What to know
- In 2019, 2,048 confirmed malaria cases and 6 deaths were reported to the CDC National Malaria Surveillance System.
- Almost all cases reported in 2019 were travel associated (imported).
Highlights
- In 2019, of the 2,048 confirmed cases, 1,388 (67.8%) occurred among U.S. civilians, 23 (1.1%) among U.S. military members, 359 (17.5%) among non-U.S. residents, and 278 (13.6%) had an unknown residence status.
- P. falciparum was the most common species (1,533 cases, 85.5%) followed by P. vivax (107 cases, 6.0%) and P. ovale (87 cases, 4.9%).
- Case classification
- Travel associated (imported): 2,017 (98.5%) cases
- The source of malaria could not be determined after an investigation for 1 (<1%) case (cryptic). For this isolated case both blood exposures and international travel were reported.
- Lost to follow up: 30 (1.5%) cases whose classification was unable to be determined.
- Among 2,017 imported cases, the region of travel was reported for 1,980 cases (98.2%). Of these, Africa was the most common region of travel, reported by 1,849 (91.7%), followed by Asia 83 (4.1%) and less than 1% of cases reported travel from South America (20 cases), Central America (10 cases), the Caribbean (5 cases), Oceania (10 cases), and the Middle East (3 cases). Of the 1,849 cases reporting travel to Africa, 1,249 (67.6%) traveled to West Africa.
- Six people died from malaria in 2019, a case fatality rate of 0.3 (Malaria Deaths and Case Fatality Rate, 2007 - 2022), and all were diagnosed with P. falciparum. One person who died was 20 to 29 years old, three were 40 to 49 years old and two were 65 years or older. Three people who died were male and three were female, and all traveled to Africa. Two had traveled to visit friends and relatives, one traveled for tourism, one for a humanitarian reason, and two for unknown reasons. None were reported to have taken chemoprophylaxis for malaria prevention.
- Thirteen jurisdictions were in the top quartile for having the most malaria cases in 2019.
Data
Number of malaria cases by demographics, region of acquisition, and primary reason for travel, by patient resident status — United States, 2019
| Demographic Table, 2019 | |||||||||||||||||||
| U.S. Military | U.S. Civilian | Non-U.S. | Not recorded | Total | |||||||||||||||
| Demographics | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | ||||
| Total | 23 | 1.1 | — | 1388 | 67.8 | — | 359 | 17.5 | — | 278 | 13.6 | — | 2,048 | 100 | — | ||||
| Male sex | 22 | 95.7 | — | 910 | 65.6 | — | 209 | 58.2 | 58.4 | 176 | 63.3 | — | 1,317 | 64.3 | 64.3 | ||||
| Female sex | 1 | 4.3 | — | 478 | 34.4 | — | 149 | 41.5 | 41.6 | 102 | 36.7 | — | 730 | 35.6 | 35.7 | ||||
| Unknown sex | 0 | 0.0 | — | 0 | 0.0 | — | 1 | 0.3 | — | 0 | 0.0 | — | 1 | 0.0 | — | ||||
| Age less than 18 years | 0 | 0.0 | — | 184 | 13.3 | — | 149 | 41.5 | — | 17 | 6.1 | 6.1 | 350 | 17.1 | 17.1 | ||||
| Age 18 – 64 years | 23 | 100.0 | — | 1,081 | 77.9 | — | 186 | 51.8 | — | 233 | 83.8 | 84.1 | 1,523 | 74.4 | 74.4 | ||||
| Age 65 years and older | 0 | 0.0 | — | 123 | 8.9 | — | 24 | 6.7 | — | 27 | 9.7 | 9.7 | 174 | 8.5 | 8.5 | ||||
| Age unknown | 0 | 0.0 | — | 0 | 0.0 | — | 0 | 0.0 | — | 1 | 0.4 | — | 1 | 0.0 | — | ||||
| Not Hispanic or Latino | 14 | 60.9 | 82.4 | 1,050 | 75.6 | 97.4 | 271 | 75.5 | 97.5 | 163 | 58.6 | 98.2 | 1,498 | 73.1 | 97.3 | ||||
| Hispanic or Latino | 3 | 13.0 | 17.6 | 28 | 2.0 | 2.6 | 7 | 1.9 | 2.5 | 3 | 1.1 | 1.8 | 41 | 2.0 | 2.7 | ||||
| Unknown | 6 | 26.1 | — | 310 | 22.3 | — | 81 | 22.6 | — | 112 | 40.3 | — | 509 | 24.9 | — | ||||
| Race Asian | 0 | 0.0 | 0.0 | 28 | 2.0 | 2.3 | 30 | 8.4 | 9.7 | 6 | 2.2 | 3.0 | 64 | 3.1 | 3.6 | ||||
| Race Black or African American | 10 | 43.5 | 47.6 | 1,017 | 73.3 | 82.0 | 255 | 71.0 | 82.3 | 169 | 60.8 | 83.7 | 1,451 | 70.8 | 81.8 | ||||
| Race White | 10 | 43.5 | 47.6 | 141 | 10.2 | 11.4 | 18 | 5.0 | 5.8 | 20 | 7.2 | 9.9 | 189 | 9.2 | 10.7 | ||||
| Race Other | 1 | 4.3 | 4.8 | 54 | 3.9 | 4.4 | 7 | 1.9 | 2.3 | 7 | 2.5 | 3.5 | 69 | 3.4 | 3.9 | ||||
| Race Unknown | 2 | 8.7 | — | 148 | 10.7 | — | 49 | 13.6 | — | 76 | 27.3 | — | 275 | 13.4 | — | ||||
| Region of acquisition3 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | ||||
| Total | 23 | 1.1 | — | 1,380 | 68.4 | — | 356 | 17.6 | — | 258 | 12.8 | — | 2,017 | 100 | — | ||||
| Africa | 14 | 60.9 | — | 1,303 | 94.4 | 95.9 | 302 | 84.8 | 85.8 | 230 | 89.1 | 93.1 | 1,849 | 91.7 | 93.4 | ||||
| Asia | 9 | 39.1 | — | 26 | 1.9 | 1.9 | 37 | 10.4 | 10.5 | 11 | 4.3 | 4.5 | 83 | 4.1 | 4.2 | ||||
| South America | 0 | 0.0 | — | 13 | 0.9 | 1.0 | 5 | 1.4 | 1.4 | 2 | 0.8 | 0.8 | 20 | 1.0 | 1.0 | ||||
| Central America / Caribbean | 0 | 0.0 | —— | 6 | 0.4 | 0.4 | 6 | 1.7 | 1.7 | 3 | 1.2 | 1.2 | 15 | 0.7 | 0.8 | ||||
| Oceania | 0 | 0.0 | — | 8 | 0.6 | 0.6 | 1 | 0.3 | 0.3 | 1 | 0.4 | 0.4 | 10 | 0.5 | 0.5 | ||||
| Middle East | 0 | 0.0 | — | 2 | 0.1 | 0.1 | 1 | 0.3 | 0.3 | 0 | 0.0 | 0.0 | 3 | 0.1 | 0.2 | ||||
| Unknown | 0 | 0.0 | — | 22 | 1.6 | — | 4 | 1.1 | — | 11 | 4.3 | — | 37 | 1.8 | — | ||||
| Africa, West | 7 | 30.4 | — | 935 | 67.8 | 68.9 | 156 | 43.8 | 44.3 | 151 | 58.5 | 61.1 | 1249 | 61.9 | 63.1 | ||||
| Primary reason for travel3 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | ||||
| Total | 23 | 1.1 | — | 1,380 | 68.4 | — | 356 | 17.6 | — | 258 | 12.8 | — | 2,017 | 100 | — | ||||
| Visiting friends and relatives | 0 | 0.0 | — | 828 | 60.0 | 79.0 | 49 | 13.8 | 17.6 | 45 | 17.4 | 75.0 | 922 | 45.7 | 65.4 | ||||
| Tourist | 0 | 0.0 | — | 64 | 4.6 | 6.1 | 8 | 2.2 | 2.9 | 4 | 1.6 | 6.7 | 76 | 3.8 | 5.4 | ||||
| Missionary or dependent | 0 | 0.0 | — | 58 | 4.2 | 5.5 | 0 | 0.0 | 0.0 | 1 | 0.4 | 1.7 | 59 | 2.9 | 4.2 | ||||
| Business | 0 | 0.0 | — | 67 | 4.9 | 6.4 | 18 | 5.1 | 6.5 | 6 | 2.3 | 10.0 | 91 | 4.5 | 6.5 | ||||
| Student or teacher | 0 | 0.0 | — | 17 | 1.2 | 1.6 | 17 | 4.8 | 6.1 | 4 | 1.6 | 6.7 | 38 | 1.9 | 2.7 | ||||
| Airline/ship crew | 0 | 0.0 | — | 2 | 0.1 | 0.2 | 3 | 0.8 | 1.1 | 0 | 0.0 | 0.0 | 5 | 0.2 | 0.4 | ||||
| Peace Corps | 0 | 0.0 | — | 5 | 0.4 | 0.5 | 0 | 0.0 | 0.0 | 0 | 0.0 | 0.0 | 5 | 0.2 | 0.4 | ||||
| Refugee or immigrant | 0 | 0.0 | — | 0 | 0.0 | 0.0 | 174 | 48.9 | 62.4 | 0 | 0.0 | 0.0 | 174 | 8.6 | 12.3 | ||||
| Military deployment | 23 | 100.0 | — | 0 | 0.0 | 0.0 | 2 | 0.6 | 0.7 | 0 | 0.0 | 0.0 | 25 | 1.2 | 1.8 | ||||
| Other | 0 | 0.0 | — | 7 | 0.5 | 0.7 | 8 | 2.2 | 2.9 | 0 | 0.0 | 0.0 | 15 | 0.7 | 1.1 | ||||
| Unknown | 0 | 0.0 | — | 332 | 24.1 | — | 77 | 21.6 | — | 198 | 76.7 | — | 607 | 30.1 | — | ||||
| 1 Percentage calculated among all subjects | |||||||||||||||||||
| 2 Percentage calculated among subjects with known responses | |||||||||||||||||||
| 3 Among imported cases | |||||||||||||||||||
In 2019, most people diagnosed with malaria in the United States were male, 18 – 64 years old, non-Hispanic or Latino ethnicity, and Black/African American race. Case patients predominantly traveled to Africa. More than half of all case patients traveled to or from West Africa. More than two thirds of U.S. civilians with malaria traveled to visit friends and relatives in 2019.
Supplementary data files
Tables with case counts by species, country of acquisition, and diagnostic confirmation method (e.g., blood smear microscopy only, or polymerase chain reaction confirmed [with or without blood smear microscopy]) are available for download for year 2019.