Bacterial

Diarrhea Prevention
Diarrhea afflicts up to 50% of troops deployed to high-risk areas. Currently, no guaranteed protective measures exist, and the global problem of antimicrobial resistance may limit treatment options. Candidate vaccines for three major causes of diarrhea (E. coli, Campylobacter and Shigella) are being developed and evaluated by the MIDRP.

Meningococcal Vaccine
Meningococcus is a bacterial disease transmitted by human aerosol and is potentially life-threatening and/or permanently debilitating. The threat to soldiers primarily occurs during basic training but is also prevalent in sub-Saharan Africa, South America, and Asia. Even a single case can be disruptive to troops. DoD successfully developed meningococcal vaccines for subtypes A, C, Y, and W-135. The MIDRP effort is now focused on subtype B.

Rickettsial Disease
Scrub typhus is caused by a bite from an infected mite or chigger and can cause severe fever with a long convalescence or death. The disease is prevalent in Asia, Australia, and many Pacific Islands. Outbreaks occurred in US marines training at Camp Fuji Japan in 2000 and then again in 2001. The MIDRP is developing a vaccine that can protect individuals from multiple strains of scrub typhus.

Wound Infection Research
MIDRP's Wound Infection (W) Program is primarily focused on development of preventive and treatment measures to control wound infections and sepsis and nosocomial transmission of bacteria following blast wound injuries and burns. MIDRP's W program is also focused on preventing and treating methicillin-resistant Staphylococcus aureus (MRSA) which is a threat to both healthy and wounded military members. MIDRP's W program will consider assessing combination therapy of existing U.S. FDA-approved antimicrobial agents as a potential solution to these problems.

Parasitic

Malaria Drugs
Malaria historically causes more casualties than enemy fire in deployments to tropical regions. Impact on soldiers ranges from loss of 14 man-days to death and can affect more than 80% of an unprotected force. The MIDRP is developing new drugs to prevent infection and accelerate recovery from severe and multidrug-resistant malaria infections.

Intravenous Artesunate
Artesunate is a water-soluble formulation of a naturally occuring antimalarial extracted from the Artemesia annua. plant (long utilized in traditional medicine in China). Development of artesunate -- which has shown great promise in early clinical trials as a treatment for severe P. falciparum malaria and could serve as a replacement for the scarcely available drug quinidine -- is underway with the aim of achieving U.S. FDA approval.

Malaria Vaccines
Vaccines to protect against Plasmodium falciparum and P. vivax malaria are being developed by the MIDRP as a long-term solution for the most significant infectious disease threat to U.S. forces worldwide. A vaccine will improve soldier performance and morale by avoiding drug side-effects, drug compliance issues, and malaria casualties. The medical logistics burden associated with drug prophylaxis, diagnosis, evacuation, hospitalization, and intensive treatment will be reduced.

Leishmaniasis
Hundreds of military personnel stationed in Iraq have been diagnosed with cutaneous leishmaniasis, a disease transmitted to humans through the bite of infected sandflies. The most common forms are cutaneous leishmaniasis, which causes skin lesions, and visceral leishmaniasis, which affects the internal organs of the body. The MIDRP is developing diagnostic and treatment devices as well as personal protective measures.

Viral

HIV Prevention
Military personnel can become infected by Human Immunodeficiency Virus (HIV) via blood transfusions, accidental blood exposure while providing humanitarian assistance, or sexual exposure. HIV impacts troop strength of U.S. and allied forces, and the political and economic stability of developing nations. Research focuses on the development of a global HIV-1 vaccine. Field sites have been established in Africa and Southeast Asia. Management is shared by the MIDRP and the National Institutes of Health.

Flavivirus Vaccines
Dengue fever is a painful disease caused by a flavivirus transmitted by a bite from an infected mosquito. Dengue is a leading cause of hospital admission in units operating in the tropics. There is currently no vaccine or drug to prevent the disease. The MIDRP manages a program for pathogenesis studies, diagnostics, and vaccine development to protect against the four types of dengue virus.

Lethal Viruses Countermeasures
Hemorrhagic fever with renal syndrome (HFRS) and other Hantavirus diseases are transmitted by contact with rodents. Endemic throughout Asia and Europe, HFRS requires evacuation and long-term extensive care, and has caused thousands of occurrences of troop morbidity and mortality. The MIDRP is pursuing DNA vaccines to prevent HFRS, as well as prevention and treatment efforts for Lassa Fever and Rift Valley Fever.

Information & Devices

Vector Control
Seventy percent of soldiers experience problems related to biting insects. The current military repellent is a greasy compound that dissolves plastic, is removed by abrasion or wetting, and is not popular with soldiers. The MIDRP is developing a new standard military insect repellent that is effective and user acceptable. Other efforts focus on the identification and control of the insect vectors of dengue and malaria and a sandfly vector control system.

Diagnostic
There is an urgent demand for field-worthy methods to rapidly diagnose infectious diseases. This is particularly relevant given concerns about biological warfare. Timely and accurate diagnosis will permit appropriate medical treatments and other protective measures.