Anopheles Mosquito Distribution and Malaria Outbreak Risk Assessment in Georgia, USA (2001–2025): Implications for Surveillance and Preparedness

Competent malaria vector species in Georgia represents an emerging public health threat. Despite the successful elimination of endemic malaria transmission from the United States, the entomological conditions necessary for re-establishment of local transmission still persists across ecologically permissive regions of the south-eastern United States. However, no comprehensive, county-level assessment of Anopheles mosquito distribution and associated malaria outbreak risk has been conducted across the state. This study analyzed 2,716 Anopheles collection records, representing 11,265 individual specimens, from 24 years of surveillance data (2001–2025). Results classified Fulton County as a high risk hot spot and critical convergence zone for malaria outbreak with the most significantly highest risk score (25), Anopheles population density (2,561) and elevated MIR activity (> 4.1%). Glynn and Lowndes counties were designated as moderate risk (15 and 12 respectively), driven primarily by substantial Anopheles populations. Conversely, DeKalb County, despite exhibiting the highest individual infection rate (MIR: 6.67%), was classified low risk (Score: 10) due to lower Anopheles abundance. Our results underscore the need for improved mosquito surveillance in high-risk counties, to address the dual health threat of arboviral and potential human malaria outbreaks under current climate change scenarios in Georgia.