Eurosurveillance - Volume 6, Issue 4, 01 April 2001

The European Surveillance Scheme for Travel Associated Legionnaires’ Disease was notified of the highest number of cases in travellers in 1999 since the scheme began in 1987. This reflects enhanced surveillance activities and an increase in the use of urinary antigen detection for Legionella pneumophila serogroup 1. The scheme's extensive reporting and investigation activities are complemented in some countries by the activities of tour operators, who have been legally responsible for the health and safety of their clients since the 1996 European Commission’s Package Travel Directive came into force. In recent years, the work conducted by the collaborators has helped establish good surveillance and control in sites used by travellers.

The number of autochthonous reported cases of malaria fell from 90 506 to 37 170 between 1996 and 1999 in the WHO European Region. There has been, however, an eight-fold increase in imported cases since the 1970s: 1500 cases were reported in 1972, 13 000 cases in 1999. France, Germany, Italy, and the United Kingdom are the west European countries with the largest numbers of cases.

We report on malaria acquired by German tourists to formerly non-endemic tourist resorts in the Dominican Republic between July 1999 and March 2000. Falciparum malaria is endemic in the western provinces and the hinterland of the Dominican Republic. By contrast, the risk of contracting malaria has always been considered so low in the main tourist resorts in the eastern part of the country that antimalarial chemoprophylaxis was not recommended.