Eighteen day old neonate presented with features of early neonatal sepsis. History of mother revealed a travel from non-endemic area of malaria to endemic area, and on the 7th gestational age mother detected as having malaria. She was treated with quinine and cured. Baby was also evaluated for congenital malaria in first few neonatal days and discharged. Now the baby on evaluation shows anemia, hepatosplenomegaly and diagnosed with a Plasmodium vivax infection on peripheral smear. The quinine failed to prevent transplacental transmission. Prolonged interval between birth and onset of symptoms may be explained by transmission late in pregnancy or during delivery or by presence of transplacentally acquired maternal antibody (IgG). Mother acquired malarial infection after travel to an endemic area and transmitted to the baby. A high level of suspicion is warranted in babies of malaria infected mothers even when the neonate peripheral smear shows no evidence of infection.
Antimalarials/therapeutic use ; Chloroquine/therapeutic use ; Infectious Disease Transmission, Vertical ; Malaria, Vivax/*congenital ; Malaria, Vivax/*epidemiology

To evaluate the factors that determine the transmission level of vivax malaria using vectorial capacity, entomological surveys were conducted from June to August, 2000. From 6 nights of human-bait collection in Paju, the human biting rate (ma) was counted as 87.5 bites/man/night. The parity of Anopheles sinensis from human baiting collections fluctuated from 41% to 71% (average 48.8%) of which the rate gradually increased as time passed on: 35.2% in Jun.; 55.0% in July; 66.2% in Aug. From this proportion of parous, we could estimate the probability of daily survival rate of An. sinensis to be 0.79 assumed with 3 days gonotrophic cycle and the expectancy of infective life through 11 days could be defined as 0.073. Blood meal analysis was performed using ELISA to determine the blood meal source. Only 0.8% of blood meals were from human hosts. We could conclude that An. sinensis is highly zoophilic (cow 61.8%). Malaria is highly unstable (stability index < 0.5) in this area. From these data, vectorial capacity (VC) was determined to be 0.081. In spite of a high human biting rate (ma), malaria transmission potential is very low due to a low human blood index. Therefore, we could conclude that malaria transmission by An. sinensis is resulted by high population density, not by high transmission potential. For this reason, we need more effort to decrease vector population and vector-human contact to eradicate malaria in Korea.
Animals ; Anopheles/*parasitology ; Human ; Insect Vectors ; Korea ; Malaria, Vivax/parasitology/*transmission ; Parity ; Plasmodium vivax/*pathogenicity/physiology ; Population Density

Three anopheline mosquitoes in Korea were studied for their abilities as vectors for Plasmodium vivax. The female mosquitoes of Anopheles lesteri, An. pullus and An. sinensis were allowed to suck malaria patient blood until fully fed, and they were then bred for 2 weeks to develop from malaria parasites to sporozoites. The result from the above confirmed the sporozoites in one An. lesteri of one individual and five An. sinensis of six individuals. We also reconfirmed that An. sinensis was the main vector to transmit malaria and An. lesteri as well as An. sinensis were able to carry Korean malaria parasites. Therefore, we propose that diversified study is needed to manage malaria projects.
Adult ; Animals ; Culicidae/*parasitology/*physiology ; Female ; Humans ; *Insect Vectors ; Korea ; Malaria/parasitology/transmission ; Male ; *Plasmodium vivax

We investigated population densities of mosquitoes infected with sporozoites in three highly epidemic areas of Josan-ri and Jangpa-ri (Paju City) and Dongjung-ri (Yeoncheon County) in Korea. Anopheline mosquitoes were collected from both indoors and outdoors by human baiting collection method during the period of the first week of June to the second week of September 1999. Total 13,296 female mosquitoes were collected and 8,650 (65.1%) were Anophelines. Thirty seven percent (3,199) of the Anopheline mosquitoes were captured outdoors and 63.9% (5,531) indoors. Employing a sandwich enzyme-linked immunosorbent assay (ELISA), we analyzed a total of 7,820 Anopheline mosquitoes and found that 7 Anopheline mosquitoes were infected with sporozoites. The positive rate in Josan-ri was 0.14% (5/3,500) and 0.15% (2/1,370) in Jangpa-ri. The total positive rate in all three surveyed areas was 0.09% (7/7,820). The mosquitoes infected with the sporozoites were detected on June 28th (n=2), July 5th (n=1), July 19th (n=1), August 9th (n=1), September 6th (n=1), and the last one on September 13th (n=1). They were all classified as Anopheles sinensis, which showed positive reaction in ELISA test. Therefore it might be concluded that A. sinensis plays an important role in re-emerging malaria transmission in Korea.
Animals ; Culicidae/*parasitology ; Enzyme-Linked Immunosorbent Assay ; Female ; Human ; Korea/epidemiology ; Malaria, Vivax/epidemiology/parasitology/transmission ; Plasmodium vivax/*isolation & purification ; Support, Non-U.S. Gov't

We had an opportunity to evaluate a child who developed fever approximately two to three weeks after the open heart surgery for tetralogy of Fallot. His peripheral blood smear showed rings and various stages of Plasmodium vivax. The patient had received packed red blood cells during the surgery and postoperative care, one unit of which was later proved sero-positive for malaria. The possibility of malaria should be included in the differential diagnosis of the patients with unexplained fever after multiple blood product transfusions for the open heart surgery.
Animal ; Blood Transfusion/*adverse effects ; Cardiac Surgical Procedures ; Case Report ; Fever/parasitology ; Human ; Infant ; Korea ; Malaria, Vivax/*transmission ; Male ; *Plasmodium vivax ; Tetralogy of Fallot/*surgery

To investigate the population densities of potential malaria vectors, Anopheles species were collected by light traps in malaria endemic areas, Paju and Gimpo, Gyeonggi-do of Korea. Five Anopheles Hyrcanus sibling species (An. sinensis, An. pullus, An. lesteri, An. kleini, and An. belenrae) were identified by PCR. The predominant species, An. pullus was collected during the late spring and mid-summer, while higher population consists of An. sinensis were collected from late summer to early autumn. These 2 species accounted for 92.1% of all Anopheles mosquitoes collected, while the other 3 species accounted for 7.9%. Taking into account of these population densities, late seasonal prevalence, and long-term incubation period (9-13 months) of the Korean Plasmodium vivax strain, An. sinensis s.s is thought to play an important role in the transmission of vivax malaria in the study areas.
Animals ; Anopheles/*classification/genetics/*growth & development ; Humans ; Malaria, Vivax/transmission ; Polymerase Chain Reaction/methods ; Population Dynamics ; Republic of Korea ; Seasons

INTRODUCTIONThe objective of the study was to determine the trend of malaria, the epidemiological characteristics, the frequency of local transmission and the preventive and control measures taken.

MATERIALS AND METHODSWe analysed the epidemiological records of all reported malaria cases maintained by the Communicable Diseases Division, Ministry of Health, from 1983 to 2007 and the Anopheles vector surveillance data collected by the National Environment Agency during the same period.

RESULTSThe annual incidence of reported malaria ranged from 2.9 to 11.1 per 100,000 population, with a sharp decline observed after 1997. There were 38 deaths, 92.1% due to falciparum malaria and 7.9% due to vivax malaria. Of the reported cases, 91.4% to 98.3% were imported, with about 90% originating from Southeast Asia and the Indian subcontinent. Among the various population groups with imported malaria, the proportion of cases involving work permit/employment pass holders had increased, while that of local residents had decreased. Between 74.8% and 95.1% of the local residents with imported malaria did not take personal chemoprophylaxis when they travelled overseas. Despite the extremely low Anopheles vector population, a total of 29 local outbreaks involving 196 cases occurred. Most of the larger outbreaks could be traced to foreign workers with imported relapsing vivax malaria and who did not seek medical treatment early. One of the outbreaks of 3 cases in 2007 was caused by Plasmodium knowlesi, a newly recognised simian malaria which was probably acquired in a forested area where long-tail macaques had been sighted.

CONCLUSIONSSingapore remains both vulnerable and receptive to the reintroduction of malaria and a high level of vigilance should be maintained indefinitely to prevent the re-establishment of endemicity. Medical practitioners should highlight the risk of malaria to travellers visiting endemic areas and also consider the possibility of simian malaria in a patient who has no recent travel history and presenting with daily fever spikes and with malaria parasite morphologically similar to that of P. malariae.

Adolescent ; Adult ; Animals ; Anopheles ; Child ; Child, Preschool ; Disease Outbreaks ; Emigrants and Immigrants ; Female ; Humans ; Incidence ; Infant ; Infant, Newborn ; Insect Vectors ; Malaria ; epidemiology ; prevention & control ; transmission ; Malaria, Falciparum ; epidemiology ; prevention & control ; transmission ; Malaria, Vivax ; epidemiology ; prevention & control ; transmission ; Male ; Middle Aged ; Plasmodium knowlesi ; Plasmodium malariae ; Population Surveillance ; Recurrence ; Retrospective Studies ; Risk Factors ; Singapore ; epidemiology ; Travel ; Young Adult

OBJECTIVETo establish a minimum medical geographic information systems (GIS) database as a spatial decision supporting system (SDSS), and to use the database into public health practice in China.

METHODSSpatial data collected from different sources were standardized as decimal degree format, including: (1) satellite images covering areas of China; (2) digital maps of China in vector files; (3) diseases database and relevant models.

RESULTSNecessary satellite images for the database have been collected from NOAA AVHRR, Landsat TM, etc., including the normalized difference vegetation index (NDVI) images from AVHRR, earth surface temperature images from AVHRR, GTOPO30 DEM images from USGS and landuse images from USGS. The digital vector files for GIS analysis were collected including political (county, provinces, country) boundaries file, environmental (drainage, land cover, soil type) vector file, population data and climate data; Data on diseases mainly generated from survey or case reporting. Relevant models on transmission of Schistosoma japonicum and Plasmodium vivax, and models of Oncomelania hupensis and Anophores sinansis were developed, and the relevant environmental factors related to incidence of cancers were mapped, to test and verify those database.

CONCLUSIONThe database unified the data from different sources for users. Minimum medical data included in the database could be used in the practice of public health. It is expected that this database be used in a wider range.

Animals ; Anopheles ; parasitology ; China ; epidemiology ; Databases, Factual ; Disease Reservoirs ; Disease Vectors ; Ecology ; Geographic Information Systems ; Humans ; Malaria ; epidemiology ; prevention & control ; transmission ; Plasmodium vivax ; Satellite Communications ; Schistosomiasis japonica ; epidemiology ; prevention & control ; transmission ; Snails ; parasitology