To the Editor.— In 1971, only 57 of the 3,047 cases of malaria reported in the United States were acquired within the country. Nine of these 57 cases of malaria were acquired through blood transfusion; 46 were needle induced in narcotic addicts who shared syringes; and one was classified as "cryptic."1 The 57th case occurred in a third-year medical student (case 2) who accidentally pricked himself with a needle contaminated by blood from a Vietnam returnee with fatal Plasmodium falciparum malaria (case 2). Report of Cases.—Case 1.— A 21-year-old soldier, previously stationed in South Vietnam, had experienced intermittent chills, fever, nausea, and vomiting since Oct 4, 1971. The patient returned to the United States Oct 12, and was admitted to the Birmingham Veterans Administration Hospital, Oct 14. He reportedly took chloroquine and primaquine regularly for 11 months while in Vietnam; however, diphenyldiaminosulfone was only irregularly taken. Results