Abstract
Spain declared the elimination of malaria in 1964. In non-endemic areas, the overwhelming majority of malaria cases are acquired abroad, and locally acquired infections are rare events. In Spain, malaria is a statutorily notifiable disease. During these fifty years more than ten thousand malaria cases have been reported, and about 0.8% of them did not have a history of recent travel. In this report, it was carried out a review of the ways in which malaria can be transmitted in non-endemic areas and a short description of the Spanish cases, aggregated by their transmission mechanisms. Four cases contracted malaria by mosquito bites; there were two autochthonous cases and two of “airport malaria”. The other 28 cases were: congenital malaria cases, transfusion-transmitted malaria, post-transplant cases, nosocomial transmission and cases in intravenous drug users. In addition, in 1971 there was an outbreak of 54 cases due to exposure to blood or blood products. So, while malaria usually is an imported disease in non-endemic areas, it should not be excluded in the differential diagnosis of persons who have fever of unknown origin, regardless of their travel history.
Highlights
Malaria is endemic in 97 countries and it is the most prevalent vector transmitted disease worldwide
In non-endemic areas, the majority of cases are imported; occasionally, cases are reported in which there is no history of travel—which necessitates a search for other modes of transmission
The information gathered during the interview prior to donating blood is not correct, and in other cases the malarial infection, especially that caused by Plasmodium malariae can persist in the host for years in a form which is subclinical [36] with parasite levels low enough to escape detection by peripheral blood analysis or through antigen detection, as these tests are not sufficiently sensitive
Summary
Malaria is endemic in 97 countries and it is the most prevalent vector transmitted disease worldwide. In 2001, a 75-year-old woman who lived close to two international airports (4 and 18 km distance, respectively), was hospitalized with intermittent fever that had lasted a week without apparent infection [21] Microscopic examination of her blood showed the presence of intraerythrocytic rings. In 1987, there was a case of a 32-year-old woman who contracted P. falciparum after having received a transfusion after delivery [24] She was hospitalized a week later with fever, and intraerythrocytic parasites were observed under microscopic analysis. The last reported case was in 2002 when a 26-year-old woman [26] received a number of blood transfusions in addition to erythrocyte concentrate The following month she presented with fever spikes and, later, a ruptured spleen. More than half of the reported cases were P. falciparum
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