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About 10% of the 1500 cases of malaria reported in the U.S. each year are considered severe by WHO criteria, which include occurrence of renal failure, acute respiratory distress syndrome (ARDS), unrousable coma, or severe anemia. Most such cases are imported by individuals with recent travel to or residence in endemic areas and are caused by Plasmodium falciparum. Cerebral malaria has a mortality rate of 100% without treatment and 15% to 30% with conventional therapy.
Quinidine — a cardiac antiarrhythmic medication — is the only FDA-approved treatment for severe malaria in the U.S. This drug has considerable toxicity, however, and in many hospitals is no longer available. Between 2007 and 2010, 102 patients with severe malaria in the U.S. w…