The past and present of malaria in Houston

Malaria has a long-standing association among diseases that affect Texans and Houstonians. Early records show that in 1935 at least 25,000 cases of malaria were reported in Texas (with at least 1500 in Houston) and that between then and 1959 the largest number occurred in August. A dramatic fall in malaria incidence occurred through the 1930s and 1940s, with a surge at the onset of World War II and very few cases in the 1950s. Texas records report 625 travel-associated cases in Texas from 1952 through 1959. Another 115 case-patients were reported by combining data from Ben Taub General Hospital between 2003 and 2009 and from the City of Houston Health Department between 2005 and 2009. These cases manifested Plasmodium falciparum disease typically among travelers to Africa (85% of recent cases) or Plasmodium vivax among Central American immigrants. Only about one-half of these patients took prophylaxis, and only 1 patient (a Cameroonian) reported having used artemisinin combination therapy.