August 22, 2023
The Maryland Department of Health confirmed the state’s first locally acquired case of malaria in more than 40 years on Aug. 18. The patient is a Maryland resident who lives in the Washington, DC, area who did not travel outside of the United States or to states with recent locally acquired malaria cases, Florida and Texas.
In June, The Centers for Disease Control and Prevention (CDC) issued a Health Alert Network health advisory in response to several confirmed Florida and Texas malaria cases. The advisory stated that, despite these cases, the risk of locally acquired malaria remains extremely low in the U.S. However, the agency advised that clinicians should consider a malaria diagnosis in any person with a fever of unknown origin regardless of their travel history. Furthermore, clinicians practicing in areas of the U.S. where locally acquired malaria cases have occurred should follow guidance from their state and local health departments.
The Food and Drug Administration’s 2022 malaria guidance defines a malaria-endemic area as “any areas with malaria where CDC recommends anti-malarial chemoprophylaxis in travelers in the CDC Health Information for International Travel (commonly known as the Yellow Book) at the time the donor is screened.”
For donor screening purposes, FDA recommends use of the table in the “Malaria” chapter of the Yellow Book for CDC’s most current recommendations on anti-malarial chemoprophylaxis. The CDC has not made recommendations for the use of chemoprophylaxis in the affected areas.
Donor screening questions for travel to Florida, Maryland or Texas are not recommended. However, AABB Standards, consistent with FDA regulations, require AABB-accredited facilities to confirm during the donor screening process that each donor is feeling healthy and well and is free of fever at the time of donation. Furthermore, donors are routinely instructed to notify the blood collection center if they develop symptoms or identify other risk of illness following their donation, providing an additional safety net to protect the blood supply.
AABB’s Transfusion Transmitted Diseases Committee is closely monitoring the reported cases. AABB will continue communications with the CDC and FDA and provide updates to AABB members in Weekly Report and on AABB’s Thursday Forum as new information emerges. Individuals with questions may contact firstname.lastname@example.org.