Vol. 32, No. 9 May 1, 2015

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Fort Detrick Volunteers Hon-ored at RecognitionCeremony, p.3

BAHC Donates to Local Shelter,p. 5

MSS PMO Personnel AttractMosquitoes in Thailand, p. 6

ELLEN CROWNUSAMRMC PUBLIC AFFAIRS

DAVID MOOREU.S. ARMY SUPPORTACTIVITY-FORT DIX

Forty-six Soldiers received the ExpertField Medical Badge at Joint Base McGuire-Dix-Lakehurst in New Jersey April 27, culmi-nating the one-week competition organizedby the U.S. Army Medical Research and Ma-teriel Command in collaboration with thePublic Health Command and the NorthernRegional Medical Command.

More than 230 candidates participatedin the Northeastern Regional EFMB com-petition, which is one of more than a dozenEFMB competitions organized worldwideeach year. EFMB awardees must pass a com-prehensive written exam and complete a se-ries of training lanes where they are tested oncombat care and othermilitary survival skills.Competitors must also complete day andnight land navigation and then, if they makeit that far, a final 12-mile road march on thelast day that must be completed within threehours. Typically, only about 15-20 percent ofthose who go out for the badge earn it eachcompetition, making the EFMB one themostcoveted honors in Army medicine.

However, it’s not all about competi-tion. The EFMB competition also providesan opportunity for Service Members ofall branches to train together and developcompetence and confidence with field andmedical tasks.

“It’s not about a badge that you put onyour chest; it’s about treating Soldiers whoare wounded on the battlefield,” said Maj.Gen. Brian C. Lein, commanding general,U.S. Army Medical Research and MaterielCommand and Fort Detrick, Maryland, andDeputy for Medical Systems to the AssistantSecretary of the Army for Acquisition.

Preparing for the EFMB competition takesmonths, both for the competitors and for the208 cadre who organized and supported theevent. The USAMRMC’s 6th Medical Logis-ticsManagement Center took the lead for thesecond year in a row at organizing the North-eastern Regional EFMB competition.

“We learned a lot of lessons from lastyear that we were able to use this year tomake the process more efficient,” saidCapt. Walter Walsh, assigned to the 6thMLMC, referring to the coordination ittakes to acquire, transport and set up allof the materiel for the tactical lanes, suchas various up-armored vehicles, litters, ra-

dios and other medical gear typically in afield environment.

The tactical lanes are set up to be bothphysically and mentally challenging.

“You want medics to be on point whenit comes to evaluating a casualty or treat-ing someone wounded. There is no wiggleroom. You need attention to detail to get itright to save someone’s life,” explained Sgt.1st Class Richard Pina, non-commissionedofficer in charge of EFMB Combat TrainingLane 1, who is currently assigned to FortBelvoir Community Hospital in Virginia.Piña earned his badge in 2010.

Maj. Clem Bermudes, officer in charge oftheLandNavigationportionof theEFMBcom-petition, said the programplacesmany stress-ors on candidates, including theoften cold andrainyweather this season can bring on the up-per east coast. This can include nights with nomoonlight or stars. Bermudes said, in somecases, more than half the team will receive a“no go” from land or night navigation.

For many of the candidates, such as Cpl.Micah Alden-Danforth, a 28-year-old seniorline medic assigned to the 371 Calvary 1stBrigade Combat Team, 10th Mountain Di-vision, this year’s EFMB competition is notthe first attempt at the badge.

“This year is about redemption for me,”said Alden-Danforth, who was one of thecandidates to earn his badge this year. “Get-ting this badge is not only prestigious, butalso a sign that you’re good at your job.”

Sgt. Lewis Williford, a lab technician as-signed to the Walter Reed Army Instituteof Research, earned his badge at last year’sEFMB competition and served as an evalu-ator this year.

“Preparation is the key,” said Williford.“Train-upprogramsreallymake thedifference.”

Train-up programs are coordinated atthe local level, often by Soldiers that havealready achieved the EFMB and now wantto pass their skills on to the next generation.The WRAIR has a robust train-up program

that began readying candidates four monthsprior to the competition with four hours oftraining twice each week.

“The concept is to ‘see one, do one andteach one,’” said Staff Sgt. Kelly McWhirter,assigned to theWRAIR. “If you get the badgeand that is the last thing that you do withit, you have failed. You have to bring othersalong with you.”

McWhirter and Capt. Matthew LoPresti,the officer in charge of EFMB Combat Train-ing Lane 3, organized the WRAIR train-upprogram, of which this year they now havethree new badge recipients, including Capt.Lindsey Nielsen, Capt. Sean Marcsisin andSgt. Erik Bigham.

“I truly believe we have the best train-upprogram in the Army,” said Nielson, whoadded, “and if I can do this with a 7-month-old baby at home, anyone can do it if theyreally set their mind to it.”

Soldiers Train and Compete for Expert Field Medical Badge

A candidate is tested on tactical medi-cal skills at the Northeastern RegionalExpert Field Medical Badge competi-tion at Joint Base McGuire-Dix-Lakehu-rst in New Jersey April 17 - 27.Photo by Ellen Crown, USAMRMC Public Affairs

Expert Field Medical Badge candidate Capt. Lindsey Nielsen (right), assigned toWalter Reed Army Institute of Research, navigates combat tactical lane 3 as shestabilizes a “patient” injured in a vehicle accident. Nielsen was one of three Sol-diers from the WRAIR to earn the badge this year.

Photo by Ellen Crown, USAMRMC Public Affairs

2 Fort Detrick StandardMay 1, 2015 Sustaining a community of excellence through restoration, environmental stewardship and workforce development

Commentary:

Command StaffMaj. Gen. Brian C. Lein

Commanding General, U.S. Army Medical

Research and Materiel Command

and Fort Detrick

Col. Steven P. MiddlecampU.S. Army Garrison Commander

Editorial StaffMelissa Myers

USAMRMC/Fort Detrick PAO

The STANDARD is an authorized unofficial newspaper,published every two weeks under the provisions of AR360-1 for the military and civilians at Fort Detrick. Circula-tion is 7,000. The STANDARD is a commercial enterprisenewspaper printed by Comprint Military Publications, 9030Comprint Court, Gaithersburg, Md., 20877, a private firm,in no way connected with the United States Government orDepartment of Defense. The contents of the STANDARD donot necessarily reflect the official views or endorsement ofthe U.S. Government, the Department of Defense or the U.S.Army. The appearance of advertising in this publication, in-cluding inserts and supplements, do not constitute endorse-

ment of DoD. Everything advertised in this publication shallbe made available for purchase, use or patronage withoutregard to race, color, religion, sex, national origin, age,marital status, physical handicap, political affiliation, or anyother nonmerit characteristic of the purchaser, user or patron.Editorial content is prepared and edited by the Fort DetrickPublic Affairs Office, 810 Schreider Street, Fort Detrick, Md.21702-5000. Editorial Offices are in Bldg. 810, Suite 004,telephone 301-619-2018; e-mail: usarmy.detrick.usag.mbx.pao@mail.mil.

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After Duty NumbersImportant After Duty Hour Numbers

The Defense Health Agency, Office of Program In-tegrity has received a significant number of concernsfrom our TRICARE beneficiaries regarding unsolicitedattempts by “call centers” to encourage them to pro-vide personal identifying information and health infor-mation so that they can allegedly provide prescribedcream medications to the TRICARE beneficiary.

TRICARE and its contractors never call and ask forpersonal identifying information or health information.Beneficiaries should be wary of unsolicited attempts byany entity asking them for personal or health informa-tion, either by phone or in person.

The “call center” will normally cold call and say, “Iam a representative calling from XYZ, we are calling totell you about a benefit TRICARE will cover for you fora prescription pain cream you are eligible for. Do youhave any of the following medical issues (list of issues)or pain? If so, TRICARE wants to get you taken care of,all we need are your doctor’s name and your TRICARE

information and we will contact your doctor and getthese medications or supplies out to you immediatelyand submit a claim.”

DHA PI strongly advises you to give NO informa-tion to these types of unsolicited requests for yourpersonal health information and personal identifyinginformation. Often these “call centers” have identifiedwhat limited information they have through “Google”searches or through individuals who have approachedyou independently and obtained information directlyfrom you.

Should you receive a phone call for this information,provide NO information. Also, please immediately sub-mit a Fraudline report to our Pharmacy Benefits contrac-tor ESI. You can report the issue to Express Scripts, Inc.

Express Scripts Fraud Tip Hotline: 1-866-759-6139Email: TRICAREfraudtip@express-scripts.comESI can also flag your profile and reject attempts to

bill for these medications. If you do receive unsolicitedmedication in the mail, you can refuse delivery.

TRICARE Beneficiaries Being Targetedby Call Centers and Others for

Unsolicited Medical Prescriptions

Military Spouse Appreciation Day is observedeach year as a way to honor the contributions,strength and resilience of military spouses whoselflessly serve alongside their Army, Navy, Ma-rines, Air Force or Coast Guard Service Member. Imight be the one wearing the uniform, butmy wifeserves right alongside of me.

President Ronald Reagan recognized the pro-found importance of spousal commitment to thereadiness and well being of military members. Hecreated Proclamation 5184 on April 17, 1984. Con-gress officially made the day part of National Mili-tary AppreciationMonth in 1999 and standardizedthe date declaring the Friday before Mother’s Dayevery year as Military Spouse Appreciation Day.

This year’s theme, “Military Spouses - TheStrength of Our Service Members,” recognizes the

significant impact spouses have on the strength ofour Service Members and the Nation.

I am proud that this year my wife, Terry, willbe speaking at the Fort Detrick celebration May 8from 1-3 p.m.; where the U.S. Army Garrison FortDetrick will honor military spouses with a fun-filled event in the Community Activities Center,Building 1529.

Throughout the course of my military career,Terry has supported my endeavors while be-ing an amazing mom to our three children. If itweren’t for her support, both at home and abroad,I wouldn’t be where I am right now.

Take some time this May to also thank thespouses for their great sacrifices and achievementsin support of our Armed Forces. Our military forcewould not be what it is today, the strongest in theworld, without our military spouses.

Military Spouse Appreciation Day

Maj. Gen. Brian C. LeinUSAMRMC and Fort Detrick Commanding General

3Fort Detrick StandardMay 1, 2015Sustaining a community of excellence through restoration, environmental stewardship and workforce development

NICK MINECCIUSAG PUBLIC AFFAIRS

The Fort Detrick Volunteer Awards Ceremony washeld April 20 at the Community Activities Center, hon-oring the members of the Fort Detrick community whovolunteered approximately 10,000 hours of their time,representing a labor savings for our community of over$208,000.

More than 50 volunteers received Certificates of Ap-preciation signed by U.S. Army Medical Research andMateriel Command and Fort Detrick CommandingGeneral Maj. Gen. Brian C. Lein and acting Command-er of U.S. Army Garrison Fort Detrick Col. Perry Clark.Individual President’s Service Awards and Group Pres-ident’s Service Awards were presented to those volun-teering between 100 to more than 1,000 hours in 2014,and some volunteers also received Governor’s Officeon Volunteerism Certificates of Appreciation for theircontinued volunteer work in support of their commu-nity and Maryland.

“Our volunteers are Soldiers, spouses, kids, retirees,members of the community, civilian employees, con-tractors, etc. They range in age from 4 - 80 plus yearsyoung. They are a vital part of many of our organiza-tions on post and in the community,” said Clark. “Vol-unteering not only supports the Fort Detrick communi-ty, but helps develop lasting relationships and links ourhearts toward a common goal. When someone donatesa handful of time, the difference made is tremendousand it shapes a community for the better while the ex-perience improves the person who donated the time.”

The 2014 Fort Detrick Volunteer of the Year, JoanDerk, was honored for not only displaying enthusiasm,commitment and selfless service, but for many years ofcontinuously volunteering. Derk also received the Gov-ernor’s Volunteer Service Certificate, signed by Gov-ernor Larry Hogan, in appreciation for her efforts, “toensure the vitality of the community in which you vol-unteer, your contribution to the citizens of Marylandand your support of Maryland’s longstanding traditionof community involvement.”

Individuals recognized for their volunteeractivities were:John WagnerDolores ChristieForest WhitingCameron ThomaBenjamin RubioDavid HandwerkerSara HandworkerCynthia GervasiSarah VaughnMaria VaughnLisa WeedNancy Sanchez De ArriagaHoward JamesLakeisha MulheronParag ApteStuti GanatraSagar MatharuJoshua EvansKarl BuschMildred BuschMichele ThomasBelinda AfiGarrett GrimSheila BrownTerrence GibsonJason SepanicJacob SepanicAnna Sepanic

Fort DetrickVolunteers Honored atRecognition Ceremony

Alton BennettDennis HelmstetterVernon KephartKatherine SuarezBrittany Branch-smithThomas StarkoskiJermaine ThomasJean GonzalezJonelle BoyeWilletta ChristianLorenzo NicholsChris CasonDebbie SkvorakAndrea RanderDenis GarciaAdaliza Pantoja-BobeJessy DonahoSheila ChestnutGabriella CantoniJames FryeCharles ChipleyMichael CaselleCarolyn WhittenburgAnthony MalavendaAllan PhillipsMiae MartinezHiginio Martinez

NICK MINECCIUSAG PUBLIC AFFAIRS

Starting in March 1943, DetrickField became shrouded in mystery af-ter years of use as an encampment ofthe 104th Aero Squadron of the 29thDivision of the Maryland NationalGuard then later a Cadet Pilot Train-ing Center until the Japanese bombedPearl Harbor and the U.S. enteredWorld War II.

In March 1943, the federal gov-ernment purchased additional land,renaming the area Camp Detrick,and making it home to the U.S. ArmyBiological Warfare Laboratories. TheUSBWL was responsible for research-ing biocontainment, decontamina-tion, gaseous sterilization, agent pu-rification and was the lead U.S. Armyagency dedicated to biological warfareresearch efforts during World War II.

For almost three decades, CampDetrick, later designated as Fort De-trick, continued with the mission ofcontinuing biological research; recog-nized as one of the leading research in-stitutions for biological agents requir-ing special containment. On Nov. 25,1969, President Richard M. Nixon out-lawed offensive biological research inthe United States, with the research atFort Detrick becoming solely focusedon defensive measures.

On Oct. 19, 1971, Nixon traveledfromWashington, Distict of Columbia,to Fort Detrick to announce he was cre-ating the Frederick Cancer ResearchFacility of the National Cancer Insti-

tute at Fort Detrick. The Department ofHealth, Education, and Welfare (laterrenamed the Department of Healthand Human Services) was afforded ap-proximately 68 acres and 70 buildingson Fort Detrick for this mission.

“In November of 1969, I made adecision that the United States wouldtake the leadership in discontinuingresearch in the development of weap-ons for biological warfare. As a resultof that decision, this facility, therefore,no longer could be used in that way.

But it was one of the finest facilities inthe world, and consequently, we foundthat, in January of this year when Imade an announcement with regard toa new initiative for conquest of cancer,we needed just what this facility had tooffer,” said Nixon during his remarksat the event.

“Consequently, today we are mak-ing an announcement that, where wehave previously had scientists--some ofthe best people that we could possiblyfind in the United States--working onweapons of war, we now have scientistsdevoting their efforts toward saving life,rather than destroying life. So I think allAmericans are very appreciative of thefact that, in terms of our conquest ofcancer program,we have one of the bestfacilities in the world right here whichwill be used for the purpose of makingprogress in that area. I think all of us,too, are very happy that we have herean indication of how the genius of man,which could be used to destroy life--that same genius can better be used tosave life,” said Nixon.

In a statement released the sameday Nixon said, “Today, we mark an-other chapter in the realization of thatdream as we announce that one of ourlargest facilities for research on bacte-riological warfare is being convertedinto a leading center for cancer re-search.”

In 1973, as a result of the 1969 lawsigned by Nixon and the Oct. 19, 1971visit to Fort Detrick, the National Can-cer Institute, also called NCI-Freder-ick, opened at Fort Detrick.

President Richard M. Nixon onFort Detrick, Oct. 19, 1971, toannounce the biological warfarefacility would be converting intothe Frederick Cancer ResearchFacility of the National CancerInstitute at Fort Detrick. Today theorganization is called the Freder-ick National Laboratory for CancerResearch.

Photo courtesy of National Archives

The Day President Nixon Visited

JENNI BENSONUSAG PUBLIC AFFAIRS

“In their uniqueness, stories of res-cue remind us all of the wide range ofchoices that we are capable of makingas individuals. Our actions in the faceof injustice of hatred always matter.”-The United States Holocaust Me-

morial MuseumThe U.S. Army Medical Research

and Materiel Command Headquartersand Headquarters Detachment hosteda Days of Remembrance CeremonyApril 17 at the Community ActivitiesCenter on Fort Detrick.

Dignitaries and local elected offi-cials participated in a remembranceceremony where Mr. Emanuel “Man-ny” Mandel served as the guest speak-er. Mandel is a survivor-volunteer atthe United States Holocaust MemorialMuseum. Manny shared his story as aHolocaust survivor and challenged theaudience to never forget.

“During these weeks each year,many of us, the survivors, are in fact

involved in these kinds of talks to fa-miliarize the world with that whichwe can familiarize them with and withwhich they cannot be familiarizedwith, once we are gone,” said Mandel.“I am one of the youngest survivorsyou will ever meet. I was born in 1936which makes me close to 80, but I’m79. Most of us will not be aroundmuchlonger to talk about our experiences;we must never forget.”

According to his bio, Manny was 7when the Germans occupied Budapestin March 1944. Manny and his familywere among a group of Jews whomAdolf Eichmann offered to trade forAllied material. In exchange for trucksand other goods, some 1,600 Hungar-ian Jews left Hungary by train, with thepromise that they would be permittedto enter Switzerland. After difficultiesin the negotiations, Manny and hisfamily were diverted to Bergen-Belsencamp. They were taken to Switzerlandby Nazi transport in late 1944, first toa Red Cross hotel near Montreux andthen to a children’s home in Heiden.

In 1945, Manny and his mother immi-grated on a British troop ship to Pal-estine. He moved to the United Statesin 1949.

During the observance, 7 candleswere lit to remember the six millionJews murdered in the Holocaust, aswell as the millions of non-Jewish vic-tims of Nazi persecution, in a candle-lighting ceremony.

Each candle was dedicated to animportant group of witnesses to theHolocaust. Ending with the lighting ofone yellow candle, dedicated to us, thenext generation, to remind us to carryon the flames of remembrance.

The United States Congress estab-lished the Days of Remembrance asthe Nation’s annual commemorationof the Holocaust. Each year, the UnitedStates Holocaust Memorial Museumleads the Nation in commemoratingthe Days of Remembrance.

This year’s theme is “Learning fromthe Holocaust: Choosing to Act.”

Fort Detrick Hosts Days ofRemembrance Observance

Fort Detrick Volunteer of the YearJoan Derk

4 Fort Detrick StandardMay 1, 2015 Sustaining a community of excellence through restoration, environmental stewardship and workforce development

SHANNON BISHOPUSAG PUBLIC AFFAIRS

Named after the former U.S.Army Medical Research Insti-tute of Infectious Diseases Com-mander Col. Richard Barquist, theFort Detrick Barquist Army HealthClinic opened its doors 15 yearsago to serve local ServiceMembersand their families.

Barquist, the USAMRIID com-mander in 1977, was known as agentle, caring individual whoseknowledge of medicine, infec-tious disease and the potentialof biological warfare made him avaluable asset to national defense,according to Fort Detrick recordsfrom 1994.

Barquist passed away in 1994and the clinic was dedicated tohim just five years later beforeopening in 2000.

Though the Walter Reed Na-tional Military Medical Center isjust a few miles down the road inBethesda, Maryland, the clinic atFort Detrick offers health care tobeneficiaries who seek care in amore local setting.

“The clinic has grown so muchfrom just a few doctors in the US-AMRIID years ago,” said BAHCCommander Lt. Col. Jason Sepan-ic. “We’re still expanding and try-ing to get more space.”

When the clinic opened, thespace featured 25,000 square feet

that consolidated primary care,radiology, occupational health,dental, pharmacy and alcohol anddrug rehabilitation into one build-ing. Since the opening, the clinichas expanded its services withinthe space to include psychology,social work and primary care forfamily members.

The clinic has also moved theoccupational health division intoa separate building to accommo-date behavioral health and physi-cal therapy services, which werenot part of the original design,according to Anna Walsh, deputycommander for administration atthe BAHC. Additionally, accordingto Walsh, total enrollment has in-

creased from approximately 2,000to 6,400 patients.

“We are much busier than wewere years ago,” said Joann Clay-bon,medical support assistant at theBAHC. “We still have more changescoming, like the new pharmacy, butthese are all good changes.”

Claybon jokingly shared thatwith more space, more doctorsand more patients she has a lotmore scanning to do.

“I want to continue to improveupon the great care here so wecan support the community,” saidSepanic. “We are trying to expandupon the current partnership wehavewith theVeteransAffairs Clinic.Wealsowant to continue to increase

the overall health of the communitythrough the triad initiative.”

In the last year, the BAHC hasmade efforts to make the clinicexperience a more pleasant andefficient one through changes tothe phone system, patient caresystems, the Nurse Advice Lineand emphasizing programs suchas the Performance Triad.

Additionally, in line with theU.S. Army Medical Command val-ues, the BAHC is also committedto synchronizing military healthcare efforts; redefining the patientcare experience and continuingto create a health system built onquality care and patient safety.

For more information aboutthe BAHC, call (301) 619-7175.

Local Clinic Celebrates 15 Years Since Opening

LORI A. DEBERNARDISAND ANNA K. APPLEGATE

TATRC

Did you know that the majorityof casualties that die on the battle-field die from uncontrolled bleed-ing? Analysis of data from conflictsin Iraq and Afghanistan indicatesthat approximately 22 percent ofService Members who died fol-lowing severe bleeding after injurycould have potentially been savedhad their hemorrhaging been con-trolled early on.

Experts in the combat casualtycare community believe that theopportunity to save casualties is inthe pre-hospital environment. Sav-ing a life does not just happen onceyou get to the hospital, it happenswhen you canmanage hemorrhageat the point of injury or in transit toa medical treatment facility.

Given this information, howwould one go about handling, oreven recognizing the need for ad-ministering a blood transfusion?The Biotechnology High Perfor-mance Computing Software Appli-cations Institute, one of the Tele-medicine & Advanced TechnologyResearch Center’s key labs, is ad-dressing this issue with develop-ment of the Automated Processingof the Physiologic Registry for As-

sessment of Injury Severity system,or APPRAISE.

The APPRAISE is an artificialintelligence-based system that canalert medics when trauma patientsare in need of massive blood trans-fusions without any human inter-vention. It collects and analyzes,in real time, vital sign informationfrom the patient during pre-hos-pital transport. It then uses the re-sults of that analysis to determineif the patient will need a massiveblood transfusion before the pa-tient arrives at the hospital.

The system consists of an off-the-shelf vital signs monitor con-nected to a ruggedized PC runningMicrosoft Windows. Dr. JaquesReifman, Ph.D., the BHSAI direc-tor, members of his team, MaximKhitrov and Jianbo Liu, Ph.D., andAndrew T. Reisner, M.D., an inves-tigator with BHSAI at the time ofdevelopment and an emergencyroom doctor at MassachusettsGeneral Hospital, collaborated todevelop the APPRAISE system.

“A benefit of the system is thatit uses standard vital signs, such asEKG, heart rate and blood pressure,which caregivers are already famil-iar with,” said Reifman. “There is noneed for training caregivers to newsensormodalities, so APPRAISE can

be easily disseminated throughoutthe health care system.”

The team worked with BostonMedFlight, a not-for-profit organi-zation operating in Boston andNewEngland that served as the equiva-lent to a shock trauma medevac,to test and validate the BHSAI-de-veloped mathematical models andalgorithms in a prospective study.

For nearly two years, the AP-PRAISE system was used in BostonMedFlight helicopters to monitortrauma patients during emergen-cy transports. Patients were thentransported to one of three hospi-tal partners: Massachusetts Gener-al Hospital, Brigham andWomen’sHospital or Beth Israel DeaconessMedical Center.

By comparing clinical andtrauma registry data with com-puter predictions, BHSAI scientistsfound that the APPRAISE systemwas able to automatically iden-tify casualties in need of massiveblood transfusions with 78 percentsensitivity and 90 percent specific-ity within 10 minutes of the startof transport to the trauma center.This was the first time that any-one, not just the Army, had beenable to collect and analyze datain real time as patients were be-ing transported. The BHSAI team

has received two U.S. patents forthe APPRAISE system and is cur-rently pursuing FDA approval anda licensing agreement with a com-mercial partner.

Excited about the results andwhat this technology could meanfor Warfighters in the future, Rei-fman said, “[The] bottom line isthat the majority of the casualtieson the battlefield are due to un-

controllable bleeding. Here, wedeployed in the civilian setting atechnology that demonstrates howwe can identify bleeding patientspre-hospital, in real time, and in afully automated fashion in a pro-spective trial.”

More information about theAPPRAISE system trial will be doc-umented in the May 2015 issue ofthe journal Shock.

BHSAI Develops System to Identify Patients with Severe Bleeding During Transport

LISA MORRISUSAMRMC PUBLIC AFFAIRS

A select group of academics from the topuniversities in the country visited the U.S.Army Medical Research and Materiel Com-mand April 16.

Directed by the non-profit Institute forDefense Analyses and sponsored by the De-fense Advanced Research Projects Agency,the Defense Science Study Group comprises15 of the most outstanding science and en-gineering professors from academic institu-tions like Stanford University, Cornell Uni-versity and the Massachusetts Institute ofTechnology, among other esteemed schools.

Members of this prestigious group havethe unique opportunity to learn about theU.S.’ security challenges through the inter-action with top-level officials from the De-partment of Defense and other governmentorganizations, various intelligence agencies,the White House and Congress.

In the two years of the program, the groupvisits military bases throughout the country,gaining a unique perspective of operatingforces andmeeting with senior commandersresponsible for the Nation’s defense.

Tours of defense laboratories and in-dustrial facilities provide further insight formembers into the technical dimensions ofnational security.

Selection for the DSSG is competitive. TheIDA solicits more than 150 nominations ofextremely well qualified scientists and engi-neers from senior leaders within major uni-versities, and only selects about 5 percent.

Leaders from the IDA hope that oncethey graduate from the program, these aca-demics can use their unique perspectives tointegrate their exposure of the inner work-ings of the government into their research tohelp develop solutions to some of the coun-try’s greater capability gaps.

“When I started the program about 30years ago, the idea was we need bright peo-ple to get educated with national defense,”

said DSSG Director Robert E. Roberts.“When they graduate from the program,they want to get involved.”

With several seasoned experts guidingthe program, the group receives a well-

rounded picture of the government’s opera-tions and requirements.

“Visits of this character are vital to thesuccess of the program. These senior uni-versity professors have expressed deepinterest in solving difficult defense prob-lems,” said retired Air Force Gen. MichaelP.C. Carns, one of the mentors to the DSSG.“They’re here to understand what the needsare, and the hope is that one of these profes-sors will adopt something they learn abouthere for their study.”

The group’s visit to the USAMRMC be-gan with an overview briefing of the com-mand from Chief of Staff Col. Richard Starrs.Members showed particular interest in thecommand’s relationship with the U.S. Foodand Drug Administration, emerging threatsand challenges, how the health of the Sol-dier impacts the health of the unit andmanymore diverse topics.

Interspersed with presentations about

Defense Science Study Group Visits USAMRMC

See USAMRMC, continued on page 6

Maxim Khitrov, a software developer and HJF contractor (left),and Jaques Reifman, Ph.D., a senior research scientist and direc-tor at the Biotechnology High Performance Computing SoftwareApplications Institute (right), demonstrate the APPRAISE system.APPRAISE is a clinically validated platform for the automated,pre-hospital, real-time collection and analysis of vital sign data.

Photo by Adam Wyatt, TATRC

Members of the Defense ScienceStudy Group tour the U.S. Army Medi-cal Research Institute of Infectious Dis-eases as a part of a visit to the U.S. ArmyMedical Research and Materiel Com-mand April 16.

Photo by Adam Wyatt, TATRC

5Fort Detrick StandardMay 1, 2015Sustaining a community of excellence through restoration, environmental stewardship and workforce development

LISA MORRISUSAMRMC PUBLIC AFFAIRS

As the U.S. Department of Defense’s largest biomedicalresearch facility, theWalter Reed Army Institute of Researchhas once again demonstrated the U.S. military’s expertisein responding to outbreaks of infectious diseases with itssuccessful completion of a phase 1 clinical trial for an Ebolavaccine candidate, the recombinant vesicular stomatitis vi-rus for the Zaire strain of Ebola.

Together with researchers from the National Institute ofAllergy and Infectious Diseases, who completed their ownphase 1 clinical trial, researchers at the WRAIR and NIAIDpublished their findings from the trials in the New EnglandJournal of Medicine April 1.

The trials, conducted independently but collaboratively,explored the safety and immunogenicity of the investiga-tional vaccine when administered at different dosages.

The Public Health Agency of Canada developed therVSV-ZEBOV and licensed the candidate to NewLink Genet-ics Corporation who, in turn, sublicensed to Merck Sharp &Dohme Corporation. The vaccine’s intent for both pre- andpost-exposure prophylaxis would allow both those exposedand those not yet exposed to Ebola to avoid developing Eb-ola virus disease.

When the 2014 Ebola epidemic occurred, it became clearto the U.S. government and the global community that theyneeded to quickly advance the development of a vaccine.

In response to this need, the Defense Threat ReductionAgency requested support from the WRAIR to prepare andexecute a human clinical trial and develop a lab test to sup-port the assessment of the vaccine’s safety.

“When DTRA approached us, we redirected our person-nel, mission and resources to meet the global need,” saidCol. Stephen Thomas, deputy commander of the WRAIRand senior author of the NEJM publication. “TheWRAIR labenterprise, which is both domestic and international, maylook like a number of individual programs, but really we area collection of science and science support professionalswith expertise in infectious diseases. We have a number ofplatforms, capabilities and competencies that are generallyapplicable to whatever the DOD determines to be a threat.”

With its adaptable platforms and capabilities, the mili-tary can direct and redirect its resources as the needs andrequirements arise.

Past efforts include supporting vaccines licensed againstHepatitis A, Adenovirus Types 4 and 7 and Japanese en-cephalitis, not to mention major accomplishments like theHIV vaccine efficacy trial in Thailand and participation inSanofi Pasteur’s Dengue vaccine phase 3 trial in Asia. No-tably, the WRAIR investigated every current malaria drugin the world and supported their clinical use, including theRTS,S that first demonstrated efficacy through studies atthe WRAIR.

“Ebola was just the next thing in line. It’s an exemplar ofwhat we do on a day-to-day basis and what we have beendoing since 1893,” said Lt. Col. Jason Regules, deputy direc-tor of the Translational Medicine Branch within the WRAIRand co-lead author of the NEJM publication.

The WRAIR worked with NewLink, Merck and the DTRAto prepare for the clinical trial, execute the trial and analyzethe data.

Preparation included working to meet the regulatoryrequirements, establishing logistical processes, helpingdesign the study and the scientific activities that wouldcharacterize the vaccine’s performance, writing the pro-tocol and submitting the plans for an independent ethicalreview.

Researchers had no difficulty in recruiting the 52 volun-teers they enrolled.

“I think the scale of the human crisis that was occurringin Africa was such that really motivated people to step for-ward,” said Regules. “This one caught everyone by surprise

through its magnitude.”Combining both centers, 40 volunteers received a single

dose of the vaccine candidate and 12 received a placebo.Researchers periodically assessed the volunteers for safetyand collected blood samples to determine who developedantibodies.

Thirty-seven of 40 volunteers in the vaccine groupshowed the intended Ebola glycoprotein antibody responsewithin two weeks of vaccination, and all of the volunteershad antibodies within 28 days of receiving the vaccine, withno significant side effects.

The vaccine intends tomake the recipient’s immune sys-tem react as if it has been exposed to the Ebola virus. If thevaccine recipient were ever naturally exposed to Ebola, theimmune system would respond and protect the individualfrom developing the Ebola virus disease.

Scientists developed the vaccine by replacing a smallportion of the VSV virus with a small, but important, com-ponent of the Ebola virus. By doing this, they can stimulatethe desired anti-Ebola immune response without actuallyexposing the recipient to any risk of developing Ebola.

“It tricks the body’s immune system into thinkingyou’ve been exposed to Ebola and prepares a protectiveresponse in the event you ever are actually exposed to thevirus,” said Thomas.

Researchers assessed the antibody response using twodifferent methods, a quantitative assay that examined thetotal amount of antibodies in the subject, and a qualitativeassay that evaluated the antibodies’ function.

“We saw a robust immune response following a singledose of the vaccine, which could be particularly useful inoutbreak interventions,” said Thomas.

The study’smissionwas to produce results thatwould helpdetermine the design of the studies in West Africa, for whichthe rVSV-ZEBOV is one of two Ebola vaccines being tested.

“These pivotal early studies helped inform dose selec-tion for testing of rVSV-ZEBOV vaccine in a large-scale clini-cal trial in West Africa,” said Regules. “We were gratified tosee that the vaccine was not associated with significant ad-verse effects in this very carefully monitored study.”

Ebola Vaccine AppearsEffective, WRAIR Publishes

Findings in NEJM

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6 Fort Detrick StandardMay 1, 2015 Sustaining a community of excellence through restoration, environmental stewardship and workforce development

DORA M. SEARS,SENIOR TECHNICAL WRITER

USAMMDA MEDICAL SUPPORT SYSTEMSPROJECT MANAGEMENT OFFICE

Representatives for the Medical SystemsSupport Project Management Office trav-eled to Kamphaeng Phet in Thailand onNov. 3-14 to evaluate the efficacy of CarbonDioxide Generator technologies in attract-ing dengue-vector mosquitos.

Jake Fox, MSS PMO product manager forthe CDG program, and Dr. Kendra Lawrence,senior scientific consultant for the U.S. ArmyMedical Materiel Development Activity,spent two weeks evaluating the efficacy andfunctionality of the CDG systems in partner-ship with the Armed Forces Research Insti-tute of Medical Sciences unit in Thailand.

The team evaluated four CDG systems incombination with the Centers for DiseaseControl miniature light trap against the lighttrap alone and against the light trap with dryice - the form of carbon dioxide currentlyused with the vector traps.

Results showed the CDG systems wereunable to surpass the dry ice, which Law-rence calls the “gold standard” for vectorattractants, in terms of the number of mos-quitos attracted to the traps. “To beat dryice, or even to be as good as dry ice, is prettyhard,” said Lawrence.

Despite its high efficacy status, however,dry ice has its drawbacks. “In most con-tingency operations you’re going to placeswhere they don’t make dry ice,” said Law-rence. CDG systems solve this problem byproducing a more portable and accessiblesource of CO2 gas.

Of the CDG systems tested in Kam-phaeng Phet, Fox said only one proved ef-fective in a real-world environment, basednot only on standards of efficacy in captur-ing the dengue-vector mosquitos, but alsooperability and reliability. Lawrence notes,however, that in terms of the number ofmosquitos attracted, “most of them did bet-ter than the light trap alone.”

According to Lawrence, malaria, den-gue fever and leishmaniasis, which top the

military’s list of vector-borne diseases, aretransmitted by mosquitoes and sand fliesattracted to CO2. Preventive medicine unitsdeployed to areas that present a significantrisk of these diseases use vector traps todefine appropriate protective measures forvector control. The CO2 attractant increas-es their effectiveness.

Fox expects data from the recent Thai-land trip, as well as from trials conductedlast May against malaria vectors in Mae Sot,Thailand, to support the decision to contin-ue development of the CDG systems. “Weexpect Milestone B and permission to enterthe Engineering and Manufacturing Devel-opment [phase] in the third quarter of fiscalyear 2015,” said Fox.

The team hopes to travel to Greece thisJuly to conduct evaluations against leish-maniasis vectors. “The plan is to test themagainst sand flies in collaboration with theUSDA lab that is there,” said Lawrence.

According to Fox, if evaluation trials con-tinue to go well, the CDG system could beready for initial operational capability in fis-cal year 2016.

MSS PMO PersonnelAttract Mosquitos in Thailand

Jake Fox, MSS PMO product managerfor the CDG program at the U.S. ArmyMedical Materiel Development Activ-ity, and Dr. Thanyalak with the ArmedForces Research Institute of MedicalSciences unit in Thailand, prep theCUBE CDG generators at the field labin Kamphaeng Phet.

Photo courtesy of Dr. Kendra Lawrence

specific focuses within the command, in-cluding Ebola research, the Chemical Bio-logical Defense Program and prostheticsresearch, the day also included a briefingfrom Maj. Gen. Brian C. Lein, commandinggeneral of the USAMRMC and Fort Detrick.

Lein answered the group’s questions inboth an informal and formal structure, in-viting their approaches before, during andafter lunch.

“The effects of sequestration could havea negative impact on the young people com-ing into the science and technology field,”said Lein in response to a question aboutretention at the USAMRMC.

After a morning of comprehensive pre-sentations providing the groupwith their firstlook into theUSAMRMC,members toured theU.S. ArmyMedical Research Institute of Infec-tious Diseases and received an overview ofboth theUSAMRIID and theU.S. ArmyCenterfor Environmental Health Research.

Members remained engaged and inter-ested throughout the day, constantly think-ing about how they could apply what theywere learning to their own research.

“I do healthcare-related robotics research.This kind of exposure allows us to hear aboutthe real problems and see how our researchfits,” said DSSG member Ayanna Howard,professor at the School of Electrical and Com-puter Engineering within the Georgia Insti-

tute of Technology. “We each look at all of thisfrom different perspectives.”

Members felt privileged they could par-ticipate in such a high-level program ofeducation and study, drawing a connectionbetween their contributions and the contri-butions of Service Members.

“Being a part of this group is an honor.It gives me an outlet to serve my country ina different way, like our men and women incombat,” said DSSG member John Dabiri,professor in the Division of Engineering andApplied Science at the California Instituteof Technology. “It’s interesting to think thatwe as scientists can contribute in some ofthe same ways.”

Everyone involved in the DSSG’s visitfrom the USAMRMC received thought-provoking inquiries, a promising forecastof the support and solutions to come fromthe group.

“The DSSG is a distinguished assemblageof some of the greatest minds in scienceand technology in the country. The factthat they come from outside the DOD givesthem fresh perspectives that they can offerus,” said Col. Erin Edgar, commander of theUSAMRIID. “I was impressed by the mul-titude of high-level questions they asked.Their intellectual curiosity surpassed thatof all other groups I’ve hosted here. A fewmembers mentioned that they would be in-terested in returning for a ‘deeper dive.’ I’dwholeheartedly welcome that.”

USAMRMC, continued from page 4

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