WEST NILE VIRUS - USA: REFUGEE ORIGIN?
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A ProMED-mail post
<http://www.promedmail.org>

Date: Thu 17 Aug 2000 18:38:50 -0700
From: Michael A. Sauri, MD, MPH&TM, FACP, FACPM <[EMAIL PROTECTED]>


My first-hand knowledge of infectious diseases and of prior military
refugee operations leads me to believe that the previous screening of
refugees coming to the United States allowed both an adequate time
(multiple incubation periods) to identify most active, communicable
diseases before they arrived in the United States, and proper coordination
of medical follow-up of those identified as needing medical care after they
arrived.

However, this was not accomplished for the very rapid "humanitarian"
airlift of Bosnian refugees who entered the United States in 1997, the
majority being located in the New York metropolitan area, from what I can
tell from talking with reservists involved in the operation. Since West
Nile virus is endemic in that area of Eastern Europe, it seems
epidemiologically the likely event that resulted in the introduction of
West Nile Virus into the United States.

It would take a study to determine if my theory is correct. I would
appreciate the input of other members of ProMED-mail on this important
issue concerning the control of emerging diseases.  This theory, if
confirmed, could identify areas in future refugee airlifts that should be
emphasized in order to avoid the entry and spread of exotic diseases in the
United States.

- --
Michael A. Sauri,MD, MPH&TM, FACP, FACPM
Infectious Disease Consultant
Washington Metropolitan Area
9715 Medical Center Drive
Suite 201
Rockville, MD 20850
<[EMAIL PROTECTED]>

[As posted in ProMED-mail, "the WNV from the recent NY City outbreak has
been shown by Ian Lipkin, by CDC workers, and by others to be essentially
identical to a recent strain from a goose in Israel"  -- so it probably did
not come from Bosnia, which on geographical grounds likely has the Romanian
strain. However, it is true that careful consideration should be given to
endemic diseases in areas from which refugees are found before airlifting
them to other countries. - Mod.JW] ..............................jw/es

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