Public Health Response to the First Locally Acquired Malaria Outbreaks in the US in 20 Years

Why were there 4 outbreaks of domestic malaria in 2023 after 20 years with no locally acquired cases?In this qualitative study, 10 locally acquired mosquito-transmitted malaria cases were reported in 4 states amid more than 2200 imported cases in 2023. Three infected mosquitoes were found in Florida, where all cases shared a Central or South American strain; no genetic or epidemiologic links were found across states, and 1 case matched African parasites.These findings suggest that sustained transmission of malaria in the US remains unlikely, though increased global travel, high temperatures and moisture, and competent vectors may raise the risk of local malaria outbreaks.

Corresponding Author: Timothy N. DeVita, MD, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30329 (uqt3@cdc.gov).

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