First autochthonous malaria case due to Plasmodium vivax since eradication, Spain, October 2010

Peralta, Patricia; Vazquez-Torres, M C; Latorre-Fandos, E; Mairal-Claver, P; Cortina-Solano, P; Puy-Azón, A; Sancho, Begoña Adiego; Leitmeyer, Katrin; Lucientes-Curdi, J.; Sierra-Moros, María José

doi:10.2807/ese.15.41.19684-en

Cited by 69 publications

(43 citation statements)

References 74 publications

(4 reference statements)

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“…In our opinion, all the factors mentioned lead to think of a very low risk of re-emergence in Spain [1], limited only to small outbreaks of introduced malaria, of which one case has already been reported in Spain [6], as long as the socioeconomic and hygiene-health conditions of the country do not deteriorate. However, the history of the disease proofs the importance of maintaining vigilance [3,14] and increasing research, especially on marshland areas [48].…”

Section: Discussionmentioning

confidence: 99%

The Historical Distribution of Main Malaria Foci in Spain as Related to Water Bodies

Sousa

García-Barrón

Vetter

et al. 2014

IJERPH

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The possible connectivity between the spatial distribution of water bodies suitable for vectors of malaria and endemic malaria foci in Southern Europe is still not well known. Spain was one of the last countries in Western Europe to be declared free of malaria by the World Health Organization (WHO) in 1964. This study combines, by means of a spatial-temporal analysis, the historical data of patients and deceased with the distribution of water bodies where the disease-transmitting mosquitos proliferate. Therefore, data from historical archives with a Geographic Information System (GIS), using the Inverse Distance Weighted (IDW) interpolation method, was analyzed with the aim of identifying regional differences in the distribution of malaria in Spain. The reasons, why the risk of transmission is concentrated in specific regions, are related to worse socioeconomic conditions (Extremadura), the presence of another vector (Anopheles labranchiae) besides A. atroparvus (Levante) or large areas of water bodies in conditions to reproduce theses vectors (La Mancha and Western Andalusia). In the particular case of Western Andalusia, in 1913, the relatively high percentage of 4.73% of the surface, equal to 202362 ha, corresponds to wetlands and other unhealthy water bodies. These wetlands have been reduced as a result of desiccation policies and climate change such as the Little Ice Age and Global Climate Change. The comprehension of the main factors of these wetland changes in the past can help us interpret accurately the future risk of malaria re-emergence in temperate latitudes, since it reveals the crucial role of unhealthy water bodies on the distribution, endemicity and eradication of malaria in southern Europe.

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Section: Discussionmentioning

confidence: 99%

The Historical Distribution of Main Malaria Foci in Spain as Related to Water Bodies

Sousa

García-Barrón

Vetter

et al. 2014

IJERPH

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“…In Greece, in 2011, at least 33 autochthonous malaria cases due to P. vivax were recorded 63,64. In Spain another case of autochthonous P. vivax infection was detected 65. We must also consider global climate change, which could help spread malaria to northern latitudes 66.…”

Section: Migration and Risk Of Induced And Reintroduced Malariamentioning

confidence: 99%

Migration and Malaria in Europe

Monge‐Maíllo

López‐Vélez

2012

Mediterr J Hematol Infect Dis

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The proportion of imported malaria cases due to immigrants in Europe has increased during the lasts decades, with higher rates associated with settled immigrants who travel to visit friends and relatives (VFRs) in their country of origin. Cases are mainly due to P. falciparum and Sub-Saharan Africa is the most common origin. Clinically, malaria in immigrants is characterised by a mild clinical presentation including asymptomatic or delayed malaria cases and low parasitic levels. These characteristics may be explained by a semi-immunity acquired after long periods of time exposed to stable malaria transmission. Malaria cases among immigrants, even asymptomatic patients with sub-microscopic parasitemia, could increase the risk of transmission and cause the reintroduction of malaria in certain areas that have adequate vectors and climate conditions. Moreover, imported malaria cases in immigrants can also play an important role in the non-vector transmission out of endemic areas, through blood transfusions, organ transplantation or congenital transmission or occupational exposures. Consequently, outside of endemic areas, malaria screening should be carried out among recently arrived immigrants coming from malaria endemic countries. The aim of screening is to reduce the risk of clinical malaria in the individual as well as to prevent autochthonous transmission of malaria in areas where it has been eradicated.

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“…In countries free of malaria like Spain or Greece, recent autochthonous cases [13-15], suggest the possibility of a malaria re-emergence from undetected imported cases.…”

Section: Introductionmentioning

confidence: 99%

Imported submicroscopic malaria in Madrid

Ramírez‐Olivencia

Rubio

Rivas

et al. 2012

Malar J

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BackgroundSubmicroscopic malaria (SMM) can be defined as low-density infections of Plasmodium that are unlikely to be detected by conventional microscopy. Such submicroscopic infections only occasionally cause acute disease, but they are capable of infecting mosquitoes and contributing to transmission. This entity is frequent in endemic countries; however, little is known about imported SMM.The goals of this study were two-fold: a) to know the frequency of imported SMM, and b) to describe epidemiological, laboratorial and clinical features of imported SMM.MethodsA retrospective study based on review of medical records was performed. The study population consisted of patients older than 15 years attended at the Tropical Medicine Unit of Hospital Carlos III, between January 1, 2002 and December 31, 2007. Routinely detection techniques for Plasmodium included Field staining and microscopic examination through thick and thin blood smear. A semi-nested multiplex malaria PCR was used to diagnose or to confirm cases with low parasitaemia.ResultsSMM was diagnosed in 104 cases, representing 35.5% of all malaria cases. Mean age (IC95%) was 40.38 years (37.41-43.34), and sex distribution was similar. Most cases were in immigrants, but some cases were found in travellers. Equatorial Guinea was the main country where infection was acquired (81.7%). Symptoms were present only in 28.8% of all SMM cases, mainly asthenia (73.3% of symptomatic patients), fever (60%) and arthromialgias (53.3%). The associated laboratory abnormalities were anaemia (27.9%), leukopaenia (15.4%) and thrombopaenia (15.4%). Co-morbidity was described in 75 cases (72.1%).ConclusionsResults from this study suggest that imported SMM should be considered in some patients attended at Tropical Medicine Units. Although it is usually asymptomatic, it may be responsible of fever, or laboratory abnormalities in patients coming from endemic areas. The possibility of transmission in SMM has been previously described in endemic zones, and presence of vector in Europe has also been reported. Implementation of molecular tests in all asymptomatic individuals coming from endemic area is not economically feasible. So re-emergence of malaria (Plasmodium vivax) in Europe may be speculated.

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First autochthonous malaria case due to Plasmodium vivax since eradication, Spain, October 2010

Cited by 69 publications

References 74 publications

The Historical Distribution of Main Malaria Foci in Spain as Related to Water Bodies

The Historical Distribution of Main Malaria Foci in Spain as Related to Water Bodies

Migration and Malaria in Europe

Imported submicroscopic malaria in Madrid

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