U.S. Malaria Cases Hit 40-Year High

Almost all the cases came from travelers to Africa, India, CDC says

By Robert Preidt

HealthDay Reporter

THURSDAY, Oct. 31 (HealthDay News) -- Malaria cases in the United States hit a 40-year high in 2011, federal health officials reported Thursday.

There were 1,925 cases of malaria that year, the highest number since 1971. That represents a 14 percent increase from 2010 to 2011.

Five people died from malaria or associated complications in 2011, according to a U.S. Centers for Disease Control and Prevention report.

Nearly 70 percent of the cases were imported from countries in Africa, and nearly two-thirds (63 percent) of those cases were acquired in West Africa. For the first time, India was the country from which the most cases were imported, CDC officials said.

"Malaria isn't something many doctors see frequently in the United States, thanks to successful malaria elimination efforts in the 1940s," CDC director Dr. Thomas Frieden said in an agency news release. "The increase in malaria cases reminds us that Americans remain vulnerable and must be vigilant against diseases like malaria because our world is so interconnected by travel."

Malaria is caused by a parasite transmitted by the bite of infected mosquitoes. There were about 219 million cases of malaria worldwide in 2010 and about 660,000 deaths from the disease.

Common symptoms of the disease include fever, headache, back pain, chills, increased sweating, muscle pain, nausea, vomiting, diarrhea and cough. Untreated infections can quickly lead to coma, kidney failure, respiratory problems, and death, the CDC said.

"Malaria is preventable. In most cases, these illnesses and deaths could have been avoided by taking recommended precautions," Dr. Laurence Slutsker, director of CDC's division of parasitic diseases and malaria, said in the news release.

Americans who travel to regions where malaria is present can protect themselves by taking antimalarial drugs and by using insect repellant, insecticide-treated bed nets, and protective clothing.

"We have made great strides in preventing and controlling malaria around the world. However, malaria persists in many areas and the use of appropriate prevention measures by travelers is still very important," Slutsker said.

The findings were published in the Nov. 1 issue of the CDC's Morbidity and Mortality Weekly Report.

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Reports of U.S. Cases of Flesh-Eating Drug Questioned

DEA says none of the drug samples tested so far has been confirmed as home-cooked krokodil

By Brenda Goodman

HealthDay Reporter

TUESDAY, Oct. 29 (HealthDay News) -- Has the new "flesh-eating" drug of abuse known as krokodil reached the United States?

The drug is dubbed krokodil, the Russian word for crocodile, because it originated in that country and can cause horrific skin lesions resembling reptilian skin. Recent media reports have suggested that the home-cooked drug, which carries the scientific name desomorphine, has now reached addicts in the United States.

But drug enforcement agents say they aren't sure, and they continue to collect and test drug samples from areas where doctors have seen patients with suspicious skin lesions.

So far, a sample sent from Chicago, where doctors report that they've treated five patients who may have used the drug, including two sisters who have been widely photographed and interviewed about their experience, proved to be heroin.

"We're checking this out. We're very, very concerned about it. We would hate to see something like this catch on here," said Barbara Carreno, a press officer at the U.S. Drug Enforcement Administration.

Krokodil has been a scourge in Russia for the last decade, where it's cooked at home as an alternative to heroin.

Carreno said the drug flourished in rural areas in Russia, where addicts didn't have access to purer narcotics. However, heroin is relatively easily accessible and cheap in the United States, so there would seem to be less of an incentive to mix up the more caustic concoction here, she said.

Krokodil is made by combining codeine pills with common ingredients such as gasoline, red phosphorus from match tips, alcohol, and iodine. Experts say the result is a highly addictive drug that's also highly corrosive to the body.

A high from a drug like morphine lasts four to six hours. But the high from krokodil lasts only about 90 minutes, added Stephen Dewey, director of the Laboratory for Behavioral and Molecular Neuroimaging at the Feinstein Institute for Medical Research in Manhasset, N.Y. Dewey studies how addictive drugs affect the brain. Typically, he said, "the shorter the high, the more addictive the drug."

Users who inject krokodil quickly suffer the consequences.

"It kills the blood supply to the skin, so the skin starts to decompose and come off," Dewey explained.

Photos of victims have been horrific. They show users with open sores that sink deep into the flesh, skin on legs and arms blackened and rotting, or fingertips eaten away as if by acid. Krokodil gets its street name from its tendency to turn human skin green and scaly.

Users who can't break the habit face amputations and death. Doctors in Oklahoma say a local man died from using krokodil last year. They say autopsy detected traces of desomorphine and other drugs in his system.

Through September, six cases of suspected krokodil abuse had been reported to U.S. poison control centers in 2013, said Brett Schuster, a spokesman for the American Association of Poison Control Centers in Alexandria, Va. Recent media reports have suggested there may be even more.

So far, however, none of the cases has been confirmed.

"We don't want to question anything that doctors are finding. I can only say that we, so far, have not gotten a sample that has turned out to be krokodil," Carreno said.

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