[Two cases of inexplicable autochthonous malaria in Toulouse, France]

Malaria involving both Plasmodium falciparum and vivax was observed in two patients hospitalized in the same room of the Cardiology Department of the Purpan University Hospital in Toulouse, France. One patient was in coma without fever by the time of diagnosis. None of the patients had traveled to malaria areas within the last 33 years. Epidemiological investigations failed to detect malaria in family members, hospital staff, or other patients. Transmission due to transfusion of infected blood, use of contaminated surgical instrumentation, or bite of an autochthonous anopheles mosquito was reasonable ruled out. Since Toulouse International Airport is located less than three kilometers from the Purpan University Hospital, the most likely explanation was airport-acquired malaria due to the bite of a mosquito imported by an aircraft coming from abroad. The hypothesis that an Anopheles mosquito survived the plane trip and then was blown into the patients' room was supported by temperature and wind conditions prevailing at the time of infection.