Serial nosocomial transmission of Plasmodium falciparum malaria from patient to nurse to patient.
BACKGROUND
Nosocomial transmission of malaria is a rare phenomenon in the United States.


OBJECTIVE
To describe the probable transmission of Plasmodium falciparum malaria from a patient to a healthcare worker and then from the healthcare worker to another patient.


METHODS
Case series.


METHODS
Two community hospitals in Massachusetts.


METHODS
Routine medical and supportive care.


METHODS
Clinical and laboratory evaluation.


RESULTS
A nurse developed falciparum malaria after a needlestick injury from a patient with documented falciparum malaria. Three days prior to her diagnosis, she cared for another patient, who subsequently developed falciparum malaria. That patient's parasite isolate genetically matched the nurse's isolate by two independent DNA fingerprinting techniques.


CONCLUSIONS
After extensive evaluation, we believe that a nurse who had acquired falciparum malaria via needlestick subsequently transmitted malaria to another patient via a break in standard precautions. The implications of this mechanism of transmission are discussed.
Alweis
Richard L
RL
Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, Massachusetts, USA.
DiRosario
Kerrie
K
Conidi
Giuseppe
G
Kain
Kevin C
KC
Olans
Richard
R
Tully
John L
JL
D000328:Adult; D000368:Aged; D002406:Catheterization, Peripheral / Q000009:adverse effects; D005260:Female; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D017757:Infectious Disease Transmission, Professional-to-Patient; D016778:Malaria, Falciparum / Q000209:etiology / Q000635:transmission*; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D016602:Needlestick Injuries / Q000469:parasitology; D009741:Nursing Staff, Hospital