France's Airports Report Increased Odyssean Malaria Cases

In recent years, there has been an increase in locally acquired malaria cases in Europe related to travelers returning from Africa, which shoulders the heaviest burden (90%+) of malaria disease reported.

In 2022, over 99% of Europe's 6,131 malaria cases (mean age 37.9 yrs) were travel-related.

To guide control measures, researchers analyzed two decades of data for locally acquired malaria in France to identify potential changes in the parasite's mode and frequency of transmission.

In France, the Paris Charles de Gaulle airport vicinity reported most cases. The Brussels airport area had the second-highest number of malaria cases in Europe,

Published by Eurosurveillance on October 10, 2024, this study revealed that locally acquired malaria cases in France have remained steady between 1995 and 2022.

However, since 2011, more cases have been caused by the bite of an infectious exotic mosquito imported via plane, luggage, or parcel, known as Odyssean malaria.

Odyssean malaria is defined as malaria in a person with no history of recent travel to a malaria-endemic region. It is also colloquially known as airport, suitcase, minibus, or taxi-rank malaria.

Airport malaria describes a Plasmodium infection acquired at or near an airport resulting from a bite from an infectious mosquito transported by aircraft from a malaria-endemic area.

Luggage malaria is further distinguished by the transport of the infectious mosquito in baggage and its release at a site of infection away from an airport.

These researchers wrote, 'Given the significant risk to patients due to a delayed diagnosis, physicians should consistently consider the possibility of locally acquired malaria in patients presenting with unexplained fever, even without a travel history, especially when thrombocytopenia is documented.'

Among patients in France with locally acquired malaria, severe cases and deaths have been more frequent than in imported cases, primarily when the patient is located near an international airport.

Furthermore, a related Systematic Review recommended, 'Strict disinfection of aircraft is crucial to prevent Odyssean malaria, and hygiene precautions are essential to contain malaria cases in healthcare settings.'

In the United States, the Centers for Disease Control and Prevention (CDC) reported 1,447 malaria cases in the U.S. Territories and non-U.S. residents during the week ending October 5, 2024.

In Florida, 57 cases of malaria have been reported in individuals with a travel history to a malaria-endemic area, such as Africa (Nigeria) and Central and South America. Last year, the CDC published a Morbidity and Mortality Weekly Report confirming local malaria cases in Florida (Sarasota, seven).

As of October 14, 2024, malaria is a vaccine-preventable disease. WHO-approved malaria vaccines are available in various African and European countries but not in the U.S.