Fw: PRO/EDR> Malaria - United States (Virginia)

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I thought some of you might be interested to read this. This is scary, because malaria in the US could be a big problem, as it is so easily transmitted. I can't help but wonder if we will have a malaria outbreak in the US before the cooler months come, or worse, next summer. The meds to treat malaria are not "clean" drugs, either--laden with potentially bad side effects, not to mention that some forms of malaria are resistant to chloroquine, which is the most prescribed drug for malaria and malaria prophylaxis. e ----- Original Message ----- From: ProMED-mail Sent: Saturday, September 07, 2002 12:52 AM promed-edr@... Subject: PRO/EDR> Malaria - United States (Virginia) MALARIA - UNITED STATES (VIRGINIA)**********************************A ProMED-mail post<http://www.promedmail.org>ProMED-mail, a program of theInternational Society for Infectious Diseases<http://www.isid.org>Date: Fri, 6 Sep 2002From: ProMED-mail <promed@...> [Many thanks to numerous subscribers who sent in reports of this incident. - Mod.SH]Source: The Washington Post [edited]<http://www.washingtonpost.com/wp-dyn/articles/A43343-2002Sep5.html>Cases of _Plasmodium. vivax_ malaria in Virginia, US----------------------------------------------------In recent weeks, 2 Loudoun County teenagers contracted malaria locally, an extremely rare occurrence that has prompted officials to launch a search for infected mosquitoes and stricken residents, local and state health officials said yesterday. Officials said a 15 year old boy and a 19 year old woman, who had not travelled abroad and who live about a mile from each other in suburban eastern Loudoun, were probably bitten and infected by mosquitoes that had sipped blood from someone who contracted malaria overseas."The fact that you have a cluster of 2 cases among people who have not travelled overseas is impressive, and it suggests there is a small malaria outbreak in Loudoun County," said Hotez, chairman of the Department of Microbiology and Tropical Medicine at Washington University. Officials said they were heartened by the fact that the type of malaria found in Loudoun, the vivax strain, is not deadly. The boy, a high school student, was admitted to hospital, while the woman, a college student, was treated and released. Both suffered high fevers, chills, fatigue, and headaches. They were given antimalarial medication and are doing well, officials said.Infected mosquitoes spread malaria, which is caused by a parasite. Both teenagers reported being bitten multiple times. The appearance of malaria has concerned many residents, especially at the end of a summer during which the Washington area has been worried about another mosquitoborne illness, the West Nile virus. "This is sort of fuel on a fire," said Steketee, the chief of the malaria epidemiology branch at the Atlanta-based Centers for Disease Control and Prevention. But Steketee said the 2 phenomena are distinct. "It's linked in the context that it's a mosquito-borne illness. But for the most part, the mosquitoes that are transmitting West Nile are a different group of mosquitoes" from those transmitting malaria, he said. Coffey Sockwell, the Northern Virginia epidemiologist for the Virginia Department of Health, said she contacted health authorities in land, the District, and other Northern Virginia jurisdictions, and none but Loudoun reported any cases of locally contracted malaria. State and county health authorities do not consider either Loudoun case to be one of "airport malaria," in which the disease is spread by mosquitoes carried on aircraft from places where malaria is endemic. The malaria-carrying anopheline mosquito normally has a range of less than a mile, and both victims live in areas that are about 7 miles from Dulles International Airport. Goodfriend, the Loudoun County health director, said officials put up extra mosquito traps in and around the Cascades and Sugarland Run neighborhoods where the 2 students live to supplement those put up as part of the fight against the West Nile virus. Additional measures to kill mosquito larvae are also being implemented, Goodfriend said, and the county is considering spraying pesticide to kill adult mosquitoes. "There may be a risk in that area," he said. But he noted that the common precautions that have been the county's mantra all year should keep people safe, including calls to wear long sleeves and insect repellent when outside.From 1957 to 2001, there were 85 recorded cases of locally transmitted malaria in the United States, Steketee said, 9 of which occurred since 1995. Among those infected were a 63 year old Virginia woman and a 19 year old New Jersey man in 1998, Steketee noted. More than 1500 cases of malaria are reported in the United States every year in people who have travelled overseas, he said. In most cases, the source of a local malaria transmission is never found. Researchers say that's because the carriers either return overseas or do not know they have malaria. rs who have developed a resistance to infection can still pass the disease on when mosquitoes bite. Virginia state epidemiologist Marr said area residents should remember that it is rare, but not unprecedented, to have local malaria transmissions. The fact that the malaria in Loudoun is not the life-threatening falciparum strain is also a blessing. "Fortunately, this is a very benign malaria," he said. "It's a curiosity more than a public health concern."[byline: staff writer lind S Helderman and staff researcher Bobbye Pratt]-- ProMED-mail<promed@...>[ProMED-mail has recorded 2 similar US cases, one in Georgia in 1997 and one also in Virginia in 1998. The report suggests that airport malaria should be ruled out, but mosquitoes can also ride in cars and the cases are only 7 miles from Dulles International Airport. Travellers from _Plasmodium vivax_-endemic countries may carry gametocytes in their blood for weeks and if immune may be completely asymptomatic. The local mosquitoes have the capacity for transmission and it is almost impossible to avoid such cases during a warm summer. The cases act as a reminder that a malaria blood film should be taken from patients with unexplained fever, even without a travel history. ­ Mod.EP][see also:2000---Malaria, vivax - Germany ex Greece 20000713.11581998---Malaria - USA (Virginia) 19980802.14701997---Malaria, locally acquired - USA (Georgia) 19970329.0664]...............ep/pg/sh/sh*##########################################################*ProMED-mail makes every effort to verify the reports thatare posted, but the accuracy and completeness of theinformation, and of any statements or opinions basedthereon, are not guaranteed. The reader assumes all risks inusing information posted or archived by ProMED-mail. 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