Abstract
Two cases of presumably airport-acquired falciparum malaria were diagnosed in Frankfurt in October 2019. They were associated with occupation at the airport, and Plasmodium falciparum parasites from their blood showed genetically identical microsatellite and allele patterns. Both had severe malaria. It took more than a week before the diagnosis was made. If symptoms are indicative and there is a plausible exposure, malaria should be considered even if patients have not travelled to an endemic area.
Highlights
On 5 October 2019, a 38-year-old man with a positive rapid diagnostic test result for malaria was transferred to the emergency department of University Hospital Frankfurt, Germany, from a local general hospital
An autochthonous infection with P. falciparum was suspected in both patients and whole blood samples were sent to the National Reference Centre for Tropical Pathogens at the Bernhard Nocht Institute for Tropical Medicine (BNITM) in Hamburg, Germany
We describe two cases of falciparum malaria that were presumed to have been acquired at Frankfurt Airport
Summary
Two cases of airport-associated falciparum malaria in Frankfurt am Main, Germany, October 2019. The patient was transferred to the University Hospital Frankfurt the morning and treatment was continued with five doses of artesunate 2.4 mg/kg intravenously and oral follow-up treatment with atovaquone/proguanil (1,000mg/400mg per day) for 3 days He made a full recovery after 16 days of Figure 1 Giemsa stain of Plasmodium falciparum trophozoites at a parasite density of 7%, case of airport-acquired falciparum malaria, Frankfurt, Germany, October 2019 (Case 1, magnification x 1,000). To case 1, he did not have any history of recent travel to malaria endemic areas, nor had he previously had blood transfusions or underlying illnesses He was working at Frankfurt Airport, and on the same night shift as Case 1 but he did not recall any insect bites
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