Peacekeepers' malaria rate alarms doctors

WASHINGTON - Navy doctors are investigating what one official called an incredibly high rate of malaria among Marines and sailors who were briefly in Liberia last month.

Forty-three patients have been evacuated from their ships off the West African shore to hospitals in Germany and the United States, 13 confirmed with one of the most common types of the mosquito-borne illness, falciparum, said Capt. Greg Martin of the National Naval Medical Center in Bethesda, Md.

The 43 represent almost 20 percent of 225 Marines and Navy personnel who went ashore last month. Officials are closely watching the rest, an unknown number of whom also are reported to have complained of symptoms, Martin said.

"There are a lot of questions about this," he said at a news conference Tuesday in the Washington suburb of Bethesda, where most were taken. He said doctors are uneasy because the cases represent "an incredibly high attack rate" among those deployed.

Doctors are looking into three possibilities, he said: That type of malaria has become resistant to the drug the Marines have been taking; troops didn't take it correctly; or the drug had gone bad or there was a flaw in its manufacture.

All going ashore are being switched to another antimalarial in case resistance is the problem, doctors said.

In addition to the confirmed cases, seven Marines tested positive in initial blood tests but have not been confirmed as having the disease, officials said.

Five of the cases are serious, including two patients with cerebral malaria, but all are expected to recover, said Lt. Cmdr. David Blazes, who is caring for those brought to Bethesda.

Martin said the Marines and sailors started taking the antimalarial drug mefloquine in late June or early July in a regimen that requires troops to begin dosing two weeks in advance of a deployment, then take the drug once a week thereafter for a month until they have been out of the risk area for a month. The military also gives troops mosquito netting and a repellent cream containing DEET.

WASHINGTON - Most of the soldiers in and around Iraq with unexplained, severe pneumonia had taken up smoking shortly before falling ill, military medical authorities said Tuesday.

The military is investigating 19 cases of severe pneumonia since March, including two fatalities. Four of those cases were linked to bacterial infections. Of the remaining 15, 10 patients, including the two who died, had elevated levels of a certain type of white blood cells.

Nine of the 10 reported they had started smoking recently, said Col. Bob DeFraites, a top Army medical officer. It's unclear whether smoking caused or contributed to the pneumonia, but since tobacco smoke damages lungs, it's a chief suspect, DeFraites said.

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