Malaria resulting from bites from infected mosquitoes transported by aircraft, luggage or even in the post are on the rise in Europe.
These cases of ‘suitcase’ malaria, also known as Odyssean malaria, have been sporadically reported for around five decades.
But a new study has found a surge over the past five years.
Malaria was eradicated in Western Europe in the 1970s and since then almost all cases have been in travellers returning from countries where the bug is still rife.
However, some cases of malaria infections not caught from travel are reported sporadically every year.
Cases ‘suitcase’ malaria, also known as Odyssean malaria, have been reported among travellers returning from countries where malaria is established
Malaria was eradicated in Western Europe in the 1970s and since most cases have been reported among travellers returning from countries where malaria is established
These include introduced infections, which are transmitted by a local mosquito after it has bitten an infected returning traveller carrying the disease in their blood.
They also include induced cases, which those related to other means of transmission such as a mother-to-child transmission and Odyssean malaria.
A systematic review analysed data on Odyssean malaria collected in Europe from 1969 to January 2024.
Of the 145 cases described from nine western European countries, including the UK, 105 were classified as airport malaria, 32 as luggage malaria, and eight as either type of malaria.
Most cases were reported in France, Belgium, and Germany, and half among patients who resided near or worked at an international airport.
Case reports of airport and luggage malaria were found to be rising, with one third of cases reported over the last five years, even as air traffic declined during the Covid pandemic.
Researchers also found people infected with malaria had a mean age of 37.9 years and were more likely to be male than female.
For the cases with a known outcome, 124 patients recovered and nine died. Patients that died were older on average, with a mean age of 57.2 years.
Similar trends were also seen in another study which analysed surveillance and case investigation data in France of locally acquired malaria from 1995 to 2022.
Researchers found a total of 117 locally acquired malaria cases but with more Odyssean cases being reported since 2011.
Of the 117 cases, 51 were categorised as Odyssean.
Most cases were among males with a median age of 34.5 years.
Half of the patients with malaria were born in a country in Africa where the disease is common, and the other half were born in France.
More than half of cases were reported in the region Île-de-France.
More than 100 were admitted to hospital, and seven patients died. Among patients with locally-acquired malaria, severe cases and death was more frequent than in imported cases.
Malaria is one of the world’s biggest killers, claiming the life of a child every two minutes, according to the World Health Organization (WHO)
To tackle the rising risk of Odyssean malaria, researchers of the analysis in France advised the strict enforcement of ‘disinsectisation’, the destruction of insects, on aircraft.
They also recommended that physicians consider the possibility of locally-acquired malaria for patients with an unexplained fever early, even if there is no travel history.
Authors of the wider systematic review highlighted the need for more structured surveillance of malaria cases in Europe, including a standardised case definition and preventative measures.
Of the 6,131 cases malarial cases reported in the EU/EEA in 2022, 99 per cent were travel related. This figure included cases of Odyssean malaria.
Malaria is usually found in tropical regions including large areas of Africa and Asia, Central and South America, and parts of the Middle East.
It is one of the world’s biggest killers, claiming the life of a child every two minutes, according to the World Health Organization.
Most of these deaths occur in Africa, where 250,000 youngsters die from the disease every year.
In 2023, there were 2,004 cases of malaria confirmed in England, Wales and Northern Ireland following travel abroad, compared to 1,369 in 2022, according to government data.
It’s thought the surge was caused by travel and a resurgence of malaria in many countries.
A high temperature, sweats, chills and headaches, as well tummy pain, a loss of appetite and muscle pains are all tell-tale signs if the disease.
It can also make children feel very tired and sleepy and give those that are infected yellow skin, a sore throat and cause difficulty breathing, according to the NHS.
The NHS suggests all people travelling to an area where malaria is found get advice from a GP, nurse, pharmacist or travel clinic before they go.
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