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Because blood is involved in the natural transmission of West Nile -- through mosquito bites -- doctors have theorized that West Nile could be transmitted through transfusions and organ transplants. Two weeks ago, health officials said they reminded the nation's blood banks to enforce a standard procedure -- rejecting donations from patients with fever and flulike symptoms, which could be symptoms of mild West Nile fever. Dr. [Jesse Goodman] said he would not expect people who have recovered from an infection to have West Nile virus in their blood for long because by the time symptoms develop, the virus is difficult to detect. In such cases, evidence of West Nile infection is based on detecting the specific antibodies that a patient's immune system develops in response to the infection. ''It is very important to recognize that unlike H.I.V. or hepatitis, West Nile virus is an acute infectious disease and we are unaware of any kind of chronic carrier state,'' Dr. Goodman said. He also said: ''If I were a person with severe chronic disease and I needed an organ transplant, concern about this would be right at the bottom of my list of things that I was worried about. Similarly, if I needed a transfusion this would be at the bottom of the list of my concerns. If I lived in an area where West Nile was circulating, which is much of the country at the moment, my greatest concern about West Nile would be to take precautions to minimize my risk of being bitten by mosquitoes.''

West Nile virus is naturally transmitted through mosquito bites. This year, the U.S. is experiencing its worst outbreak of West Nile fever since the virus was first detected in this hemisphere, in 1999 in New York City. Over the weekend, the total number of cases has risen to 638, including 31 deaths. The theoretical possibility of transmitting West Nile Virus through blood transfusions and questions about the nation's blood supply were put to a real test in recent days because of the detection of West Nile infection in one recipient of the donor's organs. That recipient has encephalitis, or inflammation of the brain. Three other recipients, in Georgia and Florida, of the same donor's organs are suspected of developing West Nile fever. Preliminary tests of a patient who died with encephalitis after receiving a kidney from the donor show evidence of infection with a mosquito-borne virus. Further tests are needed to prove it is West Nile virus

Three of four patients who received organs from one donor have apparently developed encephalitis and tests show that one recipient is infected with the West Nile virus, raising suspicion that the virus can be transmitted through organ transplants, federal health officials said yesterday. One of the four recipients died about four weeks after the transplant. Standard pathology tests from an autopsy show that the recipient had encephalitis, or inflammation of the brain and central nervous system. Tests are planned to determine if the recipient was infected with West Nile virus, which causes encephalitis. One of the four organ transplant recipients developed a mild fever that resolved. Tests are planned to determine whether that recipient had a mild case of West Nile fever. Most people infected with the virus develop a mild flu-like illness or experience no symptoms

Smallpox vaccine can lead to serious and potentially fatal complications, especially in people with impaired immune systems. The virus from which the vaccine is derived, a cousin of the smallpox virus, can spread from recipients to people with whom they come in contact and can cause life-threatening complications among them. More disturbing were the data concerning risks among people with a common skin condition, eczema. People with it, or who have had it, are at higher risk of complications from the smallpox vaccine. The rate was one case of complications per 100,000 vaccinations, a figure that exceeds the risk of paralysis from the oral polio vaccine. The government stopped oral polio vaccinations because it considered the risk too high. ''Unless it's an emergency where we may need to vaccinate everyone within a couple days, we need to go slow in the initial rollout, work out the kinks and get some experience in giving the vaccine,'' Dr. [Marcelle Layton] said. The problems include who will have legal liability for adverse reactions and risks in administering the vaccine, which is considered the most dangerous of all immunizations. Training doctors and health workers how to administer the vaccine properly and recognize a successful smallpox vaccination reaction, known as a ''take,'' could also be a challenge. Last fall, when the C.D.C. vaccinated nearly 200 staff members as part of its smallpox response team, it canceled plans to vaccinate more in part because the doctors who performed the vaccinations became alarmed at the severity of the reactions and the accompanying fever, sore arms and swollen lymph nodes. The doctors prescribed antibiotics in the mistaken belief that some vaccination takes had become infected

The drug, T-20 or enfuvirtide, is a member of a new class of drugs called fusion inhibitors that attack HIV. When added to combinations of standard drugs, injections of T-20 significantly reduced high levels of HIV in the blood among patients who were infected with resistant virus compared with those who took the standard drugs. The Food and Drug Administration has given T-20 fast-track designation. If licensed, T-20 would become the fifth class of anti- HIV drugs approved for standard use. Once started, lifetime treatment of HIV is needed, AIDS experts say. But because the T-20 trials lasted 24 weeks, the long-term benefits and dangers of the drug are not known. T-20 was developed by Trimeris and Roche from a discovery that Thomas Matthews and Dani Bolognesi made at Duke University in 1992

The study involved 5,719 men who were interviewed at dance clubs, bars and other places frequented by gays in Baltimore, Dallas, Los Angeles, Miami, New York City and Seattle. It tested the men for exposure to the AIDS virus, finding that 573 had H.I.V. Of those, 440, or 77 percent, had said they were unaware they were infected. The results of the H.I.V. tests were available to the men, but it is not known how many sought them, or learned that they were infected. In presenting an overview of the AIDS epidemic in the United States at the conference, Dr. Ronald Valdiserri, an AIDS official at the disease centers, described what he said was a growing apathy about the H.I.V. epidemic in the country. Because not all states report new H.I.V. infections, federal health officials use data from the 25 states that have monitored H.I.V. the longest to help gauge national trends. One problem officials must consider in extrapolating information elsewhere is that the 25 states account for only one-fourth of the nation's AIDS cases

The study tested the men for exposure to the AIDS virus, finding that 573 had HIV. Of those, 440, or 77 percent, had said they were unaware they were infected. The results of the HIV tests were available to the men, but it is not known how many sought them, or learned that they were infected

The rates of unawareness among minority gay men ages 15 to 29 in the study were staggeringly high. Among those studied, 90 percent of blacks, 70 percent of Latinos and 60 percent of whites said they did not know they were infected with HIV, the AIDS virus. The study involved 5,719 men who were interviewed at dance clubs, bars and other places frequented by gays in six cities: Baltimore, Dallas, Los Angeles, Miami, New York and Seattle. The study tested the men for exposure to the AIDS virus, finding that 573 had HIV. Of those, 440, or 77 percent, had said they were unaware they were infected. The results of the HIV tests were available to the men, but it is not known how many sought them or learned that they were infected. Because not all states report new HIV infections, federal health officials use data from the 25 states that have monitored HIV the longest to help gauge national trends. One problem officials must consider in extrapolating information elsewhere is that the 25 states account for only one-fourth of the nation's AIDS cases

HIV, the AIDS virus, could harm the economic, social, political and military structure in each of the five countries, a CIA official said in releasing the declassified portions of the council's report. HIV would spark tensions over spending priorities, driving up health care costs and sharpening military manpower shortages, David F. Gordon, a CIA official and the report's author, said at a news conference at the intelligence agency's headquarters here

One of the four recipients died about four weeks after the transplant. Pathology tests show the recipient had encephalitis, or inflammation of the brain and central nervous system. Tests are planned to determine if the recipient was infected with West Nile virus, which can cause encephalitis. On Friday, Dr. Julie L. Gerberding, the director of the CDC, said that 'transmission of the West Nile virus through blood and organs is biologically plausible' and that 'a leading hypothesis that we are investigating is that it is related to the organ transplant.' Meanwhile, scientists at the CDC are conducting laboratory tests on the organ donor's brain for evidence of West Nile virus or a closely related virus