Outbreak of Locally Acquired Mosquito-Transmitted (Autochthonous) Malaria - Florida and Texas, May-July 2023.

Eight cases of locally acquired, mosquito-transmitted (i.e., autochthonous) Plasmodium vivax malaria, which has not been reported in the United States since 2003, were reported to CDC from state health departments in Florida and Texas during May 18-July 17, 2023. As of August 4, 2023, case surveillance, mosquito surveillance and control activities, and public outreach and education activities continue in both states. U.S. clinicians need to consider a malaria diagnosis in patients with unexplained fever, especially in areas where autochthonous malaria has been recently reported, although the risk for autochthonous malaria in the United States remains very low. Prompt diagnosis and treatment of malaria can prevent severe disease or death and limit ongoing transmission to local Anopheles mosquitoes and other persons. Preventing mosquito bites and controlling mosquitoes at home can prevent mosquitoborne diseases, including malaria. Before traveling internationally to areas with endemic malaria, travelers should consult with a health care provider regarding recommended malaria prevention measures, including potentially taking malaria prophylaxis. Malaria is a nationally notifiable disease; continued reporting of malaria cases to jurisdictional health departments and CDC will also help ensure robust surveillance to detect and prevent autochthonous malaria in the United States.

Notes from the Field: Pediatric Death from Meningococcal Disease in a Family of Romani Travelers - Sarasota, Florida, 2015.

On January 31, 2015, the Sarasota County Office of the Medical Examiner notified the on-call epidemiologist at the Florida Department of Health, Bureau of Epidemiology of a possible death from meningococcal disease in a male child aged 17 months. The child was part of a large non-English-speaking Romani family (whose members self-identified as Gypsies), who arrived in Florida after traveling in Texas and Europe during the previous 2 months. The child had no history of prior meningococcal immunization. The family reported that the child had been sick for at least 7 days with an ear infection; however, this diagnosis was not confirmed by a physician. Because of increasing fever and onset of vomiting, emergency medical service (EMS) staff members were contacted and the child was transported to a local emergency department on January 29, 2015. Although he was reportedly interactive and alert during registration, he developed a rash while in the emergency department, his condition rapidly deteriorated, and he died within four hours. An autopsy was performed on January 30, and on January 31, the medical examiner reported Gram-negative diplococci in the cerebrospinal fluid (CSF). The on-call epidemiologist notified the Sarasota County epidemiologist to initiate investigation of the case and identify contacts at risk and needing chemoprophylaxis.

A 6-Week Worksite Positivity Program Leads to Greater Life Satisfaction, Decreased Inflammation, and a Greater Number of Employees With A1C Levels in Range.

OBJECTIVE: To determine whether a 6-week Positivity Program could impact employee cardiovascular inflammation, blood sugars, cortisol, dehydroepiandrosterone (DHEA), and/or life satisfaction. METHODS: Pre- and post-study blood draw and life satisfaction questionnaire tracked changes in 10 cardiovascular and inflammatory biomarkers for 63 employees who participated in a 6-week Positivity Program comprised of three interventions: gratitude, HeartMath's Heart Lock-In, and yoga stretches with guided imagery. RESULTS: Improvements were recorded in life satisfaction as well as in seven of 10 cardiovascular and inflammatory biomarkers, including high sensitivity C-reactive protein (HsCRP) (-27%), hemoglobin A1c (HbA1c) (-1%), glucose (-2%), myeloperoxidase (MPO) (-5%), lipoprotein-associated phospholipase-A2 (Lp-PLA2) (-9%), apolipoprotein B (ApoB) (-6%), and DHEA (1%). No improvements were recorded in cortisol (11%), small-dense LDL (sdLDL) (0%), or oxidized LDL (OxLDL) (7%). CONCLUSIONS: Data suggest that engaging in 6 weeks of a workplace Positivity Program may improve employee life satisfaction, blood sugar levels, and some markers of cardiovascular inflammation.