Can you catch malaria… at the airport? Warning of ‘suitcase infections’ fueling the spread of deadly diseases around the world
Malaria due to bites from infected mosquitoes transported by plane, luggage or even by mail is increasing in Europe.
These cases of ‘suitcase malaria’, also known as Odyssean malaria, have been reported sporadically for about fifty years.
But a new study has found an increase over the past five years.
Malaria was eradicated from Western Europe in the 1970s and since then almost all cases have involved travelers returning from countries where the disease is still widespread.
However, a few cases of malaria infections that are not caused by travel are sporadically reported every year.
Cases of ‘suitcase malaria’, also known as Odyssean malaria, have been reported among travelers returning from countries where malaria occurs
Malaria was eradicated from Western Europe in the 1970s and since most cases have been reported among travelers returning from countries where malaria occurs
These include introduced infections, which are transmitted by a local mosquito after it bites an infected returning traveler who carries the disease in their blood.
They also include induced cases, which are associated with other forms of transmission, such as mother-to-child transmission and Odyssean malaria.
A systematic review analyzed data on Odyssean malaria collected in Europe from 1969 to January 2024.
Of the 145 cases described from nine Western European countries, including Britain, 105 were classified as airport malaria, 32 as baggage malaria and eight as both types of malaria.
Most cases were reported in France, Belgium and Germany, with half among patients who lived or worked near an international airport.
Cases of malaria at airports and baggage appear to be on the rise, with a third of cases reported in the past five years, even as air traffic fell during the Covid pandemic.
Researchers also found that people infected with malaria had an average age of 37.9 years and were more likely to be male than female.
Of the cases with a known outcome, 124 patients recovered and nine died. Patients who died were on average older, with an average age of 57.2 years.
Similar trends were also observed in another study that analyzed surveillance and case study data in France of locally acquired malaria between 1995 and 2022.
Researchers found a total of 117 locally acquired malaria cases More Odyssean cases have been reported since 2011.
Of the 117 cases, 51 were categorized as Odyssean.
Most cases involved men with an average 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 the cases were reported in the Île-de-France region.
More than 100 were hospitalized and seven patients died. Among patients with locally acquired malaria, severe cases and death were more common than among imported cases.
According to the World Health Organization (WHO), malaria is one of the leading causes of death in the world. A child is killed every two minutes.
To tackle the rising risk of Odyssean malaria, researchers from the analysis in France recommended strict enforcement of ‘disinsectization’, the destruction of insects, on aircraft.
They also advised physicians to consider the possibility of locally acquired malaria early in patients with unexplained fever, even if there is no travel history.
Authors of the broader systematic review emphasized the need for more structured surveillance of malaria cases in Europe, including a standardized case definition and preventive measures.
Of the 6,131 cases of malaria reported in the EU/EEA in 2022, 99 percent were travel-related. This figure included cases of Odyssean malaria.
Malaria usually occurs in tropical areas, including large parts of Africa and Asia, Central and South America and parts of the Middle East.
According to the World Health Organization, it is one of the leading causes of death in the world, killing a child every two minutes.
Most of these deaths occur in Africa, where 250,000 young people die from the disease every year.
In 2023, 2,004 cases of malaria were confirmed in England, Wales and Northern Ireland after traveling abroad, compared to 1,369 in 2022, according to government data.
It is thought the increase was driven by travel and a resurgence of malaria in many countries.
High fever, sweating, chills and headaches, as well as abdominal pain, loss of appetite and muscle aches, are all telltale signs of the disease.
According to the NHS, it can also cause children to feel very tired and sleepy, and infected children may develop yellow skin, sore throats and breathing difficulties.
The NHS recommends that all people traveling to an area where malaria is found seek advice from a GP, nurse, pharmacist or travel clinic before traveling.