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Fast Facts on the Current Florida Malaria Outbreak

Ways to Keep You and Your Family Safe

Florida's Department of Health recently released a statement that four individuals have become infected with malaria. Malaria is caused by protozoan parasites from the genus Plasmodium: P. falciparum, P. vivax, P. malariae, and P. ovale, and is transmitted by mosquitos of the Anopheles species. It should be noted that malaria was eliminated from Florida in the late 1940s, however in 2012, 65 cases of imported (malaria were reported in Florida. Of the 2012 cases:


69% (45 cases) were P. falciparum

25% (16 cases) were P. vivax

3% (2 cases) were P. ovale

3% (2 cases) were P. malariae


USA Endemic Mosquito Vectors

In Florida, there are eight identifiable Anopheles species that can transmit malaria. The principal mosquito vector is Anopheles quadrimaculatus, which is found in every county in Florida and is most abundant in northern Florida.


Clinical Symptoms

Symptoms may vary depending on the species of malaria contracted but initial symptoms include:

  1. Lasstitude (a state of physical or mental weariness; lack of energy)

  2. Headache

  3. Anorexia

  4. Occasional nausea and vomiting

The fever stage is comprised of:

  1. Cold Stage (shivering and feeling intense cold)

  2. Hot Stage (distressing heat, dryness, burning, intense headache, nausea, and vomiting)

  3. Sweating Stage (profuse sweating)

A typical attack starts in the early afternoon and lasts from 8 to 12 hours.


Malaria and Pregnancy

Uncomplicated malaria in all stages of pregnancy is currently treated with Quinine and Clindamycin, or just Quinine if Clindamycin is unavailable.


Malaria and Children

Early symptoms of malaria in children can include irritability and drowsiness, poor appetite, and trouble sleeping. These symptoms are usually followed by chills, and then a fever with fast breathing. The fever may either gradually rise over 1 to 2 days or spike very suddenly to 105°F (40.6°C) or higher. The same pattern of symptoms (chills, fever, sweating) may repeat every 2 to 3 days depending on which malaria parasite is causing the infection. Please see the links under treatment for weight-based pediatric dosing.


Prevention

Here is a list of varying interventions around your home to prevent mosquito attacks:

  1. Clean out eaves and gutters

  2. Drill holes in or remove old tires

  3. Turn over empty plastic pots and bins

  4. Adjust tarps and equipment on outdoor recreation vehicles to remove standing water

  5. Pump out bilges on boats

  6. Replace bird bath water once a week

  7. Empty water in plant trays and hanging baskets once a week

  8. Remove vegetation and debris from drainage ditches that prevent water flow

  9. Sprinkle shavings of Irish Spring Soap around windows, doors, patios, or other areas you and your family may frequent, you can also place bars of the soap in mason jars around your home and patio

  10. Plant any combination of the following mosquito-repelling plants: Citronella grass/Lemongrass, Mint, Catnip, Sage, Petunias, Marigolds, Rosemary, Lavender, Basil, Bee Balm, Allium.

  11. You can purchase citronella candles and burners

  12. Wall outlet insect repellants

For a list of items I use to protect my family and home from mosquitos click this link.


Treatment

The international gold standard for treating nonsevere, noncomplex malaria is chloroquine and hydroxychloroquine which are FDA-approved drugs used to prevent and treat malaria. They have a long elimination half-life of 30-40 days allowing for weekly dosing when used in the prevention of malaria, and a short 48-hour treatment course when used to treat malaria.


Other medications for treating malaria include:

  1. Oral (pills) Artemether-Lumefantrine (Coartem™)

  2. Oral (pills) Atovaquone-Proguanil (Malarone™)

  3. Oral (pills) Quinine

  4. Oral (pills) Mefloquine

  5. IV (infusion) Artesunate

If you would like to get a prescription for hydroxychloroquine I recommend MyFreeDoctor.Com which is a donation-based telehealth service and is my preference for me and my family when needing primary care services. Hydroxychloroquine can be taken as a prophylaxis for malaria.


References
  1. The Florida Department of Health has Issued an Advisory Regarding Mosquito-borne Illness

  2. Florida Residence Guide: Mosquitos and Their Control: Integrated Pest Management for Mosquito Reduction Around Homes and Neighborhoods

  3. Florida Health: Mosquito-Borne Diseases

  4. Malaria: Chloroquine an Hydroxychloroquine

  5. Management of Malaria in Pregnancy

  6. Kids Health: Malaria

  7. Malaria in Children

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