New Advice on Treating Malaria
Experts' Recommendations Focus on U.S. Travelers Who Contract Malaria Overseas
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
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
But many parts of the world have malaria that resists chloroquine and other
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
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.