Local transmission of Plasmodium vivax malaria in Singapore

A localised outbreak involving 19 cases and two carriers of vivax malaria was reported at Dairy Farm from May to June 1996. Epidemiological investigations showed that the outbreak was caused by the introduction of two foreign workers with imported relapsing vivax malaria into this malaria-receptive area. Transmission of infection occurred amongst 17 other foreign workers residing in the locality and two local residents staying at a condominium nearby. The outbreak was rapidly brought under control through active case finding, isolation and treatment of infected persons, epidemic vector control measures, and improved drainage to prevent Anopheles maculatus breeding. Were it not for the very thorough epidemiological investigations in this episode, foreign workers and local residents with a recent travel history would have been misclassified as imported and the outbreak missed. Medical practitioners should always consider the possibility of malaria in a foreign worker presenting with fever and notify the case as soon as the disease is suspected.