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Latest United States Malaria Disease Surveillance Report-An Argument For Continuing Vigilance

	Latest United States Malaria Disease Surveillance Report- An Argument For Continuing Vigilance Travelers implicated in most cases, but malaria-carrying mosquitoes can still transmit the disease within the United States
The above chart illustrates the number of cases of malaria reported in the US for the time period between 1973 and 2002.

CDC received reports of 1,337 cases of malaria, with eight deaths, that occurred in 2002 in the United States. All but five cases were in persons who had traveled to a malaria-endemic area.

Prevention in Travelers

Malaria can be a fatal disease for travelers. But it can be prevented by taking one of the recommended chemoprophylaxis regimens appropriate for the region of travel, and by using personal protection measures to prevent mosquito bites.

The surveillance summary showed that only 20.9% of U.S. civilians who acquired malaria abroad had taken CDC-recommended malaria chemoprophylaxis. Most of these patients also reported non-compliance with the antimalarial drug regimen. The importance of taking correct precautions and chemoprophylaxis is underscored in the eight fatal cases of malaria.

The surveillance summary also showed that of the cases of malaria in U.S. civilians, almost half were diagnosed in immigrants living in the United States who had returned to their country of origin to visit friends and relatives. This group of travelers and their health-care providers need to be made more aware of the importance of chemoprophylaxis and other protective measures.

Travelers can obtain recommendations from CDC concerning malaria prevention by calling 1-877-FYI-TRIP or by accessing CDC’s Web sites on Traveler’s Health and on Malaria.

Early Diagnosis And Treatment

Malaria infections can be fatal if not diagnosed and treated promptly. Any person who has been to a malarious area and who develops fever or influenza-like symptoms within the year after travel should seek medical care immediately and report their travel history to their health-care provider.

Health-care providers should elicit a travel history from all patients who present with symptoms consistent with malaria. Clinicians seeking assistance with the diagnosis or treatment of patients with suspected or confirmed malaria should call the CDC Malaria Hot Line at 770-488-7788 during regular business hours, or the CDC Emergency Operations Center at 770-488-7100 during evenings, weekends and holidays. The CDC malaria Web site provides additional information on diagnosis and treatment of malaria.

Malaria In Non-Travelers

Five persons acquired malaria in 2002 without a history of travel to a malarious area. Epidemiologic investigations identified a mode of acquisition in four cases. One case was acquired probably through blood transfusion, one case was due to congenital (mother-to-fetus) transmission, and two cases were thought to represent an outbreak of locally acquired mosquito-transmitted malaria.

Even though malaria has been eradicated from the United States since 1951, U.S. residents remain at risk, especially when traveling in malaria-endemic countries. Anopheles mosquitoes that are capable of transmitting malaria are found in the United States, and constant surveillance is required to prevent reintroduction of malaria in this country.