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Malaria surveillance--United States, 1995.
H A Williams1, J Roberts, S P Kachur
1Epidemic Intelligence Service, Epidemiology Program Office, CDC, USA.
Summary
Malaria cases in the U.S. increased 15% in 1995, primarily due to more infections acquired in Asia and the Americas. Many travelers did not use recommended malaria chemoprophylaxis, highlighting the need for prevention.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Malaria is a mosquito-borne illness caused by Plasmodium parasites, posing a significant health risk to travelers and occasionally occurring domestically.
- While most U.S. malaria cases are imported, local transmission, congenital cases, and exposure via blood products can occur.
Purpose of the Study:
- To analyze malaria surveillance data in the United States for 1995.
- To identify trends in malaria cases, including geographic sources of infection and modes of transmission.
- To inform malaria prevention strategies for travelers and healthcare providers.
Main Methods:
- Data were collected through the National Malaria Surveillance System (NMSS), based on confirmed malaria cases reported to local and state health departments.
- Case investigations were conducted by health departments to gather information on illness onset, infecting Plasmodium species, and geographic origin of infection.
- Analysis focused on cases with symptom onset during 1995.
Main Results:
- A total of 1,167 malaria cases were reported in 1995, a 15% increase from 1994.
- Plasmodium vivax (48.2%) and Plasmodium falciparum (38.6%) were the most common species identified.
- Cases acquired in Asia and the Americas significantly increased, with a notable 100% rise in cases from South America. Six deaths were attributed to malaria.
- Only 15.6% of U.S. civilians who acquired malaria abroad reported adhering to recommended chemoprophylaxis.
Conclusions:
- The rise in malaria cases is linked to increased infections acquired in Asia and the Americas, potentially due to changing travel patterns or reduced chemoprophylaxis use.
- A significant proportion of U.S. civilians contracting malaria abroad were not on appropriate prophylactic medication.
- Updated prevention guidelines emphasize chemoprophylaxis and personal protective measures for travelers, and prompt medical evaluation for febrile individuals returning from endemic areas.