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Most people infected by West Nile virus suffer a mild flulike illness or experience no symptoms at all. Data from countries where West Nile has been recognized for decades suggest that even a mild infection confers lifelong immunity. There is no human vaccine for the virus. Scientists do not know why West Nile virus has hit Louisiana harder than neighboring states. Dr. [Lyle R. Petersen] said Louisiana tended to have high numbers of mosquito-borne diseases ''simply because it is an area with a lot of water and a long mosquito season'' and an abundance of ''the kinds of mosquitoes that can potentially spread West Nile virus.'' The main reservoir of West Nile virus is birds that have been bitten by infected mosquitoes. In some areas tests have shown that virtually all dead birds were infected, and health officials no longer test dead birds for the virus. ''It makes no sense to keep testing dead birds when you know all are positive,'' Dr. Petersen said

The strain of West Nile virus spreading in the United States is identical to one that infected geese and humans in Israel, but no one knows how it came here. Large numbers of bird deaths from West Nile disease have occurred concurrently with human cases only in Israel and the United States, said Dr. Lyle R. Petersen, an epidemiologist who specializes in studying insect-borne infections at the Centers for Disease Control and Prevention. West Nile virus is here to stay, health officials say. Until a vaccine is developed for humans and a clearer picture emerges of how to stop the virus's spread in nature, West Nile virus is likely to move throughout the Western Hemisphere to cause anxiety, if not major public health problems. West Nile virus has spread to 36 states and the District of Columbia. Birmingham, Ala., recently sprayed to kill virus-spreading mosquitoes. (Associated Press)(pg. F1); Brenda White of the Florida Department of Health holds a dead pet macaw that the state will test for West Nile virus infection. (Reuters)(pg. F6)

Blood bank screening for hepatitis has brought several previously hidden cases to my office door. Some privacy has been forsaken for the more important goal of keeping our blood supply safe. A doctor must be able to communicate a patient's information to another doctor, provided the patient has authorized this referral. This method has always been used and it must continue. No additional written consent for expert consultation or chart notes passed among physicians is possible without gumming up the works. And a patient should want a consulting doctor to know his history and be able to pass a comprehensive evaluation back to the primary physician. This routine optimizes care

George W. Bush, 56, passed his second annual medical checkup as president with flying colors and a prediction from the eight examining doctors that he would remain in good health for the rest of his term. After Mr. Bush ran on a treadmill and underwent other tests, the doctors said that he had no evidence of heart disease

Since the mosquito-borne West Nile virus was first detected in this hemisphere, in New York City in 1999, it has spread rapidly through much of the country...

Scientific understanding of the drug's action on the body would have suggested that it would have the opposite effect of darkening gray hair, Dr. [Brian Druker] said. The new observation, he added, ''may give us some clues to the mechanism and perhaps a safer treatment'' for gray hair. In a letter published in The New England Journal of Medicine, the French doctors said that among 133 patients treated with Gleevec, 9 had progressive return of color to their hair. The darkening effect began 2 to 14 months after the patients, five men and four women, began therapy and the hair roots had time to grow. Their ages ranged from 53 to 75 years with a median of 63.4

Mr. Bush smokes an occasional cigar, abstains from alcohol and drinks diet sodas and coffee, the doctors said. Mr. Bush, who stands six feet tall, weighed 189 pounds, three-quarters of a pound less than at the checkup in August 2001. His body fat remained unchanged at 14.5 percent and down from 19.94 percent recorded in a checkup in June 2000. Mr. Bush's father, George H. W. Bush, was treated in a hospital when he suddenly developed an abnormal rhythm, later attributed to an overactive thyroid gland in the neck. Former President Bush did not have thyroid tests before the episode. President Bush's mother, Barbara, also had the condition, which can be hereditary. President Bush's thyroid tests were normal today, the doctors said. Dr. Richard J. Tubb, Mr. Bush's personal physician, and Dr. Kenneth Cooper of the Cooper Aerobics Center in Dallas, who was Mr. Bush's doctor in Texas, supervised the checkup today. The other six members of the team included an orthopedic surgeon; an optometrist; an audiologist; a dermatologist; an eye, ear nose and throat specialist, and a cardiologist

Simple measures like spraying are the best way to control mosquitoes in areas affected by the West Nile virus outbreak, Dr. [Julie L. Gerberding] said, and they are ''in full swing and certainly are contributing to reducing the impact on human health.'' What scientists do know is that the species of mosquitoes that can transmit certain other infectious diseases -- like dengue fever, malaria and yellow fever -- are widespread in the United States. Malaria and yellow fever once were common in this country until mosquito control, treatment and epidemiologic measures eliminated domestic transmission. Although mosquitoes are still around, the malaria parasite and yellow fever virus have been largely eliminated from this country. ''This is something we are going to have to learn to live with because this virus is very well established in the bird and mosquito population,'' Dr. Gerberding said, and West Nile ''will be a problem wherever mosquitoes go.''

The federal Centers for Disease Control and Prevention has sent a team of 10 scientists to investigate how widely the virus has spread in Louisiana and elsewhere in the gulf region, and to trap insects and the animals they may have infected. One aim is to determine whether species of mosquitoes not previously identified as transmitters of the virus are in fact spreading it. Such identification would be crucial to controlling the outbreak. Health officials said they could not explain precisely why the West Nile virus had struck so fiercely in Louisiana and neighboring states. They noted, however, that encephalitis caused by other viruses had long been a significant health problem in the gulf region. The introduction of West Nile into the area only adds to the burden on the health system there. Dr. [Stephen M. Ostroff] was a leader in the epidemiological investigation of the outbreak in New York, which infected 62 people and killed seven. He said that while he would not advise people to refrain from visiting the Gulf Coast, it was important to keep in mind that groups like the elderly and those with impaired immune systems were at greater risk than others for developing severe illness from West Nile virus

Retention rates for 1-year new graduate nurses had fallen to 30% at the author's institution. Upon reviewing feedback, a lack of a new graduate orientation program was determined to be a significant factor. The challenge presented to staff development was to develop a program that would increase 1-year retention rates of new graduate nurses without incurring overtime costs or significant additional expenses. The result was a successful 8-week orientation program using multiple teaching methods. New graduates rated their own progress through the use of a self-assessment questionnaire. One-year retention rates for new graduate nurses increased to 77% after the program was implemented.