Date: Wed 30 Dec 2009
From: Patricio Leite (translated and edited)
Three people are sick with malaria in the Madeira archipelago of Portugal. One is in intensive care for complications of the disease in the Central Hospital of Funchal; the other 2 remain hospitalized but stabilized.
These people from Madeira were working in Equatorial Guinea and returned for the Christmas holidays. There is a 4th, a Brazilian national who also may be infected and is undergoing diagnostic tests.
Although they are cases of imported malaria, it is noteworthy that the archipelago of Madeira has a sub-tropical humid climate, conducive to the development of emerging diseases which are usually more prevalent in the tropics.
For example, for about the last 3 years the presence of the vector _Aedes aegypti_ has been documented, and it is now endemic in Madeira, posing the threat of dengue in the short term. In the archipelago, including the island of Porto Santo, weather conditions have allowed the survival of _Anopheles_.
Studies indicate that the next 30 years will see the emergence of diseases in Madeira, such as dengue, yellow fever, and malaria.
Patricio Leite, MD
Specialist in General & Family Medicine
Regional Health Administrator for Lisbon & the Tejo Valley, Ministry
of Health, Portugal
Ex-collaborator of Travel Medicine Consultation, Institute of Hygiene
& Tropical Medicine,
New University of Lisbon
[Portugal reported 41 imported malaria cases in 2008 (Source: <http://data.euro.who.int/cisid/
>). The climate of Madeira in December with temperatures below 20 C do not support local transmission of _Plasmodium falciparum_. Malaria is endemic in Equatorial Guinea, and the risk of infection is high without proper prophylaxis.
The introduction of dengue fever is a possibility, as in most of southern Europe. The introduction of yellow fever is a risk because the vector is present; however, yellow fever is limited to tropical areas, and Madeira probably does not, at present, have a climate which supports sustained transmission of yellow fever. - ProMed Mod.EP]