Section I. PREVENTIVE MEDICINE SERVICES

5-1. General

On the integrated battlefield, PVNTMED services will be in greater demand than at any other time, especially under BW conditions. Preventive medicine personnel will be called upon to assist the commander in determining the health hazards associated with nuclear fallout; the safety of drinking water in an NBC environment; as well as determining when to use prophylaxis, pretreatments, immunizations, and other PVNTMED measures (PMM) associated with NBC warfare. Preventive medicine personnel must be aware of the medical threat in the AO. They must continually update their medical surveillance activities to identify disease trends (endemic and epidemic), potential disease vectors, and the susceptibility of troops to these diseases. Under NBC conditions, diseases may manifest that exist in the area, but were not being transmitted to personnel. However, due to the reduced health status of personnel from exposures to or from stress-related NBC conditions, the troops begin to suffer their effects. The appearance of diseases or arthropods not known to exist in the AO are indicators that BW agents have been used. For details on PVNTMED operations, see FM 4-02.17.

5-2. Disease Incidence Following the Use of Nuclear, Biological, and Chemical Weapons

a. Determining Factors. Factors of prime importance in determining the nature and severity of the disease effects are—

Finally, the manner and situation in which nuclear weapons are used are of importance. A single weapon detonated in a socially stable area will have far less serious effects than a detonation in an area where combat has already disrupted the social stability. At Hiroshima and Nagasaki, Japan (excellent examples of the first type of situation), the survivors who could get away were able to obtain food, shelter, and care from surrounding intact areas. With prolonged combat operations, such intact areas would not be available, resulting in no food, shelter, or care for survivors. There will be a breakdown in social order and there will be a lack of effective medical support; including PVNTMED functions and facilities.

b. Disease Incidence. Without PVNTMED capabilities, increased incidence and morbidity from diseases will follow. Some diseases will predominate in incidence, depending upon the geographical areas involved and the endemic diseases present.

(1) In urban areas in temperate climates, several diseases are epidemic threats. These epidemic threats may include—

(2) There are several reasons for the increased risk of disease including, but not limited to—

5-3. Preventive Medicine Section

The PVNTMED sections of the brigade, divisional, and nondivisional medical companies perform analysis on water sources and supplies to determine the presence or absence of NBC/TIM contamination; see [Appendix I] for additional information. Based upon their findings, the water is released for consumption, or is restricted from use until it is treated (usually by water production personnel using the reverse osmosis water purification unit [ROWPU]). They also collect water samples for suspect biological agent contamination for supporting medical laboratory analysis (see [Appendix B]). They conduct medical surveillance activities, to include occupational and environmental health threat surveillance. They conduct limited entomological surveys to determine the existence of disease-vectoring arthropods in the AO. They inspect food service facilities to determine the extent, if any, of NBC contamination. They evaluate the unit's—

5-4. Preventive Medicine Detachment

The PVNTMED detachment provides PVNTMED services on an area support basis to units within their assigned AO. These services include, but are not limited to—