A locally acquired falciparum malaria via nosocomial transmission in Korea

Abstract

A 57-year old man who was admitted to an emergency room of a tertiary hospital with hemoptysis developed malarial fever 19 days later and then died from severe falciparum malaria 2 days later. He had not traveled outside of Korea for over 30 years. Through intensive interviews and epidemiological surveys, we found that a foreign patient with a recent history of travel to Africa was transferred to the same hospital with severe falciparum malaria. We confirmed through molecular genotyping of the MSP-1 gene that Plasmodium falciparum genotypes of the 2 patients were identical. It is suggested that a breach of standard infection control precautions resulted in this P. falciparum transmission between 2 patients in a hospital environment. This is the first report of a nosocomial transmission of falciparum malaria in Korea.

Keywords: Plasmodium falciparum; malaria; nosocomial transmission.

Fig. 1

Giemsa stained blood smears from the 2 patients. (A) Case 1 with 20% parasitemia. (B) Case 2 with 40% parasitemia. The slide for Case 2 was used for preparation of DNA.

Fig. 2

PCR amplification of MSP-1 gene block 2 amplified with the primer sets K2F and C3R. The block 17 region was amplified with the primer sets M16Fand CflaR. (A) The Korean patient (Lane 1), and the Myanmar patient as a positive control (Lane 2), with vivax malaria (Lane 3) and distilled water (D.W.) (Lane 4) as negative controls. (B) The Greek patient (Lane 1), the Myanmar patient (Lane 2), and D.W (Lane 3). A-100 bp molecular marker was used for analysis (Lane M).

Fig. 3

Alignment of the KI type tripeptide repeats in block 2 of the MSP-1 gene from the 2 patients, Case 1 (Lee1) and Case 2 (A1), and definition of the repeat haplotype. ^*Loci are indicated by codon (amino acid) position in a sequence alignment or by block number [18].