The nation's 20-year streak of zero locally acquired malaria cases broke in 2023 after four states have reported infections, including the first-ever case in Arkansas.
So far this year, local health departments have reported one case in Texas, seven in Florida, one in Maryland and another in Arkansas.
The last time the U.S. reported local malaria cases was 2003, when eight infections were found in Palm Beach County, Fla.
The risk of locally acquired malaria remains extremely low, according to the CDC. Clinicians are recommended to "consider the diagnosis of malaria in any person with a fever of unknown origin, regardless of international travel history, particularly if they have been to the areas with recent locally acquired malaria."
Hospitals are also advised to stock malaria diagnostic tests, intravenous artesunate, artemether-lumefantrine and atovaquone-proguanil.