Air routes
The increase in air routes from Africa potentially increase the risk of introducing airport malaria. Aircraft
Mosquitoes have been found to be attracted to the illuminated cabins rather than to the baggage compartments. Diagnosis
Mild cases may be missed. Due to the absence of a travel history in a person with fever, malaria is not usually expected, resulting in delays in diagnosis. Before the diagnosis of airport malaria can be made, other methods of transmission need to be excluded including blood transfusion, shared needles, prior exposure in endemic regions, and transmission by local mosquitoes. History taking requires information on where the person lives and works, in addition to the distance from the airport. Epidemiology
Airport malaria is rare with most cases being reported sporadically and in the summer. It is not as well recognised as malaria in a person with a travel history to a place with endemic malaria. Europe
Between 1969 and 1999, Europe saw up to 89 people diagnosed with airport malaria. The frequent flights from Sub-saharan Africa resulted in Belgium, France and the Netherlands being at highest risk.In the UK, at least 14 people with airport malaria were reported between 1969 and 1999. In 1983, 12 out of 67 aircraft flying from tropical countries to Gatwick Airport, London, contained mosquitoes. In the same year, falciparum malaria was reported in two people living 10 km (6.2 mi) and 15 km (9.3 mi) from Gatwick Airport. It was deduced that an infected mosquito accompanied aircrew to a pub near Gatwick and infected its landlord.
Airport malaria, sometimes known as baggage, luggage or suitcase malaria, occurs when a malaria infected female Anopheles mosquito travels by aircraft from a country where malaria is common, arrives in a country where malaria is usually not found, and bites a person at or around the vicinity of the airport, or if the climate is suitable, travels in luggage and bites a person further away. The infected person usually presents with a fever in the absence of a recent travel history. There is often no suspicion of malaria, resulting in a delay in diagnosis. It is typically considered as a diagnosis after other explanations for symptoms have been ruled out.Most mosquitoes on aircraft do not carry malaria and the few that do are relatively inefficient invaders. The climate of the host country also offers natural protection. The detection and treatment is the same as of malaria in general. Prevention involves control of mosquitoes at and around airports in the countries of departure and on the aircraft.Studies of airport malaria have been largely observations of individual scenarios, all unique in timing, place of infection and problems, in addition to possibilities of error. The first cases of airport malaria were reported in 1969. Climate change, the rise in international travel, and less frequent aircraft disinsection, have likely played roles in the significant increase in cases between 2010 an 2020 as compared to the previous decade in Europe.