An Outbreak of Plasmodium falciparum Malaria in U.S. Marines Deployed to Liberia

Abstract

In 2003, 44 U.S. Marines were evacuated from Liberia with either confirmed or presumed Plasmodium falciparum malaria. An outbreak investigation showed that only 19 (45%) used insect repellent, 5 (12%) used permethrin treated clothing, and none used bed netting. Adherence with weekly mefloquine (MQ) was reported by 23 (55%). However, only 4 (10%) had serum MQ levels high enough to correlate with protection (> 794 ng/mL), and 9 (22%) had evidence of steady-state kinetics (MQ carboxy metabolite/MQ > 3.79). Tablets collected from Marines met USP identity and dissolution specifications for MQ. Testing failed to identify P. falciparum isolates with MQ resistance. This outbreak resulted from under use of personal protective measures and inadequate adherence with chemo-phrophylaxis. It is essential that all international travelers make malaria prevention measures a priority, especially when embarking to regions of the world with high transmission intensity such as west Africa.

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Document Details

Document Type
Technical Report
Publication Date
Jan 01, 2010
Accession Number
ADA526537

Entities

People

  • Alan J. Magill
  • Daniel Freilich
  • David L. Blazes
  • Michael D. Green
  • Philip E. Coyne
  • Ramzy G. Azar
  • Sybil A. Tasker
  • Timothy H. Burgess
  • Timothy J. Whitman
  • Wilbur K. Milhous

Organizations

  • Naval Medical Research Center

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Acute Respiratory Distress Syndrome
  • Africa
  • Diseases And Disorders
  • Health Services
  • Infectious Diseases
  • Insect Repellents
  • Kinetics
  • Malaria
  • Medical Personnel
  • Military Personnel
  • Pain
  • Parasitic Diseases
  • Preventive Medicine
  • Public Health
  • Steady State
  • Therapy
  • West Africa

Readers

  • Parasitology and Pharmacology of Malaria.
  • Systems Analysis and Design
  • Vector-Borne Disease and Entomology