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INTRODUCED PLASMODIUM VIVAX MALARIA IN A BOLIVIAN COMMUNITY AT AN ELEVATION OF 2,300 METERS

Tuntunani, Bolivia, a community of 199 persons situated at an elevation of 2,300 meters, experienced its first malaria outbreak in 1998. Blood smears from 63 of 183 symptomatic residents were examined, and 52 showed Plasmodium vivax. An investigation two years later indicated that the epidemic resulted from introduced transmission, since persons of all ages and both sexes were infected, and there had been no travel to low-lying endemic areas in the five months preceding the epidemic. Treatment became available only two months into the epidemic, at which time 58% of the people had been ill for three weeks or longer. This outbreak demonstrates the vulnerability of highland populations with poor access to health care to introduced malaria.

Received September 7, 2002. Accepted for publication July 7, 2003.

Acknowledgments: We thank Waldo Illanes (Division of Vector-Borne Illnesses, Bolivian Ministry of Health) for providing health records. We also thank the staff of the Consejo de Salud Rural Andino and the Muncipality of Carabuco for their excellent logistical support.

Financial support: This work was supported by the Benjamin Kean Fellowship of the American Society for Tropical Medicine and Hygiene and a Paul Dudley White fellowship through the Office of Educational Enrichment at Harvard Medical School.

Authors’ addresses: Tina Rutar, 5 Stratford Place, Flemington, NJ 08822, Telephone: 617-216-4793, E-mail: tina.rutar.98{at}alum.dartmouth.org. Eduardo J. Baldomar Salgueiro, Consejo de Salud Rural Andino, Casilla 13387, La Paz, Bolivia, Telephone: 591-2-412-495, E-mails: csra{at}caoba.entelnet.bo and ebaldoma2{at}hotmail.com. James H. Maguire, Division of Parasitic Diseases, Centers for Disease Control and Prevention, Mailstop F-22, 4770 Buford Highway NE, Atlanta, GA 30341-3724, Telephone: 770-488-7766; Fax: 770-488-7761, E-mail: jmaguire{at}cdc.gov.