8 Cases of Delayed Onset P. vivax Malaria

Plasmodium vivax에 의한 지연형 말라리아 8예

South Korea has been free from endemic malaria by P. vivax since the mid-1980s, but malaria infections, including military outbreak in 1995, have been increasing steadily in the soldiers serving near the western part of Demilitarized Zone(DMZ) since its first resurgence in 1993. We experinced 8 cases of delayed onset P. vivax malaria in young men who had never been abroad and had no history of blood transfusion or parenteral use of drug. All the patients had served near the western part of DMZ during their military life. They were admitted to Yeungnam University hospital due to cyclic fever with chills and the clinical symptoms were developed 2 months to 11months after discharge from military service. Peripheral blood smears showed typical ring forms and trophozoites of P. vivax in red blood cell. Patients were treated with hydroxychloroquine and primaquine showing rapid clinical and hematologic responses in all cases, but 2 cases were relapsed later. We presumed that theses cases were delayed onset of P. vivax infection resulted from the recent outbreak in the western part of DMZ, in 1995. Therefore, we reported theses cases to emphasize the need of active surveillance and prevention.

저자들은 1994년에서 1995년 사이에 경기도 북부 휴전선 부근에서 말라리아가 유행할 때 그 지역에서 근무하고 제대한 후에 외국 여행이나 수혈의 경력이 없는 젊은 남자에서 오한과 동반된 발작적 발열 등의 임상 증상과 말초 혈액 도말 검사에 의해 삼일열 말라리아로 확진되어 치료한 8예를 경험하였다. 삼일열 말라리아의 재정착이 확인되었으므로 오한을 동반한 발열 환자의 원인으로서 말라리아가 반드시 고려 대상이 되어야 하며 말라리아 재유행에 대한 조사와 함께 감시 대책이 필요하리라 생각된다.