Reporting & Investigation of Malaria

Table of Contents

A. Purpose of Surveillance and Reporting

  • To identify imported cases of malaria.
  • To ensure that cases are appropriately contained and treated to prevent the introduction of malarial parasites into American mosquito populations.
  • To identify cases acquired in the United States, if they occur, so appropriate active surveillance and mosquito control interventions can be implemented.
  • To provide travelers with appropriate preventive health information.

B. Laboratory and Healthcare Provider Reporting Requirements

Iowa Administrative Code 641-1.3(139) stipulates that the laboratory and the healthcare provider must report. The preferred method of reporting is by utilizing the Iowa Disease Surveillance System (IDSS).  However, if IDSS is not available, the reporting number for Iowa HHS Center for Acute Disease Epidemiology (CADE) is (800) 362-2736; fax number (515) 281-5698, mailing address:

Iowa HHS, CADE
Lucas State Office Building, 5th Floor
321 E. 12th Street
Des Moines, IA 50319-0075

Postage-paid disease reporting forms are available free of charge from the Iowa HHS clearinghouse.  Call (319) 398-5133.

Laboratory Testing Services Available 

The University of Iowa State Hygienic Laboratory (SHL) performs testing for malaria.  Healthcare providers may send thick and thin blood smears to SHL.  The CDC conducts testing for malaria by serologic tests only under special circumstances (e.g., serum of a blood donor suspected of being a source of transfusion-related malaria or serum for laboratories conducting malaria-related studies) or with prior approval. For approval of serologic testing and further information contact SHL parasitology at (319) 335-4500. The SHL website is: www.shl.uiowa.edu/

C. Local Public Health Agency Follow-up Responsibilities

Case Investigation

It is the LPHA responsibility to complete a Malaria case investigation by interviewing the case and others who may be able to provide pertinent information. Much of the information required can be obtained from the case’s healthcare provider or medical record.

  1. Use the following guidelines to assist in completing the form:
    • Record the demographic information, date of symptom onset, pregnancy status, healthcare provider information, and whether hospitalized (including location and associated dates).
    • Record laboratory results, particularly the species of malaria, and the laboratory that performed the testing.
    • Record information about whether and where the case has spent time out of the country in the past four years, including duration of stay and date returned.
    • Indicate whether the case took malaria prophylaxis and, if so, what kind.
    • Record whether the case has had a history of malaria within the past 12 months.
    • Record whether the case has had a blood transfusion within the past 12 months. Note: If the patient is a recent blood donor, this information should be provided to CADE as soon as possible so CDC and other appropriate agencies can be notified.
    • Be sure to record all clinical complications and whether the illness was fatal.
    • Indicate which therapy was given for this illness.
  2. There is a “notes” section in IDSS which can be used to document other relevant aspects of the investigation that are not captured elsewhere (e.g., other risk information such as recent history of injection drug use or perinatal transmission, history of malaria prior to the last 12 months, any medical care received abroad.)
  3. If several attempts have been made to obtain case information, but have been unsuccessful (e.g., the case or healthcare provider does not return calls or respond to a letter, or the case refuses to divulge information or is too ill to be interviewed), contact IDPH and enter as much information as has been gathered. If using IDSS, select the appropriate reason under the Event tab in the Event Exception field.
  4. After completing the investigation, enter into IDSS, or send FAX and attach lab report(s) and mail (in an envelope marked “confidential”) to IDPH, Center for Acute Disease Epidemiology.  The mailing address is:

Iowa Department of Public Health, CADE
Lucas State Office Building, 5th Floor
321 E. 12th Street
Des Moines, IA 50319-0075
FAX:  515-281-5698