TO HAVE A SPECIMEN DRAWN CLOSER TO THE ACTUAL DATE OF DEPLOYMENT.

THIS CHANGE IS IAW REF Z.

15.G.3. G6PD TESTING. DOCUMENTATION OF ONE-TIME GLUCOSE-6-PHOSPHATE

DEHYDROGENASE (G6PD) DEFICIENCY TESTING IS IAW REF AA. ENSURE RESULT IS IN

MEDICAL RECORD OR DRAW PRIOR TO DEPARTURE. PRE-DEPLOYMENT MEDICAL SCREENERS

WILL RECORD THE RESULT OF THIS TEST IN THE SERVICE MEMBER'S PERMANENT MEDICAL

RECORD, DEPLOYMENT MEDICAL RECORD (DD FORM 2766) AND SERVICE SPECIFIC

ELECTRONIC MEDICAL RECORD. (REF DODI 6465.1) IF AN INDIVIDUAL IS FOUND TO BE G6PD-

DEFICIENT, THEY SHOULD BE ISSUED MEDICAL ALERT TAGS (RED DOG TAGS) THAT STATE

“G6PD DEFICIENT: NO PRIMAQUINE”. IF PRIMAQUINE IS GOING TO BE ISSUED TO A DOD

CIVILIAN OR DOD CONTRACTOR, COMPLETE THE TESTING AT GOVERNMENT EXPENSE.

15.G.4. HCG. REQUIRED WITHIN 30 DAYS OF DEPLOYMENT FOR WOMEN WHO MIGHT BE

PREGNANT. SUSPECTED PREGNANCY WILL BE RULED OUT PRIOR TO ANY IMMUNIZATION

(EXCEPT INFLUENZA) AND MEDICAL CLEARANCE FOR DEPLOYMENT.

15.G.5. DNA SAMPLE. REQUIRED FOR ALL PERSONNEL, INCLUDING CIVILIANS AND

CONTRACTORS. OBTAIN SAMPLE OR CONFIRM SAMPLE IS ON FILE BY CONTACTING THE DOD

DNA SPECIMEN REPOSITORY (COMM: 301.319.0366, DSN: 285; FAX 301.319.0369); HTTP://

WWW.AFIP.ORG/CONSULTATION/AFMES/OPERATIONS/OPERATIONS.HTML. NOTE: WEB

ADDRESS IS ALL LOWER CASE LETTERS EXCEPT `AFMES'. SEE REF C AND BB.

15.G.6. TUBERCULOSIS (TB) TESTING.

15.G.6.A. TUBERCULOSIS TESTING WILL BE PERFORMED AND DOCUMENTED IAW SERVICE

POLICY, PRIOR TO DEPLOYMENT. ONE PURPOSE OF SUCH TESTING IS TO RULE OUT ACTIVE

AND/OR PREVIOUSLY UNIDENTIFIED LATENT TB IN ORDER TO ENSURE ADEQUATE

TREATMENT. THE OTHER PURPOSE IS TO DOCUMENT A NEGATIVE TEST IN ORDER TO

DETECT A SUBSEQUENT CONVERSION AT THE TIME OF POST-DEPLOYMENT TESTING, IF

PERFORMED. ONE OF TWO TESTS MAY BE USED FOR TB SCREENING: A TUBERCULIN SKIN

TEST (TST), OR INTERFERON-GAMMA RELEASE ASSAY (IGRA, I.E. QUANTIFERON GOLD).

15.G.6.B. TST CONVERTERS AND REACTORS WILL BE HANDLED IAW SERVICE POLICY AND

CDC GUIDELINES FOR CONTROL OF TB. PERSONNEL WITH A POSITIVE TST OR IGRA TEST

SHOULD RECEIVE A SYMPTOM QUESTIONNAIRE, EXPOSURE HISTORY AND CHEST X-RAY. U.S.

FORCES AND DOD CIVILIANS WITH ACTIVE TB WILL BE EVACUATED FROM THEATER FOR

DEFINITIVE TREATMENT. U.S. CONTRACTOR EMPLOYEES AND TCN EMPLOYEES WILL BE

MEDICALLY EVACUATED AT CONTRACTOR EXPENSE TO THE COUNTRY OF ORIGIN FOR

DEFINITIVE TREATMENT. HN EMPLOYEES WILL BE REFERRED TO THE NEAREST HN MEDICAL

FACILITY FOR DEFINITIVE TREATMENT. THE DECISION TO TREAT NON-ACTIVE, LATENT

TUBERCULOSIS INFECTION (LTBI) IN U.S. FORCES AND CIVILIANS IN THEATER VERSUS AFTER

REDEPLOYMENT SHOULD INCLUDE CONSIDERATION OF THE FOLLOWING: TIME REMAINING IN

DEPLOYMENT, AVAILABILITY OF MEDICAL PERSONNEL TRAINED IN LTBI TREATMENT,

AVAILABILITY OF FOLLOW-UP DURING TREATMENT, AND AVAILABILITY OF MEDICATION.

15.G.6.C. UNIT-BASED / LARGE GROUP TB TESTING SHOULD NOT BE PERFORMED IN THE AOR.

WHILE THE NEED MAY ARISE TO PERFORM SUCH TESTING FOR CLOSE CONTACTS OF KNOWN

ACTIVE TB CASES, ROUTINE POST-DEPLOYMENT TB TESTING WILL BE DONE AFTER

REDEPLOYMENT AT THE SRP SITE OR HOME STATION.

15.H. PREDEPLOYMENT: THERAPEUTIC/CHEMOPROPHYLACTIC REQUIREMENTS. ALL

THERAPEUTIC/CHEMOPROPHYLACTIC MEDICATIONS, INCLUDING ANTIMALARIALS AND

MEDICAL CBRN DEFENSE MATERIEL (MCDM) WILL BE PRESCRIBED IAW REF C, CC, DD AND EE.

15.H.1. MALARIA CHEMOPROPHYLACTIC REQUIREMENTS.

15.H.1.A. SCREENING FOR G6PD DEFICIENCY WILL BE PERFORMED PRIOR TO DEPLOYMENT

AND ANNOTATED IN EITHER DD FORM 2766 OR THE SERVICE SPECIFIC IMMUNIZATION

DATABASE. G6PD TEST RESULTS MUST BE REVIEWED PRIOR TO PRESCRIBING PRIMAQUINE,

Modification 10 to USCENTCOM Individual Protection & Individual/Unit Deployment Policy

IAW SERVICE POLICY.

15.H.1.B. ALL CHEMOPROPHYLACTIC AGENTS WILL BE USED IAW FDA GUIDELINES.

DOXYCYCLINE WILL BE USED AS THE PRIMARY MALARIA CHEMOPROPHYLACTIC AGENT. IF

THE INDIVIDUAL HAS A CONTRAINDICATION TO DOXYCYCLINE, AND DOES NOT HAVE ANY

CONTRAINDICATION TO THE USE OF MEFLOQUINE, MEFLOQUINE MAY BE USED. IF THE

INDIVIDUAL HAS A CONTRAINDICATION TO BOTH DOXYCYCLINE AND MEFLOQUINE,

ATOVAQUONE/PROGUANIL (MALARONE®) MAY BE USED AS AN ALTERNATIVE. OTHER FDA

APPROVED AGENTS MAY BE USED TO MEET SPECIFIC SITUATIONAL REQUIREMENTS.

15.H.1.C. INFORM PERSONNEL THAT MISSING ONE DOSE OF MEDICATION OR NOT USING THE

DOD INSECT REPELLENT SYSTEM WILL PLACE THEM AT INCREASED RISK FOR MALARIA.

15.H.1.D. PERSONNEL SHOULD DEPLOY WITH THEIR ENTIRE COURSE OF MALARIA

CHEMOPROPHYLAXIS IN HAND (EXCLUDING TERMINAL PRIMAQUINE). THIS COURSE

INCLUDES: THE ENTIRE AT-RISK PERIOD (AS DEFINED IN SECTION 15.H.1.E.1); THE PRE-

EXPOSURE PERIOD (E.G., 2 DAYS FOR DOXYCYCLINE AND MALARONE®, 2 WEEKS FOR

MEFLOQUINE); AND THE TERMINAL PROPHYLAXIS PERIOD (E.G. 4 WEEKS FOR DOXYCYCLINE

AND MEFLOQUINE, 1 WEEK FOR MALARONE®).

15.H.1.E. ISSUE CHEMOPROPHYLACTIC AGENTS PREDEPLOYMENT FOR THE COUNTRIES

NOTED BELOW FOR ANY TRAVEL/DEPLOYMENT LENGTH. JTF SURGEONS MAY ALTER

REQUIREMENTS ONCE PERSONNEL ARE DEPLOYED. IN THE ABSENCE OF A RISK

ASSESSMENT CONDUCTED IAW GUIDANCE PROVIDED IN PARAGRAPH 15.L.1.A., THE

FOLLOWING COUNTRIES AND TIMEFRAMES REQUIRE CHEMOPROPHYLAXIS. THESE ARE

MINIMUM REQUIREMENTS. CHEMOPROPHYLAXIS MAY BE INDICATED FOR SPECIFIC

SITUATIONS IN OTHER AOR COUNTRIES. CONSULT THE NATIONAL CENTER FOR MEDICAL

INTELLIGENCE (NCMI) MALARIA RISK MAPS, AS OUTLINED IN PARAGRAPH 15.L.1.A., FOR

FURTHER INFORMATION. TERMINAL CHEMOPROPHYLAXIS WITH PRIMAQUINE WILL NOT BE

CONDUCTED IN THEATER, BUT RATHER ONLY AFTER REDEPLOYMENT IAW 15.L.1.A.9.

15.H.1.E.1. AFGHANISTAN: YEAR ROUND.

15.H.1.E.1.A. IF TRAVEL/DEPLOYMENT IS RESTRICTED TO ONLY THE MONTHS OF JANUARY

AND FEBRUARY, CHEMOPROPHYLAXIS IS NOT REQUIRED. IF ANY PORTION OF THE TRAVEL/

DEPLOYMENT IS OUTSIDE THIS TIMEFRAME, PRIMARY PROPHYLAXIS IS REQUIRED FOR THE

ENTIRE TIME IN THEATER WITH TERMINAL PROPHYLAXIS UPON REDEPLOYMENT.

15.H.1.E.2. PAKISTAN: YEAR ROUND.

15.H.1.E.3. TAJIKISTAN: MAY THROUGH OCTOBER.

15.H.1.E.4. YEMEN: YEAR ROUND.

15.H.2. MEDICAL CBRN DEFENSE MATERIEL (MCDM) ITEMS.

15.H.2.A. TO PROTECT AGAINST CBRN THREATS WITHIN THE AOR, DEPLOYING UNITS WILL

ENSURE THE AVAILABILITY OF THE FOLLOWING TYPES AND QUANTITIES OF MCDM ITEMS:

15.H.2.A.1. ANTIDOTE TREATMENT NERVE AGENT AUTOINJECTOR (ATNAA) (6505-01-362-7427);

THREE EACH PER DEPLOYING INDIVIDUAL.

15.H.2.A.2. DIAZEPAM INJECTION (CONVULSANT ANTIDOTE NERVE AGENT - CANA)

(6505-01-274-0951); ONE EACH PER DEPLOYING INDIVIDUAL.

15.H.2.A.3. M291A SKIN DECONTAMINATION KIT OR REACTIVE SKIN DECONTAMINATION LOTION

(RSDL). ONE M291A KIT OR ONE POUCH CONTAINING 3 PACKETS OF RSDL PER DEPLOYING

INDIVIDUAL.

15.H.2.A.4. UNITS WILL HAVE AVAILABLE EITHER CIPROFLOXIN 500MG TABS OR DOXYCYCLINE

100MG TABS; SIX EACH PER DEPLOYING INDIVIDUAL OF EITHER MEDICATION (REGARDLESS

OF CHOICE, ENSURE ADEQUATE SUPPLY OF SECOND MEDICATION TO ACCOMMODATE

INTOLERANCE TO THE DRUG OF FIRST CHOICE). THIS COVERS AN INITIAL DOSAGE TO

SUPPORT PROPHYLAXIS AND/OR TREATMENT FOR THREE DAYS PER INDIVIDUAL.

15.H.2.B. INDIVIDUAL DEPLOYERS RECEIVING MCDM ITEMS DURING PRE-DEPLOYMENT

PROCESSING WILL TURN IN THESE ITEMS TO THEIR UNIT UPON ARRIVAL IN THE AOR.

15.I. HEALTH ASSESSMENTS.

15.I.1. HEALTH ASSESSMENTS AND EXAMS. PERIODIC HEALTH ASSESSMENTS AND SPECIAL

DUTY EXAMS MUST BE CURRENT FOR THE DURATION OF TRAVEL OR DEPLOYMENT PERIOD

Modification 10 to USCENTCOM Individual Protection & Individual/Unit Deployment Policy

IAW SERVICE POLICY. SEE REF C.

15.I.2. PRE-DEPLOYMENT HEALTH ASSESSMENT (DD FORM 2795).

15.I.2.A. ALL DOD PERSONNEL (MILITARY, CIVILIAN, CONTRACTOR) TRAVELING TO THE

THEATER FOR MORE THAN 30 DAYS WILL UNDERGO A PRE-DEPLOYMENT HEALTH

ASSESSMENT WITHIN 60 DAYS OF THE EXPECTED DEPLOYMENT DATE. THIS ASSESSMENT

WILL BE COMPLETED ON A DD FORM 2795 IAW DODI 6490.03.

15.I.2.A.1. PERSONNEL TRAVELING TO THE THEATER FOR 15 OR MORE DAYS ARE

ENCOURAGED TO COMPLETE A PRE-DEPLOYMENT HEALTH ASSESSMENT IN ORDER TO

DOCUMENT THEIR HEALTH STATUS AND ADDRESS ANY HEALTH CONCERNS PRIOR TO

TRAVEL TO THEATER. THIS IS ESPECIALLY RELEVANT TO THOSE WHOSE POSITION REQUIRES

FREQUENT TRAVEL TO THE AOR. THESE INDIVIDUALS ARE ENCOURAGED TO COMPLETE AT

LEAST ONE PRE-DEPLOYMENT HEALTH ASSESSMENT EACH YEAR, ALONG WITH A

CORRESPONDING POST-DEPLOYMENT HEALTH ASSESSMENT FOR THE SAME YEAR.

15.I.2.B. FOLLOWING COMPLETION OF THE DD FORM 2795, A HEALTH CARE PROVIDER (NURSE, MEDICAL TECHNICIAN, MEDIC OR CORPSMAN) WILL IMMEDIATELY REVIEW IT. POSITIVE

RESPONSES TO QUESTIONS 2,3,4,7 OR 8 REQUIRES REFERRAL TO AN INDEPENDENT

PRACTITIONER (PHYSICIAN, PHYSICIAN ASSISTANT, NURSE PRACTICTIONER, ADVANCED

PRACTICE NURSE, INDEPENDENT DUTY CORPSMAN, INDEPENDENT DUTY MEDICAL

TECHNICIAN, OR SPECIAL FORCES MEDICAL SERGEANT).

15.I.2.C. THE COMPLETED ORIGINAL DD FORM 2795 WILL BE PLACED IN THE DEPLOYING

PERSON'S PERMANENT MEDICAL RECORD, A PAPER COPY IN THE DEPLOYMENT MEDICAL

RECORD (DD FORM 2766), AND TRANSMIT AN ELECTRONIC COPY TO THE DEPLOYMENT

MEDICAL SURVEILLANCE SYSTEM (DMSS) AT THE ARMED FORCES HEALTH SURVEILLANCE

CENTER (AFHSC).

15.I.3. AUTOMATED NEUROPSYCHOLOGICAL ASSESSMENT METRIC (ANAM).

ALL PERSONNEL WILL UNDERGO ANAM TESTING WITHIN 12 MONTHS PRIOR TO DEPLOYMENT

IAW REF FF. ANAM TESTING WILL BE RECORDED IN APPROPRIATE SERVICE DATABASE AND

ELECTRONIC MEDICAL RECORD.

15.I.4. POST-DEPLOYMENT HEALTH ASSESSMENT (DD FORM 2796).

15.I.4.A. ALL PERSONNEL WHO WERE REQUIRED TO COMPLETE A PRE-DEPLOYMENT HEALTH

ASSESSMENT WILL COMPLETE A POST-DEPLOYMENT HEALTH ASSESSMENT ON A DD FORM

2796 AS CLOSE TO THE REDEPLOYMENT DATE AS POSSIBLE, BUT NOT EARLIER THAN 30 DAYS

BEFORE EXPECTED REDEPLOYMENT DATE OR NO LATER THAN 30 DAYS AFTER

REDEPLOYMENT.

15.I.4.A.1. INDIVIDUALS WHO WERE NOT REQUIRED TO COMPLETE A PRE-DEPLOYMENT

HEALTH ASSESSMENT, BUT WHO COMPLETED ONE TO COVER MULTIPLE TRIPS TO THEATER

EACH OF 30 DAYS OR LESS DURATION, SHOULD COMPLETE A POST-DEPLOYMENT HEALTH

ASSESSMENT AT LEAST ONCE A YEAR TO DOCUMENT ANY POTENTIAL EXPOSURES OF

CONCERN RESULTING FROM ANY SUCH TRAVEL AND THE POTENTIAL NEED FOR MEDICAL

FOLLOW-UP.

15.I.4.B. ALL REDEPLOYING PERSONNEL WILL UNDERGO A FACE-TO-FACE HEALTH

ASSESSMENT WITH AN INDEPENDENT PRACTITIONER (PHYSICIAN, PHYSICIAN ASSISTANT,

NURSE PRACTICTIONER, ADVANCED PRACTICE NURSE, INDEPENDENT DUTY CORPSMAN,

INDEPENDENT DUTY MEDICAL TECHNICIAN, OR SPECIAL FORCES MEDICAL SERGEANT). THE

ORIGINAL COMPLETED COPY OF THE DD FORM 2796 MUST BE PLACED IN THE INDIVIDUAL'S

MEDICAL RECORD AND TRANSMIT AN ELECTRONIC COPY TO THE DMSS AT THE AFHSC.

15.I.5. POST-DEPLOYMENT HEALTH RE-ASSESSMENT (DD FORM 2900). ALL PERSONNEL WHO

WERE REQUIRED TO COMPLETE A PRE- AND POST-DEPLOYMENT HEALTH ASSESSMENT WILL

COMPLETE A POST-DEPLOYMENT HEALTH REASSESSMENT (DD FORM 2900) 90 TO 180 DAYS

AFTER RETURN TO HOME STATION. SEE WWW.PDHEALTH.MIL FOR ADDITIONAL INFORMATION

ON PRE- AND POST-DEPLOYMENT HEALTH ASSESSMENTS.

15.J. MEDICAL RECORD. SEE REF C.

15.J.1. DEPLOYED MEDICAL RECORD. THE DD FORM 2766, ADULT PREVENTIVE AND CHRONIC

CARE FLOWSHEET, OR EQUIVALENT, WILL BE USED INSTEAD OF DEPLOYING AN INDIVIDUAL'S

Modification 10 to USCENTCOM Individual Protection & Individual/Unit Deployment Policy

ENTIRE MEDICAL RECORD.

15.J.1.A. DEPLOYMENT PERSONNEL (MORE THAN 30 DAYS). DD2766 IS REQUIRED.

15.J.1.B. TDY PERSONNEL (15 - 30 DAYS). DD FORM 2766 IS HIGHLY ENCOURAGED,

ESPECIALLY FOR THOSE WHO TRAVEL FREQUENTLY TO THEATER, TO DOCUMENT THEATER-

SPECIFIC VACCINES AND CHEMOPROPHYLAXIS, AS REQUIRED.

15.J.1.C. TDY PERSONNEL (LESS THAN 15 DAYS). DD2766 IS NOT REQUIRED.

15.J.1.D. PCS PERSONNEL. FOLLOW SERVICE GUIDELINES FOR MEDICAL RECORD

MANAGEMENT.

15.J.2. MEDICAL INFORMATION. THE FOLLOWING HEALTH INFORMATION MUST BE PART OF

AN ACCESSIBLE ELECTRONIC MEDICAL RECORD FOR ALL PERSONNEL (SERVICE MEMBERS,

CIVILIANS AND CONTRACTORS), OR BE HAND-CARRIED AS PART OF A DEPLOYED MEDICAL

RECORD:

15.J.2.A. ANNOTATION OF BLOOD TYPE AND RH FACTOR, G6PD, HIV, AND DNA.

15.J.2.B. CURRENT MEDICATIONS AND ALLERGIES. INCLUDE ANY FORCE HEALTH

PROTECTION PRESCRIPTION PRODUCT (FHPPP) PRESCRIBED AND DISPENSED TO AN

INDIVIDUAL.

15.J.2.C. SPECIAL DUTY QUALIFICATIONS.

15.J.2.D. ANNOTATION OF CORRECTIVE LENS PRESCRIPTION.

15.J.2.E. SUMMARY SHEET OF CURRENT AND PAST MEDICAL AND SURGICAL HISTORY AND

CONDITIONS.

15.J.2.F. MOST RECENT DD FORM 2795, PREDEPLOYMENT HEALTH ASSESSMENT.

15.J.2.G. DOCUMENTATION OF DENTAL STATUS CLASSES I OR II.

15.J.2.H. IMMUNIZATION RECORD. MEDICAL DEPLOYMENT SITES WILL ENTER IMMUNIZATION

DATA THROUGH SERVICE ELECTRONIC TRACKING SYSTEMS, (ARMY-MEDPROS, AIR FORCE-

AFCITA, COAST GUARD-MRRS, NAVY-MRRS (ASHORE) OR SAMS (AFLOAT) AND MARINE

CORPS-MRRS).

15.K. PRE-DEPLOYMENT TRAINING. SEE REF C.

15.K.1. SCOPE. GENERAL ISSUES TO BE ADDRESSED. INFORMATION REGARDING KNOWN

AND SUSPECTED HEALTH RISKS AND EXPOSURES, HEALTH RISK COUNTERMEASURES AND

THEIR PROPER EMPLOYMENT, PLANNED ENVIRONMENTAL AND OCCUPATIONAL

SURVEILLANCE MONITORING, AND THE OVERALL OPERATIONAL RISK MANAGEMENT

PROGRAM.

15.K.2. CONTENT. SHOULD INCLUDE, BUT NOT BE LIMITED TO, THE FOLLOWING AREAS:

COMBAT/OPERATIONAL STRESS CONTROL AND SUICIDE PREVENTION; MILD TRAUMATIC

BRAIN INJURY RISK AND IDENTIFICATION; NUCLEAR, BIOLOGICAL, CHEMICAL THREATS

(INCLUDING REQUIRED CBRN TRAINING FOR MEDICAL PERSONNEL); ENDEMIC PLANT, ANIMAL,

REPTILE AND INSECT HAZARDS AND INFECTIONS; COMMUNICABLE DISEASES; VECTORBORNE

DISEASES; ENVIRONMENTAL CONDITIONS; SAFETY; OCCUPATIONAL HEALTH.

15.L. THEATER FORCE HEALTH PROTECTION.

15.L.1. THERAPEUTIC / CHEMOPROPHYLACTIC REQUIREMENTS.

15.L.1.A. MALARIA CHEMOPROPHYLACTIC REQUIREMENTS. WHILE PRE-DEPLOYMENT

MALARIA CHEMOPROPHYLACTIC REQUIREMENTS ARE DESCRIBED IN PARAGRAPH 15.H.1.,

COMPONENT AND JTF SURGEONS MAY MODIFY THESE REQUIREMENTS BASED ON LOCAL

RISK ASSESSMENT CONDUCTED ONCE DEPLOYED. IN CONDUCTING SUCH A RISK

ASSESSMENT, SURGEONS SHOULD REVIEW THE MOST RECENT ASSESSMENTS AND RISK

MAPS PRODUCED BY NCMI. THIS INFORMATION CAN BE ACCESSED ON UNCLASSIFIED

WEBSITE HTTPS://WWW.INTELINK.GOV/NCMI/INDEX.PHP. NCMI NO LONGER REQUIRES A

PASSWORD FOR USERS IN THE “.MIL” DOMAIN. PRODUCTS CAN ALSO BE ACCESSED ON

SIPRNET WEBSITE HTTP://WWW.AFMIC.DIA.SMIL.MIL. BASED ON NCMI RISK ASSESSMENTS,

RECOMMENDATIONS FOR CHEMOPROPHYLAXIS WILL BE PROVIDED TO COMMANDERS USING

THE FOLLOWING GUIDELINES. SEE REF DD.

15.L.1.A.1. MALARIA CHEMOPROPHYLAXIS IS GENERALLY INDICATED FOR FIELD OPERATIONS

AND RURAL EXPOSURES IN GEOGRAPHIC AREAS WHERE NCMI ASSESSES THE PROJECTED

ATTACK RATE TO BE “A SMALL NUMBER OF CASES (LESS THAN 1 PER MONTH)” OR GREATER

Modification 10 to USCENTCOM Individual Protection & Individual/Unit Deployment Policy

PER NCMI MALARIA RISK MAPS.

15.L.1.A.2. CHEMOPROPHYLAXIS IS REQUIRED IN ALL AREAS WHERE THE PROJECTED ATTACK

RATES ARE 1-10 PERCENT PER MONTH OR GREATER PER NCMI MALARIA RISK MAPS.

15.L.1.A.3. FOR AREAS WHERE NCMI ASSESSES THE PROJECTED ATTACK RATE TO BE

“LIMITED RARE CASES (LESS THAN 1 PER 1000 PER MONTH)”, CHEMOPROPHYLAXIS IS NOT

ALWAYS INDICATED. PERSONAL PROTECTIVE MEASURES MAY PROVIDE SUFFICIENT

PROTECTION. THE DECISION TO USE CHEMOPROPHYLAXIS SHOULD BE BASED ON SPECIFIC

MISSION PARAMETERS.

15.L.1.A.4. MANEUVER FORCES WITH INTERMITTENT AND UNPREDICTABLE EXPOSURES TO

RISK AREAS SHOULD EMPLOY CHEMOPROPHYLAXIS BASED ON THE HIGHEST RISK AREAS.

15.L.1.A.5. MALARIA TRANSMISSION SEASONS AS OUTLINED BY NCMI WILL BE TAKEN INTO

CONSIDERATION IN ALL CHEMOPROPHYLAXIS RECOMMENDATIONS.

15.L.1.A.6. LOCAL COMPONENT/JTF SURGEONS ARE ENCOURAGED TO CONDUCT EVIDENCE-

BASED ENTOMOLOGICAL AND EPIDEMIOLOGICAL ASSESSMENTS OF MALARIA RISK AT FIXED

BASES WHERE SIGNIFICANT NUMBERS OF PERSONNEL ARE ASSIGNED FOR PROLONGED

PERIODS. IF A CONFIDENT ASSESSMENT CAN BE MADE OF THE LOCAL RISK,

CHEMOPROPHYLAXIS POLICY FOR THAT BASE SHOULD BE MODIFIED ACCORDINGLY.

15.L.1.A.7. THE CENTCOM SURGEON'S OFFICE MUST BE NOTIFIED OF LOCAL

CHEMOPROPHYLAXIS POLICY IF DIFFERENT THAN OUTLINED IN THE CURRENT MOD

(PARAGRAPH 15.H.1). THE LOCAL COMPONENT/JTF POLICIES WILL BE STORED ON THE

COMMAND SURGEON HOME PAGE

(HTTP://HQSWEB01.CENTCOM.SMIL.MIL/INDEX.ASP?DIVISION=CCSG) UNDER THE FORCE

HEALTH PROTECTION LINK, UNDER THE SUB-LINK MALARIA POLICIES.

15.L.1.A.8. INFORM PERSONNEL THAT MISSING ONE DOSE OF MEDICATION AND NOT USING

THE DOD INSECT REPELLENT SYSTEM WILL PLACE THEM AT INCREASED RISK FOR MALARIA.

15.L.1.A.9. TERMINAL PROPHYLAXIS WITH PRIMAQUINE IS INDICATED FOR ALL

COUNTRIES IN THE USCENTCOM AOR WHERE P. VIVAX AND P. OVALE MALARIA ARE

TRANSMITTED AND WHERE CHEMOPROPHYLAXIS WAS ADMINISTERED (UNLESS

SPECIFICALLY STATED BY LOCAL COMPONENT/JTF GUIDANCE). ONCE THE DISEASE

TRANSMISSION IS TERMINATED (I.E., DEPARTURE FROM AOR), ALL PERSONNEL INDICATED

FOR TERMINAL PROPHYLAXIS WILL SEE A LICENSED MEDICAL PROVIDER. ON AN INDIVIDUAL

BASIS, THE PROVIDER WILL ENSURE THAT THE PERSON HAS BEEN TESTED FOR G6PD

DEFICIENCY. INDIVIDUALS WHO ARE NOTED TO BE G6PD-DEFICIENT WILL NOT BE

PRESCRIBED PRIMAQUINE. INDIVIDUALS SHOULD REMAIN ON MALARIA CHEMOPROPHYLAXIS

UNTIL SUCH TIME THAT THEY CAN BEGIN PRIMAQUINE AND THEN CONTINUE BOTH FOR THE

PRESCRIBED DURATION. PROVIDERS SHOULD BE AWARE THAT PRIMAQUINE DOSING

RECOMMENDATIONS OFTEN REFER TO THE BASE INGREDIENT (PRIMAQUINE PHOSPHATE

26.3MG TABLETS CONTAIN 15MG OF PRIMAQUINE BASE).

15.L.1.B. CBRN COUNTERMEASURES.

15.L.1.B.1. TO PROTECT AGAINST POSSIBLE AND POTENTIALLY INDICATED CBRN THREATS

WITHIN THE AOR, SERVICE COMPONENTS WILL BPT ACQUIRE AND ISSUE, IAW SERVICE

POLICY OR ON ORDER FROM THE CENTCOM COMMANDER, THE FOLLOWING TYPES AND QTYS

OF MCDM ITEMS FOR THEIR IN-THEATER FORCES:

15.L.1.B.1.A. PYRIDOSTIGMINE BROMIDE (PB) 30MG TABS (SOMAN NERVE AGENT

PRETREATMENT PYRIDOSTIGMINE - SNAPP); 42 TABLETS PER DEPLOYED INDIVIDUAL.

15.L.1.B.1.B. POTASSIUM IODIDE (KI) TABLETS; 14 TABS PER DEPLOYED INDIVIDUAL.

15.L.1.B.2. SERVICE COMPONENTS AND/OR JTFS WITH BASE OPERATING SUPPORT (BOS)

RESPONSIBILITY FOR BASES IN THEATER THAT ARE KEY TRANSPORTATION NODES OR R&R

SITES WILL ENSURE ADEQUATE AMOUNTS OF THE MCDM ITEMS LISTED IN PARAGRAPH

15.H.2.A. ARE PRE-POSITIONED AND STORED TO SUPPORT THE TRANSIENT POPULATION THAT

MAY RESIDE OR BE PRESENT AT THESE LOCATIONS FOR ANY PERIOD OF TIME AND ANY

INDIVIDUAL DEPLOYERS NOT ATTACHED TO A TROOP UNIT MOVEMENT.

15.L.2. HEALTH SURVEILLANCE. SEE REF C AND GG.

15.L.2.A. JOINT MEDICAL WORKSTATION (JMEWS).

Modification 10 to USCENTCOM Individual Protection & Individual/Unit Deployment Policy

15.L.2.A.1. UNITS WILL USE JMEWS AS THE PRIMARY DATA ENTRY POINT FOR DISEASE AND

INJURY (DI) REPORTING. UNITS WILL ENSURE ALL SUBORDINATE UNITS COMPLETE JOINING

AND DEPARTING REPORTS AS REQUIRED WITHIN JMEWS.

15.L.2.A.2. UNITS WILL COORDINATE JMEWS TRAINING PRIOR TO DEPLOYMENT FOR

APPROPRIATE PERSONNEL TO THE MAXIMUM EXTENT POSSIBLE. CURRENTLY, THE ARMY

USES MC4 TRAINERS TO TRAIN JMEWS, OTHER SERVICES DO NOT HAVE DIRECTED TRAINERS

AT THIS TIME.

15.L.2.B. DISEASE AND INJURY (DI) SURVEILLANCE.

15.L.2.B.1. THE LIST OF DI REPORTING CATEGORIES, THEIR DEFINITIONS, AND THE ESSENTIAL

ELEMENTS OF THE STANDARD DI REPORT CAN BE FOUND IN ENCLOSURE C OF MCM 0028-07.

15.L.2.B.2. COMPONENT AND JTF SURGEONS ARE RESPONSIBLE FOR ENSURING UNITS

WITHIN THEIR AOR ARE COLLECTING THE PRESCRIBED DNBI DATA AND REPORTING THAT

DATA THROUGH THE JMEWS ON A WEEKLY BASIS.

15.L.2.B.3.MEDICAL PERSONNEL AT ALL LEVELS WILL ANALYZE THE DI DATA FROM THEIR UNIT

AND THE UNITS SUBORDINATE TO THEM AND MAKE CHANGES AND RECOMMENDATIONS AS

REQUIRED TO REDUCE DI AND MITIGATE THE EFFECTS OF DI UPON OPERATIONAL

READINESS.

15.L.2.C. PERIODIC OCCUPATIONAL AND ENVIRONMENTAL MONITORING SUMMARY (POEMS).

15.L.2.C.1. AUTHORITY. POEMS ARE A JOINT APPROVED PRODUCT USED TO ADDRESS

ENVIRONMENTAL EXPOSURE DOCUMENTATION REQUIREMENTS ESTABLISHED BY

REFERENCES D AND MCM 0028-07.

15.L.2.C.2. TIMEFRAME. POEMS WILL BE CREATED AND VALIDATED FOR EVERY MAJOR

DEPLOYMENT SITE AS SOON AS SUFFICIENT DATA IS AVAILABLE, BUT AT LEAST ANNUALLY. IN

GENERAL, POEMS ARE A SUMMARY OF INFORMATION REFLECTING A YEAR OR MORE OF

ENVIRONMENTAL AND OCCUPATIONAL HEALTH DATA TO ENSURE ADEQUATE COLLECTION OF

EXPOSURE INFORMATION.

15.L.2.C.3. CLASSIFICATION/PUBLICATION/ACCESS. POEMS WILL BE UNCLASSIFIED BUT

POSTED ON THE PASSWORD PROTECTED DEPLOYMENT OCCUPATIONAL AND

ENVIRONMENTAL HEALTH SURVEILLANCE DATA PORTAL (HTTPS://

DOEHSPORTAL.APGEA.ARMY.MIL/DOEHRS-OEHS) WHERE JOINT OCCUPATIONAL

ENVIRONMENTAL HEALTH SURVEILLANCE DATA AND REPORTS ARE STORED. THE POEMS

TEMPLATE CAN BE FOUND AT HTTP://CHPPM-WWW.APGEA.ARMY.MIL/OEH.

15.L.2.C.4. RESPONSIBILITIES. SERVICE COMPONENTS AND JTFS ARE RESPONSIBLE FOR

ENSURING POEMS ARE COMPLETED FOR SITES IN THEIR RESPECTIVE AOR. THEY SHOULD

DEVELOP SITE PRIORITIZATION LISTS AND ENLIST THE SUPPORT OF SERVICE PUBLIC HEALTH

ORGANIZATIONS (E.G. U.S. ARMY PUBLIC HEALTH COMMAND (PROVISIONAL), FORMERLY

USACHPPM) TO DRAFT THE CONTENT OF A SITE POEMS. THE USAPHC(P) OVERSEES THE

DATA ARCHIVAL WEBSITE FOR PUBLICATION OF FINAL POEMS AND ASSOCIATED

DOCUMENTS; HOWEVER, APPROVAL OF "FINAL" POEMS MUST COME FROM THE SERVICE

COMPONENT/JTF FHP OFFICER WITH INPUT FROM PREVENTIVE MEDICINE RESOURCES IN

DIRECT OR GENERAL AREA SUPPORT.

15.L.3. REPORTABLE MEDICAL EVENT (RME) SURVEILLANCE. SEE REF I.

15.L.3.A. THE LIST OF DISEASES AND CONDITIONS THAT MUST BE REPORTED CAN BE FOUND

IN THE TRI-SERVICE REPORTABLE EVENTS GUIDELINES AND CASE DEFINITIONS AT HTTP://

WWW.AFHSC.MIL

15.L.3.B. ADVERSE MEDICAL EVENTS RELATED TO IMMUNIZATIONS SHOULD BE REPORTED

THROUGH RME IF CASE DEFINITIONS ARE MET. ALL IMMUNIZATION RELATED UNEXPECTED

ADVERSE EVENTS ARE TO BE REPORTED THROUGH THE VACCINE ADVERSE EVENTS

REPORTING SYSTEM (VAERS) AT HTTP://WWW.VAERS.HHS.GOV.

15.L.3.C. COMPONENT AND JTF SURGEONS ARE RESPONSIBLE FOR ENSURING UNITS WITHIN

THEIR AO ARE COLLECTING THE APPROPRIATE RME DATA AND REPORTING THAT DATA

THROUGH THEIR SERVICE SPECIFIC REPORTING MECHANISMS.

15.L.3.C.1. IT IS ONLY REQUIRED TO COPY CCSG FOR THE FOLLOWING RMES AT CCSG-

PMO@CENTCOM.SMIL.MIL OR CCSG-WAIVER@CENTCOM.MIL: ANTHRAX; BOTULISM; CBRN

Modification 10 to USCENTCOM Individual Protection & Individual/Unit Deployment Policy

AND TIC/TIM OEH EXPOSURE; COLD WEATHER/HEAT INJURIES; DENGUE FEVER; HANTAVIRUS

DISEASE; HEMORRHAGIC FEVER; HEPATITIS B OR C, ACUTE; MALARIA; MEASLES;

MENINGOCOCCAL DISEASE; NOROVIRUS; PLAGUE; PNEUMONIA, EOSINOPHILIC; RABIES,

HUMAN; STREPTOCOCCUS, INVASIVE GROUP A; TETANUS; TUBERCULOSIS, PULMONARY;

TYPHOID FEVER; VARICELLA.

15.L.3.D. RME REPORTING IS TO OCCUR AS SOON AS REASONABLY POSSIBLE AFTER THE

EVENT HAS OCCURRED. CERTAIN EVENTS ARE CONSIDERED URGENT RME AND IMMEDIATE

REPORTING IS REQUIRED.

15.L.4. HEALTH RISK COMMUNICATION. SEE REF C.

15.L.4.A. DURING ALL PHASES OF DEPLOYMENT, PROVIDE HEALTH INFORMATION TO

EDUCATE, MAINTAIN FIT FORCES, AND CHANGE HEALTH RELATED BEHAVIORS FOR THE

PREVENTION OF DISEASE, ILLNESS, AND INJURY DUE TO RISKY PRACTICES AND

UNPROTECTED EXPOSURES.

15.L.4.B. CONTINUAL HEALTH RISK ASSESSMENTS ARE ESSENTIAL ELEMENTS OF THE HEALTH

RISK COMMUNICATION…