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Home Eurosurveillance Edition  2012: Volume 17/ Issue 50 Article 5
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Eurosurveillance, Volume 17, Issue 50, 13 December 2012
Probable imported rather than autochthonous Plasmodium vivax cases in Italy
  1. National Institute for Infectious Diseases (Istituto Nazionale per le Malattie Infettive, INMI) “L. Spallanzani”, Rome, Italy

Citation style for this article: Nicastri E. Probable imported rather than autochthonous Plasmodium vivax cases in Italy. Euro Surveill. 2012;17(50):pii=20338. Available online:
Date of submission: 07 December 2012

To the editor: Italian colleagues describe two recent cases of probable autochthonous-introduced Plasmodium vivax malaria, suggesting that sporadic cases may be considered possible in areas with vector abundance and favourable environmental conditions [1]. Nevertheless, we have some concerns about this report: firstly, no other concurrent P. vivax malaria cases have been reported in the Pontine marshes or in the Calabria Region; secondly, no secondary cases have been reported to arise from the index cases; thirdly, the first patient visited Santo Domingo in the Dominican Republic in 2003, an area where malaria cases still occur; fourthly, as previously affirmed in a publication by the same group about an unusual case of late relapse of P. vivax four years after the acute infection [2], at least the first case could be explained as a late relapse following an asymptomatic or paucisymptomatic primary infection. In conclusion, the described cases could in our opinion be viewed as probable imported, and not autochthonous, P. vivax cases.


  1. Romi R, Boccolini D, Menegon M, Rezza G. Probable autochthonous introduced malaria cases in Italy in 2009–2011 and the risk of local vector-borne transmission. Euro Surveill. 2012;17(48):pii=20325. Available from:
  2. Durante Mangoni E, Severini C, Menegon M, Romi R, Ruggiero G, Majori G. Case report: An unusual late relapse of Plasmodium vivax malaria. Am J Trop Med Hyg. 2003;68(2):159-60.

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