Two new malaria cases at Frankfurt Airport – authorities investigate airport malaria

What is airport malaria?

Malaria is a serious infectious disease caused by plasmodia, typically transmitted through the bite of infected Anopheles mosquitoes. It is widespread in tropical and subtropical regions, whereas in Germany it is considered very rare. When cases occur without prior travel abroad, unusual transmission routes must be investigated. The Robert Koch Institute considers airport malaria to be a known but overall rare phenomenon.

At Frankfurt Airport, such cases have occurred repeatedly: in 2019, two infections were registered; in 2022, a cluster of three infections occurred; and in 2023, a single case was reported. It is notable that the incidents have always clustered in the summer months. The background is that rising temperatures during this period favor the survival of tropical mosquitoes, which can theoretically reach the region via air traffic.

Previous incidents at Frankfurt Airport

Following the cases becoming known, the Frankfurt Health Office has initiated an epidemiological investigation. This includes questioning those affected about their whereabouts in the days before the onset of symptoms, as well as examining possible points of contact on the airport grounds. Environmental sampling for mosquitoes in the surrounding area is also currently being considered, in order to identify possible breeding sites.

According to the assessment of the City Health Office, there is currently no elevated risk for travelers and employees at the airport. The likelihood of transmission in normal air travel remains very low. However, persons who develop flu-like symptoms with fever after spending time in the vicinity of the airport should seek medical attention immediately and mention their contact with the airport.

What do the authorities advise?

Frankfurt Airport is one of the largest air hubs in Europe and is one of the few locations in Germany where airport malaria has been repeatedly documented. Medical care on site is provided through the airport clinic; coordination with the Health Office of the City of Frankfurt am Main follows established reporting channels.

Overall, the authorities emphasize that these are isolated cases and there is no cause for concern among the general population. Anyone traveling on holiday to tropical regions should in any event seek advice on suitable malaria prophylaxis before traveling. Those living or working in the vicinity of the airport should follow the recommendations of the Health Office.

According to the City of Frankfurt am Main, the investigation is still ongoing. Further information is to follow once the epidemiological questioning and possible environmental samples have been evaluated. Until then, the central questions remain open: where the infected mosquitoes originated, and through which specific transmission route the two affected individuals became infected.

The phenomenon has been under intensive observation in expert circles for years. Studies by the Bernhard Nocht Institute for Tropical Medicine in Hamburg and the European Centre for Disease Prevention and Control have in the past provided evidence of imported vectors in the area of major European airports. In other European cities, such as Paris and London, individual airport malaria cases have also occurred in the past.

Background: Vectors in air traffic

With regard to aircraft air conditioning and the cold chains in air freight, experts fundamentally see the risk that mosquitoes or other vectors could survive the transport in containers or cargo holds. In Frankfurt, it is now being investigated whether a comparable mechanism may be responsible for the current cases.

The City of Frankfurt am Main announced that it would inform the public regularly about the progress of the investigation. Until then, the following applies: stay calm, seek medical advice if suspicious symptoms occur, and follow the guidance of the City Health Office.