residents to prevent malaria while traveling in countries where it is endemic. Chemoprophylaxis with antimalarial medications are recommended for U.S. civilian patients who reported reason for travel, 77.0% were visiting friends and relatives. Most patients (92.6%) had symptom onset <90 days after returning to the United States or its territories from a country with malaria transmission. The infecting species was not reported or was undetermined in 216 cases (11.9%). Infections by two or more species accounted for 17 cases (<1.0%). knowlesi was identified in the United States and its territories. For the first time since 2008, an imported case of P. falciparum accounted for most infections (1,273 ), followed by P. Of the cases in 2018, a total of 1,519 (85.0%) were imported cases that originated from Africa 1,061 (69.9%) of the cases from Africa were from West Africa, a similar proportion to what was observed in 2017. The number of cases diagnosed in the United States and its territories has been increasing since the mid-1970s the number of cases reported in 2017 was the highest since 1972. The number of cases reported in 2018 is 15.6% fewer than in 2017. Results: CDC received reports of 1,823 confirmed malaria cases with onset of symptoms in 2018, including one cryptic case and one case acquired through a bone marrow transplant. This report summarizes data from the integration of all cases from NMSS and NNDSS, CDC clinical consultations, and CDC reference laboratory reports. CDC reference laboratories provide diagnostic assistance and conduct antimalarial drug resistance marker testing on blood specimens submitted by health care providers or local or state health departments. Case investigations are conducted by local and state health departments, and reports are transmitted to CDC through the National Malaria Surveillance System (NMSS), the National Notifiable Diseases Surveillance System (NNDSS), or direct CDC clinical consultations. Period Covered: This report summarizes confirmed malaria cases in persons with onset of illness in 2018 and trends in previous years.ĭescription of System: Malaria cases diagnosed by blood smear microscopy, polymerase chain reaction, or rapid diagnostic tests are reported to local and state health departments through electronic laboratory reports or by health care providers or laboratory staff members directly reporting to CDC or health departments. Malaria surveillance in the United States and its territories provides information on its occurrence (e.g., temporal, geographic, and demographic), guides prevention and treatment recommendations for travelers and patients, and facilitates rapid transmission control measures if locally acquired cases are identified. However, among persons who have not traveled out of the country, malaria is occasionally acquired through exposure to infected blood or tissues, congenital transmission, nosocomial exposure, or local mosquitoborne transmission. Most malaria infections in the United States and its territories occur among persons who have traveled to regions with ongoing malaria transmission. These parasites are transmitted by the bite of an infective female Anopheles species mosquito. Problem/Condition: Malaria in humans is caused by intraerythrocytic protozoa of the genus Plasmodium.
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