Malaria surveillance -- United States, 2007
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  • English

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    • Description:
      "Problem/Condition: Malaria in humans is caused by intraerythrocytic protozoa of the genus Plasmodium. These parasites are transmitted by the bite of an infective female Anopheles mosquito. The majority of malaria infections in the United States occur among persons who have traveled to areas with ongoing malaria transmission. In the United States, cases can occur through exposure to infected blood products, congenital transmission, or local mosquitoborne transmission. Malaria surveillance is conducted to identify episodes of local transmission and to guide prevention recommendations for travelers. Period Covered: This report summarizes cases in persons with onset of illness in 2007 and summarizes trends during previous years. Description of System: Malaria cases confirmed by blood film, rapid diagnostic tests, or polymerase chain reaction are mandated to be reported to local and state health departments by health-care providers or laboratory staff members. Case investigations are conducted by local and state health departments, and reports are transmitted to CDC through the National Malaria Surveillance System, the National Notifiable Diseases Surveillance System, and direct CDC consultations. Data from these reporting systems are the basis for this report. Results: CDC received reports of 1,505 cases of malaria among persons in the United States, including one transfusion-related case and one fatal case, with onset of symptoms in 2007; 1,564 cases were reported for 2006. P. falciparum, P. vivax, P. malariae, and P. ovale were identified in 43.4%, 20.3%, 2.0%, and 3.5% of cases, respectively. Nine patients (0.6%) were infected by two or more species. The infecting species was unreported or undetermined in 30.2% of cases. Based on estimated volume of travel, the highest estimated relative case rates of malaria among travelers occurred among those returning from countries in West Africa. Of 701 U.S. civilians who acquired malaria abroad and for whom chemoprophylaxis information was known, 441 (62.9%) reported that they had not followed a chemoprophylactic drug regimen recommended by CDC for the area to which they had traveled. Twenty-four cases were reported in pregnant women; none had adhered to a complete prevention drug regimen. One death was reported in a person infected with P. vivax. Interpretation: No significant change in the number of malaria cases occurred from 2006 to 2007. No change was observed in the proportion of cases by species causing the infection. U.S. civilians traveling to countries in West Africa had the highest estimated relative case rates. In the majority of reported cases, U.S. civilians who acquired infection abroad had not adhered to a chemoprophylaxis regimen that was appropriate for the country where they acquired malaria. Public Health Actions: Persons at risk for malaria infection should take one of the recommended chemoprophylaxis regimens appropriate for the region of travel and use personal protection measures to prevent mosquito bites. Any person who has been to a malarious area and who subsequently has a fever or influenza-like symptoms should seek medical care immediately and report their travel history to the clinician; investigation should always include blood-film tests for malaria with immediately available results. Malaria infections can be fatal if not diagnosed and treated promptly. Recommendations concerning malaria prevention are available from CDC at or by calling the CDC Malaria Hotline (telephone: 770-488-7788). Recommendations concerning malaria treatment are available at or by calling the Malaria Hotline." - p. 1
    • Content Notes:
      Sonja Mali, Stefanie Steele, Laurence Slutsker, Paul M. Arguin, Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases.

      Includes bibliographical references (p. 10).

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