P-1769. Malaria on the Move: Rising cases in Brooklyn, New York

TL;DR

Malaria cases are rising in Brooklyn, especially among migrants, with P. falciparum and non-falciparum species showing distinct patterns based on travel history and symptoms.

Contribution

The study identifies a recent rise in malaria cases in Brooklyn and links non-falciparum malaria to migration through the Darién rainforest.

Findings

Malaria cases in the hospital increased significantly over the past 2 years, especially among migrants.

P. falciparum cases presented earlier after travel compared to non-falciparum cases.

Non-falciparum malaria was associated with migration through the Darién rainforest from Colombia to Panama.

Abstract

Malaria is an endemic disease in 85 countries, with 263 million cases reported worldwide in 2023. This represents a 4% increase from 2022. A similar trend was observed in our hospital with a significant increase in malaria cases presenting over the past 2 years, especially in migrants. This study aims to analyze this trend and describe patient and microbiologic characteristics.Rising trends in Malaria cases from 2017 to 2024Overall distribution of Plasmodium species

Rising trends in Malaria cases from 2017 to 2024

Overall distribution of Plasmodium species

We conducted a retrospective chart review of patients admitted with confirmed malaria between 2017 and 2024. Patients' travel history, country of origin, clinical course, microbiology results and treatment outcomes were recorded. Malaria diagnosis was confirmed using one or more of the following tests:Peripheral blood smearRapid antigen test ((BinaxNOW™ Malaria, Abbott, Chicago, IL)Plasmodium species polymerase chain reaction (PCR) test

Peripheral blood smear

Rapid antigen test ((BinaxNOW™ Malaria, Abbott, Chicago, IL)

Plasmodium species polymerase chain reaction (PCR) test

Seasonal presentation of Malaria cases
Comparison between Falciparum and Non-falciparum groups

Seasonal presentation of Malaria cases

Comparison between Falciparum and Non-falciparum groups

Total of 18 patients were included in the study. Figure 1 shows the number of cases admitted per year and trends between US travelers, visitors and migrants. This study also reviewed the overall prevalence of Plasmodium species (Figure 2) and its association with seasonal trends (Figure 3). Patients were categorized into two groups:

• Patients with Falciparum malaria

• Patients with non-falciparum malaria

Clinical characteristics between two groups have been summarized in Table A.

In the non-falciparum group, 6 patients had migrated through the Darién rainforest from Colombia to Panama. Initial parasitemia was higher in P. falciparum group compared to non-falciparum group. Most P. falciparum cases presented within 7 days of travel, while most non-falciparum cases presented between 7-14 days. Eight patients had severe malaria; 5 were infected with P. falciparum and 3 with P. vivax. They were treated with intravenous artesunate, followed by oral artemether/lumefantrine. All patients recovered uneventfully.

Malaria cases in USA have increased over last few years, especially among returning U.S travelers and migrants. P. falciparum is predominant in West and Central Africa, whereas P. vivax and P. ovale is endemic in South America. This rise may be attributable to migrants crossing the Darién rainforest between Colombia and Panama. A detailed travel history may help anticipate the Plasmodium species for timely diagnosis and prompt management.

All Authors: No reported disclosures

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