WHO/Cambodian MOH Statement On H5N1 Cases

 

 

 

# 6880

 

 

The newshounds on FluTrackers have been hard at work this morning (see thread started by Gert van der Hoek) tracking down details on the H5N1 reports coming out of Cambodia (see  Media: Three H5N1 Cases In Cambodia, 2 Fatal).

 

Ronan Kelly has located the joint Cambodian MOH/World Health Organization statement on these cases which you can read in full on FluTrackers).

 

The PDF is locked, so I’ll have to synopsize.

The first case, an 8-month old infant boy from Chrey Korng Village, near Phnom Pehn developed symptoms on January 8th, 2013 and H5N1 was confirmed by the Institut Pasuerur du Cambodge on January 22nd.  The infant has recovered, and had a history of coming in contact with poultry prior to becoming sick.

 

The second case, a 15-year-old girl from Snao Village, Takeo Province fell ill on January 11th, and was diagnosed with H5N1 on January 22nd.  She was hospitalized on the 17th, and despite intensive care, died on the 21st. The statement indicates there have been recent poultry deaths in the village and the girl helped to prepare food.

 

The third case, a 35-year-old man from Trapeang Sla Village, Kampon Pseu was diagnosed on the 23rd, after falling ill on the 13th of January.  Once again, there are reports of sick poultry in his village and he participated in the preparation of food.

 

So it appears that all three of these cases, while occurring at approximately the same time, are not epidemiologically linked.  

 

The fact that these three cases emanated from three separate locations is reassuring in that there appears to be no evidence of community spread of the virus among humans.

 

By the same token, the fact that the virus has been acquired by humans in three different places within the same couple of weeks speaks to how widespread the virus must be in poultry. 

WHO Coronavirus Updates

Photo Credit NIAID

# 6760

 

While we have no indication of sustained community transmission, the emergence of a novel coronavirus in the Middle East that has infected at least 9 people (with another 9 either probable or suspected cases under investigation) since April, continues to capture the world’s public health agencies attentions.

 

The World Health Organization has updated two of their coronavirus documents; their coronavirus FAQ, and their interim surveillance recommendations.

 

Both are dated December 3rd, 2012.

 

 

First, the Frequently Asked Questions file, which has seen some minor modifications since the posting yesterday.

 

Frequently Asked Questions on novel coronavirus - update

3 December 2012

What is the novel coronavirus?

This is a new strain of coronavirus that has not been previously identified in humans.
Coronaviruses are a large family of viruses that are known to cause illness in humans and animals. In humans, this large family of viruses are known to cause illness ranging from the common cold to Severe Acute Respiratory Syndrome (SARS).

What are the symptoms of novel coronavirus?

In confirmed cases of illness in humans, common symptoms have been acute, serious respiratory illness with fever, cough, shortness of breath, and breathing difficulties. Based on current clinical experience, the infection generally presents as pneumonia. It has caused kidney failure and death in some cases. It is important to note that the current understanding of the illness caused by this infection is based on a limited number of cases and may change as more information becomes available.

Can it be transmitted from person to person?

This is not known with certainty at this time. The cases occurring in the same family raises the possibility of limited human-to-human transmission. Alternatively, it is possible that the infected family members were exposed to the same source of infection, for example, in a household or workplace.

How could I become infected with this virus?

To date, we do not know how humans have become infected with this virus. Investigations are underway to determine the virus source, types of exposure that lead to infection, mode of transmission and the clinical pattern and course of disease.

(Continue . . . )

 

The Interim surveillance recommendations have been reworded for clarity, but remain pretty much the same.

 

Interim surveillance recommendations for human infection with novel coronavirus

 
3 December 2012 
Update

Based on additional information received since the original surveillance recommendations were published, WHO is updating its guidance for surveillance. WHO will continue to update these recommendations as more information becomes available.

This document has been revised to emphasize the recommendations, rather than to summarize current
case reports. Current numbers and descriptions of reported cases are found at

http://www.who.int/csr/disease/coronavirus_infections/update_20121130/en/index.html.

The substance of the recommendations has not changed. Some wording has been changed for the sake of clarity. 

<SNIP>

The following should be carefully investigated and tested for novel coronavirus:

1.  Patients under investigation

A person with an acute respiratory infection, which may include history of fever or measured fever (≥ 38°C, 100.4°F) and cough

AND 

Suspicion of pulmonary parenchymal disease (e.g. pneumonia or Acute Respiratory Distress
Syndrome (ARDS)), based on clinical or radiological evidence of consolidation. 

AND

Residence in or history of travel to the Arabian Peninsula or neighboring countries within 10 days
before onset of illness. 

AND

Not already explained by any other infection or aetiology1 , including all clinically indicated tests
for community-acquired pneumonia according to local management guidelines. It is not necessary
to wait for all test results for other pathogens before testing for novel coronavirus.

2.  Ill contacts

Individuals with acute respiratory illness of any degree of severity who, within 10 days before onset of illness, were in close physical contact 2 with a confirmed or probable case of novel coronavirus infection, while the case was ill.

Any person who has had close contact with a probable or confirmed case while the probable or confirmed case was ill should be carefully monitored for the appearance of respiratory symptoms.

If symptoms develop within the first 10 days after contact, the individual should be considered a “patient under investigation”, regardless of the severity of illness, and investigated accordingly.

3.  Clusters

Any cluster 3 of severe acute respiratory infection (SARI) 4  , particularly clusters of patients requiring intensive care, without regard to place of residence or a history of travel

AND

Not already explained by any other infection or aetiology, including all clinically indicated tests
for community-acquired pneumonia according to local management guidelines.

4.  Health care workers 

Health care workers with pneumonia, who have been caring for patients with severe acute
respiratory infections, particularly patients requiring intensive care, without regard to place of
residence or history of travel. 

AND

Not already explained by any other infection or aetiology, including all clinically indicated tests
for community-acquired pneumonia according to local management guidelines.

-------------------------------------------------------------

1 Examples of other aetiologies include Streptococcus pneumoniae, Haemophilus influenzae type B, Legionella pneumophila, other recognized primary bacterial pneumonias, influenza, and respiratory syncytial virus.

2 Close contact is defined as: 

• Anyone who provided care for the patient, including a health care worker or family member, or who had other
  similarly close physical contact;
• Anyone who stayed at the same place (e.g. lived with, visited) as a probable or confirmed case while the case was ill.
  

3  A “cluster” is defined as two or more persons with SARI, with onset of symptoms within the same two-week period and who are associated with a specific setting, such as a classroom, workplace, household, extended family, hospital, other residential institution, military barracks or recreational camp.

4  Severe Acute Respiratory Infection (SARI) is defined as:   An acute respiratory infection with:

• history of fever or measured fever of ≥ 38 C° (100.4°F) and cough;
• onset within the last seven days; and
• requiring hospitalization.

 

 

With the onset of winter finding individual coronavirus infections becomes more difficult against the background noise of seasonal ILIs (influenza-like-illness).

 

Mild cases – if they exist – are unlikely to be detected unless purely by chance. 

 

We’ve seen in H5N1 endemic countries that clusters of severe influenza or pneumonia immediately become suspect – and fodder for the local press - but most of the time have turned out to be something other than bird flu.

Given the concerns over this emerging virus, we should probably expect to see that pattern repeated here. 

 

The price we pay for vigilance against emerging diseases is the possibility of false alarms. 

 

Unless and until we start seeing a lot of lab confirmed cases coming out of these reports, it is probably best to take any preliminary (and often hyperbolic) news reports with a hefty grain of salt.

WHO Report On Radiation Exposure From Fukushima Reactor Accident

 

 

# 6341

 

 

Today, a little more than a year after Japan’s catastrophic earthquake and tsunami, the World Health Organization has released a 120 page preliminary assessment of radiation exposure from the crippled nuclear plants in Fukushima Japan.

 

Preliminary Dose Estimation from the nuclear accident after the 2011 Great East Japan Earthquake and Tsunami

 Authors:
WHO

Publication details

Number of pages: 120
Publication date: 2012
Languages: English
ISBN: 9789241593662

Downloads

• English
  pdf, 1.85Mb

Overview

The earthquake and tsunami in Japan on 11 March 2011 led to releases of radioactive material into the environment from the Fukushima Daiichi nuclear site. This report describes a preliminary estimate of radiation doses to the public resulting from this accident. These doses are assessed for different age groups in locations around the world, using assumptions described in the report.

 

The dose assessment forms one part of the overall health risk assessment being carried out by WHO of the global impact of the accident at the Fukushima Daiichi nuclear power plant. The health risk assessment is the subject of a separate WHO report which will be published in Summer 2012.

Related links

• Frequently asked questions
• Japan one year since triple catastrophe
• More on Food Safety

 

 

From the FAQ page, we get the bottom line, and for just about everyone living outside of Fukushima and neighboring prefectures, the news is very reassuring.

 

Q5. What does the report conclude?

It can be concluded that the estimated effective doses outside Japan from the Fukushima Daiichi NPP accident are below (and often far below) dose levels regarded as being very small by the international radiological protection community. Low effective doses are also estimated in much of Japan.

 

In the Fukushima prefecture and in neighbouring prefectures the effective doses are estimated to be below 10 mSv, which can be considered within the order of magnitude of the natural radiation background, except in two locations. In these two locations in the most affected part of Fukushima prefecture, the effective doses were estimated to be within a dose band of 10–50 mSv. Please see table 3 for more data on effective doses, and table 8 for comparative effective dose levels in different contexts.

 

This report focuses on effective dose as an appropriate measure given that it takes into account both internal and external exposures. In addition, the report includes information about thyroid doses because of this organ’s capacity for iodine concentration.

 

It is important to note that effective doses and thyroid doses are two different quantities that cannot be compared. Thyroid doses are organ-specific equivalent doses. See table 4 for data on specific exposure to thyroid doses.

 

 

As far as the short and long term health-risk due to exposure to radioactivity, a report is expected from the WHO later this summer.

WHO: 2012 World Health Statistics Report

 

# 6329

 

 

The World Health Organization has released the 2012 edition of their World Health Statistics report, an annual compilation of health-related data from its 194 Member States. This report also summarizes progress being made in achieving the health-related Millennium Development Goals (MDGs).

 

 

While infectious diseases get most of the world’s attention, it continues to be the NCDs (Non-Communicable Diseases) - like high blood pressure, heart disease , diabetes, and tobacco related illnesses – that exact the greatest toll on human health.

 

Some excerpts from today’s press release highlights these findings:

 

New data highlight increases in hypertension, diabetes incidence

News release

16 May 2012 | Geneva - The World health statistics 2012 report, released today, puts the spotlight on the growing problem of the noncommunicable diseases burden.

 

One in three adults worldwide, according to the report, has raised blood pressure – a condition that causes around half of all deaths from stroke and heart disease. One in 10 adults has diabetes.

 

“This report is further evidence of the dramatic increase in the conditions that trigger heart disease and other chronic illnesses, particularly in low- and middle-income countries,” says Dr Margaret Chan, Director-General of WHO. “In some African countries, as much as half the adult population has high blood pressure.”

<SNIP>

Published annually by WHO, the World health statistics is the most comprehensive publication of health-related global statistics available. It contains data from 194 countries on a range of mortality, disease and health system indicators including life expectancy, illnesses and deaths from a range of diseases, health services and treatments, financial investment in health, as well as risk factors and behaviours that affect health.

Some key trends in this year’s report are:

• Maternal mortality: In 20 years, the number of maternal deaths has decreased from more than 540 000 deaths in 1990 to less than 290 000 in 2010 – a decline of 47%. One third of these maternal deaths occur in just two countries – India with 20% of the global total and Nigeria with 14%.
• 10 year trends for causes of child death: Data from the years 2000 to 2010 show how public health advancements have helped save children’s lives in the past decade. The world has made significant progress, having reduced the number of child deaths from almost 10 million children aged less than 5 years in 2000 to 7.6 million annual deaths in 2010. Declines in numbers of deaths from diarrhoeal disease and measles have been particularly striking.

 

(Continue . . . )

DOWNLOAD THE SUMMARY BROCHURE

Available in 3 languages

• English pdf, 381kb
• French  pdf, 389kb
• Spanish pdf, 389kb

DOWNLOAD THE FULL REPORT

Available in 3 languages

• English pdf, 2.47Mb
• French pdf, 2.69Mb
• Spanish pdf, 2.84Mb

 

 

Of considerable interest to those of us who follow disease outbreaks around the world is the lack of disease and mortality information available from many low-resource countries.

 

Among low income countries, only about 1% of deaths (and their causes) are recorded, while just 34 countries – representing 15% of the world’s population – produce high quality cause-of-death documentation.

 

The two most populous countries in the world – India and China – do not have national civil registration systems in place, and instead generate estimates of births and deaths based on smaller population samples.

 

 

All of which helps to explain why, nearly two years after the end of the 2009 H1N1 pandemic, we still don’t have a good handle on how many people died from the virus.

 

This lack of surveillance and reporting extends far beyond just births and deaths, which is why there is so much ambiguity regarding the true prevalence of many diseases (including H5N1) around the world.

 

Much of the data that is available can be accessed via the WHO’s Global Health Observatory, which allows tailored online searches for health information by country or region.

 

Global Health Observatory (GHO)

• Global Health Observatory
• Data repository
• Reports
• Country statistics
• Map gallery
• Standards

Tracking West Nile Virus In Europe

 

Map credit – ECDC 

 

# 5761

 

A dozen years ago the West Nile Virus (WNV) suddenly, and quite unexpectedly, appeared in New York City. And over the next few years it spread rapidly across the United States.

 

WNV is enzootic throughout much of Africa, parts of Europe, Asia and Australia.

 

Exactly how the virus was imported into the United States remains a mystery, although interhemispheric migration bird migration, birds carried by tropical storms, legal or illegal importation of birds from countries where the virus is endemic, or even infected mosquitoes hitching a ride on an international flight have been suggested as possibilities.

 

But no matter how it arrived, it flourished and spread.

 

From the USGS Factsheet on West Nile Virus

 

As you can see, the virus managed to rapidly expand its range during the first three years of its introduction into North America.

 

In 2002, however, the virus really exploded across the nation’s landscape.

 

 

Most people infected with WNV experience only mild, or sub-clinical symptoms. A very small percentage develop WNV neuroinvasive disease (WNND), a form of encephalitis.

 

For every serious presentation, there are probably 100 mild, or asymptomatic cases.

 

Last year, it turns out, was another banner year for West Nile Virus (WNV) cases in the United States, with 1,021 cases reported - up sharply over 2009 - and 62% of those producing neuroinvasive disease (i.e., meningitis, encephalitis, or acute flaccid paralysis) - Cite.

 

And in 2010 the West Nile Virus also made headlines in Europe; with Romania, Hungary, Italy, Spain and Greece all reporting human cases. In Greece, a large outbreak affecting the northern part of the country resulted in 262 human cases and 35 deaths being reported.

 

According, the ECDC now maintains an extensive West Nile Virus surveillance page and issues weekly updates and maps.

 

The latest update reads:

 

SITUATION UPDATE

As of 16 August 2011, a total of 21 confirmed human cases of West Nile fever have been reported in the EU (20 cases in Greece and 1 in Romania) and 26 in the neighbouring countries: 19 in the Russian Federation, 2 in Albania and 5 in Israel.

 

Between 09 and 16 August 2011, 14 new confirmed human cases have been reported from Greece, including 2 cases in new prefectures: Serres (1 case) and Trikala (1 case). In Attiki prefecture, all cases are still located in East Attica sub-prefecture.

• More information on West Nile infection in Greece is available from the Hellenic Center for Disease Control and Prevention website.
• Additional information on West Nile infection in horses in Greece, both in Attiki and Serres prefectures, is available from the World Organisation for Animal Health (OIE).

Since last week’s update, in the Russian Federation, ten new laboratory confirmed human cases have been reported from oblasts where cases occurred previously (Voronezhskaya and Volgogradskaya). In addition, three cases have been reported from an adjacent area, Rostovskaya oblast, for the first time this season.

 

In Albania, two cases have been reported in Lezhe prefecture. In Israel, 5 cases have been declared since June including two in the Northern district and two in Haifa district.

 

Yesterday the World Health Organization’s  GAR (Global Alert and Response) network issued an advisory on the virus as well.

 

 

West Nile Virus Infection (WNV) in Europe

16 August 2011 - Laboratory confirmed cases of West Nile Virus infection (WNV) have been reported in a number of European countries. From the beginning of July 2011 to 11 August 2011, WNV infection has officially been reported by Albania (2 cases), Greece (22 cases) Israel (6 cases), Romania (1 case) and the Russian Federation (11 cases). The reporting reflects higher awareness among healthcare workers, enhanced laboratory capacities and favourable weather conditions with rainfall and high temperatures leading to a substantial increase in mosquitoes such as Aedes and Culex species.

 

The WHO Regional Office for Europe, together with key partners − such as the European Centre for Disease Prevention and Control (ECDC), the European Network for Diagnostics of “Imported” Viral Diseases (ENIVD) and the Network for Communicable Disease Control in Southern Europe and Mediterranean Countries (EpiSouth) − have been closely monitoring the regional situation of WNV.

 

WHO encourages the Member States to consider implementing relevant public health measures in order to minimize the impact of a potential WNV outbreak in countries at risk.

 

(Continue . . . )

 

 

The WHO maintains a West Nile Virus fact sheet, which lists the following key facts.

 

• West Nile virus can cause a fatal neurological disease in humans.
• However, approximately 80% of people who are infected will not show any symptoms.
• West Nile virus is mainly transmitted to people through the bites of infected mosquitoes.
• The virus can cause severe disease and death in horses.
• Vaccines are available for use in horses but not yet available for people.
• Birds are the natural hosts of West Nile virus.

 

 

And it isn’t just WNV that Europe is concerned over. The mosquito vectors for Malaria, Dengue, Chikungunya, WNV, even Yellow Fever all are found in parts of the EU. 

 

Increasingly, globalization, international travel and climate change are providing fresh opportunities for vector borne illnesses to spread to regions where they are not normally seen.

 

Given the rapid dissemination of the WNV in North America, it is understandable that the ECDC and the WHO are concerned, and are urging countries to get ahead of this virus before it becomes a larger threat.

Psychological First Aid: The WHO Guide For Field Workers

 

 

 

# 5760

 

I’ve written about post-disaster psychological first aid (PFA) several times in the past, including in Post Disaster Stress & Suicide Rates, PTSD Awareness Day, and Promising Practices: Psychological First Aid.

 

PTSD (Post Traumatic Stress Disorder) can often occur in the wake of a disaster or traumatic experience. Symptoms may include anxiety, depression, suicide and PTSD may even lead to drug and alcohol-related disorders.

 

Victims of personal violence, rescue and medical workers, victims of disasters, terrorism, physical or psychological trauma, and/or a combat zone are all at risk of suffering some level of PTSD.

 

PFA training – which can usually be completed in a day – teaches the lay person how to provide emotional support to those who have recently experienced, or are currently going through, an emotionally traumatic experience.

 

Friday, August 19th, is World Humanitarian Day and to coincide with that day the World Health Organization, in conjunction with The War Trauma Foundation (WTF) and World Vision International (WVI) have released a PFA guide for field workers in low and middle income countries.

 

Follow the links below to read the WHO article, and access the field guide.

 

 

 

Providing psychological first aid in emergencies

16 August 2011 -- Humanitarian emergencies - such as earthquakes, drought, or war - not only affect people’s physical health but also their psychological and social health and well-being. For World Humanitarian Day, celebrated on 19 August, WHO and partners are publishing Psychological First Aid Guide for Fieldworkers. These guidelines explain how to provide basic support to people in the immediate aftermath of extremely stressful events.

(Continue . . . )

 

Related links

• Psychological first aid: Guide for field workers
  pdf 1.38Mb
• Mental health and psychosocial support in emergencies

 

 

 

As I’ve written before, the CDC also provides a website which contains a number of resources devoted to coping with disasters.

 

Coping With a Disaster or Traumatic Event

Trauma and Disaster Mental Health Resources

The effects of a disaster, terrorist attack, or other public health emergency can be long-lasting, and the resulting trauma can reverberate even with those not directly affected by the disaster. This page provides general strategies for promoting mental health and resilience. These strategies were developed by various organizations based on experiences in prior disasters.

 

 

As does the National Center For PTSD - including videos - on how to provide Psychological First Aid.

Psychological First Aid: Field Operations Guide

For Disaster Responders

Developed jointly with the National Child Traumatic Stress Network, PFA is an evidence-informed modular approach for assisting people in the immediate aftermath of disaster and terrorism: to reduce initial distress, and to foster short and long-term adaptive functioning.

World Malaria Day

 

 

# 5517

 

 

 

Monday, April 25th is World Malaria Day. 

 

Malaria is mosquito-borne infectious disease caused by a parasite – Plasmodium – and is common in much of the world including Sub-Saharan Africa, Asia and the Americas.  

 

Plasmodium falciparum in human blood – credit wikipedia

 

There are four microscopic protozoan parasites in the genus Plasmodium (P. vivax, P. falciparum, P. malariae and P. ovale) that cause malaria in humans around the world.  Of these Plasmodium falciparum is generally the most serious.

 

The parasites multiply in the liver and infect red blood cells, resulting in recurrent fevers and headaches - and in severe cases - coma and death.

 

Malaria is an extremely serious problem in Africa, where 1 in 5 childhood deaths is due to the disease. According to the WHO’s 10 Facts on Malaria:

 

An African child has on average between 1.6 and 5.4 episodes of malaria fever each year. And every 30 seconds a child dies from malaria.

 

The World Health Organization describes tomorrow’s World Malaria Day this way:

 

World Malaria Day

25 April 2011

In 2009, about 3.3 billion people - half of the world's population - were at risk of malaria. Every year, this leads to about 250 million malaria cases and nearly 800 thousand deaths. People living in the poorest countries are the most vulnerable.

 

World Malaria Day - which was instituted by the World Health Assembly at its 60th session in May 2007 - is a day for recognizing the global effort to provide effective control of malaria. It is an opportunity:

• for countries in the affected regions to learn from each other's experiences and support each other's efforts;
• for new donors to join a global partnership against malaria;
• for research and academic institutions to flag their scientific advances to both experts and general public; and
• for international partners, companies and foundations to showcase their efforts and reflect on how to scale up what has worked.

Related links

• More about World Malaria Day
• Roll Back Malaria Partnership
• WHO Global Malaria Programme
• Topical overview: malaria

 

While there are medicines available to combat the disease, over time the parasites have developed resistance to many of the older drugs. 

According to the WHO:

 

Resistance of Plasmodium falciparum to choloroquine, the cheapest and the most used drug is spreading in almost all the endemic countries.

 

Resistance to the combination of sulfadoxine-pyrimethamine which was already present in South America and in South-East Asia is now emerging in East Africa.

 

And since about 2007, evidence of resistance to a newer drug regimen known as ACT (Artemisinin Combination Therapy), has been showing up on the Cambodian-Thai border.  

 

Most recently, the same resistance has been observed in Myanmar, as we learn from this IRIN feature article.

 

MYANMAR: Anti-malarial drug resistance "hotspots" identified

Photo: Wikipedia

Malaria is a leading cause of death in Myanmar

BANGKOK, 19 April 2011 (IRIN) - Health experts had barely finished one project to contain anti-malarial drug resistance along the Thai-Cambodia border when their attention was drawn to Myanmar, where early warning signs suggest a waning influence of the anti-malarial drug Artemisinin.

(Continue . . . )

 

 

Although a far greater problem in the developing world, the CDC’s latest MMWR provides us with a surveillance report on Malaria in the United States for 2009.

Here is a link and an excerpt:

 

Malaria Surveillance --- United States, 2009

Surveillance Summaries

April 22, 2011 / 60(SS03);1-15

CDC received reports of 1,484 cases of malaria, including two transfusion-related cases, three possible congenital cases, one transplant case and four fatal cases, with an onset of symptoms in 2009 among persons in the United States.

 

This number represents an increase of 14% from the 1,298 cases reported for 2008. Plasmodium falciparum, P. vivax, P. malariae, and P. ovale were identified in 46%, 11%, 2%, and 2% of cases, respectively. Thirteen patients were infected by two or more species. The infecting species was unreported or undetermined in 38% of cases.

 

Among the 1,484 cases 1,478 were classified as imported.

 

 

Malaria, like Dengue and Chikungunya, are increasingly becoming concerns in the developed world, including the United States and parts of Europe. 

 

While relatively uncommon, locally acquired cases of Malaria do occur in the United States.  Late last year we saw a suspected case in Jacksonville Florida (see Florida: Locally Acquired Malaria Case Suspected).

 

In 2006, the CDC issued a guide for the investigation of Malaria in the United States, that included the following data on cases between 1957 and 2003.

 

September 8, 2006 / 55(RR13);1-9

Locally Acquired Mosquito-Transmitted Malaria: A Guide for Investigations in the United States

EXCERPT

In the United States, approximately 1,000--1,500 cases of malaria are reported annually to CDC (3). Nearly all of the cases diagnosed in the United States are imported from regions of the world where malaria is endemic. However, a limited number of cases also are acquired through local mosquito borne transmission.

 

From 1957, when the Malaria Branch started conducting malaria surveillance, to 2003, a total of 63 domestic outbreaks have occurred, constituting 156 cases (annual range: 1--32) that resulted from locally acquired mosquitoborne transmission (Figure 1) (4--11).

 

Of the 63 outbreaks, the highest number of cases occurred in California (17 [27%]) (Figure 2). Outbreaks also have occurred in 23 states. Since approximately 1991, a trend has developed in which outbreaks have occurred in more populated areas (e.g., urban and suburban areas). P. vivax has been the predominant species involved (47 [74.6%] of 63), followed by P. falciparum (seven [11.1%] of 47), and P. malariae (five [10.6%] of 47) (Figure 3).

 

 

To finish up our preview of World Malaria Day we have a CDC Grand Rounds video from November of 2010.

 

 

Malaria Eradication: Back to the Future

 

Tune in to Malaria Eradication: Back to the Future, in CDC’s Public Health Grand Rounds monthly series, presented November 18, 2010.

 

You’ll hear four current and former CDC malaria experts discuss review the history of the malaria eradication campaign (1950s-70s), discuss current control successes and challenges, and explore strategies to eliminate, and eventually eradicate, this deadly disease, which caused approximately 860,000 deaths in 2008.

Watch: Malaria Eradication: Back to the Future [CDC | YouTube]