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Ebola: Information for U.S. Healthcare Workers and Settings

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Disease Name: Malaria


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Please review the Idaho Reportable Disease Rules (IDAPA 16.02.10) for the most up-to-date information.


Overview / Case Definition

Malaria is a mosquito-borne disease caused by a parasite; intraerythrocytic protozoa of the genus Plasmodium (e.g., P. falciparum, P. vivax, P. ovale, and P. malariae among other species). The first two species cause the most infections worldwide. P. falciparum is the agent that most commonly causes severe and potentially fatal malaria. P. vivax and P. ovale may have dormant liver stage parasites, which can reactivate and cause malaria several months or years after the infecting mosquito bite. P. malariae can result in long lasting infections and if untreated can persist asymptomatically in the human host for years, even a lifetime. About 1,600 cases of malaria are reported each year in the United States, most of which are imported, i.e., acquired in malaria-endemic countries.

The first symptoms of malaria (most often fever, chills, sweats, headaches, muscle pains, nausea, and vomiting) are often not specific and are also found in other diseases (such as influenza and other common viral infections). Likewise, the physical findings are often not specific (elevated temperature, perspiration, tiredness). In severe malaria (caused by P. falciparum), clinical findings (confusion, coma, neurologic focal signs, severe anemia, respiratory difficulties) are more striking and may increase the suspicion index for malaria.


Restrictions

None


Reporting

Within 3 working days

Reportable by Healthcare and Labs:

Reportable by Food Service Facility:

Suspect Reportable:

Reporting Timeframe: Within 3 working days



Diagnosis / Testing

Rapid diagnostic test (RDT) for circulating malaria-specific antigens, Polymerase Chain Reaction (PCR) test for species specific parasite DNA.

The Idaho Bureau of Laboratories (IBL) will send specimens to CDC upon request, for confirmation and/or speciation. Please call 208-224-2235 for submission requirements.  CDC offers free speciation and drug resistance testing for malaria cases diagnosed in the United States.

CDC testing includes PCR-confirmation of species, identification of drug resistance mutations, and when possible, parasite culture for direct susceptibility testing.  Diagnostic laboratories should be encouraged to send a pre-treatment whole blood sample (EDTA) directly to CDC (through the IBL) along with the specimen submission form http://www.cdc.gov/laboratory/specimen-submission/pdf/form-50-34.pdf

Testing without an informed consent:  a physician may order blood tests for malaria when an informed consent is not possible and there has been, or is likely to be, significant exposure to a person’s blood or body fluids by a person providing emergency or medical services.


Treatment

Treatment of Malaria:  Guidelines for Clinicians (United States): http://www.cdc.gov/malaria/diagnosis_treatment/clinicians2.html


Additional Information


Click to Call South Central Public Health District

Click to Call the Idaho State Epidemiologist

Click to Call Idaho State Communications