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Mosquito-transmitted malaria acquired in Texas
S B Mundy1, A C White, J S Hines
1Veterans Affairs Medical Center, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
Southern Medical Journal
|June 1, 1996
Summary
Locally acquired malaria, previously thought eradicated in the US, has re-emerged. This study highlights a Plasmodium vivax case in Houston, likely mosquito-transmitted, emphasizing the need to consider malaria in febrile patients regardless of travel history.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- Malaria was historically endemic in the United States before World War II.
- Locally acquired malaria was believed to have been eradicated in the US.
- Resurgence of autochthonous malaria cases reported since the mid-1980s.
Observation:
- A 62-year-old male presented with fever, malaise, and weakness at Houston VA Medical Center.
- Peripheral blood smear confirmed Plasmodium vivax infection.
- The patient had no recent international travel history for 37 years and no prior malaria diagnosis.
Findings:
- The patient reported significant mosquito exposure, suggesting local transmission.
- Two additional cases of presumed locally acquired, mosquito-borne malaria were identified in Houston.
- Plasmodium vivax malaria was confirmed in these cases.
Implications:
- This case series indicates a potential re-establishment of local malaria transmission cycles in the US.
- Non-specific symptoms of malaria necessitate a high index of suspicion.
- Physicians should consider malaria in the differential diagnosis of febrile illnesses, even in patients without a travel history to endemic areas.