Diaz noted that the second most common means of transmitting malaria in regions where malaria is rare involves mosquitoes local to the region biting a traveler previously infected in a malaria-prone location. The mosquito then goes on to infect people living in the non-endemic region.
In the third instance, "airport malaria" is considered to be the least likely transmission scenario in malaria-free locales. In this case, a malaria-infected mosquito actually makes it way onto a plane traveling into a non-endemic zone. It then leaves the plane upon landing and bites somebody within a mile or so of the airport.
The authors point out that in 1999, the West Nile virus probably arrived in the United States by air via an infected traveler or an infected mosquito, eventually leading to the infection of local wild birds that in turn flew across the United States The result: 4,000 human infections that caused the death of 263 patients.
To highlight the serious potential for malaria to track the same route into currently non-infected regions, the researchers observe that a 1983 analysis of international planes coming from tropical regions to Gatwick Airport in London found that 12 of 67 planes were carrying mosquitoes.
To date, two cases of "airport malaria" were identified at Gatwick in 1983, and another six cases were uncovered at Charles de Gaulle Airport in Paris in 1994.
"It's very rare," admitted Diaz. "But it will happen here in the U.S., if it hasn't happened already."
Meanwhile, Dr. Philip Tierno, director of clinical microbiology and immunology at New York University Medical Center, suggested that plane fumigation is one potential solution to the problem.
"In an article I wrote about a year or two ago, I stressed the need to fumigate airlines as the passengers disembark, especially if they originate from areas that have endemic malaria," he said. "But airlines don't w
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