Odyssean malaria in North West province
Updated: 08 March 2017
The National Institute for Communicable Diseases (NICD) has been notified of two persons with malaria from Swartruggens, North West province. Neither person had travelled to a known malaria transmission area. Unfortunately one patient passed away due to complications of malaria.These two cases are not linked in any way to the cases reported in Doornport, Tshwane. The second patient is in hospital receiving malaria treatment. A team comprising members from the Vector Control Reference Laboratory at NICD, District Health Services, Environmental Health and Communicable Disease Control programmes from the North West province department of health will conduct an investigation in the area
It is likely that the patients acquired malaria from the bite of an infected Anopheles mosquito inadvertently translocated from a malaria endemic area via a vehicle such as a minibus, car or suitcaseor an aeroplane – the area is close to an airport– ratherthan from local transmission.
These incidents are rare, but a few cases of ‘Odyssean’ malaria are confirmed each year and coincide with the seasonal increase in malaria cases from January to April. These cases do not represent an expansion in the malaria transmission areas in South Africa.
Malaria treatment is very effective if administered early in the course of the illness but unfortunately these cases are often diagnosed late due to the non-specific signs and symptoms of malaria, and the absence of a travel history to a known malaria transmission area,which is key to suspecting malaria as the cause of fever. Healthcare practitioners are encouraged to be vigilant with respect to malaria in all patients presenting with unexplained fever (>38°C) and flu-like illness, even in the absence of a travel history.
Following on heavy rains on the Highveld there has been an increase in culicine mosquito populations but these mosquitoes never transmit malaria.
Due to recent heavy rains, an increase in ambient temperatures and high humidity, there has been a significant increase in malaria cases both within the usual malaria transmission areas in South Africa (northeast Limpopo, lowveld areas of Mpumalanga but excluding Mbombela, and the far northern areas of KwaZulu-Natal) and in neighbouring countries, especially in Mozambique, during the 2016/2017 malaria season. A number of malaria cases have also been reported from Thabazimbi and Lephalale in Limpopo province mostly from rural villages. The area was historically prone to malaria during favourable years, so this is not totally unusual. Residents and visitors to the area should be vigilant for any flu-like illness with fever and seek urgent medical care and be tested for malaria.
Malaria must be urgently considered in any resident in or traveller from a known malaria transmission areas with acute onset of fever orflu like-illness – fever, headache, muscle pains, chills and sweats. Urgent blood tests must be done, and repeated if negative. Malaria treatment is very effective ifadministered early in the course of the illness.
Travellers to known malaria transmission areas during the coming two months must take precautions to reduce mosquito bites and may consider malaria preventive medication for high risk areas.