Paired Malaria Infections in France
Paired Malaria Infections in France
By Carol A. Kemper, MD, FACP
Dr. Kemper is Clinical Associate Professor of Medicine, Stanford University, Division of Infectious Diseases; Santa Clara Valley Medical Center.
Dr. Kemper does research for GSK Pharmaceuticals, Abbott Laboratories, and Merck. Infectious Disease Alert's Physician Editor, Stan Deresinski, MD, FACP, Clinical Professor of Medicine, Stanford, Associate Chief of Infectious Diseases, Santa Clara Valley Medical Center, serves on the speaker's bureau for Merck, Pfizer, Wyeth, Ortho-McNeil (J&J), Schering-Plough, and Cubist, does research for the National Institute of Health, and is an advisory board member for Schering-Plough, Ortho-McNeil (J&J), and Cepheid. Peer reviewer Connie Price, MD, Assistant Professor, University of Colorado School of Medicine, reports no consultant, stockholder, speaker's bureau, research, or other financial relationship with any company related to this field of study.
Source: Pomares-Estran C, et al. Malaria Journal 2009;8:202-204.
This article originally appeared in the November 2009 issue of Infectious Disease Alert.
Autochthonous cases of malaria are rarely reported in areas non-endemic for malaria — and generally occur within or near international airports. This curious report documents a young Parisian couple traveling around France on vacation in August 2008, who both developed fever, vertigo, and nausea, prompting a trip to the emergency room in Saint Raphael on the French Riviera. The man was hospitalized for a day and then discharged with no clear diagnosis. Within a day, both became progressively ill, returning to the ER for further care. Routine blood cell counts demonstrated thrombocytopenia, which prompted blood smears, surprisingly revealing intraerythrocytic parasites consistent with P. falciparum in both young people.
Parasite DNA extracted from blood samples was examined for four genetic loci, demonstrating the two isolates were identical.
The couple had no history of travel outside of France, and no history of transfusion, needle sharing, or intravenous drug use. Their vacation had brought them within eight miles of the Charles de Gaulle airport in Paris, and then up to Normandy, where the temperatures were 18°C (too cold to support Anopheles spp.), and then on to the French Riviera, where they fell ill. An intensive environmental search identified no other risk factors for malaria, and no Anopheles mosquitoes were found in any area visited by the couple. The only possible conclusion, stated Health Authorities, was that an isolated mosquito roaming outside of Charles de Gaulle airport bit both young people.
As an ID Fellow years ago, phone calls from the lab reporting malaria parasites on a blood smear, done for purposes of a manual cell count, were infrequent. But, such detection was important and often resolved some of the more puzzling cases of fever in patients without clear risk factors for malaria. With the universal use of automated cell counts, we seldom hear about such cases.
Autochthonous cases of malaria are rarely reported in areas non-endemic for malaria and generally occur within or near international airports.Subscribe Now for Access
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