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Malaria Transmission Under an Unusual Circumstance Causing Death in Two Siblings

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  • 1 Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.
  • | 2 Department of Biochemistry, Kuvempu University, Shivamogga, Karnataka, India.
  • | 3 Light House Polyclinic, Spandana Center for Metabolic Medicine, Mangalore, Karnataka, India.
  • | 4 National Institute of Malaria Research, Bangalore Field Station, ICMR Complex, Bangalore, Karnataka, India.
  • | 5 Directorate of Health and Family Welfare Services, Government of Karnataka, Bangalore, Karnataka, India.
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Two school-going siblings from a family residing in a presumed malaria non-endemic locality ∼90 km from Mangalore city in southwestern India contracted Plasmodium falciparum infection. In both cases, misunderstanding of initial clinical symptoms as due to viral hepatitis resulted in progression to severe malaria before malaria treatment was initiated. Despite treatment at a tertiary hospital, the children died of cerebral malaria and multi-organ dysfunction. Active case detection in the affected locality suggested that the infection was transmitted from infected individuals who worked in nearby malaria-endemic areas and periodically visited their families. A lesson from this study is that lethal falciparum malaria can be transmitted in regions of India, believed to be non-endemic for the disease, resulting in fatal outcomes if diagnosis is missed or delayed. Implementation of effective surveillance and control measures as well as preparedness for malaria detection and diagnosis are necessary in areas that are potentially disposed to malaria transmission even though they are presumed to be non-endemic.

Author Notes

* Address correspondence to D. Channe Gowda, Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033. E-mail: gowda@psu.edu

Financial support: This work was supported by the National Institutes of Health Global Infectious Diseases Grant D43 TW008268.

Authors' addresses: Kiran K. Dayanand and D. Channe Gowda, Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Hershey, PA, E-mails: kirankumar91284@gmail.com and gowda@psu.edu. Kishore Punnath, Valleesha N. Chandrashekar, and Rajeshwara N. Achur, Department of Biochemistry, Kuvempu University, Shivamogga, Karnataka, India, E-mails: kishoresbioworld@gmail.com, vallesha.nc@gmail.com, and rajachur@gmail.com. Srinivas B. Kakkilaya, Light House Polyclinic, Spandana Centre for Metabolic Medicine, Mangalore, Karnataka, India, E-mail: skakkilaya@gmail.com. Susanta K. Ghosh and Sathyanarayan N. Tiwari, National Institute of Malaria Research, Bangalore Field Station, Bangalore, Karnataka, India, E-mails: ghoshnimr@gmail.com and snt57.nimr@gmail.com. Sudarshan S. Kadambi, Health and Family Welfare Services, Government of Karnataka, Bangalore, Karnataka, India, E-mail: sudarshan.kadambi@gmail.com.

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