Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Aug 24:67:101627.
doi: 10.1016/j.nmni.2025.101627. eCollection 2025 Oct.

Airport/seaport and autochthonous malaria in Europe from 1969 to 2022: A systematic review

Daniela Balzli  1 , Nejla Gültekin  2 , Zeno Stanga  2 , Ismail Ülgür  2 , Nadja Hedrich  1 , Jan Fehr  3 , Patricia Schlagenhauf  3
Affiliations
Review

Airport/seaport and autochthonous malaria in Europe from 1969 to 2022: A systematic review

Daniela Balzli et al. New Microbes New Infect. .

Abstract

Background: In the context of this paper, airport/seaport malaria denotes the accidental relocation by air or sea of a malaria infected mosquito to Europe, a non-endemic area, the survival of the transported mosquito and subsequent blood meal and infection of a local person. Autochthonous malaria refers to locally transmitted cases of malaria in Europe.

Methods: The systematic review followed PRISMA guidelines and was registered on PROSPERO (CRD42023444243). PubMed and Ovid MEDLINE electronic databases as well as EMBASE, Scopus and CINAHL were searched for eligible papers. The selection process followed strict inclusion and exclusion criteria.

Results: We included 68 papers describing 115 cases of airport, seaport or autochthonous malaria in Europe, with a total of 68 airport/seaport malaria cases and 47 autochthonous malaria cases. France, Germany, Italy and Spain reported both types of malaria cases. Cases of airport/seaport malaria only were reported from Belgium, Luxembourg, Switzerland and the United Kingdom. Cases of autochthonous malaria only were reported from Greece, Malta and the Netherlands. The case fatality rates for airport/seaport malaria were 13.24 % and for autochthonous malaria 2.13 % respectively.

Conclusion: The importance of airport/seaport and autochthonous malaria is related to the frequently delayed or missed diagnosis, leading to high case fatality rates. Rising temperature may facilitate the importation and proliferation of competent Anopheles vectors. Increased human migration and travel with malaria parasite carriage may contribute to the reemergence of autochthonous malaria in Europe.

Keywords: Airport; Autochthonous; Europe; Malaria; Seaport.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Distribution of airport and seaport malaria cases in Europe.
Fig. 2
Fig. 2
Number of papers and cases for airport malaria.
Fig. 3
Fig. 3
Number of papers and cases for seaport malaria.
Fig. 4
Fig. 4
Proportion of Plasmodium spp. in airport/seaport malaria cases in Europe.
Fig. 5
Fig. 5
Distribution of autochthonous malaria cases in Europe.
Fig. 6
Fig. 6
Number of papers and cases for autochthonous malaria.
Fig. 7
Fig. 7
Proportion of Plasmodium spp. in autochthonous malaria cases.
See this image and copyright information in PMC

References

    1. Fischer L., Gültekin N., Kaelin M.B., Fehr J., Schlagenhauf P. Rising temperature and its impact on receptivity to malaria transmission in Europe: a systematic review. Trav Med Infect Dis. 2020;36 - PubMed
    1. Holy M., Schmidt G., Schröder W. Potential malaria outbreak in Germany due to climate warming: risk modelling based on temperature measurements and regional climate models. Environ Sci Pollut Res Int. 2011 Mar;18(3):428–435. - PubMed
    1. Danis M., Mouchet M., Giacomini T., Guillet P., Legros F., Belkaïd M. Paludisme autochtone et introduit en Europe. Med Maladies Infect. 1996 Apr 1;26:393–396. - PubMed
    1. Danis K., Baka A., Lenglet A., Van Bortel W., Terzaki I., Tseroni M., et al. Autochthonous Plasmodium vivax malaria in Greece, 2011. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 2011 Oct 20;16(42) - PubMed
    1. Velasco E., Gomez-Barroso D., Varela C., Diaz O., Cano R. Non-imported malaria in non-endemic countries: a review of cases in Spain. Malar J. 2017 Jun 29;16(1):260. - PMC - PubMed

LinkOut - more resources