title: Notes from the Field: Imported Cases of Malaria--Puerto Rico, July-October 2015.
abstract: On July 16 2015, the Puerto Rico Department of Health (PRDH) was notified of a case of malaria, diagnosed by a hospital parasitology laboratory in a student who had traveled to Punta Cana, Dominican Republic, during late June for a school-organized graduation trip. Malaria is a mosquito-borne parasitic infection, characterized by fever, shaking chills, headaches, muscle pains, nausea, general malaise, and vomiting (1). Malaria can be clinically difficult to distinguish from other acute febrile illnesses, and a definitive diagnosis requires demonstration of malaria parasites using microscopy or molecular diagnostic tests. The student's initial diagnosis on July 10 was suspected dengue virus infection. Puerto Rico eliminated local malaria transmission during the mid-1950s (2); however, reintroduction remains a risk because of the presence of a competent vector (Anopheles albimanus) and ease of travel to areas where the disease is endemic, including Hispaniola, the island shared by the Dominican Republic and Haiti, and the only island in the Caribbean with endemic malaria (3). During 2014, the Dominican Republic reported 496 confirmed malaria cases and four associated deaths; Haiti reported 17,662 confirmed cases and nine deaths (4). During 2000-2014, Puerto Rico reported a total of 35 imported malaria cases (range = 0-7 per year); three cases were imported from Hispaniola. During June-August 2015, eight confirmed malaria cases among travelers to the Dominican Republic were reported to CDC's National Malaria Surveillance System (CDC, unpublished data, 2015).
authors.forename: Emilio
authors.initials: E
authors.lastname: Dirlikov
authors.forename: Carmen
authors.initials: C
authors.lastname: Rodríguez
authors.forename: Shirley
authors.initials: S
authors.lastname: Morales
authors.forename: Laura Castro
authors.initials: LC
authors.lastname: Martínez
authors.forename: Juan B
authors.initials: JB
authors.lastname: Mendez
authors.forename: Anibal Cruz
authors.initials: AC
authors.lastname: Sanchez
authors.forename: Jesús Hernández
authors.initials: JH
authors.lastname: Burgos
authors.forename: Zobeida
authors.initials: Z
authors.lastname: Santiago
authors.forename: Rosa Ivette
authors.initials: RI
authors.lastname: Cuevas-Ruis
authors.forename: Sheila Adorno
authors.initials: SA
authors.lastname: Camacho
authors.forename: Enid Román
authors.initials: ER
authors.lastname: Mercado
authors.forename: Jessica Falcón
authors.initials: JF
authors.lastname: Guzmán
authors.forename: Kyle
authors.initials: K
authors.lastname: Ryff
authors.forename: Carolina
authors.initials: C
authors.lastname: Luna-Pinto
authors.forename: Paul M
authors.initials: PM
authors.lastname: Arguin
authors.forename: Stella M
authors.initials: SM
authors.lastname: Chenet
authors.forename: Luciana
authors.initials: L
authors.lastname: Silva-Flannery
authors.forename: Dragan
authors.initials: D
authors.lastname: Ljolje
authors.forename: Julio Cadiz
authors.initials: JC
authors.lastname: Velázquez
authors.forename: Dana
authors.initials: D
authors.lastname: Thomas
authors.forename: Brenda Rivera
authors.initials: BR
authors.lastname: Garcia
mesh_terms: D000293:Adolescent; D004293:Dominican Republic / Q000453:epidemiology; D005260:Female; D006801:Humans; D008288:Malaria / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010963:Plasmodium falciparum / Q000302:isolation & purification*; D011647:Puerto Rico / Q000453:epidemiology; D014195:Travel