Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Update to share new information with clinicians, public health authorities, and the public about locally acquired malaria cases identified in the United States. On August 18, 2023, a single case of locally acquired malaria was reported in Maryland in the National Capital Region. This case was caused by the Plasmodium falciparum (P. falciparum) species and is unrelated to the cases involving local transmission of Plasmodium vivax (P. vivax) malaria in Florida and Texas described in the HAN Health Advisory 494issued on June 26, 2023. As an update to that report, to date, Florida has identified seven cases and Texas has identified one case of locally acquired P. vivax malaria, but there have been no reports of local transmission of malaria in Florida or Texas since mid-July 2023.
P. falciparum malaria can rapidly cause severe illness and even death if not quickly diagnosed, therefore rapid diagnosis and treatment is imperative. In addition to routinely considering malaria as a cause of febrile illness among patients with a history of international travel to areas where malaria is transmitted, clinicians should consider a malaria diagnosis in any person with an unexplained cause of fever, regardless of their travel history. The risk to the U.S. public for locally acquired mosquito-transmitted malaria remains very low. The most effective way to prevent malaria in the United States is for travelers to malaria-endemic areas to take appropriate steps to prevent acquiring malaria while traveling—including taking medications to prevent malaria—and ensuring early diagnosis and treatment of imported cases of malaria and preventing mosquito bites.
Malaria is a medical emergency and should be treated accordingly. Patients suspected of having malaria should be urgently evaluated in a facility that is able to provide rapid diagnosis and treatment as soon as possible, within 24 hours of the patient’s presentation. Order microscopic examination of thin and thick blood smears and a rapid diagnostic test (RDT), if available, to diagnose malaria as soon as possible. Hospitals should have a plan to rapidly diagnose and treat malaria as soon as possible, within 24 hours of the patient’s presentation. Key recommendations on treatment are below. Additional information on diagnosing and treating malaria, including details of treating the dormant liver stages caused by certain species of Plasmodium, is available on the CDC website.
This HAN alert contains much more information, including symptoms, recommendations for clinicians as well as the public, hospitals, laboratories and public health officials. Please take some time to review the alert.
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