September 21, 2023

Why I’m Worried About Malaria in the US

Editor’s Note: Arick Wierson is an Emmy Award-winning television producer and former senior media advisor to former New York City Mayor Michael Bloomberg. He advises corporate clients on communications and political strategies in the United States, Africa and Latin America. Follow him on Twitter @ArickWierson. Read more opinion on CNN.

Last week, the U.S. Centers for Disease Control and Prevention (CDC) announced a public health advisory that five cases of locally acquired malaria had been identified in Texas and Florida. The Florida Department of Health has since reported two more cases of locally acquired malaria. While there are an estimated 2,000 cases of malaria in the U.S. each year, mostly contracted while traveling, the news from the CDC marks the first time in more than 20 years that the deadly parasite has been found locally.

Arick Wierson-Tunheim

Arick Wierson-Tunheim

What this means, in plain English, is that there are an unknown number of mosquitoes in the US that carry the potentially deadly Plasmodium vivax strain of malaria, allowing it to spread.

Let’s not mince words: this is a big problem. I know firsthand what can happen if someone doesn’t recognize the disease and don’t get treated for it quickly; ten years ago I almost succumbed to Plasmodium falciparum strain of malaria while living in sub-Saharan Africa. In my case, which I detailed in a blog post, it was my unfamiliarity with the disease and my inability to early identify its telltale symptoms (including chills, headache, muscle aches, fatigue, nausea, vomiting, and diarrhea). that put me in a coma for over a week and led to near kidney and lung failure. And it’s the same unfamiliarity with malaria that most Americans share that worries me the most.

In Angola, where I became infected with the malaria parasite, almost everyone is very aware of the disease and its symptoms. The challenges there are of a public health nature, namely access to medicines and doctors. In the US, however, one of the biggest challenges will be recognizing the disease early so that it can be treated quickly.

Fortunately, the country has been considered malaria-free since the 1950s. This effectively means that several generations of Americans have no memory of what it is like to live in malarial areas and are not used to recognizing the symptoms of the disease.

The risk of someone infected with malaria getting a nagging headache from flu or hoping that the fever and chills he or she is experiencing will eventually pass can easily – as in my case – become a recipe for death.

“Malaria symptoms can present themselves like many other diseases, especially in the early stages,” said Kelly Searle, a professor of epidemiology and public health. at the University of Minnesota School of Public Health. Searle studies how malaria affects communities and how it can be eliminated if possible. “The problem here in the United States is not treatment per se, but awareness. It’s not really on the average American’s radar. The vast majority of Americans who develop a headache or fever will not immediately suspect they have malaria. This delay in seeking medical attention allows the disease to spread more aggressively, both within the patient and, with mosquitoes as a vector, within the community.”

But aside from Americans’ lack of awareness of malaria, what causes it to be transmitted locally cases in Texas and Florida that are of most concern is the risk of American doctors being inattentive to the disease.

Dr. Glenn Wortmann, the director of infectious diseases at the MedStar Washington Hospital Center in Washington, D.C., with whom I recently spoke about the cases reported in Texas in Florida, indicated that prior to this recent CDC advisory, doctors almost never contracted malaria. as a possible diagnosis for patients who had not recently traveled abroad.

He said that usually “99.9% of doctors do not consider malaria a local disease. We are very well aware of ‘airport malaria’ – those who may bring the disease with them from overseas travel. But once someone indicates that they have not recently traveled abroad, it kind of falls off the list.”

But patients’ ignorance of the disease and the potential for some doctors — especially those who practice in places far away from Texas and Florida — not to think of malaria when diagnosing patients may be only part of the problem, and both can be effectively addressed through ongoing communication and education. What can’t be so easily resolved are the structural conditions – both economic and climate-related – that make the return of malaria in the US that much more concerning this time around.

As global travel and trade increase, coupled with an extended mosquito season and an expanding mosquito belt due to global warming, the likelihood of malaria reestablishing itself in the US is higher than at any time in recent decades, experts say.

According to dr. John Roberts, a Los Angeles-based emergency public health physician with the International Medical Corps with whom I spoke about the issue: “In the public health arena, we often say that the globalized economy is driving the exchange of goods, services… and bugs. But what is different now is climate change. Rising temperatures are increasing the range of the mosquito’s anopheles genus, the main vector for malaria; combined with increased global trade, the likelihood of malaria being reintroduced to the US is greater than it has been since it was completely eradicated half a century ago.

“In terms of public health, we have been anticipating the return of malaria here at home for some time now. The only question now is, are these five reported cases about it or are they the ‘tip of the iceberg’? Because this strain of malaria can be dormant for quite some time in some people, it may be some time before we know the full extent of the challenge we face
from a public health perspective,” added Roberts.

My battle with malaria has changed my life in so many ways. My encounter with death in Africa was a wake-up call to the ephemeral nature of our short time here on Earth. For me, life is no longer about making long-term plans and looking ahead to the future; malaria has shown me that tomorrow is far from certain and that we all need to invest in enjoying the present. Additionally, while I’ve been lucky enough to have no long-term health consequences, it opened my eyes to this global killer that infects nearly a quarter of a billion people on the planet each year and kills more than half a million people. The CDC was wise to get ahead of the problem and warn the media and medical community about this resurfacing threat to public health.

Let’s hope more people pay attention.

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