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. 2024 Oct;29(41):2400133.
doi: 10.2807/1560-7917.ES.2024.29.41.2400133.

Locally acquired malaria: a retrospective analysis of long-term surveillance data, European France, 1995 to 2022

Hugues Delamare  1 , Arnaud Tarantola  2 , Marc Thellier  3   4 , Clémentine Calba  5 , Olivier Gaget  6 , Paul-Henri Consigny  7 , Frederic Simard  8 , Sylvie Manguin  9 , Elise Brottet  10 , Marie-Claire Paty  1 , Sandrine Houze  11   4 , Henriette De Valk  1 , Harold Noël  1
Affiliations

Locally acquired malaria: a retrospective analysis of long-term surveillance data, European France, 1995 to 2022

Hugues Delamare et al. Euro Surveill. 2024 Oct.

Abstract

BackgroundIn European France, the bulk of malaria cases are travel-related, and only locally acquired cases are notifiable to assess any risk of re-emergence.AimsWe aimed to contribute to assessing the health impact of locally acquired malaria and the potential of malaria re-emergence in European France by documenting modes of transmission of locally acquired malaria, the Plasmodium species involved and their incidence trends.MethodsWe retrospectively analysed surveillance and case investigation data on locally acquired malaria from 1995 to 2022. We classified cases by most likely mode of transmission using a classification derived from the European Centre for Disease Prevention and Control. A descriptive analysis was conducted to identify spatial and temporal patterns of cases.ResultsFrom 1995 to 2022, European France reported 117 locally acquired malaria cases, mostly due to Plasmodium falciparum (88%) and reported in Île-de-France (54%), Paris Region. Cases were classified as Odyssean malaria (n = 51), induced malaria (n = 36), cryptic malaria (n = 27) and introduced malaria (n = 3). Among the 117 patients, 102 (93%) were hospitalised, 24 (22%) had severe malaria and seven (7%) died.ConclusionLocally acquired malaria remains infrequent in European France, with four reported cases per year since 1995. However, with the recent increasing trend in Odyssean malaria and climate change, the risk of re-emergence in non-endemic countries should be monitored, particularly in areas with autochthonous competent vectors. The vital risk of delayed diagnosis should make physicians consider locally acquired malaria in all patients with unexplained fever, especially when thrombocytopenia is present, even without travel history.

Keywords: Anopheles spp.; Epidemiology; Locally acquired malaria; Plasmodium spp.; Surveillance.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Classification of locally acquired malaria cases by mode of transmission
Figure 2
Figure 2
Flowchart of locally acquired malaria database
Figure 3
Figure 3
Locally acquired malaria cases by mode of transmission, European France,1995–2022 (n = 117)
Figure 4
Figure 4
Odyssean malaria seasonality, European France,1995–2022 (n = 48a)
Figure 5
Figure 5
Evolution of induced cases, with detailed type of artificial contamination, European France 1995–2022 (n = 36)
See this image and copyright information in PMC

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