Published Date: 2008-01-24 12:00:13
Subject: PRO/EDR> Malaria, falciparum - EU ex India (Goa): Sweden
Archive Number: 20080124.0294
MALARIA, FALCIPARUM - EUROPEAN UNION ex INDIA (GOA): SWEDEN
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Date: Thu 24 Jan 2008
From: Urban Hellgren <urban.hellgren@karolinska.se>, Malin Ackerfors
<malin.ackerfors@karolinska.se>
A new case of _Plasmodium falciparum_ malaria imported from Goa to Europe
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A 55-year-old Swedish woman visited Goa (Candolim beach) and Kerala
in India for 2 weeks. She travelled back to Sweden on 5 Dec 2007. No
malaria chemoprophylaxis. Approximately 2 weeks after return, on 18
Dec 2007, she fell ill with fever and a mild cough. Finally, on 28
Dec 2007, thick and thin films were done and _P. falciparum_ with a
parasitaemia of 1.8 percent was diagnosed. _P. falciparum_
gametocytes were also found. The patient was uneventfully treated
with a standard dose of mefloquine and discharged 4 days later.
This case illustrates the risk of missed malaria diagnosis if the
symptoms are somewhat atypical and the patient has visited areas were
malaria endemicity is less recognized. Kerala is considered more or
less free of malaria and Goa has been classified as an area with very
low transmission, where short-term standard tourists usually do not
need any prophylaxis. However, during the 2006-2007 winter season in
Goa, an increased number of _P. falciparum_ cases among tourists were
reported. Later, an increased incidence also among the indigenous
population was confirmed by local authorities.
The patient probably contracted falciparum malaria during her stay at
Candolim beach. This indicates that the there might be an increased
risk for malaria transmission in Goa also during the present tourist season.
--
Dr Urban Hellgren
<urban.hellgren@karolinska.se>
Dr Malin Ackefors
<malin.ackerfors@karolinska.se>
Department of Infectious Diseases
Karolinska University Hospital Huddinge
S-14652 Stockholm
Sweden
and
Tomas Jelinek
TroMedEurop
<jelinek@bctropen.de>
[The case shows that there still is a risk of malaria in Goa. The
data released by the Indian authorities showed that malaria cases in
Goa more than tripled during the 1st half of 2007 compared to the
same period 2006 (see ProMED-mail 20070716). We are looking forward
to the figures for the 2nd half of 2007, and for the time being it
looks like tourists to Goa should still be recommended malaria
chemoprophylaxis. - Mod.EP]
Goa on the west coast and Kerala in southwestern India, can be
located on the HealthMap/ProMED-mail interactive map at
<http://healthmap.org/promed?v=22.9,79.6,5>. - CopyEd.MJ]
See Also
2007----
Malaria - India (Goa, Rajastan) 20070716.2287
Malaria - EU ex India (Goa) (02): UK 20070301.0728
Malaria - EU ex India (Goa) 20070112.0150
Malaria - Germany, Sweden ex India (Goa) 20070102.0014
Denmark ex India (Goa): RFI 20070101.0001
2006
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Malaria - India (West Bengal) 20060627.1783
Malaria - India (Assam) (03) 20060507.1318
2005
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Malaria, resistant - India 20050107.0047
2004
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Malaria - India (Mumbai) 20041002.2716
2003
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Malaria - India (Haryana) (02) 20031018.2620
Malaria - India (Kerala): request for information 20030605.1378
2002
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Malaria - India (Assam) 20020613.4483
2001
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Malaria - India (Assam) 20010604.1102
2000
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Malaria - India (Uttar Pradesh) 20001017.1777
1999
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Malaria, vivax, resistant - India (Mumbai) 19990316.0389
1996
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Malaria - India, 1995 (5) 19960405.0652
...................................ep/mj/mpp
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