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Malaria Finds its Way to the U.S. Again

Global Health Surveillance

Climate Change Is a Driver of More Than “Bad Air”

Wherever and whenever animals have been domesticated for human use, zoonotic disease has followed. Horses conveyed the common cold virus; from chickens came bird flu, shingles, and chicken pox; pigs and ducks donated influenza; from cattle arose measles, tuberculosis, and smallpox; and from mosquitoes, we got dengue, West Nile, Zika, and malaria. Continued human domestication of plants and animals then accelerated each of them, especially mosquito-borne diseases. 

The National Institutes of Health notes that “although malaria had been linked with swamps ever since the condition known as Roman fever inspired the name mal’aria (‘bad air’), Laveran [a French military doctor, 1845-1922] knew from contemporary scientific articles that many diseases previously ascribed to miasmas, or evil vapors, were in fact caused by microbes. Thus, he predicted: ‘Swamp fevers are due to a germ.’”

It has been estimated that of the 108 billion humans to ever live, approximately 52 billion have been killed by mosquito-borne diseases. Unfathomable has been the destruction by this tiny apex predator over time. Following the first locally transmitted cases in the southern U.S. in 20 years, including cases in Florida and Texas, malaria has been in the news once again. 

While malaria may once again be “new” to the U.S., it is endemic in other parts of the world. According to the World Health Organization, nearly half of the world’s population was at risk of malaria in 2021, with an estimated 247 million cases of the disease worldwide. This resulted in an estimated 619,000 deaths, with the African Region (which includes the majority of the African continent) carrying a disproportionately high share of the global malaria burden. In 2021, the Region was home to 95% of malaria cases and 96% of malaria deaths. Children under the age of five accounted for about 80 percent of all malaria deaths in the Region.

Our Gene Olinger, Ph.D., suggests that “mosquito-borne disease is now a constant threat to the Americas.” We spoke with him to learn more about this threat. 

Why are public health professionals worried about malaria showing up in the U.S.?

Climate change! As the weather warms in southern regions of the U.S., the mosquito vector (the female Anopheles mosquito), which is typically killed or whose population is substantially reduced during the winter, is able to reach levels that can feed on infected people and then transmit malaria to others.     

How should people prepare and protect themselves from malaria?

People should do what they can to avoid mosquito bites and support local and regional mosquito control programs. Those with special medical needs should discuss options with their clinicians, which may include prophylactic drug therapy. 

What do you expect for the future of mosquito-borne disease in the Americas?

Mosquito-borne disease is now a constant threat to the Americas. The mosquito vector and the conditions to allow its spread are becoming optimal. A few cases can explode into many cases very quickly. Fortunately, public health and medical health are ready to help!


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