Blood and Malaria

Severely ill patients needing blood transfusions and heroin addicts "skin-popping" with dirty needles would seem to have little in common. But now they share the danger of contracting malaria. The U.S. Center for Disease Control reports an increasing number of cases of malaria in both addicts and patients.

Toward the end of World War II, health authorities feared that malaria, then being rapidly eradicated in the U.S., would be re-established by servicemen returning from the Mediterranean and Pacific theaters. Their alarm proved groundless. Many servicemen did harbor the parasites (Plasmodium vivax) of the milder, relapsing form of malaria, but there was no large reservoir of human beings from whom mosquitoes could spread the disease.

By contrast, the return of servicemen from Viet Nam has coincided with an enormous increase in the use of hypodermic needles for popping heroin. Some servicemen in Viet Nam have acquired almost simultaneously both the heroin habit and the virulent, fulminating form of malaria caused by the parasite Plasmodium falciparum.

Addict Donors. The coincidence is proving dangerous because many drug addicts try to donate blood to get the price of a fix. At Fort Bragg, N.C., for example, a 20-year-old soldier addict became severely ill last July. Since he had never been outside the U.S., Army medics had no reason to suspect malaria, especially of the falciparum type. Only after this was diagnosed was it learned that he had recently donated two pints of blood. One of these was transfused into a fracture patient in a New York hospital, but the recipient escaped malaria. The other pint was flown to Viet Nam and has not been traced.

The Center for Disease Control knows of no deaths from falciparum malaria transmitted by one addict to another through shared needles. But it fears some may occur because the disease, unfamiliar to Stateside doctors, is difficult to diagnose in its early stages. Yet early diagnosis is essential because falciparum is a swift killer.

The most troubling malaria statistic involves parasite-contaminated blood. At least eight nonaddict patients receiving transfusions have become infected, three with falciparum. These infections originated with returned-soldier addicts in California's Ventura County. The blood they sold was used in several states. In all the known transfusion cases, the infection has been cured or satisfactorily suppressed.

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