The parasite that causes malaria is wiped out in the United States, but the disease can still cause problems. Doctors so rarely see patients who have it, that they do not always recognize malaria's symptoms.  The U.S. Centers for Disease Control and Prevention is now trying to educate American doctors and patients about the symptoms and treatment of malaria.  VOA's Carol Pearson has more.

Dr. Phyllis Kozarsky is a malaria specialist at Emory University in Atlanta, Georgia. "We see a case of malaria in our clinic probably about once a month now.  So it's becoming more frequent."

Malaria is transmitted in tropical and subtropical areas including sub-Saharan Africa, parts of Asia and parts of South America.

People get it when bitten by an infected mosquito.  When American travelers visit countries where the disease is prevalent, or when immigrants or visitors from these countries come to the U.S., they may bring the disease with them.

"We get a lot of requests for assistance with diagnoses and management of malaria," says Kozarsky.

Dr. Monica Parise and her colleagues at the U.S. Centers for Disease Control and Prevention created new guidelines for diagnosis and treatment, available on the Internet at the center's web site, The guildlines can also be found in the Journal of the American Medical Association. "We think we've come up with very comprehensive guidelines that can be useful to clinicians if they have patients who travel and come back with malaria."

Malaria can be hard to diagnose, because its main symptoms, fever and fatigue, are present in many illnesses.  The guidelines include lots of detailed medical information about blood tests for diagnosis, and different drugs for treatment.  But there are simpler guidelines as well. "Both doctors and patients can do a lot so malaria isn't missed.  When doctors are evaluating a patient who has a fever, they need to ask about a travel history to find out if somebody's gone to a malarious area."

And patients need to tell doctors about their travels.  Amy Wald did just that when she returned from a visit to Africa and felt feverish and exhausted. She called her regular doctor, but ended up seeing a specialist. "I wouldn't expect an American doctor to know what to do when a patient comes in with malaria."

Dr. James Maguire says that is a major problem. He specializes in parasitic diseases at the University of Maryland Medical School. "I think we have a problem in medical education in some, not all, medical schools where parisitology teaching has been de-emphasized, so many physicians haven't had much background information, and so oftentimes, they are taken by surprise and miss the diagnosis." 

The U.S. Centers for Disease Control and Prevention wants doctors and patients to know more about the dangers and treatment of malaria to keep this disease at bay in the U.S.

Some video courtesy of The Journal of The American Medical Association