Epidemiological update: Local cases of malaria in Greece, September- October 2013

Epidemiological update

​The Hellenic Centre for Disease Control and Prevention (KEELPNO) has reported three autochthonous cases of Plasmodium vivax malaria up to 16 November 2013; two from Alexandroupolis municipality in the region of Evros and one from the municipality of Sofades in the Karditsa region.  The cases had onset of symptoms from end of September to beginning of November 2013.

In addition to the three autochthonous cases, Greece reported 17 confirmed cases classified as imported malaria. Ten of the imported cases were among immigrants from malaria endemic countries and seven were among travellers to malaria endemic areas.  Eight of the imported cases were due to Plasmodium vivax infections and nine were due to Plasmodium falciparum.The three autochthonous cases in 2013 are reported from agricultural areas where immigrants from malaria endemic countries reside and work. It is the first time since 2009 that the Alexandroupolis municipality has been affected.  Alexandroupolis is an historical area of malaria transmission that shares environmental and epidemiological characteristics with the areas were autochthonous transmission of Plasmodium vivax has occurred since 2009; large wetlands and farms, and migrant workers from malaria endemic countries living in the area. The occurrence of autochthonous Plasmodium vivax cases in Alexandroupolis is therefore not unexpected.The current risk of malaria infection is restricted mainly to persons residing or working in the affected areas of Greece. The risk for tourists visiting Greece is considered very low because the transmission areas are agricultural and do not attract large number of tourists (see ECDC update). The use of standard mosquito biting prevention measures continues to be recommended for Greece. The 2013 malaria transmission season is now coming to an end and the risk will decrease further.