May 22, 2007 -- What's the best way to treat malaria when a traveler brings it to the U.S.? It depends, malaria experts report.
Today's edition of The Journal of the American Medical Association includes the latest recommendations on malaria treatment in the U.S.
Malaria is a blood infection that is most commonly spread by mosquitoes. Native cases of malaria have been eliminated from the U.S., but it's still common in other parts of the world. Global travelers may pick up malaria and bring it back to the U.S.
"Every year in the U.S., about 1,200 cases of malaria are reported, resulting in up to 13 deaths per year," write the researchers, who included the CDC's Kevin Griffith, MD, MPH.
Griffith's team reviewed malaria treatment research conducted from 1966 to 2006.
They conclude that diagnosing and treating malaria remains a "challenge" for U.S. doctors as increasing numbers of people in the U.S. journey to countries where malaria is common.
Malaria Treatment Recommendations
Chloroquine remains the treatment of choice for malaria contracted in countries without chloroquine-resistant malaria, according to Griffith and colleagues.
But many parts of the world have malaria that resists chloroquine and other drugs.
For malaria from those areas, Griffith's team recommends Malarone, which combines the drugs atovaquone and proguanil, or taking quinine with one of these three antibiotics: tetracycline, doxycycline, or clindamycin.
Severe malaria cases should be treated with the drug quinidine, since another class of drugs called artemisinins isn't yet available, note Griffith and colleagues.
Malaria should be treated in a hospital, since the disease can be deadly, and U.S. doctors should be aware of its symptoms, which may include fever, chills, headache, nausea, vomiting, diarrhea, abdominal pain, back pain, weakness, dizziness, confusion, cough, and coma.
Those symptoms don't necessarily indicate malaria. Lab tests are needed to confirm malaria. The recent travel history of patients is also a big clue about their potential malaria exposure.
The journal notes that the researchers' recommendations don't necessarily reflect the CDC's views.
New Treatments Scarce
Every year, more than a million people worldwide die from malaria, according to an editorial published with the study.
"There likely will be a role for vaccine development in disease prevention, but new drugs appear to be few and far between" when it comes to malaria, note the editorialists, who are Gianna Zuccotti, MD, MPH, and Catherine DeAngelis, MD, MPH.
Zuccotti is the journal's contributing editor. DeAngelis is the journal's editor in chief.
Traveling to an area where malaria is common? Before you leave, check with your doctor about malaria prevention.