Health Professionals

Clinical Updates

9 August 2010

Malaria in Maharashtra, India

An increased number of malaria cases have been reported in Maharashtra state, India [1]. Between January and May 2010, a total of 25,775 cases were reported, compared to 16,149 during the same period of 2009 [1]. According to media reports, the majority of cases have occurred in the city of Mumbai [2].

In 2010, from 1 January to 5 August, the HPA Malaria Reference Laboratory has received reports of a total of 87 cases of imported malaria in travellers arriving in the UK from India [3]. One infection was due to Plasmodium falciparum, the remainder were due to P. vivax. Where a destination was specified, 10 had visited Mumbai. The majority of cases (55) were reported during June and July; five of which specified Mumbai as the destination. During the whole of 2009, 99 cases of malaria imported from India were reported, 20 of which specified Mumbai as the destination. Eighty six were due to P.vivax infection, and 13 due to P. falciparum.

The recent increase in cases has coincided with the monsoon season which began in June in Maharashtra [4].

Advice for travellers

The city of Mumbai is considered to be a low risk area for malaria; malaria prevention tablets are not currently recommended by the Health Protection Agency Advisory Committee on Malaria Prevention (ACMP). In the rest of Maharashtra state malaria prevention tablets, proguanil plus chloroquine are usually recommended. See ACMP malaria guidelines.

Mosquitoes that transmit malaria generally bite between sunset and sunrise. All travellers are advised to take insect bite avoidance measures. 

Detailed malaria advice, together with information on other health risks for travellers to India, can be found on the NaTHNaC Country Information Page.

Travellers should seek medical attention promptly if they become unwell on their return and inform their doctor that they have been in a malarious area. Healthcare workers should consider malaria in ill patients who have returned from the tropics.

The ACMP and NaTHNaC will continue to monitor the situation and further Clinical Updates will be posted on the NaTHNaC website as appropriate.

References

1. Directorate of National Vector Borne Disease Control Programme. Malaria monthly epidemiological situation. 25 July 2010. [Accessed 9 August 2010]. Available at: http://www.nvbdcp.gov.in/Doc/Mal-MES-may2010.pdf

2. ProMED-mail. Malaria in Mumbai. ProMED-mail 2010; 17 Jul: 20100717.2397. [Accessed 9 August 2010]. Available at: http://apex.oracle.com/pls/otn/f?p=2400:1001:8139661847719

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3. Chiodini PL. Health Protection Agency Malaria Reference Laboratory. [personal communication, 5 August 2010].

4. India Meteorological Department. Normal dates of onset of southwest monsoon. [Accessed 9 August 2010]. Available at: http://www.imd.gov.in/section/nhac/dynamic/Monsoon_frame

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