Malaria in a returning traveler from Jamaica. 2014

Michael Kavanaugh, and Mary Bavaro
Division of Infectious Disease, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134.

Malaria in Jamaica is a real, but uncommon entity and poses a health risk to our Department of Defense personnel, which should not be overlooked in returning travelers. Malaria in Jamaica was actually considered eradicated in the 1960s, but there has been a reemergence attributed to the combination of Haitian nationals as well as endemic Anopheles mosquitoes in the Kingston area. Our facility recently admitted a 33-year-old Marine who had two Emergency Department visits before being evaluated for malaria. He had returned from Kingston 14 days before presentation, which included fever, night sweats, and headache followed by a period of malaise prior to the next paroxysm. He was found to have a 1.5% parasitemia with Malaria falciparum that borders on severe malaria. Fortunately, he was treated effectively with atovaquone/proguanil and had a favorable outcome. The Center for Disease Control acknowledges that malaria is present in Jamaica, but only recommends mosquito avoidance without prophylaxis. This case emphasizes the need to consider malaria in differential diagnosis in Jamaica as well as in any returning travelers with fever because of broad global travel.

UI MeSH Term Description Entries
D007563 Jamaica An island in the Greater Antilles in the West Indies. Its capital is Kingston. It was discovered in 1494 by Columbus and was a Spanish colony 1509-1655 until captured by the English. Its flourishing slave trade was abolished in the 19th century. It was a British colony 1655-1958 and a territory of the West Indies Federation 1958-62. It achieved full independence in 1962. The name is from the Arawak Xaymaca, rich in springs or land of springs. (From Webster's New Geographical Dictionary, 1988, p564 & Room, Brewer's Dictionary of Names, 1992, p267)
D008297 Male Males
D008889 Military Personnel Persons including soldiers involved with the armed forces. Air Force Personnel,Armed Forces Personnel,Army Personnel,Coast Guard,Marines,Navy Personnel,Sailors,Soldiers,Submariners,Military,Force Personnel, Air,Personnel, Air Force,Personnel, Armed Forces,Personnel, Army,Personnel, Military,Personnel, Navy,Sailor,Soldier,Submariner
D009326 Naval Medicine The practice of medicine concerned with conditions affecting the health of individuals associated with the marine environment. Nautical Medicine,Medicine, Nautical,Medicine, Naval
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D014195 Travel MOVEMENT across different GEOGRAPHIC LOCATIONS. Land Travel,Sea Travel,Land Travels,Sea Travels,Travel, Land,Travel, Sea,Travels,Travels, Land,Travels, Sea
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.
D016778 Malaria, Falciparum Malaria caused by PLASMODIUM FALCIPARUM. This is the severest form of malaria and is associated with the highest levels of parasites in the blood. This disease is characterized by irregularly recurring febrile paroxysms that in extreme cases occur with acute cerebral, renal, or gastrointestinal manifestations. Plasmodium falciparum Malaria,Malaria, Plasmodium falciparum

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