{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T19:06:32Z","timestamp":1780513592591,"version":"3.54.1"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"United States Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U01CK000633"],"award-info":[{"award-number":["U01CK000633"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Plasmodium vivax causes over 9 million malaria cases globally. While rare in the United States, New York City (NYC) reports the highest number of travel-associated cases. In 2023, cases peaked alongside the arrival of &amp;gt;265 000 migrants from malaria-endemic regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed P. vivax cases reported to the NYC Department of Health (2018\u20132024) and analyzed clinical data from patients admitted to NYC Health + Hospitals (H + H) over the same period. Cases were confirmed via blood smear, rapid diagnostic test, or polymerase chain reaction (PCR). Data on travel history, presentation, diagnostics, treatment, and outcomes were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In NYC, the number of P. vivax cases rose from 6 of 206 malaria cases (2.9%) in 2018 to a record 63 of 346 (18.2%) in 2023, with 43 of 250 (17.2%) in 2024. Of 41 H + H admissions, 40 (97.6%) were recent migrants, mainly from South America and Asia. Severe malaria occurred in 10 patients (24.4%), with 5 (12.2%) requiring intensive care. Rapid diagnostic tests were used in 38 cases (93%); PCR had a median 8-day turnaround. Primaquine was prescribed to 32 (78%) after G6PD testing. Relapses occurred in 7 patients (17%), mostly among those not receiving liver-stage therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The rise in P. vivax malaria in NYC parallels migration trends from endemic areas. Timely diagnosis and liver-stage therapy are critical to reducing morbidity and relapses. While nearly all cases were imported, delayed species confirmation or incomplete treatment risks potential local transmission, requiring heightened clinician awareness and public health vigilance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag293","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T11:41:47Z","timestamp":1778845307000},"source":"Crossref","is-referenced-by-count":0,"title":["An Increase in Imported\n                    <i>Plasmodium vivax<\/i>\n                    Malaria in New York City: Clinical and Demographic Trends Following Recent Migration"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9236-3439","authenticated-orcid":false,"given":"Cesar G","family":"Berto","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, University of Alabama at Birmingham , Birmingham, Alabama ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8585-7202","authenticated-orcid":false,"given":"Maria Alyssa","family":"Policarpio","sequence":"additional","affiliation":[{"name":"Department of Medicine, NewYork City Health + Hospitals\/Jacobi, Albert Einstein College of Medicine , Bronx, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coral","family":"Vargas-Pena","sequence":"additional","affiliation":[{"name":"Department of Medicine, NewYork City Health + Hospitals\/Jacobi, Albert Einstein College of Medicine , Bronx, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5199-0807","authenticated-orcid":false,"given":"Mike","family":"Antwi","sequence":"additional","affiliation":[{"name":"The Bureau of Communicable Disease, NewYork City Department of Health & Mental Hygiene , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Slavinski","sequence":"additional","affiliation":[{"name":"The Bureau of Communicable Disease, NewYork City Department of Health & Mental Hygiene , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2670-7167","authenticated-orcid":false,"given":"Asha","family":"Abdool","sequence":"additional","affiliation":[{"name":"The Bureau of Communicable Disease, NewYork City Department of Health & Mental Hygiene , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renee N","family":"King","sequence":"additional","affiliation":[{"name":"The Bureau of Communicable Disease, NewYork City Department of Health & Mental Hygiene , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7267-3596","authenticated-orcid":false,"given":"Tsoline","family":"Kojaoghlanian","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Maimonides Children's Hospital of Brooklyn , Brooklyn, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna P","family":"Daily","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Montefiore Medical Center\/Albert Einstein College of Medicine , Bronx, NewYork ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6445-3744","authenticated-orcid":false,"given":"Nishant","family":"Prasad","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, NewYork-Presbyterian Queens Hospital , Flushing, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0199-7012","authenticated-orcid":false,"given":"Maria R","family":"Velasquez","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, NewYork City Health + Hospitals\/Metropolitan , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4109-3464","authenticated-orcid":false,"given":"Alison D","family":"Ridpath","sequence":"additional","affiliation":[{"name":"Malaria Branch, Division of Parasitic Diseases and Malaria, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8512-1576","authenticated-orcid":false,"given":"Christina M","family":"Coyle","sequence":"additional","affiliation":[{"name":"Department of Medicine, NewYork City Health + Hospitals\/Jacobi, Albert Einstein College of Medicine , Bronx, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,16]]},"reference":[{"key":"2026060314074156100_ofag293-B1","first-page":"356","volume-title":"World malaria report 2023","author":"World Health Organization","year":"2023"},{"key":"2026060314074156100_ofag293-B2","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/S0140-6736(19)31096-7","article-title":"Mapping the global endemicity and clinical burden of Plasmodium vivax, 2000\u201317: a spatial and temporal modelling study","volume":"394","author":"Battle","year":"2019","journal-title":"Lancet"},{"key":"2026060314074156100_ofag293-B3","doi-asserted-by":"crossref","first-page":"79","DOI":"10.4269\/ajtmh.2007.77.79","article-title":"Vivax malaria: neglected and not benign","volume":"77","author":"Price","year":"2007","journal-title":"Am J Trop Med Hyg"},{"key":"2026060314074156100_ofag293-B4","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1128\/CMR.00074-12","article-title":"Evidence and implications of mortality associated with acute Plasmodium vivax malaria","volume":"26","author":"Baird","year":"2013","journal-title":"Clin Microbiol Rev"},{"key":"2026060314074156100_ofag293-B5","doi-asserted-by":"crossref","first-page":"15","DOI":"10.4269\/ajtmh.16-0141","article-title":"Global epidemiology of Plasmodium vivax","volume":"95","author":"Howes","year":"2016","journal-title":"Am J Trop Med Hyg"},{"key":"2026060314074156100_ofag293-B6","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.pt.2024.04.015","article-title":"The biology and pathogenesis of vivax malaria","volume":"40","author":"Anstey","year":"2024","journal-title":"Trends Parasitol"},{"key":"2026060314074156100_ofag293-B7","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1097\/QCO.0000000000000867","article-title":"Update on pathogenesis, management, and control of Plasmodium vivax","volume":"35","author":"Khan","year":"2022","journal-title":"Curr Opin Infect Dis"},{"key":"2026060314074156100_ofag293-B8","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1186\/1475-2875-13-481","article-title":"Severe vivax malaria: a systematic review and meta-analysis of clinical studies since 1900","volume":"13","author":"Rahimi","year":"2014","journal-title":"Malar J"},{"key":"2026060314074156100_ofag293-B9","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1038\/nm0111-48","article-title":"Defying malaria: fathoming severe Plasmodium vivax disease","volume":"17","author":"Bassat","year":"2011","journal-title":"Nat Med"},{"key":"2026060314074156100_ofag293-B10","doi-asserted-by":"crossref","first-page":"e67","DOI":"10.1093\/cid\/cis615","article-title":"Postmortem characterization of patients with clinical diagnosis of Plasmodium vivax malaria: to what extent does this parasite kill?","volume":"55","author":"Lacerda","year":"2012","journal-title":"Clin Infect Dis"},{"key":"2026060314074156100_ofag293-B11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.ss7108a1","article-title":"Malaria surveillance\u2014United States, 2018","volume":"71","author":"Mace","year":"2022","journal-title":"MMWR Surveill Summ"},{"key":"2026060314074156100_ofag293-B12","first-page":"e91971","article-title":"Imported malaria in New York: geographic patterns and implications for emergency physicians","volume":"17","author":"Webb","year":"2025","journal-title":"Cureus"},{"key":"2026060314074156100_ofag293-B13","volume-title":"Accounting for asylum seeker services: asylum seeker census","author":"Office of the New York City Comptroller","year":"2023"},{"key":"2026060314074156100_ofag293-B14","author":"Servicio Nacional de Migraci\u00f3n (Panam\u00e1)"},{"key":"2026060314074156100_ofag293-B15","volume-title":"Malaria: clinical features","author":"Centers for Disease Control and Prevention (US)","year":"2024"},{"key":"2026060314074156100_ofag293-B16","volume-title":"Malaria: diagnosis & treatment (United States): treatment (U.S.): guidelines for clinicians (part 1)","author":"Centers for Disease Control and Prevention (US)","year":"2009"},{"key":"2026060314074156100_ofag293-B17","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1093\/cid\/ciab610","article-title":"Relapse of Plasmodium vivax and Plasmodium ovale malaria with and without primaquine treatment in a nonendemic area","volume":"74","author":"W\u00e5ngdahl","year":"2022","journal-title":"Clin Infect Dis"},{"key":"2026060314074156100_ofag293-B18","volume-title":"Southwest land border encounters (by component)","author":"U.S. Customs and Border Protection (US)","year":"2024"},{"key":"2026060314074156100_ofag293-B19","doi-asserted-by":"crossref","first-page":"417","DOI":"10.15585\/mmwr.mm7318a2","article-title":"Notes from the field: increases in imported malaria cases\u2014three southern U.S. border jurisdictions, 2023","volume":"73","author":"Mitchell","year":"2024","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026060314074156100_ofag293-B20","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.3201\/eid3007.240177","article-title":"Plasmodium vivax infections among immigrants from China traveling to the United States","volume":"30","author":"Khamly","year":"2024","journal-title":"Emerg Infect Dis"},{"key":"2026060314074156100_ofag293-B21","doi-asserted-by":"crossref","first-page":"1800139","DOI":"10.2807\/1560-7917.ES.2019.24.5.1800139","article-title":"Malaria in Eritrean migrants newly arrived in seven European countries, 2011 to 2016","volume":"24","author":"Sond\u00e9n","year":"2019","journal-title":"Euro Surveill"},{"key":"2026060314074156100_ofag293-B22","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1186\/s12936-018-2586-9","article-title":"Area of exposure and treatment challenges of malaria in Eritrean migrants: a GeoSentinel analysis","volume":"17","author":"Schlagenhauf","year":"2018","journal-title":"Malar J"},{"key":"2026060314074156100_ofag293-B23","doi-asserted-by":"crossref","first-page":"133","DOI":"10.4269\/ajtmh.2006.75.133","article-title":"Imported non-Plasmodium falciparum malaria: a five-year prospective study in a European referral center","volume":"75","author":"Bottieau","year":"2006","journal-title":"Am J Trop Med Hyg"},{"key":"2026060314074156100_ofag293-B24","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1503\/cmaj.090171","article-title":"Delay in diagnosis: malaria in a returning traveller","volume":"180","author":"Boggild","year":"2009","journal-title":"CMAJ"},{"key":"2026060314074156100_ofag293-B25","doi-asserted-by":"crossref","first-page":"ofu034","DOI":"10.1093\/ofid\/ofu034","article-title":"Severe morbidity and mortality risk from malaria in the United States, 1985\u20132011","volume":"1","author":"Hwang","year":"2014","journal-title":"Open Forum Infect Dis"},{"key":"2026060314074156100_ofag293-B26","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1590\/0037-868212382013","article-title":"Plasmodium vivax malaria: related factors to severity in the State of Maranh\u00e3o, Brazil","volume":"46","author":"Raposo","year":"2013","journal-title":"Rev Soc Bras Med Trop"},{"key":"2026060314074156100_ofag293-B27","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s12936-021-04006-4","article-title":"Risk factors for the accuracy of the initial diagnosis of malaria cases in China: a decision-tree modelling approach","volume":"21","author":"Li","year":"2022","journal-title":"Malar J"},{"key":"2026060314074156100_ofag293-B28","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.tmaid.2017.12.002","article-title":"Time delays in the diagnosis and treatment of malaria in non-endemic countries: a systematic review","volume":"21","author":"Bastaki","year":"2018","journal-title":"Travel Med Infect Dis"},{"key":"2026060314074156100_ofag293-B29","doi-asserted-by":"crossref","first-page":"taab156","DOI":"10.1093\/jtm\/taab156","article-title":"Care-seeking delay of imported malaria to China: implications for improving post-travel healthcare for migrant workers","volume":"29","author":"Lu","year":"2022","journal-title":"J Travel Med"},{"key":"2026060314074156100_ofag293-B30","doi-asserted-by":"crossref","first-page":"2009","DOI":"10.1128\/JCM.02562-16","article-title":"Update on malaria diagnostics and test utilization","volume":"55","author":"Mathison","year":"2017","journal-title":"J Clin Microbiol"},{"key":"2026060314074156100_ofag293-B31","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1186\/1475-2875-12-113","article-title":"Misclassification of Plasmodium infections by conventional microscopy and the impact of remedial training on the proficiency of laboratory technicians in species identification","volume":"12","author":"Obare","year":"2013","journal-title":"Malar J"},{"key":"2026060314074156100_ofag293-B32","first-page":"CD011431","article-title":"Rapid diagnostic tests for diagnosing uncomplicated non-falciparum or Plasmodium vivax malaria in endemic countries","volume":"2015","author":"Abba","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"2026060314074156100_ofag293-B33","doi-asserted-by":"crossref","first-page":"e864","DOI":"10.1093\/cid\/ciac728","article-title":"Food and drug administration approval of artesunate for severe malaria: enough to achieve best practice?","volume":"76","author":"Thomas","year":"2023","journal-title":"Clin Infect Dis"},{"key":"2026060314074156100_ofag293-B34","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.4269\/ajtmh.19-0230","article-title":"Expanded availability of intravenous artesunate for the treatment of severe malaria in the United States","volume":"100","author":"Rosenthal","year":"2019","journal-title":"Am J Trop Med Hyg"},{"key":"2026060314074156100_ofag293-B35","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/S1473-3099(23)00430-9","article-title":"Effect of primaquine dose on the risk of recurrence in patients with uncomplicated Plasmodium vivax: a systematic review and individual patient data meta-analysis","volume":"24","author":"Commons","year":"2024","journal-title":"Lancet Infect Dis"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofag293\/68295679\/ofag293.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofag293\/68295679\/ofag293.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofag293\/68295679\/ofag293.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T18:07:51Z","timestamp":1780510071000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofag293\/8679197"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,16]]},"references-count":35,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofag293","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,6]]},"published":{"date-parts":[[2026,5,16]]},"article-number":"ofag293"}}