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Surveillance and outbreak report Open Access
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Abstract

Febrile illnesses are common in travellers returning from south-east Asia. However, malaria is a rare diagnosis in this population. A series of infections was noted in German travellers returning from Thailand since 2012. Infectious disease and tropical medicine facilities registered by the German Society for Tropical Medicine and International Health were contacted in March 2017, and asked to report previous cases. In addition, surveillance data from the Robert Koch-Institute were analysed. The facilities reported a total of six -positive cases, all were returning travellers from Thailand. The -positive cases made up 6/9 of all diagnosed malaria cases imported from Thailand in the time period 2012 to 2017. In 4/5 of cases where a malaria rapid diagnostic test had been applied it revealed a negative result. is an important differential diagnosis in travellers returning from south-east Asia with itineraries that include Thailand. This study highlights the importance of this species in this patient subgroup. Whenever malaria is suspected in a returning traveller from Thailand, should be taken into consideration and a differential PCR be executed as currently the unequivocal diagnosis of is based on nuclear amplification techniques.

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/content/10.2807/1560-7917.ES.2018.23.29.1700619
2018-07-19
2024-11-17
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2018.23.29.1700619
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References

  1. World Bank (WB). International tourism, number of departures. Washington, DC: WB; 2017. [Accessed 19 Aug 2017]. Available from: http://data.worldbank.org/indicator/ST.INT.DPRT?locations=DE
  2. Fleck S, Jäger H, Zeeb H. Travel and health status: a survey follow-up study. Eur J Public Health. 2006;16(1):96-100.  https://doi.org/10.1093/eurpub/cki144  PMID: 16030132 
  3. Robert Koch-Institute (RKI). Infektionsepidemiologisches Jahrbuch für 2015. [Infection Epidemiological Yearbook for 2015]. Berlin: RKI; 2016. German. Available from: https://www.rki.de/DE/Content/Infekt/Jahrbuch/Jahrbuch_2015.pdf?__blob=publicationFile
  4. Thailand Department of Tourism. Nonthaburi; 2015. [Accessed 19 Aug 2017]. Available from: http://tourism2.tourism.go.th/home/details/11/221/24710
  5. World Health Organization (WHO). World Malaria Report 2016. Geneva: WHO; 2016.
  6. Deutsche Gesellschaft für Tropenmedizin und Internationale Gesundheit (DTG) e. V. (DTG). Hamburg: DTG; 2017. [Accessed 19 Aug 2017]. Available from: http://dtg.org/empfehlungen-und-leitlinien/empfehlungen/malaria.html
  7. Jongwutiwes S, Buppan P, Kosuvin R, Seethamchai S, Pattanawong U, Sirichaisinthop J, et al. Plasmodium knowlesi Malaria in humans and macaques, Thailand. Emerg Infect Dis. 2011;17(10):1799-806.  https://doi.org/10.3201/eid1710.110349  PMID: 22000348 
  8. Nakaviroj S, Kobasa T, Teeranaipong P, Putaporntip C, Jongwutiwes S. An autochthonous case of severe Plasmodium knowlesi malaria in Thailand. Am J Trop Med Hyg. 2015;92(3):569-72.  https://doi.org/10.4269/ajtmh.14-0610  PMID: 25535314 
  9. Kroidl I, Seilmaier M, Berens-Riha N, Bretzel G, Wendtner C, Löscher T. "Affenmalaria" nach Thailandreise. [Monkey malaria (Plasmodium knowlesi infection) after travelling to Thailand]. Dtsch Med Wochenschr. 2015;140(11):815-7. PMID: 26080720 
  10. Orth H, Jensen BO, Holtfreter MC, Kocheril SJ, Mallach S, MacKenzie C, et al. Plasmodium knowlesi infection imported to Germany, January 2013. Euro Surveill. 2013;18(40):20603.  https://doi.org/10.2807/1560-7917.ES2013.18.40.20603  PMID: 24128698 
  11. Mackroth MS, Tappe D, Tannich E, Addo M, Rothe C. Rapid-Antigen Test Negative Malaria in a Traveler Returning From Thailand, Molecularly Diagnosed as Plasmodium knowlesi. Open Forum Infect Dis. 2016;3(1):ofw039.  https://doi.org/10.1093/ofid/ofw039  PMID: 27006963 
  12. Seilmaier M, Hartmann W, Beissner M, Fenzl T, Haller C, Guggemos W, et al. Severe Plasmodium knowlesi infection with multi-organ failure imported to Germany from Thailand/Myanmar. Malar J. 2014;13(1):422.  https://doi.org/10.1186/1475-2875-13-422  PMID: 25367021 
  13. Ehrhardt J, Trein A, Kremsner P, Frank M. Plasmodium knowlesi and HIV co-infection in a German traveller to Thailand. Malar J. 2013;12(1):283.  https://doi.org/10.1186/1475-2875-12-283  PMID: 23941258 
  14. Ta TT, Salas A, Ali-Tammam M, Martínez MC, Lanza M, Arroyo E, et al. First case of detection of Plasmodium knowlesi in Spain by Real Time PCR in a traveller from Southeast Asia. Malar J. 2010;9(1):219.  https://doi.org/10.1186/1475-2875-9-219  PMID: 20663184 
  15. Kantele A, Marti H, Felger I, Müller D, Jokiranta TS. Monkey malaria in a European traveler returning from Malaysia. Emerg Infect Dis. 2008;14(9):1434-6.  https://doi.org/10.3201/eid1409.080170  PMID: 18760013 
  16. Kantele A, Jokiranta TS. Review of cases with the emerging fifth human malaria parasite, Plasmodium knowlesi. Clin Infect Dis. 2011;52(11):1356-62.  https://doi.org/10.1093/cid/cir180  PMID: 21596677 
  17. Bronner U, Divis PC, Färnert A, Singh B. Swedish traveller with Plasmodium knowlesi malaria after visiting Malaysian Borneo. Malar J. 2009;8(1):15.  https://doi.org/10.1186/1475-2875-8-15  PMID: 19146706 
  18. Berry A, Iriart X, Wilhelm N, Valentin A, Cassaing S, Witkowski B, et al. Imported Plasmodium knowlesi malaria in a French tourist returning from Thailand. Am J Trop Med Hyg. 2011;84(4):535-8.  https://doi.org/10.4269/ajtmh.2011.10-0622  PMID: 21460005 
  19. van Hellemond JJ, Rutten M, Koelewijn R, Zeeman AM, Verweij JJ, Wismans PJ, et al. Human Plasmodium knowlesi infection detected by rapid diagnostic tests for malaria. Emerg Infect Dis. 2009;15(9):1478-80.  https://doi.org/10.3201/eid1509.090358  PMID: 19788819 
  20. Link L, Bart A, Verhaar N, van Gool T, Pronk M, Scharnhorst V. Molecular detection of Plasmodium knowlesi in a Dutch traveler by real-time PCR. J Clin Microbiol. 2012;50(7):2523-4.  https://doi.org/10.1128/JCM.06859-11  PMID: 22573596 
  21. Angelo KM, Libman M, Caumes E, Hamer DH, Kain KC, Leder K, et al. , GeoSentinel Network. Malaria after international travel: a GeoSentinel analysis, 2003-2016. Malar J. 2017;16(1):293.  https://doi.org/10.1186/s12936-017-1936-3  PMID: 28728595 
  22. Lee KS, Cox-Singh J, Brooke G, Matusop A, Singh B. Plasmodium knowlesi from archival blood films: further evidence that human infections are widely distributed and not newly emergent in Malaysian Borneo. Int J Parasitol. 2009;39(10):1125-8.  https://doi.org/10.1016/j.ijpara.2009.03.003  PMID: 19358848 
  23. Antinori S, Galimberti L, Milazzo L, Corbellino M. Biology of human malaria plasmodia including Plasmodium knowlesi. Mediterr J Hematol Infect Dis. 2012;4(1):e2012013.  https://doi.org/10.4084/mjhid.2012.013  PMID: 22550559 
  24. World Health Organization (WHO). Guidelines for the Treatment of Malaria. Geneva: WHO; 2015.
  25. Lee KS, Cox-Singh J, Singh B. Morphological features and differential counts of Plasmodium knowlesi parasites in naturally acquired human infections. Malar J. 2009;8(1):73.  https://doi.org/10.1186/1475-2875-8-73  PMID: 19383118 
  26. Barber BE, William T, Grigg MJ, Piera K, Yeo TW, Anstey NM. Evaluation of the sensitivity of a pLDH-based and an aldolase-based rapid diagnostic test for diagnosis of uncomplicated and severe malaria caused by PCR-confirmed Plasmodium knowlesi, Plasmodium falciparum, and Plasmodium vivax. J Clin Microbiol. 2013;51(4):1118-23.  https://doi.org/10.1128/JCM.03285-12  PMID: 23345297 
  27. Abbott. BinaxNOW Malaria. City: Abbott; 2017. Available from: https://www.alere.com/en/home/product-details/binaxnow-malaria.html
  28. Vinnemeier CD, Rothe C, Kreuels B, Addo MM, Vygen-Bonnet S, Cramer JP, et al. Response to fever and utilization of standby emergency treatment (SBET) for malaria in travellers to Southeast Asia: a questionnaire-based cohort study. Malar J. 2017;16(1):44.  https://doi.org/10.1186/s12936-017-1678-2  PMID: 28122576 
  29. Behrens RH, Carroll B, Hellgren U, Visser LG, Siikamäki H, Vestergaard LS, et al. The incidence of malaria in travellers to South-East Asia: is local malaria transmission a useful risk indicator? Malar J. 2010;9(1):266.  https://doi.org/10.1186/1475-2875-9-266  PMID: 20920352 
  30. Barber BE, Rajahram GS, Grigg MJ, William T, Anstey NM. World Malaria Report: time to acknowledge Plasmodium knowlesi malaria. Malar J. 2017;16(1):135.  https://doi.org/10.1186/s12936-017-1787-y  PMID: 28359340 
  31. Department of Field Support (DFS). Cartographic Section of the United Nations. Map of Thailand 2009.
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