Anthroponotic cutaneous leishmaniasis (CL) is a common cause of ulcerative lesions and disfiguring scarring among children in Afghanistan. Most lesions occur on the face and are commonly caused by the trypanosome protozoan parasite Leishmania tropica, transmitted by the bite of an infected sandfly (Phlebotomus sergenti). This study compared the effectiveness of a single localized treatment with thermotherapy to 5 days of intralesional administration of Glucantime for the treatment of CL. Three hundred and eighty-two patients with CL were randomly assigned to the two treatment groups and followed for 6 months. The cure rate for the thermotherapy group was 82.5%, compared to 74% in the Glucantime group. The authors concluded that a single localized treatment with thermotherapy was more effective than 5 days of intralesional administration of Glucantime. Additionally, thermotherapy was more cost-effective, with fewer side effects, of shorter duration, and with better patient compliance than intralesional Glucantime.

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Deet, the lactone CIC-4, and the piperidine compounds A13-37220 and A13-35765 were evaluated for initial repellency against laboratory-reared Anopheles albimanus Wiedemann, An. freeborni Aitken, An. gambiae Giles, An. stephensi Liston, and Phlebotomus papatasi (Scopoli) using a dose-response testing procedure on human volunteers. In addition, deet and CIC-4 were tested against Lutzomyia longipalpis (Lutz & Neiva). In general, the repellency of A13-37220, A13-35765, and CIC-4 was not markedly different from that of deet against each species tested; however, the different species varied greatly in response to the repellents. Overall, An. stephensi, L. longipalpis, and P. papatasi were the most sensitive, and An. albimanus the most tolerant species. The four repellents subsequently were tested against An. stephensi and An. albimanus to determine the duration of repellency. AI3-37220 provided effective (> 90%) protection against An. stephensi bites for 7 h, whereas deet, AI3-35765, and CIC-4 provided 6, 5, and 3 h of protection, respectively. Each of the four compounds provided < 1 h of protection against An. albimanus bites.

Two recent outbreaks of locally acquired, mosquito-transmitted malaria in Virginia in 1998 and 2002 demonstrate the continued risk of endemic mosquito-transmitted malaria in heavily populated areas of the eastern United States. Increasing immigration, growth in global travel, and the presence of competent anopheline vectors throughout the eastern United States contribute to the increasing risk of malaria importation and transmission. On August 23 and 25, 2002, Plasmodium vivax malaria was diagnosed in 2 teenagers in Loudoun County, Virginia. The Centers for Disease Control and Prevention (CDC) deemed these cases to be locally acquired because of the lack of risk factors for malaria, such as international travel, blood transfusion, organ transplantation, or needle sharing. The patients lived approximately 0.5 mi apart; however, 1 patient reported numerous visits to friends who lived directly across the street from the other patient. Two Anopheles quadrimaculatus s.l. female pools collected in Loudoun County, Virginia, and 1 An. punctipennis female pool collected in Fairfax County, Virginia, tested positive for P. vivax 210 with the VecTest panel assay and enzyme-linked immunosorbent assay (ELISA). In addition, 2 An. quadrimaculatus s.l. female pools collected in Montgomery, Maryland, tested positive for P. vivax 210. The CDC confirmed these initial results with the circumsporozoite ELISA. The authors believe that this is the 1st demonstration of Plasmodium-infected mosquitoes collected in association with locally acquired human malaria in the United States since the current national malaria surveillance system began in 1957.