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Malaria (Plasmodium spp.)
1995 Case Definition
The 1995 case definition appearing on this page was re-published in the 1997 MMWR Recommendations and
Reports titled Case Definitions for Infectious Conditions Under Public Health Surveillance
[MMWR 1997;46(RR10)] (available at http://www.cdc.gov/mmwr/preview/mmwrhtml/00047449.htm).
Thus, the 1995 and 1997 versions of this case definition are identical.
Clinical description
Signs and symptoms are variable; however, most
patients experience fever. In addition to fever, common associated
symptoms include headache, back pain, chills, sweats, myalgia,
nausea, vomiting, diarrhea, and cough. Untreated Plasmodium
falciparum infection can lead to coma, renal failure, pulmonary
edema, and death. The diagnosis of malaria should be considered
for any person who has these symptoms and who has traveled to
an area in which malaria is endemic. Asymptomatic parasitemia
can occur among persons who have been long-term residents of
areas in which malaria is endemic.
Laboratory criteria for diagnosis:
Case classification
Confirmed: an episode
of microscopically confirmed malaria parasitemia in any person
(symptomatic or asymptomatic) diagnosed in the United States,
regardless of whether the person experienced previous episodes
of malaria while outside the country.
Comment
A subsequent attack experienced by the same person
but caused by a different Plasmodium species is counted as an
additional case. A subsequent attack experienced by the same
person and caused by the same species in the United States may
indicate a relapsing infection or treatment failure caused by
drug resistance.
Blood smears from questionable cases should be
referred to the National Malaria Repository, CDC, for confirmation
of the diagnosis.
Cases also are classified according to the following
World Health Organization categories:
- Autochthonous:
- Indigenous: malaria acquired
by mosquito transmission in an area where malaria is
a regular occurrence
- Introduced: malaria acquired
by mosquito transmission from an imported case in an
area where malaria is not a regular occurrence
- Imported: malaria acquired outside
a specific area (e.g., the United States and its territories)
- Induced: malaria acquired through
artificial means (e.g., blood transfusion, common syringes,
or malariotherapy)
- Relapsing: renewed manifestation (i.e.,
of clinical symptoms and/or parasitemia) of malarial infection
that is separated from previous manifestations of the same
infection by an interval greater than any interval resulting
from the normal periodicity of the paroxysms
- Cryptic: an isolated case of malaria
that cannot be epidemiologically linked to additional cases
See also:
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