Two residents of Lake Worth, Florida in the US, contracted malaria in July 2003. As neither of them had been out of the country, doctors concluded they caught the disease from mosquitoes that bit them in Florida, that in fact the malaria had been "locally transmitted."

The local media had a field day with this news, but at one time these cases wouldn't have been noted.

"It's probably the worst night of my life. I mean just cold sweats. I mean you don't eat, you just, you know vomit. You just, headaches like you wouldn't believe … I hope nobody else gets it. It's horrendous."
Jeff Smith, Lake Worth, Florida - malaria victim.

For three centuries, malaria plagued the United States, from the Deep South up to Michigan. When falciparum malaria entered the colony of South Carolina in the 1680's the area developed a widespread grim international reputation for unwholesomeness.

"Those who want to die quickly, go to Carolina," advised the English. "Carolina in the spring is a paradise, in the summer a hell, and in the autumn a hospital," commented a German traveller. As late as 1914, as many as 600 000 people in the United States suffered from locally transmitted malaria.

Mosquito abatement measures, such as draining wetlands, using pesticides, effective drugs, and lifestyle changes ended malaria's grip on the US. These days cases like those in Lake Worth are a reminder of how lucky we are. They also serve as a timely reminder of how unfortunate are those who still live in malarial areas.

In the US, we may be essentially malaria-free, but the rest of the world is not. Every year 1 to 2 million people continue to die from malaria. Of these, 90% are pregnant women, and children under the age of five.

But an incredible 300 to 500 million people become ill from malaria each year and suffer its terrible path to only partial recovery, because it is well known that malaria can recur easily, so initial sufferers tend to suffer more than once. They suffer from the vomiting and the fevers, and the cold sweats, and the punishing headaches. Many suffer because the developed world won't help them use all measures possible, including the use of pesticides in indoor residual spraying, to stop the spread of the disease.

Mr Smith puts it well. It's horrendous.