Published Date: 2012-07-17 18:05:26
Subject: PRO> Malaria, P. vivax - Greece: autochthonous (AT)
Archive Number: 20120717.1205005
MALARIA, P. VIVAX - GREECE: AUTOCHTHONOUS (ATTICA)
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Tue 17 Jul 2012
Source: ECDC [edited]
Epidemiological update: Local case of malaria in Greece
The Greek Centre for Disease Control and Prevention (KEELPNO) has informed about a recent case of autochthonous _Plasmodium vivax_ malaria.
On 22 Jun 2012, a case of locally acquired malaria infection was reported in Greece. The case is a 78-year-old Greek citizen who presumably acquired the infection close to Marathon, Attica region; onset of symptoms was around 7 Jun 2012.
Laboratory investigation revealed _Plasmodium vivax_, confirmed by molecular biology (PCR). The case reported no travel to an endemic country in the past 5 years.
The Marathon area is a historical place of malaria transmission, combining humid zones and intensive agricultural activities. Climatic conditions are now considered favourable for local vector development. In 2011, an autochthonous case occurred in a nearby location.
According to Greek authorities, active screenings of neighbours and seasonal immigrants is carried out to detect malarial infection, and vector control measures are being implemented.
ECDC is currently reviewing the epidemiological and background information of this case in order to assess the level of risk for travellers. ECDC is consulting relevant international partners, in particular the Greek Health Authorities, WHO-EURO IHR team and US CDC, for a coordinated assessment.
[Last year (2011) Greece reported an outbreak with 20 autochthonous and 16 imported cases of _P. vivax_ (Eurosurveillance edition 2011; 16(42)
2 forms of _P. vivax_ exist, temperate zone _P. vivax_ which may have an incubation period of 9 months or longer and tropical zone P. vivax with a short incubation period (reviewed by White NJ. Malaria J 2011;10:297). The 2 types can also be distinguished by genetic markers (Miao M et al. BMC Evol Biol. 2012;12:22).
If the _P. vivax_ seen in Greece in 2011 behaves as the temperate zone _P. vivax_ with a long incubation period, there should be _P. vivax_ cases that appear this autumn which were infected in the 2011 transmission season.
Public health measures for malaria control in Greece can be found here: http://www.keelpno.gr/Portals/0/Files/English%20files/Malaria%20report%2029-6-2012.pdf. The measures include screening of immigrants from endemic areas and a few cases have been found.
The public health surveillance with active case detection in the areas reporting P. vivax in 2011 therefore is needed and cases infected in 2011 will be expected.
HealthMap/ProMED location: http://healthmap.org/r/2L1i. - Mod.EP]