Imported malaria in adults in Auckland

Malaria is an increasing hazard of tropical travel. Sixty-five cases were notified to the Health Department in 1980 and there is clear evidence of under notification. We reviewed the notes of 19 adults admitted to the infectious disease unit, Auckland Hospital, between 1 January 1979 and 31 March 1982. The typical patient admitted is a young caucasian New Zealander presenting three months after returning from Papua New Guinea where he took prophylaxis: he is febrile, infected with P. vivax, has splenomegaly but is not anaemic. Others presented atypically, especially with the potentially lethal P. falciparum. Four patients are described to highlight particular aspects of malaria management. Suggestions for prophylaxis and therapy are made in the light of changing global patterns of resistance of plasmodia, and particularly of P. falciparum to chloroquine.