Malaria Cases: Greece Update, October 11, 2012

A map of Greece showing the locations of Athens, Evrotas, Karditsa, Markopoulo, Marathon, Viotia region, and Xanthi.

The Centers for Disease Control and Prevention (CDC) has received information that there have been 14 additional P. vivax malaria cases identified in Greece; four that are locally-acquired cases in Greek residents with no previous travel, and 10 cases in immigrants. Those 10 cases could have either been imported or acquired locally. Between January 1 and October 1, 2012, Greece has reported a total of 70 cases of malaria. Of those 70 cases, 54 were caused by P. vivax (12 are locally acquired, 2 are relapses, and 40 occurred in immigrants). Those 40 cases among immigrants from P. vivax-endemic countries, could have either been imported or acquired locally. The immigrants reported being in Greece from as short as a few days before onset of symptoms to as long as 4 years before the onset of symptoms.

Three of the new cases occurred in areas where malaria had not been previously identified. (see map) The first occurred in an agricultural setting in Selino, Xanthi. The second case was in a patient who travelled within Greece, and was believed to have become infected with malaria in Viotia. The third case occurred in a patient from Karditsa.

The fourth new case had onset of symptoms at the end of September and is believed to have acquired the infection in Evrotas in the Laconia (southeastern Peloponnese) region. The agricultural area of Evrotas was the principal site of the 2011 P. vivax outbreak and was also where other locally-acquired were identified in June, July, and August of 2012.

No new cases have been reported in Markopoulo and Marathon, two areas were cases had been identified during June through August. No locally transmitted malaria cases have been reported in Athens.

The Hellenic CDC continues to work with the European CDC and has responded by enhancing its surveillance systems for malaria cases and malaria vectors. In current- and previously affected- areas, mosquito control has been intensified, healthcare providers educated about early malaria diagnosis and treatment, and the public has been informed about the symptoms of malaria and the prevention of mosquito bites.

There are no changes to the current CDC recommendations for preventive antimalarial drugs for travel to the agricultural areas of Evrotas in the Laconia region. If traveling to the affected areas, discuss the benefits and risks of taking malaria prophylaxis based on your itinerary, duration of travel, and activities--as well as your other medications and health conditions--with a health care provider knowledgeable about travel medicine. Mosquito avoidance measures are also recommended, such as insect repellant and sleeping in either an air conditioned or well-screened setting or under a treated bed-net, to prevent malaria infection. Malaria prophylaxis is not currently recommended for travelers to Marathon and Markopoulo. Travelers to these two areas should rely on mosquito avoidance measures to prevent malaria infection.

See the CDC Malaria website for additional health information about malaria including prevention of mosquito bites and drugs for malaria prevention. For general health information for travelers to all areas of the world, see the CDC Traveler's Health website.