NICD was notified of a malaria case in Soshanguve, City of Tshwane, Gauteng Province. A team comprising members of the NICD Parasitology and Vector Control Reference Laboratories, District Health Services, Environmental Health and Communicable Disease Control programmes, conducted an investigation in the area on 4 December 2019. The patient, a 19-year-old pregnant woman, had not travelled to a known malaria area. She presented with ‘flu-like illness at a primary health facility in mid-November, and was referred to hospital, where malaria was diagnosed and treated. The patient’s family lives in a community where many persons from local and international malaria-endemic regions reside.
The patient likely acquired malaria from the bite of an infective Anopheles mosquito inadvertently transported from a malaria-endemic area via a road vehicle, a phenomenon known as odyssean malaria (see NICD Communiqués vol. 18 (5) May 2019 and vol. 18 (1) January 2019). No specific vector control interventions are required and such cases do not represent an expansion of the malaria transmission zone in South Africa. Malaria awareness education activities were done in the area.
Increases in imported and odyssean malaria cases are anticipated during and after the festive season holidays. All healthcare practitioners are encouraged to consider malaria as a differential diagnosis in patients presenting with unexplained fever (>38°C) and progressive ‘flu-like illness, even in the absence of a travel history to a malaria-endemic region. Primary health clinics in Gauteng Province are supplied with rapid diagnostic test kits and artemether-lumefantrine (Coartem) for early diagnosis and treatment of malaria. Malaria alerts, treatment and prevention guidelines are available here.