A case of malaria in a three-month old infant was confirmed on Wednesday, February 24th, 2018. The infant was originally admitted to the hospital one month ago for a different ailment, when she was found to have malaria (the specific type of malaria was not reported) [1]. The case is suspected to have been contracted the disease locally in Madrid, as there is no record of the child visiting a malaria endemic area. A working group comprised of the hospital leadership and public health officials was created to determine how transmission occurred, and the investigation is ongoing [1].
This is cause for concern as malaria was eradicated from Spain in 1964 [1]. Since that time, the only cases of malaria in Spain occurred in travelers who contracted the disease when visiting other countries. Several hospital patients in Madrid, most recently in 2010 and 2011, contracted the disease from other infected individuals also staying in the hospital at that time [1].
Malaria is an infectious disease transmitted through the bite of an infected mosquito. It can also be transmitted from person-to-person if there is exposure to the blood of an infected person because the malaria parasites are found in red blood cells [2]. Symptoms of malaria include high fever, chills, and flu-like illness. The severity of the symptoms can vary and are sometimes fatal. Children are particularly at risk of dying from malaria; globally, over 450,000 children die from malaria each year [3]. Despite malaria being eradicated in Spain, certain species of Anopheles mosquitos, the genus that transmits malaria, are present in the region [4].
Only one other case of locally transmitted malaria has been reported in Spain, which occurred in Aragon in 2010, a northeastern region [5]. The source of infection could not be identified, but the Plasmodium vivax parasite found in the patient was suspected to come from an infected Anopheles atroparvus mosquito which is present in the region [5]. It is clear that the threat of malaria transmission in Europe is low; however, it is possible. Health care providers must maintain a strong sense of awareness of the possibility for transmission in order to quickly provide the best treatment when cases do occur.
Sources:
[1] http://outbreaknewstoday.com/spain-local-transmission-malaria-madrid-21460/
[2] https://www.cdc.gov/malaria/about/faqs.html
[3] https://www.unicef.org/media/media_81674.html
[4] https://www.cdc.gov/malaria/about/biology/mosquitoes/map.html
[5] http://www.eurosurveillance.org/content/10.2807/ese.15.41.19684-en
