Odyssean Malaria - Doornpoort, Tshwane update
07 March 2017
The National Institute for Communicable Diseases (NICD) was notified of two persons with malaria from Doornpoort, a suburb in the northern part of the City of Tshwane. Neither person had travelled to a known malaria transmission area. Unfortunately both patients passed away due to complications of malaria. A team comprising members from the Vector Control Reference Laboratory at NICD, District Health Services, Environmental Health and Communicable Disease Control programmes conducted an investigation in the area.
An examination of both residences and the surrounds yielded no Anopheles mosquitoes or larvae. There are Culex mosquitoes breeding in the general area as expected. Female anopheles mosquitoes are the vectors responsible for malaria; mosquitoes of the genus Culex never transmit malaria. The evidence available therefore suggests that these cases did not result from local transmission in Pretoria and they likely acquired malaria from the bite of an infective Anopheles mosquito inadvertently transported from a malaria endemic area via a vehicle such as a minibus, car, bus or aeroplane.
No specific vector control interventions are recommended at this stage. The local community and Tshwane residents in general should not be alarmed as these cases do not represent an expansion of the malaria transmission zone in South Africa. A malaria awareness campaign has been rolled out in the area and these activities should continue. All healthcare practitioners are encouraged to consider malaria as a differential diagnosis in all patients presenting with unexplained fever (>38°C) and flu-like illness especially in the presence of a change in the level of consciousness and/ or progressive jaundice even in the absence of a travel history to a malaria endemic region.
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.
Malaria must be urgently considered in any resident in or traveller from a known malaria transmission areas with acute onset of fever or flu like-illness – fever, headache, muscle pains, chills and sweats. Urgent blood tests must be done, and repeated if negative. Malaria treatment is very effective if administered early in the course of the illness.
Travellers to known malaria transmission areas during the coming months must take precautions to reduce mosquito bites and may consider malaria preventive medication for high risk areas.
For more information on malaria – click on the links below
2014_Frean_SAMJ_Odyssean_Malaria outbreaks in Gauteng