Page 136 - Journal of Special Operations Medicine - Winter 2015

Figure 5 Field-expedient “toilet.” truth to this it should also be acknowledged that DNBI
still has a tremendously negative (and often avoidable)
impact on mission accomplishment and can have lasting
impact on an individual’s health and readiness. Irritable
bowel syndrome, which may result from a bout of diar-
rheal illness, can be a complicated and long-term prob-
5
lem and like most DNBI can often be avoided with a
little bit of planning.

References
1. Conger NG, Paolino KM, Osborn EC, et al. Health care re-
sponse to CCHF in US soldier and investigation of nosocomial
transmission to health care providers, Germany, 2009. Emerg
Infect Dis. 2015 Jan [10 Aug 15]. http://dx.doi.org/10.3201/
eid2101.141413.
2. Krasnov BR. Functional and evolutionary ecology of fleas: a
techniques should not be ignored or delayed. It can ei- model for ecological parasitology. Cambridge, UK: Cambridge
ther be addressed during the planning process and have University Press; 2008.
little to no impact on a mission or it can be left out of the 3. Capinera JL. Encyclopedia of entomology, Vol 4. 2nd ed. New
York, NY: Springer Science + Business Media BV; 2008.
planning process and cause significant challenges down 4. Baron S. Medical microbiology. 4th ed. University of Texas
the road. There is a very effective human waste man- Medical Branch at Galveston, Galveston, Texas; 1996.
agement solution now available through military sup- 5. Shah ED, Riddle MS, Chang C, Pimentel M. Estimating the
ply channels or commercial off the shelf: the “portable contribution of acute gastroenteritis to the overall prevalence
toilet” and the “wag bag” (Figure 6). These two items of irritable bowel syndrome. J Neurogastroenterol Motil. 2012;
18:200–204.
coupled with a well managed burn process will allow
Soldiers to easily manage human waste and therefore
decrease the potential spread and operational impact of Disclosures
diarrheal illness on our force. The authors have nothing to disclose.

Figure 6 Wag bag (Bag, Waste Kit, NSN 4510014850760/
NIIN 014850760) and “Go Anywhere” portable toilet
(Commode, Field, NSN 4510-01-485-0736).
COL Caci commands the 47th Combat Support Hospital at
Joint Base Lewis McChord. She spent 6 years as the chief of
preventive medicine for the USASOC Surgeon’s Office and
has numerous combat and peacetime deployments. E-mail:
jennifer.b.caci.mil@mail.mil.

MAJ Rufolo is the commander for the 155th Medical Detach-
ment (Preventive Medicine) and the former 1st SFG(A) ESEO.

CPT Davis is the 5th SFG(A) Environmental Science Officer.
There is something to be said about “embracing the
suck” and accepting the reality of living and working SFC(P) Cruz is the 5th SFG(A) Senior Preventive Medicine
in austere environments. Some would say that it is sim- NCO.
ply part of being an operator and that issues related to
DNBI are part of doing business. While there is some MAJ Lang is the USARAF Force Health Protection Officer.

124 Journal of Special Operations Medicine Volume 15, Edition 4/Winter 2015