Eight people WHO had not travelled to a Malaria-endemic country caught Plasmodium falciparum, the deadliest Malaria parasite, at or near Frankfurt Airport, and three have died, the European Centre for Disease Prevention and Control (ECDC) reported on 18 September1. Six worked at the airport, with onsets from early July; two lived in separate households within 5 km and fell ill in early September.
Airport Malaria, caught from an infected mosquito that has arrived on a plane, is rare. A 2024 review pooling every published report counted 105 airport Malaria cases in Europe between 1969 and 2022, in clusters of up to six, so Frankfurt's eight exceed the record. Malaria diagnosis usually starts with a travel history, and none of the eight had one. Earlier this year ECDC tracked locally acquired falciparum malaria in Mayotte, the French island in the Indian Ocean where the parasite circulates; Frankfurt has no such local transmission on record.
Frankfurt's health department has trapped no Anopheles mosquitoes, the only carriers of human Malaria, near the airport or in the residents' district of Schwanheim, the public broadcaster hessenschau reported on 29 September2. ECDC considers repeated arrivals of infected mosquitoes on aircraft likely, and says local Anopheles involvement "cannot be excluded"; local transmission has not been confirmed. Parasite genotyping, which compares the parasites' genetic code, is due at the end of October and should show whether one source or several lie behind the eight.
Germany does not require disinsection, the spraying of arriving aircraft cabins with insecticide, and the airport operator Fraport has told staff to watch for fever, according to hessenschau3. Without spraying, the defence rests on staff and doctors recognising fever as possible Malaria in someone WHO has not travelled.
