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Malaria: A Devastating Public Heath Concern

Malaria: Actors in the War

US pre-eradication
before 1951
US post-eradication
1951 to 2000
CDC today
Gates Foundation
Global Fund
US government

"Of the ten species of Anopheles mosquitoes found in the United States, the two species that were responsible for malaria transmission prior to eradication (Anopheles quadrimaculatus in the east and An. freeborni in the west) are still widely prevalent; thus there is a constant risk that malaria could be reintroduced in the United States." [3]

US organizations have been receiving money to control malaria since 1914, when control activities were necessary to allow soldiers to train year round in states endemic with malaria.  Malaria control was even pivotal in the construction of the Panama Canal.  In 1906 the disease afflicted over 80 percent of the employees working on the Canal.  In 1933 malaria still affected 30 percent of the population in the Tennessee River valley.  In conjunction with later organization and efforts the Tennessee Valley Authority eliminated malaria by reducing mosquito breeding grounds, among other things.  In 1942 the Office of Malaria Control in War Areas (MCWA) was established to combat malaria and other vector borne diseases around military training bases in the southern United States during World War II.  The goal was to prevent the reintroduction of malaria into civilian populations.  Soldiers were either stationed in areas of the United States that had large mosquito populations, or they had contracted the disease in other countries endemic with malaria.  MCWA was also responsible for training state and local health department officials in effective strategies to control malarial outbreaks.  MCWA was the leader in fighting malaria until 1946 when it was transformed into the Communicable Disease Center (CDC) of the U.S. Public Health Service, what we now know as the Center for Disease Control and Prevention (CDC).

affected countries in 1946 affected countries in 1994
 "Geographical distribution of malaria before 1946"           "Epidemiological status of malaria, 1994"
source: accessed on 4/25/06

During the first years after inception, the CDC worked in conjunction with the State and local health agencies of the 13 states where malaria was still endemic, as part of the National Malaria Eradication Program.  The CDC, located in Atlanta, Georgia, was founded in an area highly affected by malaria, the southeastern United States, where malaria was endemic at the time.  When the CDC began measures to eradicate malaria, the program consisted primarily of DDT application to the interior of dwellings and in some cases to entire regions where malaria had been reported in recent years.  Other measures included drainage, removal of mosquito breeding sites, and occasional insecticide spraying from aircrafts.  Controlling water levels and insecticide applications effectively reduced the number of mosquito breeding grounds, thus battling the problem at its source, killing the vector that transmits the disease from sick to healthy individuals.  These efforts had impressive results.  In 1949 over 4,650,00 homes had been treated with pesticides and the United States was declared free of malaria as a major public health concern.[1]  Malaria was eradicated in the United States in 1951, as outlined by the National Malaria Society criteria for eradication: "Malaria may be assumed to be no longer endemic in any given area when no primary indigenous case has occurred there for three years".[2]

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