In 2022, 1,999 confirmed malaria cases and 10 deaths were reported to the CDC National Malaria Surveillance System.
Key findings
- In 2022, of the 1,999 confirmed cases, 1,315 (65.8%) occurred among US civilians, 279 (14.0%) among non-US residents, 17 (<1.0%) among US military members, and 388 (19.4%) had an unknown residency status.
- P. falciparum species cause the most serious illness and death, and 1,376 cases (84.5%) with a species determination in 2022 were P. falciparum. The second and third most common species certainly were P. vivax(145 cases, 8.9%) and P. ovale(58 cases, 3.6%).
- Case classification
- Travel-related (imported): 1,870 (93.5%) cases
- From blood exposure (induced): 1 (<1.0%) case
- The source of malaria could not be determined after investigation (cryptic) for 3 (<1.0%) cases. For these isolated cases, all reported travel to an endemic country more than two years before disease onset or potentially had a diagnosis of babesiosis.
- Lost to follow-up: 125 (6.3%) cases whose classification could not be determined.
- Among 1,870 imported cases, the region of travel was reported for 1,843 cases (98.5%). Of these, Africa was the most common travel region, reported by 1,663 (90.2%), followed by Asia 79 (4.3%), Central America 53 (2.9%), South America 43 (2.3%), and less than 1% of cases reported travel in the Caribbean, Oceania and the Middle East. Among the 1,663 cases that reported travel in Africa, 1,088 (65.4%) traveled in West Africa.
- Ten people with malaria died in 2022, a death rate of 0.5%. In 2022, eight of the fatal cases were diagnosed withP. falciparumand two cases had an undetermined species. One person who was 10–20 years old died, one was 30–39 years old, three people were 50 to 59 years old, two were 60 to 64 years old, and three people who died were 65 years or older. All ten people who died in 2022 were men, and all ten had traveled in Africa. Two had traveled to visit friends and relatives, two had traveled as a missionary, one for tourism, and five had unknown reasons for travel. Eight of those killed were US civilians, one was a non-US resident, and one had an unknown residency status. None of the patients who died reported taking medication during the trip to prevent malaria.
- Thirteen jurisdictions were in the top quartile for having the most malaria cases (ranging from 61 to 238 cases).
Results
Number of malaria cases by demographics, area of acquisition, and primary reason for travel, by patient’s residency status — United States, 2022
| Demographic table, 2022 | |||||||||||||||||||
| US military | American civilian | Non-U.S | Not busy | Total | |||||||||||||||
| Demographics | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | ||||
| Total | 17 | 0.9 | — | 1315 | 65.8 | — | 279 | 14.0 | — | 388 | 19.4 | — | 1999 | 100 | — | ||||
| Male gender | 17 | 100 | — | 831 | 63.2 | 63.2 | 191 | 68.5 | — | 226 | 58.2 | 58.4 | 1265 | 63.3 | 63.3 | ||||
| Female gender | 0 | 0 | — | 483 | 36.7 | 36.8 | 88 | 31.5 | — | 161 | 41.5 | 41.6 | 732 | 36.6 | 36.7 | ||||
| Unknown | 0 | 0 | — | 1 | 0.1 | — | 0 | 0.0 | — | 1 | 0.3 | — | 2 | 0.1 | — | ||||
| Age under 18 years | 0 | 0 | — | 196 | 14.9 | 14.9 | 69 | 24.7 | — | 53 | 13.7 | — | 318 | 15.9 | 15.9 | ||||
| Age 18 – 64 years | 17 | 100 | — | 1005 | 76.4 | 76.5 | 198 | 71.0 | — | 300 | 77.3 | — | 1520 | 76.0 | 76.1 | ||||
| Age 65 years and older | 0 | 0 | — | 113 | 8.6 | 8.6 | 12 | 4.3 | — | 35 | 9.0 | — | 160 | 8.0 | 8.0 | ||||
| Age unknown | 0 | 0 | — | 1 | 0.1 | — | 0 | 0.0 | — | 0 | 0.0 | — | 1 | 0.1 | — | ||||
| Not Hispanic or Latino | 10 | 58.8 | 71.4 | 1119 | 85.1 | 98.1 | 187 | 67.0 | 76.6 | 309 | 79.6 | 95.7 | 1625 | 81.3 | 94.4 | ||||
| Hispanic or Latino | 4 | 23.5 | 28.6 | 22 | 1.7 | 1.9 | 57 | 20.4 | 23.4 | 14 | 3.6 | 4.3 | 97 | 4.9 | 5.6 | ||||
| Unknown | 3 | 17.6 | — | 174 | 13.2 | — | 35 | 12.5 | — | 65 | 16.8 | — | 277 | 13.9 | — | ||||
| Race Asian | 0 | 0.0 | 0.0 | 16 | 1.2 | 1.4 | 10 | 3.6 | 4.7 | 7 | 1.8 | 3.1 | 33 | 1.7 | 2.0 | ||||
| Race Black or African American | 6 | 35.3 | 54.5 | 955 | 72.6 | 82.0 | 130 | 46.6 | 61.3 | 172 | 44.3 | 77.1 | 1263 | 63.2 | 78.4 | ||||
| Race white | 4 | 23.5 | 36.4 | 126 | 9.6 | 10.8 | 26 | 9.3 | 12.3 | 22 | 5.7 | 9.9 | 178 | 8.9 | 11.1 | ||||
| Race Other | 1 | 5.9 | 9.1 | 67 | 5.1 | 5.8 | 46 | 16.5 | 21.7 | 22 | 5.7 | 9.9 | 136 | 6.8 | 8.4 | ||||
| Breed unknown | 6 | 35.3 | — | 151 | 11.5 | — | 67 | 24.0 | — | 165 | 42.5 | — | 389 | 19.5 | — | ||||
| Acquisition region3 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | ||||
| Total | 17 | 0.9 | — | 1262 | 67.5 | — | 275 | 14.7 | — | 316 | 16.9 | — | 1870 | 100 | — | ||||
| Africa | 10 | 58.8 | — | 1203 | 95.3 | 96.2 | 173 | 62.9 | 63.1 | 277 | 87.7 | 92.0 | 1663 | 88.9 | 90.2 | ||||
| Asia | 7 | 41.2 | — | 23 | 1.8 | 1.8 | 33 | 12.0 | 12.0 | 16 | 5.1 | 5.3 | 79 | 4.2 | 4.3 | ||||
| South America | 0 | 0.0 | — | 17 | 1.3 | 1.4 | 20 | 7.3 | 7.3 | 6 | 1.9 | 2.0 | 43 | 2.3 | 2.3 | ||||
| Central America / Caribbean | 0 | 0.0 | — | 5 | 0.4 | 0.4 | 47 | 17.1 | 17.2 | 2 | 0.6 | 0.7 | 54 | 2.9 | 2.9 | ||||
| Oceania | 0 | 0.0 | — | 3 | 0.2 | 0.2 | 0 | 0.0 | 0.0 | 0 | 0.0 | 0.0 | 3 | 0.2 | 0.2 | ||||
| Middle East | 0 | 0.0 | — | 0 | 0.0 | 0.0 | 1 | 0.4 | 0.4 | 0 | 0.0 | 0.0 | 1 | 0.1 | 0.1 | ||||
| Unknown | 0 | 0.0 | — | 11 | 0.9 | — | 1 | 0.4 | — | 15 | 4.7 | — | 27 | 1.4 | — | ||||
| Africa, the West | 4 | 23.5 | — | 812 | 64.3 | 64.9 | 87 | 31.6 | 31.8 | 185 | 58.5 | 61.5 | 1088 | 58.2 | 59.0 | ||||
| Primary reason for travel3 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | No. | (%)1 | (%)2 | ||||
| Total | 17 | 0.9 | — | 1262 | 67.5 | — | 275 | 14.7 | — | 316 | 16.9 | — | 1870 | 100 | — | ||||
| Visiting friends and family | 3 | 17.6 | 21.4 | 691 | 54.8 | 82.4 | 24 | 8.7 | 14.3 | 70 | 22.2 | 86.4 | 788 | 42.1 | 71.5 | ||||
| Tourist | 0 | 0.0 | 0.0 | 48 | 3.8 | 5.7 | 5 | 1.8 | 3.0 | 4 | 1.3 | 4.9 | 57 | 3.0 | 5.2 | ||||
| Missionary or dependent | 0 | 0.0 | 0.0 | 32 | 2.5 | 3.8 | 0 | 0.0 | 0.0 | 1 | 0.3 | 1.2 | 33 | 1.8 | 3.0 | ||||
| Business | 0 | 0.0 | 0.0 | 43 | 3.4 | 5.1 | 8 | 2.9 | 4.8 | 3 | 0.9 | 3.7 | 54 | 2.9 | 4.9 | ||||
| student or teacher | 0 | 0.0 | 0.0 | 10 | 0.8 | 1.2 | 12 | 4.4 | 7.1 | 2 | 0.6 | 2.5 | 24 | 1.3 | 2.2 | ||||
| Airline/ship crew | 0 | 0.0 | 0.0 | 5 | 0.4 | 0.6 | 0 | 0.0 | 0.0 | 0 | 0.0 | 0.0 | 5 | 0.3 | 0.5 | ||||
| Peace Corps | 0 | 0.0 | 0.0 | 0 | 0.0 | 0.0 | 0 | 0.0 | 0.0 | 0 | 0.0 | 0.0 | 0 | 0.0 | 0.0 | ||||
| Refugee or immigrant | 0 | 0.0 | 0.0 | 0 | 0.0 | 0.0 | 115 | 41.8 | 68.5 | 0 | 0.0 | 0.0 | 115 | 6.1 | 10.4 | ||||
| Military deployment | 11 | 64.7 | 78.6 | 0 | 0.0 | 0.0 | 1 | 0.4 | 0.6 | 0 | 0.0 | 0.0 | 12 | 0.6 | 1.1 | ||||
| Other | 0 | 0.0 | 0.0 | 10 | 0.8 | 1.2 | 3 | 1.1 | 1.8 | 1 | 0.3 | 1.2 | 14 | 0.7 | 1.3 | ||||
| Unknown | 3 | 17.6 | — | 423 | 33.5 | — | 107 | 38.9 | — | 235 | 74.4 | — | 768 | 41.1 | — | ||||
| 1 Percentage calculated among all subjects | |||||||||||||||||||
| 2 Percentage calculated among subjects with known responses | |||||||||||||||||||
| 3 Among imported cases | |||||||||||||||||||
In 2022, most people diagnosed with malaria in the United States were men, 18–64 years of age, non-Hispanic or Latino ethnicity, and Black/African American race. Case patients traveled predominantly in Africa. More than half of all patients traveled to or from West Africa. More than half of US civilians with malaria traveled to visit friends and family in 2021.
Supplementary data files
Tables of number of cases by species, country of acquisition and method of diagnostic confirmation (e.g. blood smear microscopy only or polymerase chain reaction confirmed [with or without blood smear microscopy]) is available for download in the year 2022.
