Genetic Spatiotemporal Anatomy of Plasmodium vivax Malaria Episodes in Greece, 2009-2013

• Published in: Emerging infectious diseases Vol. 24; no. 3; pp. 541 - 548
• Main Authors: Spanakos, Gregory, Snounou, Georges, Pervanidou, Danai, Alifrangis, Michael, Rosanas-Urgell, Anna, Baka, Agoritsa, Tseroni, Maria, Vakali, Annita, Vassalou, Evdokia, Patsoula, Eleni, Zeller, Herve, Van Bortel, Wim, Hadjichristodoulou, Christos
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.03.2018; Centers for Disease Control and Prevention
• Subjects: Alleles; Analysis; Emerging diseases; Genetic aspects; Genetic research; genetic spatiotemporal anatomy; Genetic Spatiotemporal Anatomy of; Genetic Variation; Genome, Protozoan; Genotype; Geography; Greece; Greece - epidemiology; Health aspects; History, 21st Century; Human health and pathology; Humans; Infection; Infectious diseases; Life Sciences; Malaria; Malaria Episodes in Greece, 2009–2013; Malaria, Vivax - epidemiology; Malaria, Vivax - history; Malaria, Vivax - parasitology; Malaria, Vivax - transmission; Microbiology and Parasitology; migrants; parasites; Parasitology; Plasmodium vivax; Plasmodium vivax - genetics; Santé publique et épidémiologie; Spatio-Temporal Analysis; Greece; Greece; Plasmodium vivax; transmission; microsatellite marker; migrants; parasites; malaria; PvMSP-3α; genetic spatiotemporal anatomy
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid2403.170605

An influx of immigrants is contributing to the reemergence of Plasmodium vivax malaria in Greece; 1 persistent focus of transmission is in Laconia, Pelopónnese. We genotyped archived blood samples from a substantial proportion of malaria cases recorded in Greece in 2009-2013 using 8 microsatellite markers and a PvMSP-3α gene fragment and plotted their spatiotemporal distribution. High parasite genetic diversity with low multiplicity of infection was observed. A subset of genetically identical/related parasites was restricted to 3 areas in migrants and Greek residents, with some persisting over 2 consecutive transmission periods. We identified 2 hitherto unsuspected additional foci of local transmission: Kardhítsa and Attica. Furthermore, this analysis indicates that several cases in migrants initially classified as imported malaria were actually locally acquired. This study shows the potential for P. vivax to reestablish transmission and counsels public health authorities about the need for vigilance to achieve or maintain sustainable malaria elimination.