- The Washington Times - Sunday, September 8, 2002

The United States is becoming more susceptible to exotic diseases such as malaria and West Nile virus because of the ease with which residents travel abroad and foreigners travel here, health officials say.

"As we become more global, we come in contact with more and different types of infectious diseases that may not have been seen in the United States in the past," said Loudoun Countys health director, Dr. David Goodfriend.

A 15-year-old boy and a 19-year-old woman who contracted malaria last week in Loudoun County are taking antibiotics and are recovering. They were most likely bitten by an infected mosquito that had previously bitten a person who had contracted the disease abroad and unknowingly brought it into the county, Dr. Goodfriend said.

He said that based on the countys aggressive mosquito abatement efforts and U.S. malaria statistics, officials do not expect a malaria outbreak in the region.

The West Nile virus, however, continues to spread. Doctors in Los Angeles are treating a woman who has tested positive for the virus in preliminary laboratory results, California health officials said Friday. The results of further tests will not be known for a week.

If confirmed, the case would be the first human infection in the western United States.

"The virus arrival in California is anticipated, but unexpected at this time since it is not present in any contiguous states," said Dr. Thomas Garthwaite, director and chief medical officer of the Los Angeles County Department of Health Services.

The first human West Nile infection in the United States was reported in New York City in 1999; the virus has since infected humans in 28 states, including Maryland and Virginia, and the District.

In Virginia, two new human cases were reported Thursday, bringing the state total of human infections to five. Nationally, the number of confirmed human cases this year hit 854, with 43 dead, the federal Centers for Disease Control and Prevention in Atlanta reported.

Dr. Anthony A. Marfin, a CDC epidemiologist, said as many as 150,000 people could be infected with the virus in the United States, although most of them will never suffer any symptoms or know they have it.

The virus usually causes significant symptoms only among the elderly and those with weakened immune systems. In younger people, the virus produces few or no symptoms. Symptoms include headaches, fever, body aches, rashes and swollen lymph glands. More severe symptoms include high fever, neck stiffness, stupor, disorientation, coma, tremors, convulsions and paralysis.

The number of cases is expected to fall as the weather gets colder and disease-carrying mosquitoes disappear, officials said. In the past few years, West Nile virus has disappeared by December, but the disease has spread much farther this year and cases could appear well into next year.

CDC investigators have begun focusing on two West Nile victims who may have contracted the disease not from mosquito bites, but through blood transfusions. A Georgia woman who received blood from 63 persons as doctors tried to save her from a car accident and a Mississippi woman who received blood from 18 persons during an obstetrical procedure both contracted the disease.

Federal officials have urged blood banks to pay attention to would-be donors, screening out anyone who may have the virus. But many people infected do not appear to be sick, and there is no blood screening test available.

Health officials say West Nile virus has been able to spread so quickly in the United States because it has been carried from region to region by birds, which are much more likely to become infected than people.

That explains why there has not been a major malaria outbreak in the United States: Malaria is carried only by mosquitos.

Unlike birds, which can cover hundreds of miles in a year, mosquitos spend their whole lives in an area less than a mile wide.

There were 85 cases of malaria reported in the United States between 1957 and 2001, according to CDC officials, who maintain that the disease most commonly strikes one or two victims in a community without spreading further.

But among immigrants from countries where malaria is common and among travelers who have visited malaria-infected areas, there are about 1,200 cases of malaria in the United States annually, CDC officials said.

Dr. Goodfriend said the two Loudoun County teenagers had not traveled outside the United States, marking the first time in recent years that Virginia has seen two malaria cases not involving any international travel.

County health officials have embarked on a public education campaign and are continuing mosquito abatement efforts already being implemented to control West Nile virus, Dr. Goodfriend said. He added that people who have a fever or chills should see a doctor rather than treat the symptoms like those of a common cold.

This article is based in part on wire service reports.

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