Hospital professionals should strictly follow standard precautions to avoid rare, but possible hospital-acquired malaria

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The occurrence of sporadic cases of hospital-acquired malaria in the EU is a reminder that such transmission is possible, although uncommon. Clinicians and healthcare providers in hospitals should be aware of the possibility of hospital transmission and strictly follow standard precautions for infection prevention and control, concludes ECDC risk assessment issued today.

Between January 2016 and April 2018, six sporadic malaria hospital transmissions have been identified in the EU, in four Member States: Italy (two cases), Spain (two cases), Greece (one case) and Germany (one case).

The risk of further spread of malaria in the EU associated with these events is considered negligible, states the risk assessment. Hospital transmission of malaria is uncommon and sporadic cases have occurred in the EU in the past decades. Recent events do not correspond to an increase in the number of such cases by country.

However, the events are a reminder that standard precautions (i.e. basic measures) for infection prevention and control should be strictly followed by healthcare professionals in hospitals, to avoid the rare, but possible transmission of malaria in healthcare settings.

In the scientific literature, hospital-acquired malaria has been associated to healthcare procedures related to blood-borne transmission (injection or infusion), during which devices or equipment were contaminated by the patient’s blood (e.g. injections, insulin administration devices, gloves).

Hospitals should ensure that standard precautions for infection prevention and control are strictly implemented, e.g. safe injection practices, changing gloves after procedures, safe handling of intravascular catheters or capillary blood testing devices.

Even if hospital-acquired malaria is uncommon, clinicians and healthcare providers should consider it in patients with unexplained fever or a malaria-like clinical syndrome, especially if their hospital stay coincides with that of a malaria-infected patient.