What to know
In 2022, 1,999 confirmed malaria cases and 10 deaths were reported to the CDC National Malaria Surveillance System.
Key findings
- In 2022, of the 1,999 confirmed cases, 1,315 (65.8%) occurred among U.S. civilians, 279 (14.0%) among non-U.S. residents, 17 (<1.0%) among U.S. military members, and 388 (19.4%) had an unknown residence status.
- P. falciparum species causes the most severe disease and death, and 1,376 cases (84.5%) with a species determination in 2022 were P. falciparum. The second and third most common species determined were P. vivax (145 cases, 8.9%) and P. ovale (58 cases, 3.6%).
- Case classification
- Travel associated (imported): 1,870 (93.5 %) cases
- From blood exposure (induced): 1 (<1.0%) case
- The source of malaria could not be determined after an investigation (cryptic) for 3 (<1.0%) cases. For these isolated cases, all reported travel to an endemic country more than two years prior to illness onset or potentially had a diagnosis of babesiosis.
- Lost to follow-up: 125 (6.3%) cases whose classification was unable to be determined.
- Among 1,870 imported cases, the region of travel was reported for 1,843 cases (98.5%). Of these, Africa was the most common region of travel, reported by 1,663 (90.2%), followed Asia 79 (4.3%), Central America 53 (2.9%), South America 43 (2.3%), and less than 1% of cases reported travel in the Caribbean, Oceania, and the Middle East. Among the 1,663 cases reporting travel in Africa, 1,088 (65.4%) traveled in West Africa.
- Ten people with malaria died in 2022, a case fatality rate of 0.5%. In 2022, eight of the fatal cases were diagnosed with P. falciparum, and two cases had an undetermined species. One person who was 10 – 20 years old died, one was 30 – 39 years old, three people were 50 to 59 years old, two were 60 to 64 years old, and three people who died were 65 years or older. All ten people who died in 2022 were male, and all ten had traveled in Africa. Two had traveled to visit friends and relatives, two had traveled as a missionary, one for tourism, and five had unknown travel reasons. Eight of the people who died were U.S. civilians, one was not a U.S. resident, and one had an unknown residence status. None of the patients who died reported having taken a medication during travel to prevent malaria.
- Thirteen jurisdictions were in the top quartile for having the most malaria cases (range from 61 to 238 cases).
Results
Number of malaria cases by demographics, region of acquisition, and primary reason for travel, by patient resident status — United States, 2022
| Demographic Table, 2022 | |||||||||||||||||||
| 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 | 17 | 0.9 | — | 1315 | 65.8 | — | 279 | 14.0 | — | 388 | 19.4 | — | 1999 | 100 | — | ||||
| Male sex | 17 | 100 | — | 831 | 63.2 | 63.2 | 191 | 68.5 | — | 226 | 58.2 | 58.4 | 1265 | 63.3 | 63.3 | ||||
| Female sex | 0 | 0 | — | 483 | 36.7 | 36.8 | 88 | 31.5 | — | 161 | 41.5 | 41.6 | 732 | 36.6 | 36.7 | ||||
| Unknown | 0 | 0 | — | 1 | 0.1 | — | 0 | 0.0 | — | 1 | 0.3 | — | 2 | 0.1 | — | ||||
| Age less than 18 years | 0 | 0 | — | 196 | 14.9 | 14.9 | 69 | 24.7 | — | 53 | 13.7 | — | 318 | 15.9 | 15.9 | ||||
| Age 18 – 64 years | 17 | 100 | — | 1005 | 76.4 | 76.5 | 198 | 71.0 | — | 300 | 77.3 | — | 1520 | 76.0 | 76.1 | ||||
| Age 65 years and older | 0 | 0 | — | 113 | 8.6 | 8.6 | 12 | 4.3 | — | 35 | 9.0 | — | 160 | 8.0 | 8.0 | ||||
| Age unknown | 0 | 0 | — | 1 | 0.1 | — | 0 | 0.0 | — | 0 | 0.0 | — | 1 | 0.1 | — | ||||
| Not Hispanic or Latino | 10 | 58.8 | 71.4 | 1119 | 85.1 | 98.1 | 187 | 67.0 | 76.6 | 309 | 79.6 | 95.7 | 1625 | 81.3 | 94.4 | ||||
| Hispanic or Latino | 4 | 23.5 | 28.6 | 22 | 1.7 | 1.9 | 57 | 20.4 | 23.4 | 14 | 3.6 | 4.3 | 97 | 4.9 | 5.6 | ||||
| Unknown | 3 | 17.6 | — | 174 | 13.2 | — | 35 | 12.5 | — | 65 | 16.8 | — | 277 | 13.9 | — | ||||
| Race Asian | 0 | 0.0 | 0.0 | 16 | 1.2 | 1.4 | 10 | 3.6 | 4.7 | 7 | 1.8 | 3.1 | 33 | 1.7 | 2.0 | ||||
| Race Black or African American | 6 | 35.3 | 54.5 | 955 | 72.6 | 82.0 | 130 | 46.6 | 61.3 | 172 | 44.3 | 77.1 | 1263 | 63.2 | 78.4 | ||||
| Race White | 4 | 23.5 | 36.4 | 126 | 9.6 | 10.8 | 26 | 9.3 | 12.3 | 22 | 5.7 | 9.9 | 178 | 8.9 | 11.1 | ||||
| Race Other | 1 | 5.9 | 9.1 | 67 | 5.1 | 5.8 | 46 | 16.5 | 21.7 | 22 | 5.7 | 9.9 | 136 | 6.8 | 8.4 | ||||
| Race Unknown | 6 | 35.3 | — | 151 | 11.5 | — | 67 | 24.0 | — | 165 | 42.5 | — | 389 | 19.5 | — | ||||
| Region of acquisition3 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | ||||
| Total | 17 | 0.9 | — | 1262 | 67.5 | — | 275 | 14.7 | — | 316 | 16.9 | — | 1870 | 100 | — | ||||
| Africa | 10 | 58.8 | — | 1203 | 95.3 | 96.2 | 173 | 62.9 | 63.1 | 277 | 87.7 | 92.0 | 1663 | 88.9 | 90.2 | ||||
| Asia | 7 | 41.2 | — | 23 | 1.8 | 1.8 | 33 | 12.0 | 12.0 | 16 | 5.1 | 5.3 | 79 | 4.2 | 4.3 | ||||
| South America | 0 | 0.0 | — | 17 | 1.3 | 1.4 | 20 | 7.3 | 7.3 | 6 | 1.9 | 2.0 | 43 | 2.3 | 2.3 | ||||
| Central America / Caribbean | 0 | 0.0 | — | 5 | 0.4 | 0.4 | 47 | 17.1 | 17.2 | 2 | 0.6 | 0.7 | 54 | 2.9 | 2.9 | ||||
| Oceania | 0 | 0.0 | — | 3 | 0.2 | 0.2 | 0 | 0.0 | 0.0 | 0 | 0.0 | 0.0 | 3 | 0.2 | 0.2 | ||||
| Middle East | 0 | 0.0 | — | 0 | 0.0 | 0.0 | 1 | 0.4 | 0.4 | 0 | 0.0 | 0.0 | 1 | 0.1 | 0.1 | ||||
| Unknown | 0 | 0.0 | — | 11 | 0.9 | — | 1 | 0.4 | — | 15 | 4.7 | — | 27 | 1.4 | — | ||||
| Africa, West | 4 | 23.5 | — | 812 | 64.3 | 64.9 | 87 | 31.6 | 31.8 | 185 | 58.5 | 61.5 | 1088 | 58.2 | 59.0 | ||||
| Primary reason for travel3 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | ||||
| Total | 17 | 0.9 | — | 1262 | 67.5 | — | 275 | 14.7 | — | 316 | 16.9 | — | 1870 | 100 | — | ||||
| Visiting friends and relatives | 3 | 17.6 | 21.4 | 691 | 54.8 | 82.4 | 24 | 8.7 | 14.3 | 70 | 22.2 | 86.4 | 788 | 42.1 | 71.5 | ||||
| Tourist | 0 | 0.0 | 0.0 | 48 | 3.8 | 5.7 | 5 | 1.8 | 3.0 | 4 | 1.3 | 4.9 | 57 | 3.0 | 5.2 | ||||
| Missionary or dependent | 0 | 0.0 | 0.0 | 32 | 2.5 | 3.8 | 0 | 0.0 | 0.0 | 1 | 0.3 | 1.2 | 33 | 1.8 | 3.0 | ||||
| Business | 0 | 0.0 | 0.0 | 43 | 3.4 | 5.1 | 8 | 2.9 | 4.8 | 3 | 0.9 | 3.7 | 54 | 2.9 | 4.9 | ||||
| Student or teacher | 0 | 0.0 | 0.0 | 10 | 0.8 | 1.2 | 12 | 4.4 | 7.1 | 2 | 0.6 | 2.5 | 24 | 1.3 | 2.2 | ||||
| Airline/ship crew | 0 | 0.0 | 0.0 | 5 | 0.4 | 0.6 | 0 | 0.0 | 0.0 | 0 | 0.0 | 0.0 | 5 | 0.3 | 0.5 | ||||
| Peace Corps | 0 | 0.0 | 0.0 | 0 | 0.0 | 0.0 | 0 | 0.0 | 0.0 | 0 | 0.0 | 0.0 | 0 | 0.0 | 0.0 | ||||
| Refugee or immigrant | 0 | 0.0 | 0.0 | 0 | 0.0 | 0.0 | 115 | 41.8 | 68.5 | 0 | 0.0 | 0.0 | 115 | 6.1 | 10.4 | ||||
| Military deployment | 11 | 64.7 | 78.6 | 0 | 0.0 | 0.0 | 1 | 0.4 | 0.6 | 0 | 0.0 | 0.0 | 12 | 0.6 | 1.1 | ||||
| Other | 0 | 0.0 | 0.0 | 10 | 0.8 | 1.2 | 3 | 1.1 | 1.8 | 1 | 0.3 | 1.2 | 14 | 0.7 | 1.3 | ||||
| Unknown | 3 | 17.6 | — | 423 | 33.5 | — | 107 | 38.9 | — | 235 | 74.4 | — | 768 | 41.1 | — | ||||
| 1 Percentage calculated among all subjects | |||||||||||||||||||
| 2 Percentage calculated among subjects with known responses | |||||||||||||||||||
| 3 Among imported cases | |||||||||||||||||||
In 2022, 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 in Africa. More than half of all case patients traveled to or from West Africa. More than half of U.S. civilians with malaria traveled to visit friends and relatives in 2021.
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 years 2022.