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March 23, 1990

Malaria: Triple Whammy for a Traveler

JAMA. 1990;263(12):1634-1635. doi:10.1001/jama.1990.03440120056030

To the Editor.—  Malaria remains a danger to nonimmune travelers in areas of the world where the disease is still endemic. Plasmodium vivax, Plasmodium falciparum, Plasmodium ovale, and Plasmodium malariae are the four species of malaria that infect humans. Travelers usually contract no more than one of these species, so it is certainly rare for a person to acquire three species within a 15-month period. We report one such case.

Report of a Case. —  A 39-year-old white man who worked for a state university in Florida became ill while visiting the Philippines in May 1987. The patient, who had a fever and chills for 7 to 10 days, continued weekly malaria prophylaxis of sulfadoxine/pyrimethamine and chloroquine, and his condition improved.He returned to the United States on June 24,1987, and discontinued prophylaxis within 2 to 3 weeks. When fever and chills returned on August 1, 1987, his blood