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Malaria - Europe - 2017
Opening date: 11 September 2017 Latest update: 15 September 2017
Epidemiological summary
Greece
As of 17 August 2017, Greece reported five autochthonous cases of P. vivax malaria acquired via vector-borne transmission following a likely exposure in the regions of Dytiki Ellada in West Greece for four cases and Sterea Ellada in Central Greece for one case [6]. Greece reports that these cases resulted from a local transmission following recent introduction of P. vivax in the II. Detailed reports 4/15 European Centre for Disease Prevention and Control (ECDC) Postal address: ECDC 171 83 Stockholm, Sweden Visiting address: Tomtebodav?gen 11a, Solna, Sweden www.ecdc.europa.eu Epidemic Intelligence duty email: support@ecdc.europa.eu Link to ECDC CDTR web page ? including related PowerPoint? slides The CDTR may contain confidential or sensitive information (i.e. EWRS) and therefore, its distribution is restricted to authorized users only. COMMUNICABLE DISEASE THREATS REPORT Week 37, 10-16 September 2017 area (introduced cases).
The dates of onset of the cases range between 2 May and 22 July 2017. In addition, Greece reported one locally acquired case of P. falciparum in the region of Ipeiros, in north-west Greece, with date of onset of symptoms between 17 and 23 July 2017. The case, who has no travel history to a malaria-endemic area, was hospitalised for a non-infectious medical condition in a ward where another patient was treated for P. falciparum malaria. The most likely place of exposure for this particular case was a healthcare facility but it was not possible to determine the exact mode of transmission (mosquito vector or of iatrogenic origin). The investigation excluded transmission through blood transfusion, but instead suggested a nosocomial transmission, either mosquito-borne within the heathcare facility or of iatrogenic origin. No locally acquired malaria cases were reported in the area.
Italy
On 5 September, Italy reported a fatal case of malaria [33]. The case was a four-year-old girl with no travel history to a malariaendemic country. She was admitted on 13 August 2017 to a hospital in the Veneto region and diagnosed with diabetes mellitus. After returning from the Veneto region, she was admitted to a Trento hospital for her diabetes (16 to 21 August) and later consulted a pharyngitis on 31 August 2017. On 2 September, she was admitted to hospital again and diagnosed with P. falciparum malaria. She was subsequently transferred to the tropical diseases reference centre in Brescia where she died on 4 September. Epidemiological investigations showed that two patients infected with P. falciparum were hospitalised in the same ward during her stay in the Trento hospital. An investigation in the Trento hospital did not identify any breaches of medical procedures that could result in an iatrogenic transmission. Entomological investigations in the Trento area did not reveal the presence of Anopheles mosquitoes. Entomological surveys in Bibione, where the girl spent her holidays, were conducted. Molecular sequencing of the Plasmodium strain from the girl and from the two children hospitalised concomitantly is ongoing.
France
On 7 September, France reported two locally-acquired cases of malaria in the department of Allier in the Auvergne-Rh?ne-Alpes region of central France. Both cases attended a wedding that took place between 11 and 16 August 2017 in Moulins, Allier department, France. On 30 August 2017, the first case was diagnosed after admission to hospital in the southwest of France for fever, chills and sweats evolving since 26 August. The patient did not travel abroad and had no risk factors for induced malaria. The only recent trip was to Moulins and its surrounding for attending the wedding. On 1 September, a second case who attended the same wedding was diagnosed upon returning home. The case had onset of symptoms on 26 August 2017 and had neither exposure to induced malaria nor a recent travel history to a malaria-endemic area. The Regional Health Agency of Auvergne-Rh?ne-Alpes implemented active case finding in the neighbouring laboratories and hospitals. None of the wedding attendees reported a recent travel history to a malaria-endemic country or symptoms compatible with malaria. However, an imported case of P. falciparum malaria from Burkina Faso was identified to have stayed in Moulins and its surroundings for several days within the two weeks before the wedding. Entomological investigations conducted in the areas visited by the imported case and autochthonous cases did not find evidence of the presence Anopheles plumbeus, a potential competent vector of P. falciparum. The French National Reference Centre for Malaria is gathering samples for molecular typing to assess the link between the imported and the two autochthonous cases.
The United Kingdom ex. the northern part of Cyprus
On 8 September, the United Kingdom reported (through the Early Warning and Response System) three cases of P. vivax malaria in travellers returning from Esentepe, the northern part of Cyprus. Two of the cases were siblings aged twelve years that travelled independently from the third case. The three cases stayed in the northern part of Cyprus for two to three weeks in August and developed symptoms on 29 August. They were laboratory confirmed upon returning to the UK.
Opening date: 11 September 2017 Latest update: 15 September 2017
Epidemiological summary
Greece
As of 17 August 2017, Greece reported five autochthonous cases of P. vivax malaria acquired via vector-borne transmission following a likely exposure in the regions of Dytiki Ellada in West Greece for four cases and Sterea Ellada in Central Greece for one case [6]. Greece reports that these cases resulted from a local transmission following recent introduction of P. vivax in the II. Detailed reports 4/15 European Centre for Disease Prevention and Control (ECDC) Postal address: ECDC 171 83 Stockholm, Sweden Visiting address: Tomtebodav?gen 11a, Solna, Sweden www.ecdc.europa.eu Epidemic Intelligence duty email: support@ecdc.europa.eu Link to ECDC CDTR web page ? including related PowerPoint? slides The CDTR may contain confidential or sensitive information (i.e. EWRS) and therefore, its distribution is restricted to authorized users only. COMMUNICABLE DISEASE THREATS REPORT Week 37, 10-16 September 2017 area (introduced cases).
The dates of onset of the cases range between 2 May and 22 July 2017. In addition, Greece reported one locally acquired case of P. falciparum in the region of Ipeiros, in north-west Greece, with date of onset of symptoms between 17 and 23 July 2017. The case, who has no travel history to a malaria-endemic area, was hospitalised for a non-infectious medical condition in a ward where another patient was treated for P. falciparum malaria. The most likely place of exposure for this particular case was a healthcare facility but it was not possible to determine the exact mode of transmission (mosquito vector or of iatrogenic origin). The investigation excluded transmission through blood transfusion, but instead suggested a nosocomial transmission, either mosquito-borne within the heathcare facility or of iatrogenic origin. No locally acquired malaria cases were reported in the area.
Italy
On 5 September, Italy reported a fatal case of malaria [33]. The case was a four-year-old girl with no travel history to a malariaendemic country. She was admitted on 13 August 2017 to a hospital in the Veneto region and diagnosed with diabetes mellitus. After returning from the Veneto region, she was admitted to a Trento hospital for her diabetes (16 to 21 August) and later consulted a pharyngitis on 31 August 2017. On 2 September, she was admitted to hospital again and diagnosed with P. falciparum malaria. She was subsequently transferred to the tropical diseases reference centre in Brescia where she died on 4 September. Epidemiological investigations showed that two patients infected with P. falciparum were hospitalised in the same ward during her stay in the Trento hospital. An investigation in the Trento hospital did not identify any breaches of medical procedures that could result in an iatrogenic transmission. Entomological investigations in the Trento area did not reveal the presence of Anopheles mosquitoes. Entomological surveys in Bibione, where the girl spent her holidays, were conducted. Molecular sequencing of the Plasmodium strain from the girl and from the two children hospitalised concomitantly is ongoing.
France
On 7 September, France reported two locally-acquired cases of malaria in the department of Allier in the Auvergne-Rh?ne-Alpes region of central France. Both cases attended a wedding that took place between 11 and 16 August 2017 in Moulins, Allier department, France. On 30 August 2017, the first case was diagnosed after admission to hospital in the southwest of France for fever, chills and sweats evolving since 26 August. The patient did not travel abroad and had no risk factors for induced malaria. The only recent trip was to Moulins and its surrounding for attending the wedding. On 1 September, a second case who attended the same wedding was diagnosed upon returning home. The case had onset of symptoms on 26 August 2017 and had neither exposure to induced malaria nor a recent travel history to a malaria-endemic area. The Regional Health Agency of Auvergne-Rh?ne-Alpes implemented active case finding in the neighbouring laboratories and hospitals. None of the wedding attendees reported a recent travel history to a malaria-endemic country or symptoms compatible with malaria. However, an imported case of P. falciparum malaria from Burkina Faso was identified to have stayed in Moulins and its surroundings for several days within the two weeks before the wedding. Entomological investigations conducted in the areas visited by the imported case and autochthonous cases did not find evidence of the presence Anopheles plumbeus, a potential competent vector of P. falciparum. The French National Reference Centre for Malaria is gathering samples for molecular typing to assess the link between the imported and the two autochthonous cases.
The United Kingdom ex. the northern part of Cyprus
On 8 September, the United Kingdom reported (through the Early Warning and Response System) three cases of P. vivax malaria in travellers returning from Esentepe, the northern part of Cyprus. Two of the cases were siblings aged twelve years that travelled independently from the third case. The three cases stayed in the northern part of Cyprus for two to three weeks in August and developed symptoms on 29 August. They were laboratory confirmed upon returning to the UK.
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