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Domestic Activities

On This Page:
Surveillance | Advice to Travelers | Consultations with Clinicians and Diagnostic Assistance | Advice to Blood Collection Centers | Investigations of Locally Transmitted Malaria | Other Investigations

Surveillance

The great majority of cases of malaria occurring in the United States are acquired overseas. However, U.S. cases can also occur through exposure to infected blood products or organ transplants, by congenital transmission, or by local mosquito-borne transmission. Malaria surveillance is conducted to guide prevention recommendations for travelers and to identify episodes of local transmission. In collaboration with state and local health departments throughout the United States, CDC conducts ongoing malaria surveillance (malaria is a reportable disease), and reports (PDF – 123KB) are transmitted to CDC through the National Malaria Surveillance System. Annually cases are tabulated and a summary of diagnosed malaria cases is reported in the CDC publication, Morbidity & Mortality Weekly Report (MMWR).

 More: National Malaria Surveillance System

Advice to Travelers

Generally, the risk of a malaria infection during international travel depends on the region and location of travel, season of travel, individual factors, and diligence in use of protective measures. International travelers are advised to contact their healthcare provider, health department or a travel medicine specialist for information and to obtain necessary prophylactic medication, as needed at least 6 weeks before departure.

Travelers' health information is available through CDC's toll free Voice Information Service at 1-877-FYI-TRIP (877-394-8747) and through the Travelers' Health web page www.cdc.gov/travel.

CDC also provides recommendations for preventing malaria and other infectious diseases in the publication Health Information for International Travel, also known as the "Yellow Book". This publication is written primarily for health-care providers; however others who advise travelers such as travel agencies, airlines, missionary organizations, and academic institutions may find it useful. The online version of the "Yellow Book" is updated frequently when indicated by important changes in disease distributions or specific preventative measures.

Clinicians, other health-care providers, and travel agencies are able to order brochures on Preventing Malaria in Travelers: A Guide for Travelers to Malaria-Risk Areas to make available to travelers. To obtain copies of the brochure, call the CDC Malaria Hotline at 770-488-7788.

Consultations with Clinicians and Diagnostic Assistance

CDC provides, on a 24-hour basis, consultations for clinicians needing guidance on diagnosis, management of malaria cases, access to antimalarial medication, or urgent issues related to adverse antimalarial drug reactions.

Rapid and accurate diagnosis of malaria is integral to the appropriate treatment of affected individuals and in preventing the further spread of infection in the community. As a national reference center for malaria diagnosis, CDC provides diagnostic and technical assistance to State Health Departments on malaria diagnosis (other entities needing diagnostic assistance should approach CDC through their respective State Health Departments). CDC provides reference microscopic diagnosis and other specialized tests such as serology and PCR. Additionally, telediagnosis and training are provided for malaria and other parasitic diseases through the DPDx website.

Assistance can be provided through the CDC Malaria Hotline (770-488-7788) from 8:00 am to 4:30 pm Eastern time. After hours or on weekends and holidays, call the CDC Emergency Operation Center at 707-488-7100 and ask to page the person on call for the Malaria Branch. Do not use email to ask for clinical advice; email is not constantly monitored and there may be delays in answering.

CDC also provides on-line interactive training where clinicians, laboratorians, and other health professionals may examine malaria case studies to improve their knowledge on diagnosis and treatment of malaria as well as public health concerns related to malaria in the United States.

Advice to Blood Collection Centers

Past exposure to malaria is an important reason for donor deferral by blood centers in the United States. Travelers who have been in malarious areas must be deferred for blood donations for a period of time. To avoid unnecessary deferrals contributing to a shortage of blood products as well as inappropriate acceptance of donors, blood center personnel must accurately assess potential malaria exposure in travel destinations worldwide. The Food and Drug Administration (FDA)'s Guidance for Industry specifically denotes CDC as the agency responsible for determining malaria risk areas that are to be used for donor deferral. A key instrument for such assessments used by blood centers is CDC's document Health Information for International Travelers ("Yellow Book").

Additionally, to better assist blood banks in determining blood deferrals and supplement information for the greater public, a new web-based interactive Malaria Risk Map is available on the CDC malaria website to better determine malaria risk for persons who will travel or have traveled to specific areas throughout the world.

 More: Blood Donor Screening

Investigations of Locally Transmitted Malaria

At the request of the states, CDC assists in investigations of locally transmitted malaria. This is particularly important because, even though malaria has been eliminated from the US since the late 1940's, there is a constant risk of reintroduction due to the presence of capable Anopheles vectors that can be infected by persons who have traveled or immigrated from malarious areas. It is important to limit the spread of an outbreak through the efforts of rapid recognition of the outbreak, accurate diagnosis, and case management. Additionally, transmission is impeded through community education, personal protection measures against mosquito bites (e.g., using insect repellent containing DEET), and vector control. The last locally transmitted malaria outbreak occurred in Palm Beach County, Florida in 2003.

 More: Documents Related to Investigations of Locally Transmitted Malaria

Other Investigations

In collaboration with state and local health departments, CDC investigates uncommon occurrences such as malaria transmitted by transfusion or by sharing injection needles.

 More: Documents Related to Other Investigations

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