TUESDAY, June 27, 2023 (HealthDay News) — Public health officials are warning doctors, especially those in southern states, to be on the lookout for local spread of malaria after five cases have been reported in the United States in the past two months.

This is the first time there has been local spread in this country since 2003. Four of the cases were found in Florida and the fifth was in Texas, the U.S. Centers for Disease Control and Prevention said in a health alert it issued Monday.

“Despite these cases, the risk of locally acquired malaria remains extremely low in the United States,” the agency added in its alert.

For most people, malaria symptoms begin 10 days to four weeks after infection, although a person may feel ill as early as seven days or as late as one year after infection, the CDC said. If not treated promptly, malaria may progress to a life-threatening stage, in which mental status changes, seizures, renal failure, acute respiratory distress syndrome, and coma may occur. Malaria infection during pregnancy is linked with high risks of both maternal and perinatal morbidity and mortality, the agency added.

The United States has had 11 malaria outbreaks since 1992, including one involving eight cases in Palm Beach County Florida in 2003, according to the CDC. While about 2,000 malaria cases are diagnosed each year, most are from travelers. Health officials should also think about how to access the first-line treatment for severe malaria, intravenous artesunate.

Those diagnosed in the U.S. “are improving” after receiving treatment, the CDC reported.

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