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MALARIA, AUTOCHTHONOUS - ITALY (02): (LATINA)
*********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

******
[1]
Date: Fri 6 Nov 2009
From: Dr Zeno Bisoffi
<zeno.bisoffi@sacrocuore.it>


Autochthonous malaria in Italy ­ probably not
---------------------------------------------
I would suggest to carefully check this information about autochthonous
malaria in Italy!

First of all, this would not be "the 1st case of malaria in which the
person was infected in Italy since then" (1970), as a previous and well
documented case of vivax malaria had been transmitted by a local mosquito
in 1997, in the "Maremma" of Tuscany (Lancet 1998;351:1246-7).

Secondly, past travel history should be carefully ascertained: in our
practice we have seen several cases of vivax malaria after years (up to > 6
y) after last visiting an endemic area, which would be by no mean exceptional.

As is well known, "endemic" areas for Plasmodium vivax still include
countries such as Southern Turkey relatively close to Italy. And finally,
other forms of "cryptic" malaria do exist and have been reported more
frequently (in non endemic countries including Italy) than cases of
transmission by local mosquitoes.

Therefore I disagree that "It is conceivable that malaria may have returned
to the area". Of all the possibilities, this appears to me by and large the
most unlikely.

I strongly suggest that before disseminating in a hurry unlikely infos,
taken from the general press, that could create alarm (I have personally
already received many mails only this morning), this should checked with
the doctors in charge of the patients, in this case the colleagues from
Spallanzani Hospital!

--
Dr Zeno Bisoffi
Primario, Centro per le Malattie Tropicali
Head, Centre for Tropical Diseases
Directeur, Centre pour les Maladies Tropicales
Director, Centro para Enfermedades Tropicales
Ospedale S. Cuore, 37024 Negrar - Verona (Italy)
<zeno.bisoffi@sacrocuore.it>

[ProMED-mail thanks Professor Zeno Bisoffi for his comment. We agree that
there are other more likely explanations for the case than the reemergence
of malaria in Italy, and we will be happy to post further details of the
case. We do not even know the species of malaria and the dates of the visit
to Fondi, and as pointed out above a detailed travel history including
visits to other Mediterranean countries is needed to evaluate where the
patient was infected. - Mod.EP]

******
[2]
Date: Sat 7 Nov 2009
Source: Gideon [edited]
<http://www.gideononline.com/blog/2009/1 ... -in-italy/>


Autochthonous malaria in Italy ­ background data
------------------------------------------------
A recent case in the Lake Fondi [not confirmed infected in the Fondi
Region. - Mod.EP] region reminds us that the potential for malaria
transmission persists in Europe.

Sporadic reports of cryptic, airport-, and locally-acquired malaria have
appeared in the Italian literature in recent years.

Historical background:
- malaria was eradicated from Sardinia during 1946 to 1950, through massive
application (267 metric tons) of DDT;
- a single endemic case (_Plasmodium vivax_ in Palma di Montechiaro,
Sicily) was reported in 1956; with sporadic cases in the area of Palermo
during 1962;
- Italy was declared "malaria-free" in 1970;
- a single case of autochthonous malaria (_P. vivax_) was reported in
Maremma (Tuscany) in 1997 -- _Anopheles labranchiae_ was implicated as the
vector.

Although disease rates have increased in recent years due to imported
malaria (see graph at
<http://www.gideononline.com/blog/wp/wp- ... taly11.JPG>),
imported malaria continues to be less common than in neighboring France and
Switzerland. (see graph at
<http://www.gideononline.com/blog/wp/wp- ... taly21.JPG>)

Malaria in Italy:
1. 411 000 cases of malaria were reported in 1949;
2. 74 641 cases were reported on Sardinia in 1946, 39 303 in 1947, 15 121
in 1948, 1314 in 1949, 0 in 1950, 9 in 1951, 0 in 1952;
3. 1087 cases of malaria were reported during 1973 to 1982, 5843 during
1986 to 1996 (including 7 transfusion-related, 2 "airport malaria" and 7
cryptic), 3354 during 2002 to 2006 -- 71 per cent among foreigners;
4. 98 per cent of cases reported during 1989 to 1997 were imported, 106
characterized as relapses and 19 acquired in Italy;
5. 407 cases of imported malaria among children ages 0 to 18 were reported
during 1992 to 2002 -- 82 per cent due to _P. falciparum_;
6. 86 per cent to 92 per cent of cases were acquired in Africa (1995 to 2006);
7. 73 per cent of malaria cases reported during 1986 to 1997 were caused by
_P. falciparum_ and 20 per cent _P. vivax_;
8. _P. falciparum_ accounted for 74 per cent of cases during 1989 to 1997;
84 per cent during 1999 to 2000; 85 per cent during 2002 to 2006.

Vectors:
- the potential vectors for Italy are _Anopheles superpictus_ and _An.
labranchiae_;
- _An. atoparvus_ was once active in transmission, and is still present in
Tuscany (Fucecchio and Cerbaie woodlands, Grosseto and Siena);
- _An. sacharovi_ was previously found in Puglia and Sardina, but was
absent as of 1994. _An. labranchiae_ is found in Tuscany (Grosseto Province
and areas of intensive rice cultivation), Apulia (coastal plains of the
Adriatic from Lesina lake to the Candelaro River), Calabria (coastal plains
of the Tirrenian and Ionian sides and the close hinterland), Puglia, Sicily
(rural coastal and hilly areas), and Sardinia (rural coastal and hilly areas);
- _An. superpictus_ is found in Calabria (coastal plains of the Tirrenian
and Ionian sides and the close hinterland) and Sicily (rural coastal and
hilly areas).

--
communicated by:
Steve Berger
Geographic Medicine
Tel Aviv Medical Center
<mberger@post.tau.ac.il>

[ProMED-mail thanks Professor Steve Berger for providing background
information on malaria in Italy since the Second World War. Even though 19
cases were acquired in Italy, it does not mean that there is a sustained
reservoir in Italy and sustained transmission from such a reservoir, but
rather that limited transmission is possible from gametocyte carriers
infected abroad. - Mod.EP]

MALARIA, AUTOCHTHONOUS ­ ITALY (03)
***********************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Sat 7 Nov 2009
From: Prof. Beniamino Cenci Goga
<cencigog@unipg.it>


More information on transmission potential of malaria in Italy
--------------------------------------------------------------
For readers who wish to get more information:

1. The 1997 case
(<http://www.ncbi.nlm.nih.gov/pubmed/9643 ... t=Abstract>) was
interpreted by the authors of the investigation (Lancet 1998; 351(9111):
1246-7) as "These investigations suggest that the index case of malaria was
caused by local anopheline mosquitoes infected with exogenous _Plasmodium
vivax_," -- that is, local mosquito -- exogenous plasmodium.

2. CDC points to an interesting perspective paper updated in 2001: "Could
malaria reappear in Italy?" <http://www.cdc.gov/ncidod/EID/vol7no6/romi.htm#1>.

--
Prof Beniamino Cenci Goga, DVM, PhD, mECVPH
Facolta di Medicina Veterinaria
Perugia
Italy
Teaching: <http://www.unipg.it/cencigog>
Laboratory: <http://www.unipg.it/cencigog/bioita.html>
<cencigog@unipg.it>

[ProMED-mail thanks Professor Beniamino Cenci Goga for the information. The
2001 paper in Emerging Infectious Diseases concludes that "The overall
malariogenic potential of Italy appears to be low, and reintroduction of
malaria is unlikely in most of the country."

We believe this is still the situation, and hope that we will soon receive
confirmation that the patient referred to in the 1st posting was not
infected in Fondi. ­ Mod.EP]

Malaria: Forscher testen neue Waffe gegen den Kinder-Killer

Eine Infektion mit dem Malariaüberträger birgt vor allem für Kleinkinder eine tödliche Gefahr. Alle 30 Sekunden stirbt irgendwo auf der Welt ein Kind an der Krankheit – in 90 Prozent der Fälle in Afrika. Experten setzen auf einen neuen Impfstoff: Dieser soll nun an bis zu 16.000 afrikanischen Kindern erprobt werden. mehr...

Grüsse
Alexander

Mit Tees und Pulver gegen Malaria
11.11.2009 - Deutsche Welle

Sie sieht aus wie ein Petersilie - und wirkt Wunder: Die Heilpflanze "Artemisia annua" hilft gegen Malaria. Für Afrika könnte das ein Durchbruch sein. Denn hier ist Malaria noch immer die häufigste Todesursache ... mehr

Gruß
Birgitt

MALARIA - KENYA: (MOUNT KENYA) REQUEST FOR INFORMATION
******************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Fri 1 Jan 2010
Source: Visit Bulgaria [edited]
http://visitbulgaria.info/12245-increas ... al-warming



Malaria transmission increase on Mount Kenya
--------------------------------------------
According to a team of researchers funded by the UK Government's
Department for International Development (DfID), global warming is to
be blamed for the 7-fold increase in the malaria cases on Mount Kenya.

In the past 20 years, the average temperature on the mountain has
risen by 2-degrees Centigrade, allowing the disease to crop up in the
higher altitude areas, with the local population having no or little
immunity to the disease.

According to the researchers, the average temperature in the Kenyan
Central Highlands has risen from 17 deg C [62.6 deg F] in 1989 to 19
deg C [66.2 deg F] today.

Since the parasite matures only in temperatures above 18 deg C [64.4
deg F], it was absent from the region prior to the 1990s. However,
with average temperatures now above 18 deg C [64.4 deg F], malaria
epidemics have increased in the past decade, malaria-carrying
anopheles mosquitoes discovered in Naru Moro, which is over 6175 ft
(1900 m) above sea level in 2005.

Similar outbreaks elsewhere are also attributed to multiple factors
like resistance to drugs, including changes in the way land is used,
such as, changes in drainage systems, population explosion etc.,
though the only change in Mount Kenya has been the rise in temperature.

The change in temperature is being blamed on emissions from human
activity, rather than climatic changes due to natural causes. Rising
temperatures on the slopes of Mount Kenya have put an extra 4 million
people at risk of malaria, as the disease creeps into the higher
altitude areas.

Church meetings and local health clinics are being held for educating
people in high-altitude areas on how climate change could impact then
by spreading malaria into their area.

Extremely worrying, developing nations like Kenya need support to
help them tackle the potentially devastating impacts of climate change.

[Byline: Anna Tomova]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[A recent study from another area of Kenya (John CC et al: Possible
interruption of malaria transmission, highland Kenya, 2007-2008.
Emerg Infect Dis. 2009 Dec; 15(12): 1917-24;
<http://www.cdc.gov/eid/content/15/12/pdfs/09-0627.pdf>) in highland
areas of Kipsamoite and Kapsisiywa, Kenya, found that after
introducing annual household indoor residual spraying with a
synthetic pyrethroid and artemether/lumefantrine was implemented in
2005 no microscopy-confirmed cases of malaria occurred at the sites
in 2007-2008, and less than 0.3 percent of persons were positive for
_Plasmodium falciparum_ by microscopy or PCR at any time.

A previous study (Chen et al: New records of _Anopheles arabiensis_
breeding on the Mount Kenya highlands indicate indigenous malaria
transmission. Malar J. 2006 Mar 7; 5:17;
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1420308/>) found that
_Anopheles arabiensis_ in Karatina and Naro Moru on the highlands at
elevations of 1720-1921 m [5643-6303 ft] above sea level. Malaria
cases were recorded in the 2 highland locations in the past 10 years
with an increasing trend. The study concludes that local malaria
transmission on the Mount Kenya highlands is possible due to the
presence of _An. arabiensis_, and notes that malaria cases on the
highlands west of Mount Kenya have been noticed since 10-20 years ago.

ProMED-mail will be happy to publish more details from the DfID
study. - Mod.EP]

[The HealthMap/ProMED-mail interactive map of Kenya is available at
<http://healthmap.org/r/011->. - Sr.Tech.Ed.MJ]

Impfstoffe
Hoffnung im Kampf gegen Malaria
16.01.2010 - FAZ

Als der Molekularbiologe Joe Cohen sich daranmachte, einen Impfstoff gegen Malaria zu entwickeln, war Ronald Reagan Präsident der Vereinigten Staaten und das Internet noch eine Sache für Technikfreaks. Es war das Jahr 1987, und der in Kairo geborene und in Amerika ausgebildete Wissenschaftler arbeitete als Molekularbiologe für den britischen Pharmakonzern Smith Kline ... mehr

Gruß
Birgitt

Forscher fanden Erreger der gefährlichen Variante Malaria tropica auch bei Menschenaffen
18.01.2010 - Standard

Montpellier/Washington - Der Erreger der gefährlichsten Malariavariante beim Menschen, Malaria tropica, ist überraschend auch bei Gorillas nachgewiesen worden. Forscher aus Frankreich und den USA fanden zudem zwei bislang unbekannte Formen der Malariaparasiten bei den Tieren aus Afrika. Unklar sei noch, ob sich die Gorillas bei Menschen oder anderen Primaten angesteckt hätten und wie stark die Tiere erkrankt seien, schreiben die Wissenschafter in den "Proceedings" der US-Akademie der Wissenschaften ("PNAS"). Dennoch müsse künftig bei der Bekämpfung der von Mücken übertragenen Infektion daran gedacht werden, dass auch Menschenaffen die Erreger in sich tragen können ... mehr

Gruß
Birgitt

Malariabekämpfung in Afrika: Giftkrieger im Sprüheinsatz

DDT ist ein hochgiftiges Pestizid. Afrikanische Länder nutzen die Chemikalie zur Malaria-Bekämpfung. Zwar gibt es einige Erfolge - doch Wissenschaftler warnen: Für Mensch und Tier ist die Sprühstrategie hochriskant. mehr...

Grüsse
Alexander

Schaut doch mal da.

http://wuestenschiff.de/phpbb/viewtopic ... highlight=

und da

http://www.nusag.ch/index.html

liebe grüsse

hans peter

Gates says malaria vaccine may be ready in three years
26.01.2010 - BBC

Microsoft founder Bill Gates has told the BBC that a vaccine for malaria could be just three years away. Mr Gates is a key campaigner against the disease which kills a million people a year, most of them children. Since it was formed, his foundation has spent billions of dollars in the fight against malaria. Just like smallpox, Mr Gates believes the disease can be eradicated. As yet, there is no vaccine, but, Mr Gates says, a breakthrough is near ... mehr
_____________________________________________

Impfstoff
Doppelschlag gegen Malaria und Cholera
27.01.2010 - Focus

Eine Kombi-Impfung gegen zwei der schwersten Infektionskrankheiten ist auf gutem Weg. Sie soll sogar billig und damit für die hauptsächlich Betroffenen erschwinglich sein [...] Die Studie ist im Fachmagazin „Plant Biotechnology“ erschienen ... mehr


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Birgitt

Medizin: Ölkonzern kämpft gegen Malaria
06.02.2010 - Handelsblatt

Der Ölkonzern Marathon will Äquatorialguinea von der Malaria befreien. Auch aus Eigeninteresse: Das Land ist inzwischen zum drittgrößten Ölproduzenten südlich der Sahara geworden und damit für das US-Unternehmen ein wichtiger Geschäftspartner ... mehr

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Birgitt

Africa malaria drugs 'low-grade'
08.02.2010 - BBC

Africans suffering from malaria may be getting sub-standard treatment, a study by US-based experts has suggested. Researchers from the Pharmacopeia group found that between 26% and 44% of anti-malaria drugs in Uganda, Senegal and Madagascar were of poor quality. The group, conducting the study for the World Health Organization, said low-grade drugs were being used in both public and private health practices ... mehr

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Birgitt

DDT gilt als gefährliches Gift.
Aber in Afrika rettet das Insektizid Millionen Menschen, sagen Malaria-Experten
09.02.2010 - Tagesspiegel

Das Gift haben die Männer auf ihren Rücken geschnallt, in silbernen Kanistern, die in der Mittagssonne funkeln. Sie tragen blaue Overalls und grüne Atemmasken, in der Hand halten sie eine Sprühpistole. So gehen sie auf die ärmlichen Hütten zu. Sie sind gekommen, um die Mücken, die Malaria übertragen, zu bekämpfen – mit DDT ... mehr

Gruß
Birgitt

MALARIA ­ AFRICA: COUNTERFEIT DRUGS
****************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Tue 9 Feb 2010
Source: CBC News Canada [edited]
<http://www.cbc.ca/health/story/2010/02/ ... sinin.html>



Bad malaria pills raise resistance fears in Africa
--------------------------------------------------
High rates of the most effective type of
malaria-fighting drugs sold in 3 African
countries are poor quality -- including nearly
half the pills sampled in Senegal -- raising
fears of increased drug resistance that could
wipe out the last weapon left to battle a disease
that kills 1 million people each year, according
to a US report released Monday [8 Feb 2010].
Between 16 percent and 40 percent of
artemisinin-based drugs sold in Senegal,
Madagascar, and Uganda failed quality testing,
including having impurities or not containing
enough active ingredient, the survey found.

Artemisinin-based drugs are the only affordable
treatment for malaria left in the global medicine
cabinet. Other drugs have already lost
effectiveness due to resistance, which builds
when not enough medicine is taken to kill all of
the mosquito-transmitted parasites. If
artemisinin-based drugs stop working, there is no
good replacement and experts worry many people could die.

"It is worrisome that almost all of the
poor-quality data that was obtained was a result
of inadequate amounts of active (ingredients) or
the presence of impurities in the product," said
Patrick Lukulay, director of a nongovernmental US
Pharmacopeia program funded by the US government,
which conducted the survey. "This is a disturbing trend that came to light."

The study is the 1st part of a 10-country
examination of antimalarials in Africa by the US
and the World Health Organization (WHO). It
follows evidence from the Thai-Cambodian border
that artemisinin-based drugs there are taking
longer to cure malaria patients, the 1st sign of drug resistance.

The 3-country report also found bad drugs in both
the public and private health sectors, meaning
governments -- some buying medicines with donor
funds -- are not doing enough to keep
poor-quality pills out. All of the drugs tested
from the public sector in Uganda, however, passed
the quality tests. But 40 percent of the
artemisinin-based drugs in Senegal failed.

"There are countries where donated medicines are
not subjected to quality controls, they're just
accepted," said Lukulay. "There are countries in
Africa where Chinese products have been donated
and found to be unacceptable later in the public sector."

A total of 444 samples of artemisinin-based
combination drugs along with the antimalarial
sulfadoxine-pyrimethamine -- to which resistance
has already developed -- were 1st screened
locally using visual inspection and basic lab
tests. Sulfadoxine-pyrimethamine is still used,
mainly for preventative treatment for pregnant women.

Nearly 200 samples then underwent full quality
control testing in a US laboratory to examine the
amount of active ingredient present and drug
purity. For both drugs, 44 percent from Senegal
failed the full quality testing, followed by 30
percent from Madagascar and 26 percent from Uganda.

While the study is not the 1st to assess the
quality of antimalarials in Africa, it is the
most rigorous and complete. Similar failure rates
were found in previous work, but those did not
focus specifically on artemisinin-based drugs.

"I am alarmed by these results because it means
there are many cases of malaria that are being
only partially treated, and that just guarantees
acceleration of artemisinin drug resistance,"
said Rachel Nugent, deputy director for Global
Health at the Center for Global Development, a US
think tank. "It is the most comprehensive study
out there on antimalarials and should be a
wake-up call." Nugent was not involved in the study.

[Byline: Margie Mason]


--
Communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>

[The problems with substandard drugs or even
counterfeit drug is receiving increased attention
and is most probably one of the most important
factors driving the development of resistance to
antimalarial drugs. See for instance this study:
Bate R et al. Antimalarial drug quality in the
most severely malarious parts of Africa - a six
country study. PLoS One. 2008;3(5):e2132.

The new data suggest that quality control in
mandatory in each country and using thin layer
chromatography has been suggested to be easy and
reliable in countries without access to HPLC
(high pressure liquid chromatography) (Ioset &
Kaur. Simple field assays to check quality of
current artemisinin-based antimalarial
combination formulations. PLoS One. 2009,30;4(9):e7270).

The recent development of artemisinin resistance
at the Thai-Cambodia border is also believed to
be driven by substandard formulations.

ProMED suggested in December 2009 (Malaria,
artemisinin resistance - SE Asia
(02) 20091230.4386) that counterfeit drugs and
under-dosing can only be dealt with in
resource-poor countries by providing malaria
treatment free of charge, just as anti-HIV
treatment is provided free of charge
(Schlagenhauf P and Petersen E. Antimalaria drug
resistance: the mono-combi-counterfeit triangle.
Expert Rev Anti Infect Ther. 2009;7:1039-42).

WHO - Guidelines for the treatment of malaria, second edition

Seiten: 194
Erscheinungsjahr: 2010
Sprache: Englisch
ISBN: 9789241547925



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Birgitt