
In 2014 no locally
acquired case was recorded in Greece.

Always fight that Bite in Greece
Always fight that Bite in Greece
Caution:September, wet, as so, a peak Mosquito month

- malaria is more common in the wet season.
Take Care at Night!

Malaria Greece in yellow
Malaria Greece in yellow

Note to the traveler
Note to the traveler

Before you go
Although risk varies, all travelers to malaria-risk countries should take precautions to prevent malaria.
Take a repellent

You should use an effective insect repellent on clothing and any exposed skin 24/7
Because you will definitly need sunscreen also, remember the reprellent comes after sunscreen
Smart tip to follow
Smart tip to follow
For example, back-packing or travelling to rural areas is generally more risky than staying in urban hotels.
Watch out for Season
Watch out in Humidity Days and Season
- In some countries ( like Greece, as the paraites' infectiousness has proved in the recent years, ) the risk varies between seasons - malaria is more common in the wet season
Remember with Malaria
Remember with Malaria
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MALARIA emerged BACK in GREECE in 2011 (36 years after it was erradicated )
MALARIA emerged BACK in
Preventing malaria - four stepsThere is an ABCD for prevention of malaria. This is:
- Awareness of risk of malaria.
- Bite prevention.
- Antimalarial medication - Chemoprophylaxis (taking antimalarial medication exactly as prescribed).
- Prompt Diagnosis and treatment.
During Your Journey
During Your Journey
Where you sleep
Where you sleep

- If you sleep outdoors or in an unscreened room, you should use mosquito nets impregnated with an insecticide (such as pyrethroid). The net should be long enough to fall to the floor all round your bed and be tucked under the mattress.
- Check the net regularly for holes. Nets need to be re-impregnated with insecticide every six to twelve months (depending on how frequently the net is washed) to remain effective. Long-lasting nets, in which the pyrethroid is incorporated into the material of the net itself, are now available and can last up to five years.
- Sleeping in an air-conditioned room reduces the likelihood of mosquito bites, due to the room temperature being lowered.
- Doors, windows and other possible mosquito entry routes to sleeping accommodation should be screened with fine mesh netting.
What you wear

What you wear
- If practical, you should try to cover up bare areas with long-sleeved, loose-fitting clothing, long trousers and socks - if you are outside after sunset - to reduce the risk of mosquitoes biting.
- Clothing may be sprayed or impregnated with permethrin, which reduces the risk of being bitten through your clothes.
The Repellent
The Repellent
- Diethyltoluamide (DEET) is safe and the most effective insect repellent and can be sprayed on to clothes.
- It lasts up to three hours for 20%, up to six hours for 30% and up to 12 hours for 50% DEET.
- There is no further increase in duration of protection beyond a concentration of 50%
- . When both sunscreen and DEET are required, DEET should be applied after the sunscreen has been applied.
- DEET can be used on babies and children over 2 months of age. In addition,
- DEET can be used, in a concentration of up to 50%, if you are pregnant.
- It is also safe to use if you are breast-feeding.
- If you have sensitive skin you may find DEET irritating. Insecticides containing picaridin are a useful alternative.
What you spray

- You should spray the room before dusk with an insecticide (usually a pyrethroid) to kill any mosquitoes that may have come into the room during the day. If electricity is available, you should use an electrically heated device to vaporise a tablet containing a synthetic pyrethroid in the room during the night.
- The burning of a mosquito coil is not as effective.
Herbal remedies have not been tested for their ability to prevent or treat malaria and are therefore not recommended. Likewise, there is no scientific proof that homoeopathic remedies are effective in either preventing or treating malaria and they are also not recommended.
After You Return from your Journey

if you feel unwell and have recently visited an area in which there is malaria, you should seek prompt medical advice, even if you have taken your antimalarial medication correctly.
What the Greek CDC does for Malaria ***efficient elimination of the Locally Acquired Infections in three years
What the Greek CDC does for Malaria

Greece has been malaria-free since 1974, but a number of significant factors may lead to the re-establishment of the disease, mainly:
i) the large number of immigrants from malaria-endemic countries, who work mostly in the farming sector combined with
(ii) the circulation of Anopheles mosquitoes, the competent vector of the disease, in many areas of Greece.
Fewer locally-acquired malaria cases were recorded in 2012, compared with 2011 and minimal in 2013
Overall 55% decrease in locally acquired cases was noted in 2012 compared to 2011 and
72% decrease in locally-acquired cases in Evrotas, Lakonia.
Furthermore, active case detection in Evrotas improved significantly the timeliness of diagnosis of malaria in the area.
- Early detection,
- appropriate investigation and
- appropriate treatment of malaria cases combined with
- effective vector control (larviciding and IRS) represent the main components of the public health strategy to prevent further transmission and re-establishment of malaria in Greece.
Malaria
in Greece
Malaria in Greece occurs in well-defined agricultural areas which were known receptive areas for the disease, particularly in Evrotas municipality (Regional Unit Lakonia). Likewise, the three cases from 2013 are reported from similar agricultural areas where immigrants from malaria endemic countries reside and work. The occurrence of autochthonous these areas in 2013 is therefore not unexpected
- .The current risk for malaria infectionin Greece is to persons residing and/or working in the affected areas of Greece.
- The risk for travellers is considered to be low since all areas from where malaria is currently reported are agricultural rather than areas which attract tourists.
- The use of standard mosquito biting prevention measures continues to be recommended.
- Moreover, as the malaria transmission season is coming to an end, the risk will decrease even further.
sources: Greek CDC
( KEELPNO), ECDC) Greek to me November25/11/2013
Malraria on Call
USA: In Case you were asking

CDC.GOV MALARIA CALL FOR TRAVELERS
Some callers tell a story of becoming ill within two or three days of arrival at their destination and being told by a local healthcare provider they consulted that they have malaria, which is highly improbable given the short period of time between their arrival and when their symptoms occurred.

What happens when the caller to the hotline is a U.S. resident already traveling abroad who becomes ill with what could be malaria?
Each year, the hotline handles dozens of these calls.
Contact the Greek CDC (HCDCP,KEELPNO)
My advice to the traveler who becomes ill abroad? See a reputable healthcare provider as soon as possible.It’s important to know whether it really is malaria and if not, to get appropriate diagnostics and treatment for whatever else the illness might be. I tell them to contact the U.S. embassy or consulate in their host countryA U.S. consular officer can assist in locating medical services and informing family or friends .cdc.gov

Alert Links and Numbers
For immediate response, and alert emergency links in Greece and abroad, visit on Greek2m
Greece: Update by resources
Greece: Update by resources

By CDC.gov, Updated 12/21/2012
The Hellenic CDC continues to work with the European CDC and has responded with enhanced surveillance, targeted testing and treating among migrants, and vector control activities. In current- and previously affected- areas healthcare providers have been educated about early malaria diagnosis and treatment, and the public has been informed about the symptoms of malaria and the prevention of mosquito bites.
Malaria Greek CDC 2013 Update
Malaria epidemiologic surveillance data, until 14.10.2013
In 2013 (up to 14/10/2013), a total of 16 laboratory confirmed cases of malaria have been reported to the Hellenic CDC, of which 15 were classified as imported (10 cases in migrants from malaria- endemic countries and 5 in returning travellers). Of the 15 imported cases, 8 cases are confirmed as P. vivax infections (7 migrants from malaria- endemic countries and 1 in returning traveller) and 7 cases are confirmed as P. falciparum (3 migrants from malaria- endemic countries and 4 in returning travellers). The remaining one (1) case refers to a Greek patient with no travel history to a malaria endemic country and evidence of locally acquired infection in the municipality of Alexandroupolis. Symptom onset was in week 39/2013 (23-29/9/2013).
The case classification by place of residence/exposure of all the malaria cases reported to the Hellenic CDC in 2013 is presented in Table 1.
view the official Greek CDC source

Greek CDC on Malaria
Epidemiologic data, 2011
In 2011, a total of 96 laboratory confirmed cases of malaria were recorded in Greece, of which 54 imported (9 in returning travelers and 45 cases in migrants from malaria-endemic countries, classified based on their arrival date in Greece and/or past history of malaria) and 42 without reported travel history to malariaendemic areas (34 Greeks and 8 immigrants from non-endemic countries). A cluster of 36 P. vivax malaria cases with no travel history to malaria-endemic areas was reported in the Municipality of Evrotas (Lakonia District) along with 6 P. vivax sporadic cases in 4 other Regional Units (Evia, Larissa, East Attiki and Viotia)
More specifically in Evrotas, Lakonia 28 cases of P. vivax malaria were recorded in Greek citizens and 8 in migrant farm workers from non-endemic countries (Morocco (2), Poland (1) and Romania (5, 2 of which were diagnosed in Romania). In addition, 23 P. vivax cases were reported from the same area in migrant farm workers from malaria-endemic countries (Pakistan (21), Afghanistan (2)) with unclear travel history.
go to full report by cases and regions of malaria transmissions in Greece, at the official Greek CDC website
Epidemiologic data, 2012
In 2012, a total of 92 laboratory confirmed cases of malaria were reported in Greece, of which 73 have been classified as imported (9 in returning travelers and 64 in migrants from malaria-endemic countries based on their arrival date in Greece and/or past history of malaria). Of the 70 imported cases with known Plasmodium species, 54 cases are confirmed P.vivax infections, 15 P.falciparum (8 in migrants from malariaendemic countries and 7 in returning travelers) and 1 case is a P. vivax and P. falciparum co-infection. For the immigrants from endemic countries, P. vivax infections most likely represent relapses of past malaria infection from their country of origin.
The remaining nineteen (19) cases refer to patients with no history of travel to a malaria endemic country (13 Greek, 2 Moroccan, 3 Romanian, 1 Albanian) with evidence that they have acquired the infection locally during transmission period 2012. All locally acquired cases were confirmed with Plasmodium vivax infection.
Four additional malaria cases reported in 2012 were attributed to previous transmission periods and are not included in the analysis of this report. Specifically, 2 P. vivax cases were attributed to the 2011 transmission periods: one case referred to a Moroccan migrant (diagnosed in April 2012), resident of the Municipality of Evrotas (Lakonia District), and the other referred to a 7 year old Greek girl with onset of symptoms in August 2012 and a history of 4-week stay in Evrotas, Lakonia during the transmission period 2011.
Moreover, 2 P. malariae cases were also reported in elderly patients, attributed to exposure many years ago.