The early increase in malaria cases has continued in Limpopo and Mpumalanga Provinces, including cases being reported from the Kruger National Park and some of the surrounding private lodges. The very mild winter conditions experienced in the region have been favourable to ongoing mosquito breeding. The annual indoor residual spraying programme is due to commence shortly and will hopefully result in a decrease in transmission. 

Health care workers should have heightened awareness for malaria in any person living in or recently returned from a malaria area and who presents with a fever or flu-like illness. This is especially important given that the influenza season has been prolonged, and that malaria and influenza have overlapping symptoms in the early stages of disease.

A number of recent misdiagnoses of malaria as influenza have occurred, leading to a delay in diagnosis with serious consequences. Malaria tests should always be done when persons have compatible symptoms and a travel history to a malaria-endemic area. Tests should be repeated if initial results are negative. 

Source: Division of Public Health Surveillance and Response, NICD-NHLS (lucilleb@nicd.ac.za); Amayeza Information Centre; Department of Clinical Pharmacology, University of Cape Town