99thth Area Medical Laboratory Area Medical Laboratory (AML)(AML)

Capability BriefCapability Brief

SAFMLS 2007SAFMLS 2007

COL David Craft, COL David Craft, PhD D(ABMM)PhD D(ABMM)

Commander, 9Commander, 9thth AML AML

Mission

On order, deploy worldwide in tailored teams to conduct

health threat detection, confirmation & medical

surveillance for biological, chemical, radiological (CBRNE)

occupational / environmental health & endemic diseases

and consequence management to protect and

sustain the health of the force across the full

spectrum of military operations.

AML Organization

ALO: 1ALO: 1

TotalTotal: 19 Officers; 24 Enlisted; : 19 Officers; 24 Enlisted; 43 43 Aggr.Aggr.

Full TimeFull Time: 6 Officers; 24 Enlisted; : 6 Officers; 24 Enlisted; 3030 Aggr. Aggr.

AMLAML

ENDEMIC DISEASE (ENDEMIC DISEASE (BWBW))OCC/ENV HLTH(OCC/ENV HLTH(RADRAD))

NBC NBC CW / TIC / TIMCW / TIC / TIMHEADQUARTERSHEADQUARTERS

FORSCOMFORSCOM4444thth MEDCOM MEDCOM

ASSIGNEDMicrobiologist (71A)Biochemist (71B)Environmental Science Officer (72D)Med Lab Tech/NCO (12-91K)PvntMed Spec/NCO

(3-91S)Food Inspection NCO (91R)Health Physics Spec/NCO (3-91SN4)

PROFIS (13)PrevMed Phys (60C)Infectious Disease Physician (61G)Vet Pathologist (64D)Vet Microbiologist (64E)Microbiologist (71A)Biochemist (3-71B)Nuclear Med Science Officer (2-72A)Entomologist (72B)Sanitary Engineer (72E)BioMed Info Mgmt (70D)

AML Technical ExpertiseScientists, Clinicians, Certified Techs …DEPTH

Commander Executive Officer (71E)S-1 Personnel Admin Specialist (42A)S-3 Med Ops/Intel Officer (70H)S-4 Med Log NCO (91J)

Sergeant Major (91K)Wheeled Vehicle Mechanic

(63B)Cook (92G)

AML Support Staff

Tailored TeamsAML – PAX 30 (43 w/ PROFIS)

25,000 cu ft / 10 vehicles

AML(-) Expeditionary Force – PAX 136 pallets / 4 vehicles

Section (heavy either C,B,R/N) – PAX 5-82 pallets / 3 vehicles

Dragon (HMMWV) – PAX 2

Detection on Integrated Battlefield

M93A1 FOX Reconnaissance SystemNuclear and Chemical detectionand Biological sampling

Biological Integrated Detection System (BIDS)Semi-automated biological detection/identification

Joint Biological PointDetection System

CBRN - Nuclear, Biological, and Chemical AgentsField confirmation

Environmental and Occupational HealthConfirmatory and definitive

Medical Surveillance (DNBI, outbreak investigations, health risk assessment, etc; PROFIS physicians)

Zoonotic and Animal Disease (rabies detection and vector borne diseases; PROFIS scientists and clinicians)

Analytical Capabilities

Reach Back Capabilities & Collaboration

WRAIR

USAMRIID

USAMRICDAFMIC

CHPPM20th SUPCOM

AFRRI

AML

Interagency

BWBW / Endemic Disease Section / Endemic Disease Section

Mission

Provide confirmatory analysis of BW agents in environmental and clinical samples using

multiple techniques, provide diagnostic capability to identify outbreaks of regionally specific Endemic diseases, and serve as a resource of information for theater medical

personnel.

BW / Endemic Disease Staff

Microbiologist MAJ 71A

Medical Laboratory NCO E6 68K

Medical Lab Sergeant E5 68K

Med Lab Specialist E4 68K

Med Lab Specialist E3 68K

Scientist:

Technician:

BW / Endemic Disease PROFIS

Preventive Med Physician LTC 60C

Infectious Disease Physician MAJ 61G

Vet Pathologist MAJ 64D

Vet Microbiologist MAJ 64E

Microbiologist MAJ 71A

Clinician / Scientist:

DNA Detection (PCR)

R.A.P.I.D.S. device

PROTEIN Detection (ECL)

M1M device

Culture (growth)

BW / Endemic Disease Capabilities

BW Testing Strategy – multiple algorithmsPresumptive Positive Sample, and then…

DNA Detection

Multiple MarkersFor Agent of Interest

Culture

ReportResults

Remaining agents

Remaining agents

Protein Detection

Agent of Interest

Report results

Report resultsReport (+)

Report (+)

Analytical EquipmentAnalytical Equipment

BW / Endemic Disease SectionBW / Endemic Disease Section

R.A.P.I.D.S. 2

M1M Origen Analyzer 2

Microscan 1

BL2 Hood 1

BL1 Hood 1

Centrifuge 1

Microscope 1

Sterilizer 1

Solo Refrigerator 2

Freezer -20C 1

Freezer -80C 1

Hemacool 2

Thermocycler 96 well 1

Incubator 1

RAPIDS

M1M

Microscan

BW / Endemic Disease Capabilities

BW / Endemic Disease Equipment

Cryostat/Microtome

Immuno Histo ChemStaining

Collaborative & Reachback Initiatives

USAMRIID DSD/FIBWA – BW/Endemic DiseaseVet Path – Endemic DiseaseMicro – Endemic Disease

WRAMC Microbiology Laboratory

NBC Section / NBC Section / CW – TIC – TIMCW – TIC – TIM (Chem Threat Analysis)(Chem Threat Analysis)

Mission

Conduct theater level analytical chemistry support by providing

confirmation level analysis for the identification of chemical warfare agents

and toxic industrial compounds in air, water, soil or other matrices; serve as a

resource of information for theater medical personnel.

Chemical Threat Analysis Staff

Biochemist MAJ 71B

Medical Laboratory NCO E6 68K (2)

Medical Lab Sergeant E5 68K (2)

Med Lab Specialist E4 68K (2)

Med Lab Specialist E3 68K (2)

Scientist:

Technician:

Chemical Threat Analysis PROFIS

Biochemist LTC 71B

Biochemist MAJ 71B

Biochemist CPT 71B

Scientist:

Chemical Threat Analysis Capabilities

• Monitor and test soil, water & air for screening confirmation and identification of unknown chemical contaminants (TIC/TIM) using analytical chemistry equipment.

• Test for extremely low level (ppb-ppm) presence of chemical warfare agents. G agents (nerve), V agents (nerve) and HD (blister) are the focus.

• Analyze patient’s blood for exposure to nerve agent by testing for cholinesterase inhibition.

Analytical EquipmentAnalytical EquipmentCW/TIC/TIM NBC CW/TIC/TIM NBC

Aglient GC/MS 1

Dynatherm Air Sampler 1

MIDI System 1

Fume Hood 1

Blower 1

Refrigerator undercounter 1

DigiDart 1

BetaScout 1

AN PDR-77 1Agilent GC/MS

Collaborative & Reachback Initiatives

USAMRICD GC/MS Operation

CHPPM Radiation Threat Characterization

Equipment Familiarization

Private Agilent / MIDICompanies

CDS Analytical

EAI Corporation

RAD / Occupational / RAD / Occupational / Environmental Health Threat Environmental Health Threat

Assessment SectionAssessment Section

Mission

Provide theater level occupational and environmental health threat assessments, by conducting air, water, soil, entomological,

epidemiological and radiological surveillance and laboratory analyses while serving as a resource of information for theater medical

personnel.

RAD/Occupational/Environmental Health Staff

Environmental Science Officer MAJ 72D

Health Physics NCO E6 68S N4

Food Inspection SGT E5 68R

Health Physics NCO E5 68S N4

Preventive Med NCO E5 68S

Preventive Med NCO E5 68S

Preventive Med SPC E4 68S N4

Preventive Med SPC E4 68S

Scientist:

Technician:

RAD / Occupational / Environmental Health PROFIS

Nuclear Med Science Officer LTC 72A

Nuclear Med Science Officer CPT 72A

Entomologist MAJ 72B

Sanitary Engineer MAJ 72E

Scientist:

Rad / Occ / Env Health Threat Assessment Capabilities

• Environmental Baseline Surveys– Radiological Surveillance – Ambient Air Monitoring– Composite and Grab Soil Sampling– Drinking / Source Water Surveillance– Entomological Surveillance

• Occupational/Industrial Hygiene Services (TIC/TIM)

• Food/Water Vulnerability Assessments

Analytical EquipmentAnalytical EquipmentRad/Env/Occ Rad/Env/Occ TIC/TIMTIC/TIM

HAPSITE GC/MS 1

HazmatID 1

WQAS PM 1

Refrigerator undercounter 1

Freezer mechanical 2

Identifinder 1

AN PDR-77 1

AN VDR-2 1

Multi-gas monitor 1

Mercury vapor analyzer 1

Staplex air sampler 1

Entomology Lab 1

Ambient air sampler 5

Water Testing Kit Bacteriological 1

SKC pumps 6 Hazmat ID

HAPSITE GC/MS

Analytical EquipmentAnalytical EquipmentRadiologicalRadiological /Env/Occ Health /Env/Occ Health

HAPSITE GC/MS 1

HazmatID 1

WQAS PM 1

Refrigerator undercounter 1

Freezer mechanical 2

Identifinder 1

AN PDR-77 1

DART 1

Multi-gas monitor 1

Mercury vapor analyzer 1

Staplex air sampler 1

Entomology Lab 1

Ambient air sampler 5

Water Testing Kit Bacteriological 1

Scintillation counter 6

AN PDR-77

Identifinder

Staplex

Collaborative & Reachback Initiatives

Center for Health Promotion & Preventive MedicineOcc/Environmental Surveillance Training

Ambient Air Monitoring

Pest Surveillance

Specimen Preparation

Radiation Survey

Tailored Teams1. AML – PAX 30 (43 w/ PROFIS)

25,000 cu ft / 10 vehicles

2. AML(-) Expeditionary Force – PAX 136 pallets / 4 vehicles

3. Tailored Section (heavy either C,B,R/N) – PAX 5-82 pallets / 3 vehicles

4. Dragon (HMMWV) – PAX 2

1. Area Medical Laboratory with all capabilities

Detection Equipment in Hardened Shelters (ISO)

Chemical Biological

1. Area Medical Laboratory with all capabilities

1. Area Medical Laboratory with all capabilities

2. Expeditionary Lab2. Expeditionary Lab

LabLab Officer 71E O-5Officer 71E O-5Inf Dis Phys 61G O-4Inf Dis Phys 61G O-4

ESO – 72D O-3ESO – 72D O-3Prev Med NCO 68S20Prev Med NCO 68S20

Hlth Phys NCO 68S20N4Hlth Phys NCO 68S20N4

Biochemist 71B O-4Biochemist 71B O-4Med Lab NCO 68K30Med Lab NCO 68K30Med Lab SPC 68K20 Med Lab SPC 68K20 Med Lab SPC 68K20Med Lab SPC 68K20

Microbiologist 71A O-4Microbiologist 71A O-4Med Lab NCO 68K30Med Lab NCO 68K30 Med Lab NCO 68K20Med Lab NCO 68K20Med Lab SPC 68K10Med Lab SPC 68K10

Rad/Occ/Env HealthRad/Occ/Env Health CBRNCBRN Endemic DiseaseEndemic Disease

HeadquartersHeadquarters

13 Personnel (5 Officers, 8 Enlisted)Equipment tailored to mission

3. Tailored Team (BW) Equipment

M1M Device (Protein) 96 Samples / plate

Analysis completed in ~1hr

Reagents from JPEO-CBD (CRP)

5 - 8 Personnel

3. Tailored Team (BW) Equipment

R.A.P.I.D.s Device

Real-Time DNA (PCR) analysis

32 Samples capacity

Analysis complete in ~45min

Reagents from JPEO-CBD (CRP), USAMRIID, NMRC andWRAIR

5 - 8 Personnel

4. Dragon Mobile Laboratory2 - 3 Personnel

4. Dragon Mobile Laboratory2 - 3 Personnel

4. Dragon Mobile Laboratory

ProcessingExtractionB WC WRAD

Preliminary Detection

2 - 3 Personnel

QUESTIONS?