title: Malaria Transmission Under an Unusual Circumstance Causing Death in Two Siblings.
abstract: 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.
authors.affiliation: Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania. Department of Biochemistry, Kuvempu University, Shivamogga, Karnataka, India.
authors.forename: Kiran K
authors.initials: KK
authors.lastname: Dayanand
authors.affiliation: Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.
authors.forename: Kishore
authors.initials: K
authors.lastname: Punnath
authors.affiliation: Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.
authors.forename: Valleesha N
authors.initials: VN
authors.lastname: Chandrashekar
authors.affiliation: Light House Polyclinic, Spandana Center for Metabolic Medicine, Mangalore, Karnataka, India.
authors.forename: Srinivas B
authors.initials: SB
authors.lastname: Kakkilaya
authors.affiliation: National Institute of Malaria Research, Bangalore Field Station, ICMR Complex, Bangalore, Karnataka, India.
authors.forename: Susanta K
authors.initials: SK
authors.lastname: Ghosh
authors.affiliation: National Institute of Malaria Research, Bangalore Field Station, ICMR Complex, Bangalore, Karnataka, India.
authors.forename: Sathyanarayan N
authors.initials: SN
authors.lastname: Tiwari
authors.affiliation: Department of Biochemistry, Kuvempu University, Shivamogga, Karnataka, India.
authors.forename: Rajeshwara N
authors.initials: RN
authors.lastname: Achur
authors.affiliation: Directorate of Health and Family Welfare Services, Government of Karnataka, Bangalore, Karnataka, India.
authors.forename: Sudarshan S
authors.initials: SS
authors.lastname: Kadambi
authors.affiliation: Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania. gowda@psu.edu.
authors.forename: D Channe
authors.initials: DC
authors.lastname: Gowda
mesh_terms: D002648:Child; D003951:Diagnostic Errors; D017809:Fatal Outcome; D005260:Female; D006505:Hepatitis / Q000175:diagnosis; D006801:Humans; D007194:India; D016779:Malaria, Cerebral / Q000175:diagnosis* / Q000635:transmission*; D016778:Malaria, Falciparum / Q000175:diagnosis* / Q000635:transmission*; D008297:Male; D035781:Siblings; D012959:Socioeconomic Factors; D062606:Tertiary Care Centers