In the US, there have been alarming reports of locally acquired malaria for the first time in 20 years. At the time, there were worries that these might be the outbreak’s initial symptoms. What significant difficulties did these situations bring to light nearly two months later?
As more nations eradicate malaria, their concerns shift to surveillance and preventing a resurgence of the disease. A relatively limited number of malaria cases are reported annually in areas and nations that have been “malaria free” for many years; these instances are typically the result of a patient’s travels to endemic areas. For instance, 99.7% of malaria cases in the EU were ascribed to travel to endemic areas, according to the ECDC’s Malaria- Annual Epidemiological Report for 2021. These cases are more prevalent during and immediately following the summer vacation.
In 2021, thirteen instances of malaria were, nevertheless, verified to have originated in the EU. Four of these cases were recorded in Greece; three of them were caused by Plasmodium falciparum in the Attica region and one by Plasmodium vivax in Thessaloniki. Blood transfusion was ruled out in these patients, but the mode of transmission remained still unknown. Nine cases were recorded in France, and eight of them were P. falciparum-associated (two instances were related to airports, two to hospitals, and two were undetermined). In France, there was only one instance of Plasmodium ovale malaria, which is likely to have been a recurrent infection.
Five cases of locally acquired malaria in the USA made for alarming headlines in June 2023. What’s the cause of all this media interest? Locally transmitted malaria cases have been extremely uncommon in the United States, according to Peter McElroy, PhD, Chief, Malaria Branch, Division of Parasitic Diseases and Malaria. In Palm Beach County, Florida, between July and August 2003, the final instance of locally contracted Plasmodium vivax malaria that was transmitted by a mosquito was documented.
As more cases have been revealed, like the one that was reported in Maryland last week, there were initially concerns in the mainstream media about what these cases might potentially signify. These incidents demonstrate the necessity of ongoing observation, as well as quick diagnosis and care, in order to stop isolated incidents from turning into epidemics. On this final point, Dr. McElroy concurs, saying, “The risk of developing malaria in the United States is quite low. The discovery of locally acquired malaria, however, emphasizes:
The prospect for local transmission remaining
The requirement for surveillance to find malaria in the United States and track trends
The significance of quick identification and support with treatment for professionals who may encounter patients with a potential or confirmed case of malaria who are unfamiliar with it
Rapid malaria diagnosis and treatment can stop the disease’s progression to severe illness or death and reduce the spread of the disease to nearby Anopheles mosquitoes. To avoid contracting malaria and other diseases spread by mosquitoes, people can take precautions against mosquito bites and manage mosquito populations at home.
Nine instances of locally acquired malaria have already been reported; seven are in Florida, one is in Texas, and one is in Maryland. Oddly, P. vivax is said to have been the cause of eight of the cases, but P. falciparum was found in the Maryland case. This is extremely dissimilar to the imported/travel-related malaria that is seen in the US; only 10% of imported malaria in the US is caused by P. vivax and 70% by P. falciparum.
Few people are aware that the CDC was initially established in 1949 to assist in combating malaria in the United States, where the disease posed a serious threat. Dr. McElroy claims that combating malaria on a daily basis is still effective, and it helps state and municipal health departments look into instances like those in May to August. An explanation of the CDC’s daily activities and how it assists in cases of malaria outbreaks (source: CDC).