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Molecular Characterization of a Cluster of Imported Malaria Cases in Puerto Rico

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  • 1 Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia;
  • | 2 Atlanta Research and Education Foundation, Decatur, Georgia;
  • | 3 Office of Epidemiology and Research, Puerto Rico Department of Health, San Juan, Puerto Rico;
  • | 4 Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, Georgia
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The Caribbean island of Hispaniola is targeted for malaria elimination. Currently, this is the only island with ongoing transmission of malaria in the Caribbean. In 2015, six patients from Puerto Rico and one from Massachusetts, who traveled to Punta Cana, Dominican Republic, were confirmed to be infected with Plasmodium falciparum. Additional molecular analysis was performed at the Centers for Disease Control and Prevention to characterize the drug-resistant alleles and Plasmodium population genetic markers. All specimens carried wildtype genotypes for chloroquine, sulfadoxine-pyrimethamine, and artemisinin resistance genetic markers. A mutation in codon 184 (Y/F) of Pfmdr-1 gene was observed in all samples and they shared an identical genetic lineage as determined by microsatellite analysis. This genetic profile was similar to one previously reported from Hispaniola suggesting that a clonal P. falciparum residual parasite population present in Punta Cana is the source population for these imported malaria cases.

Author Notes

Address correspondence to Venkatachalam Udhayakumar, Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, MS D-67, Atlanta, GA 30333. E-mail: vxu0@cdc.gov

Financial support: This work was supported by the Centers for Disease Control and Prevention and by the Antimicrobial Resistance Working Group. Stella M. Chenet was supported by the American Society of Microbiology/CDC Postdoctoral Research Fellowship.

Authors’ addresses: Stella M. Chenet, Naomi W. Lucchi, Kimberly Mace, Paul M. Arguin, and Venkatachalam Udhayakumar, Center for Global Health/Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: schenet@asu.edu, frd9@cdc.gov, igd3@cdc.gov, pma0@cdc.gov, and vxu0@cdc.gov. Luciana Silva-Flannery and Dragan Ljolje, Atlanta Research and Education Foundation, Decatur, GA, E-mails: vva3@cdc.gov and wou3@cdc.gov. Emilio Dirlikov, Puerto Rico Department of Health, San Juan, Puerto Rico, Office of Epidemiology and Research, San Jose, Pueto Rico, and Division of Scientific Education and Professional Development, Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: klt9@cdc.gov. Brenda Rivera-García, Puerto Rico Department of Health, Epidemiology and Research Office, San Juan, Puerto Rico, E-mail: brendarivera@salud.pr.gov.

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