What is it with all the exotic, mosquito-borne illnesses in Florida all at once?
On top of 10 cases of dengue fever since January in Broward and Miami-Dade counties, seven people have contacted malaria so far this year in Florida, all in Sarasota County between the end of May and the end of July.
According to WGCU, the PBS station in Southwest Florida, those infected in the recent outbreak, which included one person in Texas as well as seven in Sarasota, constitute “the largest U.S. group to become infected with malaria in nearly a century.”
Malaria “remains one of the world’s greatest public health concerns, infecting about 219 million people a year … and killing on average about 660,000 – mostly children in Africa,” according to WGCU.
With those grim statistics and seven confirmed cases just 160 miles due west of Vero Beach, some Treasure Coast residents are concerned about an outbreak here. But a local medical expert says there is little danger.
“There is really no need for concern,” said Dr. Kruti Yagnik, an infectious disease doctor with Cleveland Clinic’s Indian River Hospital. “There are seven documented cases in Sarasota County and one in Texas but that is out of millions and millions of people. It’s extremely rare in the United States and we believe that this cluster is attributed to people traveling. While all seven patients have denied traveling to malaria prone countries, it’s impossible to test everyone living and visiting the area.
“Most likely those cases were spread by someone who traveled to an infected area like Asia or Africa and were bitten by a mosquito but didn’t have any symptoms,” she added. “When they returned home to Florida, they were bitten by a different mosquito that in turn transmitted the disease to the next human it bit. Fortunately, the strain of malaria that was briefly transmitted in Florida is very treatable, and all seven of the infected people have been treated and are doing well.”
Concerted efforts to stamp out malaria in the U.S. began at the start of the 20th century and “by 1947, home-grown malaria in America was considered eliminated,” according to WGCU.
Outside the United States, nearly half of the world’s population lives in areas of risk, which are largely concentrated in tropical and subtropical regions, especially in sub-Saharan Africa, South Asia and parts of Central and South America. The most vulnerable victims are persons with little or no immunity to the disease like young children, pregnant women and travelers or migrants coming from areas with little or no malaria transmission.
According to the CDC, malaria is caused by infection with plasmodium parasites, which are transmitted to humans through the bites of infected mosquitoes. Once inside the human body, these parasites invade and multiply within red blood cells, leading to flu-like symptoms including fever, chills, sweating, headache, muscle aches and fatigue. Severe cases can include complications such as anemia, organ failure, cerebral malaria and death.
“Malaria is transmitted by mosquitoes,” Dr. Yagnik reiterated. “It isn’t contagious like a cold or virus. We all get mosquito bites, but in most cases that’s all it is – a mosquito bite. A malaria-infected mosquito bite is hard to differentiate from any other mosquito bite. It manifests in the same reddish, puffy bump. If six to 10 days after you’ve been bitten you start to feel sick – then you can make that association and alert your doctor.
“A simple blood drop viewed under a microscope will reveal whether or not you have the disease. If you do, an oral medication can be prescribed. It’s very curable if treated early.”
There’s also a rare phenomenon called airport malaria, which is caused by infected mosquitoes transported rapidly by aircraft from a malaria-endemic country to a non-endemic country. If local conditions allow for their survival, even briefly, the jet-setting mosquitoes can potentially bite local residents.
Another possible way to transmit malaria is through blood transfusion, which is extremely rare in the United States due to rigid screening of prospective donors. In fact, the CDC states that on average only one case of transfusion transmitted malaria occurs in the United States every two years.
Potentially a child could contract malaria from its infected mother before or during delivery, but again this is very rare in the United States.
“If you are planning to travel to a high malaria risk country you should definitely see your healthcare provider before you go because there are medications you can take before, during and after your trip to decrease your chances of getting the disease,” Dr. Yagnik said.
“The type of medication you’ll be prescribed will depend on where you are traveling. Your doctor will consult a CDC travel health directory to find out what strain of malaria or any other diseases you’ll encounter in your visit and prescribe medications targeted for those strains. If you get bit by a mosquito in a foreign country and feel ill, a local doctor will test you and readily have medication for that particular strain if necessary.”
There are some simple steps to protect yourself from mosquito bites, especially during the summer months when they are most prevalent. If you are outside, wear long sleeves and long pants. Apply an insect repellent with DEET, as it most effectively repels the little parasite-bearing pests. You should also eliminate any standing water from around your house because that’s where mosquitoes breed.
Malaria remains a formidable global health challenge, particularly in regions where poverty and limited healthcare access contribute to its prevalence, but scientists are working on rapid tests designed to diagnose the disease in minutes so treatment can be started before it can spread. And a vaccine has recently been approved for children in Africa where the mortality rate from malaria is high.
As far as Treasure Coast residents are concerned, the risk remains minimal despite the Sarasota outbreak, according to Dr. Yagnik.
Dr. Kruti Yagnik received her medical education at Nova Southeastern College of Osteopathic Medicine in Fort Lauderdale, her internship and residency in Internal Medicine at Shands at the University of Florida, and her fellowship in Infectious Diseases and Geographic Medicine at the University of Texas Southwestern Medical Center. Her office is in the Health and Wellness Building, Suite 203, 3450 11th Court in Vero Beach. To schedule an appointment call 772-794-5631.
