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MALARIA - EUROPE, USA, ex GAMBIA
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A ProMED-mail post
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International Society for Infectious Diseases
<http://www.isid.org>
[1]
Date: Mon 1 Dec 2008
Source: GeoSentinel [edited]
<http://www.geosentinel.org>
GeoSentinel, the global surveillance program of the International
Society of Travel Medicine (ISTM) wishes to report additional
travel-related clusters and cases of _Plasmodium falciparum_ malaria
acquired in the Gambia
A total of 7 cases of _Plasmodium falciparum_ have presented to GeoSentinel:
- 4 cases at our Cambridge, UK (CBG) site located at Addenbrooke's
Hospital, University of Cambridge;
- 2 cases at our Oslo Norway Site (OSL) located at Ulleval Hospital; and
- 1 case at our Bronx, New York site (BXL) located at Bronx Lebanon Hospital.
Dates of presentation have been from 26 Sep to 14 Nov [2008],
suggesting increased transmission since early September [2008]. 4
cases have been in immigrants visiting friends and relatives (VFR
travelers), 2 in tourists, and 1 in a missionary volunteer.
All 7 have recovered. None had taken chemoprophylaxis. One patient
from the UK had been specifically advised against doing so by a trip
organizer, another took no prophylaxis despite a previous episode of
malaria in 2004 after a trip to Tanzania.
Several recent studies have reported on significant decreases in
malaria transmission in the Gambia to the end of 2007 as perhaps
associated with control efforts (Lancet of 1 Nov 2008; 372: 1545-54;
<http://www.malariajournal.com/content/7/1/235.
Indeed, prior to the current cases, the last previous cases of
malaria from the Gambia reported to GeoSentinel were in 2005 from our
Zurich site, though we had no reporting sites in the UK during 2005
and 2006.
These recent travel-related cases once again point to the benefit of
sentinel travelers in the rapid detection of changes in disease
transmission patterns and secondly to the need for chemoprophylaxis
in all travelers to West Africa.
--
Communicated by:
David O Freedman, MD (Birmingham, Alabama, USA)
Effrosyni Gkrania-Klotsas, MD (Cambridge, UK)
Mogens Jensenius, MD (Oslo, Norway)
Stefan Hagmann, MD (Bronx, New York, USA)
For GeoSentinel
<geosentinel@geosentinel.org>
******
[2]
Date: Mon 1 Dec 2008
Source: European Network on Imported Infectious Disease Surveillance
(TropNetEurop) [edited]
<http://www.tropnet.net>
Netherlands
-----------
Report from Dutch national infection surveillance meeting last
Thursday [27 Nov 2008].
In the Netherlands, 8 patients have been reported with _P.
falciparum_ malaria after returning from the Gambia (1st day of
illness between [21 Sep and 14 Nov 2008]. One patient had died, 5
travelers did not use chemoprophylaxis, one traveller was non
compliant, and 2 had used homeopathic medication.
[Leo Visser, Leiden, The Netherlands]
Norway
------
We have had 2 patients with _P. falciparum_ infection from the Gambia
in November [2008].
[Bjorn Myrvang, Oslo, Norway]
United Kingdom
--------------
We too have had this week a P falciparum malaria case in a patient
from the Gambia. No malaria prophylaxis!
[Matthias Schmid, Newcastle General Hospital, Newcastle upon Tyne,
United Kingdom]
Spain
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Two _P. falciparum_ patients from Barcelona. The patients where from
the Gambia but living in Spain and took no chemoprophylaxis.
[Joaquim Gascon, Barcelona, Spain]
Denmark
-------
The patient who died of suspected malaria in Denmark has now been
confirmed to have malaria at the autopsy, bringing the total number
of cases to 8.
[Carsten Schade Larsen & Eskild Petersen, Aarhus, Denmark]
--
Communicated by:
Tomas Jelinek
<jelinek@bctropen.de>
TropNetEurop coordinator
Berlin Center for Travel and Tropical Medicine
Jagerstr. 67-69, 10117 Berlin, Germany
<http://www.bctropen.de>
[The total number of cases reported is now 32 from TropNetEurop and 7
from the GeoSentinel network, with 2 fatalities and several patients
in intensive care and on ventilators. It is surprising that so many
travelers have been visiting a highly endemic area without
chemoprophylaxis, which indicates that pre-travel advice has been
insufficient. Some travelers had been advised to use chloroquine as a
single drug prophylaxis, which has been obsolete in the Gambia since
at least 15 years back.
ProMED-mail would be happy to post data on malaria in the indigenous
population in the Gambia if it is available. The surge in imported
cases shows that transmission must be very high in the Gambia and a
surge in malaria in children, pregnant women, and adults with little
clinical immunity would be expected for example seen by an increasing
number of admission at local hospitals.
Maps of the Gambia are available at
<http://www.lib.utexas.edu/maps/africa/gambia.gif>
and the HealthMap/ProMED-mail interactive map at
<http://healthmap.org/promed/en?v=13.5,-15.5,6>. - Mod.EP]
[see also:
Malaria, imported - Europe ex Gambia 20081128.3752
2005
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Malaria - UK ex Gambia 20051211.3567
2003
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Malaria - Liberia (USA military personnel) (05) 20031021.2642
2002
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Malaria, change of drug policy - Africa 20020509.4146
Malaria, malarone resistant - Africa 20020118.3300
2001
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Malaria, mefloquine resistant - Tanzania 20011213.3015
2000
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Malaria, imported - Europe ex Gambia, Senegal (03) 20001213.2177
1999
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Malaria, drug resistant - Africa: overview 19990320.0444
1997
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Development of antimalarial resistance (08) 19970226.0453]
...................................ep/mj/lm
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