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Malaria surveillance--United States, 2001.

Scott Filler1, Louise M Causer, Robert D Newman

  • 1Epidemic Intelligence Service, Epidemiology Program Office, Division of Parasitic Diseases, National Center for Infectious Diseases, CDC, USA.

Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, D.C. : 2002)
|July 24, 2003
PubMed
Summary

Malaria cases in the U.S. decreased slightly in 2001, primarily due to fewer cases from Asia and the Americas, though cases from Africa increased. Most U.S. civilians acquiring malaria abroad did not use recommended preventive drugs.

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Area of Science:

  • Medical Entomology
  • Infectious Diseases
  • Parasitology

Background:

  • Malaria is transmitted by Anopheles mosquitoes and caused by Plasmodium parasites.
  • Most U.S. malaria cases are imported by travelers, but local transmission, blood product exposure, and congenital cases also occur.
  • Malaria surveillance is crucial for identifying local transmission and informing traveler prevention strategies.

Purpose of the Study:

  • To report and analyze malaria cases in the United States for the year 2001.
  • To identify trends in malaria incidence, geographic sources of infection, and species involved.
  • To assess the effectiveness of chemoprophylaxis among U.S. travelers.

Main Methods:

  • Data were collected through the National Malaria Surveillance System (NMSS), based on blood film-confirmed cases reported to health departments.

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  • Case investigations were conducted by local and state health departments.
  • Analysis included case counts, species identification, geographic origin, and traveler chemoprophylaxis adherence.

    • Main Results:

    • A total of 1,383 malaria cases were reported in the U.S. in 2001, a 1.4% decrease from 2000.
    • Plasmodium falciparum (50.1%) and P. vivax (27.8%) were the most common species.
    • Cases acquired in Africa increased by 13.2%, while those from Asia and the Americas decreased.
    • Only 20.2% of U.S. civilians who acquired malaria abroad reported using recommended chemoprophylaxis.
    • Eleven malaria-related deaths occurred, primarily from P. falciparum infections.

    Conclusions:

    • The slight decrease in malaria cases in 2001 may reflect natural variation, changes in transmission, reduced travel, or improved prophylaxis, though increased African cases offset decreases elsewhere.
    • A significant proportion of U.S. travelers acquiring malaria abroad did not adhere to recommended chemoprophylaxis.
    • Prompt diagnosis and treatment are critical, and travelers should use chemoprophylaxis and personal protective measures.
    • Two cases were acquired within the U.S., highlighting the potential for local transmission or other non-travel related routes.