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See https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.40.11.1405 for a contemporaneous 1950 description of how autochthonous malaria was eliminated in the continental US. A key ingredient was development and implementation of a surveillance case definition, with case report forms forwarded to a central authority (at CDC) for review against the case definition. This allowed public health workers to ignore a very large fraction of the case reports, which had a low probability of actually being malaria, and to focus their efforts where there actually was continuing transmission.

Also, don't underplay the importance of increases in the prevalence of air conditioning and of effective screens in reducing the transmission of mosquito-borne illnesses. During my time in Florida public health (1990-2012) we saw a recurring pattern that transmission of such illnesses (Saint Louis Encephalitis, West Nile Virus, Zika, etc as well as malaria) happened among people who spent time in the evening sitting outside their modest homes to get cool, because of no or limited air conditioning. Sleeping outside because of lack of housing is also an obvious risk factor. So you need not just the right vector etc but also opportunities for people to be exposed to infected mosquitoes.

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Thank you. As a gardener it is also a timely reminder to check for standing water.

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Jul 5·edited Jul 5

Thank you for bringing climate disruption into a public health discussion, once again. I assume you didn’t want to fully address the perhaps tangential issue of insecticides, except to mention Silent Spring. As a local public health official in MA we do our best to address EEE through education and non-pesticide measures. The fallback position of the state’s public health response is aerial spraying. The chemicals used are less toxic than DDT, but their ecological impact is still a bit of an unknown, in my opinion.

Perhaps a more full discussion of the public health impact of pesticide and herbicide use would be useful at some point.

Thanks to you and your helpers for your good work!!

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An interesting read. I live in the Northeast and I noticed this year a flock of chimney sweeps zooming around this year and the mosquito population along with other insects seems to be minimal in our yard, which we do not treat with any chemicals. An interesting observation on my part, as unscientific as it is.

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Looks to me like you and the major media missed something really big, and a possible reason for these malaria cases. You are smart, so is this something you did not think of or is it something that cannot be discussed?

"However, Anopheles mosquito vectors, found throughout many regions of the country, are capable of transmitting malaria if they feed on a malaria-infected person." This quote is on this CDC webpage from June 26: https://emergency.cdc.gov/han/2023/han00494.asp

There are huge numbers of people coming over the border all the time now from Mexico - a nation that has some Malaria. These illegal and legal immigrants come from all over the world and they could have malaria. So an malaria infected immigrant gets bit in Texas or Florida by a mosquito, and then that same mosquito transmits the disease to an American who never left the country.

This shows that it's possible for a person to get malaria without ever traveling outside the U.S.

Any comments? Let's see.

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There is something else regarding mosquitoes and the diseases they spread which is not mentioned in this article. That's the existence of genetically engineered mosquitoes in the U.S.. Have they actually been effective in reducing disease in the U.S.? Some say yes, some say no. But it is a large scale experiment which could have a bad result, and cannot be easily reversed if it does go bad.

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Regarding Silent Spring, I'm curious how many know about the flaws with it? https://www.thenewatlantis.com/publications/the-truth-about-ddt-and-silent-spring

We should not accept living with malaria or other similar diseases again if we have the means of eradicating and limiting them, without significant unintended consequences.

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Apologies for off topic, but this is hot off the press from Oxford University, and great news for those interested in getting a Novavax booster this fall. Punchline: Single shot of Novavax (for 12-16 year olds who had Pfizer 8 weeks earlier) led to fewer breakthrough infections and 8 months of protection. Fingers crossed everyone is allowed access to the Novavax booster this fall. Link here:

https://www.ox.ac.uk/news/2023-07-06-novavax-covid-19-vaccine-second-dose-generates-high-immune-response-young-people

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founding

Where in Florida were the 4 cases? Curious because I live in Orlando, FL

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5 cases. that's not many. Could quickly escalate to a major disaster. But I bet Bill Gates is on it with a new vaccine and save us, like he did from covid. Trust the science!

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