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Published Date: 2012-09-20 18:17:38
Subject: PRO/EDR> Malaria, P. vivax - Greece (03)
Archive Number: 20120920.1302970

MALARIA, P. VIVAX - GREECE (03)
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[1]
Date: Mon 17 Sep 2012
Source: ProMED-mail HealthMaps [edited]
http://healthmap.org/ln.php?1295616&u3392

Malaria in Greece - Travelers' Health - CDC
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As of 5 Aug 2012, 8 cases of malaria have been reported from the Attica and Laconia regions of Greece. Cases have occurred in the cities of Marathon, Markopoulo, and Evrotas. No cases have been reported in Athens.

The Hellenic (Greek) CDC and the European CDC are improving surveillance for malaria cases. In affected areas, mosquito control has been intensified; healthcare providers have been educated, and the public has been informed.

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[2]
Date: Sat 15 Sep 2012
Source: ECDC [edited]
http://ecdc.europa.eu/en/publications/Publications/ECDC_CDTR_9.15.12.pdf

Since June 2012, 8 autochthonous cases of malaria caused by _Plasmodium vivax_ infection have been reported from Greece. Local control measures have been implemented in accordance with national guidelines.

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[3]
Date: Fri 7 Sep 2012
Source: ECDC [edited]
http://ecdc.europa.eu/en/press/news/Lists/News/ECDC_DispForm.aspx?List=32e43ee8%2De230%2D4424%2Da783%2D85742124029a&ID=721&RootFolder=%2Fen%2Fpress%2Fnews%2FLists%2FNews

On 22 Jun 2012, the Hellenic Centre for Disease Prevention and Control (KEELPNO) reported the 1st locally acquired case of _Plasmodium vivax_ (_P. vivax_) malaria, from the Marathon area in the Attica region, Greece.

As of 3 Sep 2012, KEELPNO has reported 50 cases of malaria since the beginning of 2012 in Greece. 42 of these concerned immigrants from malaria-endemic countries and were classified as imported cases, while 8 were classified as locally acquired. Of those 8 cases, 4 were reported from the municipality of Evrotas, Laconia and 4 from the department of East Attica in the Marathon area (2) and in Markopoulo (2). All samples were confirmed _P. vivax_ positive by the reference public health laboratory.

In 2011, 40 cases of _P. vivax_ infection were reported in Greece in patients without travel history to a malaria-endemic area from 5 different districts, namely Laconia (34), Attica (2), Evvoia (2), Viotia (1) and Larisa (1). A cluster involving 27 Greek resident cases and 7 immigrant cases from non-endemic countries was identified in the area of Evrotas, Laconia. In addition, 23 cases of _P. vivax_ in Lakonia were reported in migrant farm workers from malaria-endemic countries.

Malaria is an infectious disease caused by _Plasmodium_ parasites and transmitted by _Anopheles_ mosquitoes. The incubation period varies between 7 and 15 days, but long incubation periods of several months (and years) have been observed for _P. vivax_ malaria.

According to ECDC's risk assessment, the risk to travellers is considered to be low since both areas are agricultural rather than tourist areas. The risk for further extension of malaria transmission into Europe in relation to this event is considered low at present. Taking account of the present malaria situation in Greece, ECDC, the consulted experts from EuroTravNet, and WHO do not recommend chemoprophylaxis for travellers to the agricultural areas of the Laconia region. The use of standard mosquito biting prevention measures continues to be recommended.

The KEELPNO, in collaboration with the Ministry of Health and Social Solidarity and all stakeholders, developed and are implementing the strategic plan of action for malaria control in the country, which defines the control activities to be undertaken during the _Anopheles_ season (spring-autumn 2012) in Greece. The main goal is to avoid the reestablishment of the disease in the country through coordinated actions, which are implemented nationally and locally in a systematic manner.

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[_P. vivax_ is found in a temperate climate variant and a tropical climate variant. The temperate climate _P. vivax_ variant has an incubation period of 8-9 months. To understand the present situation in Greece, it is important to type the _P. vivax_ isolates to know whether they belong to the temperate variant (long incubation period type) or tropical _P. vivax_ variant (short incubation type) in order to know whether the patients were infected in 2011 or 2012. - Mod.EP

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1Gzi.]

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