This species was a common malaria vector in Italy until the country was declared malaria free in 1970. Five cases of airport malaria were reported in Geneva in the hot summer of 1989.In Spain, 1964 marked the elimination of malaria following sanitary and socioeconomic developments. However, over the following 50 years, more than 10 000 cases of malaria were reported, of which 0.8% had no history of recent travel. Airport malaria was reported in two people. In 1984, a 76-year-old woman died from P. falciparum after visiting relatives less than 6 kilometres (3.7 mi) from Madrid airport. Suspected to have pneumonia, the diagnosis was not initially clear. In 2001, a second woman was diagnosed, treated and recovered. Other countries
There have not been any confirmed reports of airport malaria in the US. However, between 1957 and 2003, there were 156 people reported with malaria who had no history of travel or other risk factors. Some were likely to be caused by airport malaria. A small number of airport malaria reports have come from Florida.Airport malaria was first reported in Australia in 1996. Prevention
The WHO International Health Regulations give guidance on prevention of airport malaria. Mosquito control programmes also recommend procedures for aircraft coming from endemic areas and for the receiving airports, including the surrounding 400 metres (1,300 ft) of area.Routine aircraft disinsection of aircraft has been shown to reduce mosquitoes on aircraft. Insecticide can also be sprayed on the ground.
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.