What parents need to know about malaria — and how to keep kids safe amid U.S. outbreaks
The Centers for Disease Control and Prevention (CDC) has issued an health advisory after five cases of malaria were detected in two states. The cases, which were identified in Florida and Texas, were locally acquired — meaning, patients got malaria in the U.S. and not from traveling to areas where malaria is widespread.
The disease once circulated widely in the U.S., but was considered eliminated from the country by 1951 after the use of insecticides and antimalarial treatments became common. The CDC now says there's "concern for a potential rise" in malaria cases and urges health care providers to plan for “rapid access” to IV forms of artesunate, which is considered the first-line treatment for severe malaria in the U.S.
The CDC notes that all of the malaria patients who were recently diagnosed have received treatment for the disease and are getting better. “Locally acquired mosquito-borne malaria has not occurred in the United States since 2003 when eight cases of locally acquired P. vivax malaria were identified in Palm Beach County, Florida,” the agency says.
While the CDC says that the risk of locally acquired malaria is still extremely low in the U.S., it notes that the risk is higher in areas where conditions allow the Anopheles mosquito (which spreads the disease) to survive during most or all of the year.
“Right now, there are very few cases in the United States, but it is very possible that this number will increase,” Dr. Keri Cohn, director of global health for the division of emergency medicine and attending physician in the Center for Global Health at the Children’s Hospital of Philadelphia, tells Yahoo Life. “Malaria can cause very serious illness in both children and adults.”
If you have children in areas where mosquitoes are common, it's understandable to have questions about malaria. Here's what you need to know.
What is malaria?
Malaria is a serious and potentially fatal disease caused by a parasite, according to the CDC. The parasite usually infects a certain type of mosquito that feeds on humans and transmits the disease. However, it's not typically spread from person to person (although there have been cases of a mother passing it on to a fetus during pregnancy), Dr. Thomas Russo, professor and chief of infectious disease at the University at Buffalo in New York, tells Yahoo Life.
More than 240 million cases of malaria happen each year worldwide — and 95% of them are in Africa, per the CDC. Nearly all cases of malaria in the U.S. are brought to the country from other parts of the world.
Infants, children under the age of five, pregnant women, travelers, and people with HIV or AIDS are at a higher risk of severe infection, according to the World Health Organization (WHO).
Signs of malaria
“Symptoms of malaria are largely non-specific,” Russo says. Meaning, they can be difficult to tell from those of other illnesses without a proper diagnosis. These are the most common signs of the disease, the CDC says:
fever
chills
headache
muscle aches and pains
fatigue
nausea
vomiting
diarrhea
These are more severe symptoms of malaria, according to the WHO:
extreme tiredness and fatigue
impaired consciousness
multiple convulsions
difficulty breathing
dark or bloody urine
jaundice (yellowing of the eyes and skin)
abnormal bleeding
Symptoms usually start anywhere from 10 days to four weeks after someone was infected, but a patient can feel sick anywhere from a week to a year after they became infected, the CDC says.
How can you tell malaria apart from more common illnesses?
A condition that causes fever, along with headache and muscle pains sounds a lot like COVID-19 or the flu. But there are a few key differences. “Malaria doesn't cause respiratory-type illnesses, like COVID-19 or the flu,” Dr. Ian Michelow,division head of pediatric infectious diseases and immunology at Connecticut Children’s Specialty Group, tells Yahoo Life. “It’s not going to look like a cough or cold and doesn’t typically cause nasal congestion or a runny nose in the early stages.”
If your child has what looks like a common cold, Michelow says it’s probably a respiratory virus — not malaria. “The main thing with malaria is a fever that’s unexplained by anything else that you’d expect from a child of this age,” he says.
Even if your child has an unexplained fever, it’s not likely to be due to malaria at this point, Russo says. “But the general rule is, when in doubt, get assessed,” he says.
And if your pediatrician suspects your child may have malaria, Russo adds, they can request a blood test.
How is malaria treated?
“We have very good treatments for malaria,” Cohn says. “The risk is delayed diagnosis where kids can get sicker if they are not diagnosed and treated promptly.”
In the U.S., the disease is treated with prescription drugs, although the CDC says that the type of drugs and length of treatment depend on the type of malaria, where the person was infected, their age, whether they’re pregnant and how sick they are when they start treatment.
The most common antimalarial drugs include chloroquine phosphate and artemisinin-based combination therapy (ACT), according to the Mayo Clinic. However, there are other medications available if needed. “Treatment is very effective,” Michelow says. “You can eradicate it, and it won’t come back if you treat it properly.”
How to keep kids safe from malaria
The best way to keep kids safe from malaria is to do your best to prevent mosquito bites, Michelow says. “Deet is safe and approved for use in children over the age of 2 months," he says. Michelow recommends keeping mosquito repellent away from children’s faces and hands. “Kids put their fingers in their mouth,” he points out.
Michelow also suggests looking for a repellent with a low concentration of Deet and to apply it just once a day. “Just be aware that the low percentage of Deet only lasts for a few hours as opposed to those with greater concentrations of 25% to 30%,” he says. “You still have to be cautious to prevent exposure to mosquitoes.”
If you prefer not to use Deet, Michelow says that picaridin and oil of lemon eucalyptus can be helpful too. Russo also recommends not being outside during times when mosquitoes are known to be active, which is typically at dusk and dawn. And, if it’s not too hot out, he says it’s worth considering covering your child's arms and legs when you go outside.
But doctors stress that parents shouldn’t stress about malaria right now. “I’m not too concerned, and I don’t think parents need to be too worried about this,” Michelow says. “This is something that the U.S. health care system can deal with fairly effectively.”
Russo agrees. “The risk is low, but it’s not zero,” he says.
Still, Michelow says that it’s important for parents to be aware that malaria can be a threat. “Knowledge is power,” he says. “If there is unexplained fever in a child in an area where malaria has been reported, you can ask your doctor to test them.”
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