Five cases of malaria have been detected in the U.S. in the last two months. That marks the first time there’s been local spread in in 20 years. A health alert from the Centers for Disease Control and Prevention says four cases were detected in Florida and one in Texas. Infected people can suffer fever, chills and flu-like illness. They also can develop severe complications and die if they are not treated. Health officials are warning doctors — especially in southern states — to be aware of the possibility of infection and think about how to access the first-line treatment for severe malaria in the United States.