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Two fatal autochthonous cases of airport malaria, Belgium, 2020.

ABSTRACT: We report an outbreak investigation of two fatal cases of autochthonous Plasmodium falciparum malaria that occurred in Belgium in September 2020. Various hypotheses of the potential source of infection were investigated. The most likely route of transmission was through an infectious exotic Anopheles mosquito that was imported via the international airport of Brussels or the military airport Melsbroek and infected the cases who lived at 5 km from the airports. Based on genomic analysis of the parasites collected from the two cases, the most likely origin of the Plasmodium was Gabon or Cameroon. Further, the parasites collected from the two Belgian patients were identical by descent, which supports the assumption that the two infections originated from the bite of the same mosquito, during interrupted feeding. Although airport malaria remains a rare event, it has significant implications, particularly for the patient, as delayed or missed diagnosis of the cause of illness often results in complications and mortality. Therefore, to prevent such severe or fatal outcomes, we suggest a number of public health actions including increased awareness among health practitioners, especially those working in the vicinity of airports, and increased surveillance of exotic mosquito species at airports.

SUBMITTER: Van Bortel W

PROVIDER: S-EPMC9027149 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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Two fatal autochthonous cases of airport malaria, Belgium, 2020.

Van Bortel Wim W Van den Poel Bea B Hermans Greet G Vanden Driessche Marleen M Molzahn Helmut H Deblauwe Isra I De Wolf Katrien K Schneider Anna A Van Hul Nick N Müller Ruth R Wilmaerts Leen L Gombeer Sophie S Smitz Nathalie N Kattenberg Johanna Helena JH Monsieurs Pieter P Rosanas-Urgell Anna A Van Esbroeck Marjan M Bottieau Emmanuel E Maniewski-Kelner Ula U Rebolledo Javiera J

Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 20220401 16

We report an outbreak investigation of two fatal cases of autochthonous <i>Plasmodium falciparum</i> malaria that occurred in Belgium in September 2020. Various hypotheses of the potential source of infection were investigated. The most likely route of transmission was through an infectious exotic <i>Anopheles</i> mosquito that was imported via the international airport of Brussels or the military airport Melsbroek and infected the cases who lived at 5 km from the airports. Based on genomic anal ...[more]

PMID: 35451360

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Project description:BackgroundMycetoma is a chronic granulomatous infection involving cutaneous and subcutaneous tissues. It is endemic in tropical and subtropical areas, but sporadic cases have been reported also in countries of temperate climate. The purpose of this paper is to review the cases of mycetoma in European subjects (and presumably acquired in Europe), to give an insight in the main factors associated with this condition, and to describe two previously unpublished cases observed at our Centre.Methods and findingsPubMed was systematically searched for case reports and case series of mycetoma in Europeans reported between 1980 and 2014, using specific search strategies. Two further cases diagnosed by the authors are described. Forty-two cases were collected. Eleven cases were caused by Scedosporium apiospermium, mainly in immunosuppressed patients from Bulgaria, Germany, the Netherlands, Portugal, Slovenia, Spain and the United Kingdom. Excluding all patients with immunosuppression, 29 cases remain. Most of them were reported from Bulgaria and in Albanian patients (all diagnosed outside Albania). In the Bulgarian case series many different micro-organisms, both bacteria and fungi, were isolated, while all the 5 cases from Albania were caused by Actinomadura spp. Other countries reporting cases were Greece, Italy and Turkey. In general, Actinomadura spp is the most frequent causative agent isolated, followed by Nocardia spp and Madurella mycetomatis. The foot was the most reported site involved. Most patients were medically treated, but unfortunately a long-term follow up (at least one year) was available only in a few cases.ConclusionsOur review and our own cases suggest that Europeans without travel history can be affected by Madura foot. The lack of a surveillance system is likely to cause an underreporting of cases. Moreover, the unfamiliarity of Western doctors with this peculiar infection may cause a mismanagement, including unnecessary amputations.

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Two fatal autochthonous cases of airport malaria, Belgium, 2020.

Publications

Two fatal autochthonous cases of airport malaria, Belgium, 2020.

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