FORT DETRICK, Md. — The Armed Forces Research Institute of Medical Sciences recently provided comprehensive biosurveillance in support of exercise Cobra Gold 2024, a joint multinational military exercise in Thailand.
AFRIMS, a part of U.S. Army Medical Research and Development Command’s Walter Reed Army Institute of Research, provided unit commanders and medical personnel with real-time data that enabled them to protect personnel against a wide range of health threats such as rickettsia in rodents, leptospirosis in water and mosquito-borne diseases such as dengue during the exercise.
As part of its mission to identify and close capability gaps in the treatment and prevention of infectious diseases, AFRIMS — a bilateral U.S. Army-Royal Thai Army medical research institute that serves as WRAIR’s expeditionary medical response platform in Asia and Oceania — conducts entomological surveillance and collects, processes and analyzes field samples in support of military exercises such as Cobra Gold throughout the U.S. Indo-Pacific Command. These activities help them better understand the impact of infectious diseases on readiness during an actual conflict.
“Infectious diseases can debilitate warfighters and take them out of the fight,” says Maj. Daniel Boudreaux, a microbiologist with AFRIMS who was involved in the pre-exercise planning as well as surveillance during the exercise itself. “Exercises like Cobra Gold are a great way to simulate what can happen when people who are immunologically naive to the diseases prevalent in Southeast Asia are sent here to fight. We provide that information to force health protection providers so they can come up with solutions to reduce the effects of those infectious diseases on warfighters.”
Established in 1982 as a bilateral maritime exercise involving the United States and Thailand, Cobra Gold has grown steadily and today includes military units from Japan, Indonesia, the Republic of Korea, Singapore and Malaysia. Several other countries, including Australia, India and China, participate in humanitarian exercises or as observers. The two-week long exercise incudes combined arms live-fire training scenarios, tabletop exercises and an amphibious exercise.
Although Cobra Gold 2024 took place from Feb. 27 to March 8, 2024, AFRIMS began conducting pre-exercise infectious disease surveillance activities in late January. Maj. Erica Lindroth and Capt. Alyssa Mann, respectively AFRIMS’ chief and deputy chief of entomology, led a team of 15 Thai Foreign Service nationals and Royal Thai Army personnel who fanned out across the various exercise locations to collect mosquitoes, ticks, rodents and other parasites and brought them back to the AFRIMS laboratory for testing. For this year’s exercise, the surveillance teams also tested for the Zika virus, of which there was an outbreak in Thailand around the time of the exercise.
“We aim to support the combatant commands and the warfighter, so when new requirements arise, such as testing for Zika virus, our goal is to demonstrate flexibility and promptly meet that demand,” explains Maj. Taylor Whitten, AFRIMS’ executive officer. “We're constantly exploring diverse approaches and avenues to effectively communicate the risks identified during pre-exercise surveillance. This ensures the operational force can take mitigation measures beforehand and arrive fully prepared.”
Once the exercise got underway, AFRIMS continued to provide support to the COCOMs by collecting and testing biological samples from warfighters and coordinating aid stations. AFRIMS provided real-time aggregate testing data to exercise surgeon cells within 24 hours, providing awareness of infectious disease threats like respiratory and diarrheal infections. Staff Sgt. Matthew Pascual, a preventive medicine specialist who coordinated field sample collections and aid station coordination efforts throughout the exercise, said that while the medical officers valued the timely data, junior warfighters often needed encouragement to participate in the sample collection program when they reported to sick call.
“Some of the Soldiers understood, but some of them were still apprehensive about providing samples,” recalls Pascual. “I had to put on my salesman hat and walk the Soldiers through what we were doing and why it was important. But I know how to talk to people!”
During the exercise, AFRIMS staff also provided tours of their facilities to exercise medics, Royal Thai Army officers and other participants to help them learn about the institute’s mission.
“We brought eight Soldiers from the 11th Airborne Division to our facility and showed them every single part of our capabilities — bacterial and parasitic diseases, entomology, retrovirology, veterinary medicine, virology — and you could see the ‘a-ha moment’ when they grasped what we do and how we’re contributing to the Army,” says Pascual. “With that buy-in, they can go and tell their leaders, ‘Hey, these AFRIMS folks are actually doing some really good stuff for us.’”
As vital as it is for helping ensure global COCOM readiness, exercise support is only a small part of AFRIMS’ overall mission, says Whitten.
“AFRIMS has three core capabilities: disease biosurveillance; medical countermeasure development such as diagnostics, therapeutics and vaccines; and strategic partnerships to include a storied history of global health security cooperation with foreign militaries,” explains Whitten. “We're about 500 strong, headquartered in Thailand but with satellite sites in Nepal, Cambodia, the Philippines and an exchange officer in Australia. Only 5% of our personnel are Americans; everyone else is a foreign national, and they're just as committed to AFRIMS’ defense health and global health mission as we are. Our dedicated scientific professionals are trying to make the world better every day.”
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