1. An outbreak of Plasmodium falciparum malaria in U.S. Marines deployed to Liberia.
- Author
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Whitman TJ, Coyne PE, Magill AJ, Blazes DL, Green MD, Milhous WK, Burgess TH, Freilich D, Tasker SA, Azar RG, Endy TP, Clagett CD, Deye GA, Shanks GD, and Martin GJ
- Subjects
- Adult, Animals, Antimalarials administration & dosage, Antimalarials pharmacology, Humans, Insect Repellents administration & dosage, Insect Repellents pharmacology, Liberia epidemiology, Male, Mefloquine administration & dosage, Mefloquine therapeutic use, Mosquito Control, Mosquito Nets, Patient Compliance, Protective Clothing, United States, Young Adult, Disease Outbreaks, Malaria, Falciparum epidemiology, Military Personnel, Plasmodium falciparum drug effects
- 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 chemophrophylaxis. 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..
- Published
- 2010
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