Malaria in the Republic of Korea, 1993-2007. Variables related to re-emergence and persistence of Plasmodium vivax among Korean populations and U.S. forces in Korea.

Abstract:

:Malaria was eradicated and the Republic of Korea (ROK) declared "malaria free" in 1979. However, in 1993, a temperate strain of vivax malaria, expressing both latent and nonlatent disease populations, re-emerged near the demilitarized zone (DMZ), rapidly spread to civilian sectors near the DMZ, and increased exponentially in ROK military, veteran, and civilian populations through 1998. Malaria among all ROK populations decreased 5-fold from a high of 4142 cases in 2000 to a low of 826 cases in 2004, before increasing again to 2180 cases by 2007. Each malaria case in the ROK is reported in the metropolitan area/province where the diagnosis is made, which may be at some distance from the area where infection occurred. Therefore, it is difficult to ascertain transmission sites since approximately 60% of vivax malaria in Korea is latent with symptoms occurring >1 month to 24 months after infection. A review of case diagnosis for civilian, veteran, and military populations shows that nearly all malaria south of Gyeonggi and Gangwon Provinces is the result of veterans exposed in malaria high-risk areas along the DMZ and returning to their hometowns where they later develop malaria. Thus, malaria currently remains localized near the DMZ with limited transmission in provinces south of Seoul and has not spread throughout Korea as previously hypothesized. This report describes the reemergence of vivax malaria cases in civilian and military ROK populations and U.S. military personnel and assesses variables related to its transmission and geographic distribution.

journal_name

Mil Med

journal_title

Military medicine

authors

Kim HC,Pacha LA,Lee WJ,Lee JK,Gaydos JC,Sames WJ,Lee HC,Bradley K,Jeung GG,Tobler SK,Klein TA

doi

10.7205/milmed-d-01-6208

subject

Has Abstract

pub_date

2009-07-01 00:00:00

pages

762-9

issue

7

eissn

0026-4075

issn

1930-613X

journal_volume

174

pub_type

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