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Imported Malaria in Montagnard Refugees Settling in North Carolina: Implications for Prevention and Control
Lynn A. Paxton
Lynn A. Paxton
Division of Parasitic Diseases, National Center for Infectious Diseases, and Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control and Prevention, Division of Health Services, North Carolina Department of Environment, Health, and Natural Resources, Atlanta, Georgia
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Laurence Slutsker
Laurence Slutsker
Division of Parasitic Diseases, National Center for Infectious Diseases, and Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control and Prevention, Division of Health Services, North Carolina Department of Environment, Health, and Natural Resources, Atlanta, Georgia
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Linda J. Schultz
Linda J. Schultz
Division of Parasitic Diseases, National Center for Infectious Diseases, and Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control and Prevention, Division of Health Services, North Carolina Department of Environment, Health, and Natural Resources, Atlanta, Georgia
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Stephen P. Luby
Stephen P. Luby
Division of Parasitic Diseases, National Center for Infectious Diseases, and Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control and Prevention, Division of Health Services, North Carolina Department of Environment, Health, and Natural Resources, Atlanta, Georgia
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Rebecca Meriwether
Rebecca Meriwether
Division of Parasitic Diseases, National Center for Infectious Diseases, and Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control and Prevention, Division of Health Services, North Carolina Department of Environment, Health, and Natural Resources, Atlanta, Georgia
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Paul Matson
Paul Matson
Division of Parasitic Diseases, National Center for Infectious Diseases, and Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control and Prevention, Division of Health Services, North Carolina Department of Environment, Health, and Natural Resources, Atlanta, Georgia
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Alexander J. Sulzer
Alexander J. Sulzer
Division of Parasitic Diseases, National Center for Infectious Diseases, and Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control and Prevention, Division of Health Services, North Carolina Department of Environment, Health, and Natural Resources, Atlanta, Georgia
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In the winter of 1992, some 402 Southeast Asian refugees were resettled in North Carolina. They received very limited medical screening before immigration and many arrived in the United States with significant health problems, including several tropical infectious diseases. These refugees had lived for many years in remote areas along the Vietnam-Cambodia border, where there is intense transmission of malaria, including Plasmodium falciparum resistant to most antimalarial drugs available in the United States. Of 322 refugees screened after arrival in North Carolina, 187 (58%) were infected: 33% with P. falciparum, 23.5% with P. vivax, 23.5% with P. malariae, and 2.1% with P. ovale. Most infected persons were asymptomatic and infections with multiple species were common. Because of the documented high infection prevalence and the probable presence of many subpatent infections, all nonpregnant refugees were treated with halofantrine; those with P. vivax or P. ovale infections were given primaquine as well. This group accounted for the largest cluster of malaria cases reported in the United States in the last 50 years. Their rapid relocation, with minimal medical screening prior to arrival, resulted in a significant burden to the refugees and to the health-care system. Coordination between immigration agencies, the public health community, and medical workers in communities where the refugees are settled is critical for U.S.-based management of imported tropical diseases.
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| Past two years | Past Year | Past 30 Days | |
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| Abstract Views | 315 | 91 | 4 |
| Full Text Views | 20 | 1 | 0 |
| PDF Downloads | 23 | 2 | 0 |