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EDITOR:
Steve
Van Nattan
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This is a story which is typically couched in restraint. BUT, I have lived in Africa, and I have had malaria. I know that the Anopheles mosquito has always been thought to be strictly a resident of Africa. This account indicates a VERY strong likelihood that this species of mosquito has now got a foothold in Europe. This also shows the folly of assuming that AIDS cannot adapt to vector born methods and species in the USA and Europe which could pass AIDS to humans. |
In Luxembourg three cases of Plasmodium falciparum malaria have been diagnosed in people who had visited a malaria endemic area. A husband and wife had travelled by air from Luxembourg to Scotland via Brussels on 30 May and returned on 18 June. The woman was admitted to the Centre Hospitalier de Luxembourg on 29 July with fever and raised aminotransferases. Diagnosis was made by a blood smear and later confirmed by the Institute of Tropical Medicine in Antwerp, Belgium. The husband who was also febrile was advised to have a blood test, which proved positive for P. falciparum malaria. They live in a village situated about 2 km east of Luxembourg airport. The third patient, unrelated to the previous two, had not travelled by air. She lives in a village situated 3 to 4 km east of the airport and was admitted to hospital in the town of Trier in Germany. Her illness was reported widely in the German media on 12 August.
In l997 two cases of airport P. falciparum malaria were diagnosed in Luxembourg. One was in a child who was admitted to hospital with a persistent fever. A blood test showed a severe pancytopenia and acute leukaemia was suspected. When the blood smear was examined more thoroughly, it showed the presence of P. falciparum. A few days later her mother became febrile and malaria was diagnosed on a blood smear. Both diagnoses were confirmed by the Institute of Tropical Medicine in Antwerp. Mother and child had recently travelled from Luxembourg airport to Iceland, but they had never been in a malaria endemic area. They lived in a village 1 to 2 km east of the airport .
These five cases of malaria have occurred during periods of high summer temperatures, which may have allowed imported Anopheles mosquitoes to survive. A common feature of the five cases seen in 1997 and 1999 was severe thrombocytopenia.
The diagnosis of malaria should be considered in patients with high fever without an obvious cause, even when they have had no history of travel to a malaria endemic country, especially if they live near an international airport and if the blood tests show thrombocytopenia. Individual countries should check that the World Health Organization’s recommendations on aircraft disinsecting procedures are being implemented. Luxembourg is considering whether to introduce aircraft disinsecting on selected flights.
Reported by Dr Robert Hemmer,
(hemmer.robert@chl.lu),
National Service of Infectious Diseases,
Centre
Hospitalier de Luxembourg,
Luxembourg.
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