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. 2022 Apr;27(16):2100724.
doi: 10.2807/1560-7917.ES.2022.27.16.2100724.

Two fatal autochthonous cases of airport malaria, Belgium, 2020

Wim Van Bortel  1   2 , Bea Van den Poel  3 , Greet Hermans  4   5 , Marleen Vanden Driessche  6 , Helmut Molzahn  7 , Isra Deblauwe  1 , Katrien De Wolf  1 , Anna Schneider  1 , Nick Van Hul  1 , Ruth Müller  1 , Leen Wilmaerts  8 , Sophie Gombeer  9 , Nathalie Smitz  10 , Johanna Helena Kattenberg  11 , Pieter Monsieurs  11 , Anna Rosanas-Urgell  11 , Marjan Van Esbroeck  12 , Emmanuel Bottieau  12 , Ula Maniewski-Kelner  12 , Javiera Rebolledo  13
Affiliations

Two fatal autochthonous cases of airport malaria, Belgium, 2020

Wim Van Bortel et al. Euro Surveill. 2022 Apr.

Abstract

We report an outbreak investigation of two fatal cases of autochthonous Plasmodium falciparum malaria that occurred in Belgium in September 2020. Various hypotheses of the potential source of infection were investigated. The most likely route of transmission was through an infectious exotic Anopheles mosquito that was imported via the international airport of Brussels or the military airport Melsbroek and infected the cases who lived at 5 km from the airports. Based on genomic analysis of the parasites collected from the two cases, the most likely origin of the Plasmodium was Gabon or Cameroon. Further, the parasites collected from the two Belgian patients were identical by descent, which supports the assumption that the two infections originated from the bite of the same mosquito, during interrupted feeding. Although airport malaria remains a rare event, it has significant implications, particularly for the patient, as delayed or missed diagnosis of the cause of illness often results in complications and mortality. Therefore, to prevent such severe or fatal outcomes, we suggest a number of public health actions including increased awareness among health practitioners, especially those working in the vicinity of airports, and increased surveillance of exotic mosquito species at airports.

Keywords: Belgium; Odyssean malaria; Plasmodium falciparum; airport malaria; autochthonous transmission; malaria.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Discriminant analysis of principle components, autochthonous malaria cases, Belgium, 2020 (n = 2)
Figure 2
Figure 2
Direct and indirect flights from Africa to the international airport Brussels, 1 August–15 September 2019 and 2020
See this image and copyright information in PMC

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