New Malaria Recommendations for Greece

New Malaria Recommendations for Greece

Malaria prophylaxis is now indicated for Lakonia region of Greece. A travel notice titled “New Malaria Recommendations for Greece” has been added to the site. New recommendations for Greece are also reflected in the Yellow Book’s country-specific malaria information and the

Greece destination page.

The Centers for Disease Control and Prevention (CDC) has received updated information on malaria cases in Greece. According to a recent publication by Greek health authorities [K Danis, A Baka, A Lenglet, W Van Bortel, et al. Autochthonous Plasmodium vivax malaria in Greece,

2011. Eurosurveillance. 2011 Oct 20, 16(42)], since 27 Sep 2011, a total of 20 malaria cases have been reported in persons with no history of travel to a malaria-endemic area. An additional 16 cases have been identified in persons from malaria endemic countries in whom importation versus local transmission of malaria could not be determined. All cases were confirmed to be _P. vivax. The majority (20 cases) occurred in the southern region of the country, specifically in the Laconia district in the south. Other cases occurred in the Evia/Euboea (island east of the Central Greece region), Eastern Attiki, Voitia, and Larissa districts

The Hellenic CDC of Greece continues to work with the European CDC and has responded by enhancing its surveillance system and intensifying mosquito control in affected areas, raising awareness among health care providers and hospitals about early malaria diagnosis and

treatment, and educating the public about prevention of mosquito bites.

Because of the ongoing evidence of malaria transmission in Laconia district, CDC is recommending that travelers to Laconia district in Greece take anti-malarial medicines to prevent malaria. Recommended antimalarials include one of the following: atovaquone-proguanil (Malarone TM), chloroquine, doxycycline, mefloquine, or primaquine. Note that primaquine is contraindicated in people with glucose-6-phosphate dehydrogenase (G6PD) deficiency. If primaquine is chosen, the traveler must be screened for G6PD deficiency prior to use.

For the districts of Evia/Euboea, Eastern Attiki, Voitia, and Larissa, anti-malarials are not recommended at this time because there have only been a limited number of cases.

Measures to prevent mosquito bites should also be taken for all of these districts with malaria. These measures include using insect repellent when outdoors, and staying in an air-conditioned or well-screened area, or sleeping under an insecticide treated bed net during the peak biting period for mosquitoes (dusk and dawn).