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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.
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.
Demonstration of malaria parasites in blood films
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.
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:
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