Nosocomial Malaria and Saline Flush

An investigation of malaria in a US patient without recent travel established Plasmodium falciparum molecular genotype identity in 2 patients who shared a hospital room. P. falciparum can be transmitted in a hospital environment from patient to patient by blood inoculum if standard pre-cautions are breached. Almost all of the 1,400 cases of malaria reported eachyear in the United States are acquired by mosquito bite during travel in malaria-endemic areas (1). However, mosquito transmission in the United States accounts for a few cases each year (2). Nosocomial malaria represents person-to-person transmission of parasite-infected erythro-cytes through blood transfusion, needlestick injury, improper use of blood glucometers, multidose heparin vials, organ transplantation, contaminated catheters that deliver contrast medium, or rarely, open wounds (3–6)