MMWR Morb Mortal Wkly Rep. 2024 Oct 24;73(42):646-649. doi: 10.15585/mmwr.mm7342a2.
A case of locally acquired (autochthonous) mosquito-transmitted Plasmodium vivax malaria was diagnosed in Arkansas in September 2023. This represents the 10th autochthonous case identified nationally in 2023, after 20 years without recorded local mosquitoborne malaria transmission in the United States. The public health response included case investigation, active case surveillance, mosquito surveillance and control, assessment of medical countermeasures, and clinical and public outreach. Prompt diagnosis and appropriate treatment of malaria can improve clinical outcomes and, in addition to vector control, minimize risk for local transmission. Clinicians should consider malaria among patients who have traveled to countries where malaria is endemic, or with unexplained fever regardless of travel history. Although the risk for autochthonous malaria in the United States remains very low, its reemergence highlights the importance of vectorborne disease preparedness and response. Examples of such efforts include improving awareness among clinicians, access to diagnostics and antimalarial medications, and capacity for mosquito surveillance and control. Collaboration and communication among CDC, health departments, local jurisdictions, clinicians, hospitals, laboratories, and the public can support rapid malaria diagnosis, prevention, and control. Before traveling internationally to areas where malaria is endemic, travelers should consult with their health care provider regarding recommended malaria prevention measures, including chemoprophylaxis and precautions to avoid mosquito bites, to reduce both personal and community risk.
2023 年 9 月,阿肯色州诊断出一例本地(原生)蚊媒传播的间日疟原虫疟疾。这是美国 20 年来首次报告本地疟疾病例,也是 2023 年全国第 10 例本地疟疾病例。公共卫生应对措施包括病例调查、主动病例监测、蚊媒监测和控制、医疗对策评估以及临床和公众外展。及时诊断和适当的疟疾治疗可以改善临床结果,除了控制病媒外,还可以最大限度地减少本地传播的风险。对于曾前往疟疾流行国家旅行或有不明原因发热的患者,临床医生应考虑疟疾的可能性,无论其旅行史如何。尽管美国发生本地疟疾的风险仍然非常低,但它的再次出现凸显了准备和应对蚊媒疾病的重要性。此类努力的例子包括提高临床医生的认识、获得诊断和抗疟药物的途径,以及蚊媒监测和控制的能力。美国疾病控制与预防中心(CDC)、卫生部门、地方司法管辖区、临床医生、医院、实验室和公众之间的合作和沟通可以支持快速诊断、预防和控制疟疾。在前往疟疾流行地区之前,旅行者应向医疗保健提供者咨询有关推荐的疟疾预防措施,包括化学预防和避免蚊虫叮咬的预防措施,以降低个人和社区的风险。