1 Areas “affected” by malaria in 2019 season, May 2019

The “Working Group (WG) for the designation of areas affected by vector-borne diseases” of the National Committee for the Prevention and Control of Tropical Diseases of the Ministry of Health has convened and decided upon which areas should be designated as “affected”, following the recording of an introduced P.vivax malaria case (1st generation of transmission) in 2019. The WG of experts has carefully examined the following data:  the total epidemiological data concerning malaria in Greece since 2009, the number and characteristics of all cases reported to the National Public Health Organization (N.P.H.O.) up to 24th May 2019, the characteristics of the population to which they correspond, and the geomorphological characteristics of the corresponding areas,  the available entomological data for the years 2011-2019, especially for the area with the introduced case, and  the literature concerning the flight range of mosquito vectors, especially Anopheles sacharovi, which is considered to be the main malaria vector in our country. According to the suggestion of European experts, an “affected area” is defined as falling within a radius of 2-6 km around the probable place of exposure of the locally acquired cases. In Greece, an affected area is usually defined by a radius of 6 km around the probable place of exposure. However, if this defined circle includes sections of large urban centres or cities (that cannot be easily divided) or if a smaller radius is deemed adequate (e.g. based on entomological data, history of cases in an area, geomorphology, etc.), the WG - following risk assessment – decides upon the exact designation of the affected area. Consequently, the WG has concluded that: Α. Areas “affected” by malaria, based on the report of the introduced case (1st generation transmission) in 2019 (up to 24/05/2019), include the following areas (which are added to those of paragraph B):

I. The following communities and villages of the Regional Unit of in Region, Greece: i. From the Municipality of Farkadona, Municipal Unit of Pelinnaioi (Pelinnees):  Nomi  Petroporos  Cervota  Taxiarches  Faneromeni ii. From the Municipality of Trikala, Municipal Unit of Estiaiotida:  Megalochori  Patoulia iii. From the Municipality of Trikala, Municipal Unit of Megala Kalivia:  Glinos

Β. In addition, as malaria “affected” remain all the following villages and communities that are linked to nine introduced P.vivax malaria cases (1st generation transmission) that were diagnosed in 2018:

I. The following communities and villages of the Regional Unit of Evros in East & Thrace Region: i. From the Municipality of Alexandroupoli, Municipal Unit of Feres:  Ardani  Vrisoula  Kavisos  Poros  Feres 2

ΙΙ. The following communities, villages and areas of the Metropolitan Unit: i. From the Municipality of Delta, Municipal Unit of :  Municipal Community of Kalochori  Municipal Community of Nea Magnisia  Municipal Community of (Diavata, Agia Sofia)  Municipal Community of

ii. From the Municipality of Ampelokipoi-, Municipal Unit of Menemeni:  Municipal Community of Menemeni (including the areas of Nea Menemeni, Vosporos, Agios Nektarios-Dendropotamos, Mouries)

iii. From the Municipality of Kordelio-, Municipal Unit of Eleftherios - Kordelio:  Municipal Community of Eleftherios-Kordelio (Eleftherios-Kordelio, including the areas of Neo Kordelio, Dialogi, Eleftheria)

iv. From the Municipality of Kordelio-Evosmos, Municipal Unit of Evosmos:  From the Municipal Community of Evosmos: area east of the roadway that is delimited by Meander Street, Alexander the Great Street and Aristotle Street (including the area of Agios Kosmas, Evosmos) (Appendix).

Measures for blood safety that refer to all Greek Blood Transfusion Services for the above mentioned areas, as well as for the whole country, are decided and communicated by the Hellenic National Blood Transfusion Centre (ΕΚΕΑ, www.ekea.gr).

Haemovigilance Measures (SKAE-N.P.H.O.)  Guidelines for blood donors, in case of fever of unknown origin after blood donation, to inform the Blood Transfusion Service where they donated blood, regardless of the area.  In case of malaria transmission after receiving transfusion of blood/Red Blood Cells, SKAE conducts a retrospective and trace-back investigation, in collaboration with the Blood Transfusion Services involved, for the identification and reexamination of the implicated blood donors.

Appendix: Roadway (highlighted in red) of the Municipal community of Evosmos of the Municipality of Kordelio-Evosmos, that includes Meander Street, Alexander the Great Street, Karaoli Dimitrios and Aristotle Street, east of which the affected area of the Municipal community of Evosmos is delimited (source: Google Earth).

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