Malaria was endemic in Finland until the beginning of the 20th century, the people used to lived inside smoke-heated chimneyless log cabins together with animals, mosquitoes... and Plasmodium vivax...
Only a few species of mosquitos can carry the parasite. None of them live in that part of Europe. The swamps around the city of Rome were historically infested with those skeeters which is why we use the Italian word for the disease (which means "bad air").
No, most probably the mosquitoes will not survive the winter. Besides, given enough effort, Malaria can be eradicated and even a poor tropical country like Sri Lanka has has done that where mosquitoes are quite common throughout the year
Kinda wild. I spent most of my childhood a couple hours drive from a malaria region and never heard of anyone getting sick locally that hadn’t travelled that way. So multiple people in Germany seems surprising.
I got malaria twice in Africa. First time bad, second time REAL bad. I thought about death a little.
There was a good story of a Dutchman living in Mali who got malaria a few times (everyone does). It’s manageable with the meds.
Anyway he flies home, then develops symptoms. Goes to hospital and they freak. Full hazmat suits, isolation, doctors visiting from all over because they’d never seen it. Guy ends up dying because they wouldn’t give him the meds, because they didn’t know if it was safe, or what the right thing to do was.
Moral of the story is that for anyone spending time in malaria zones, take the meds home with you. If you get symptomatic, take the meds and maybe not go to hospital in the developed world.
Meds I took was “coartem” and an injectable.
I'm asking about the Dutchman story the parent wrote. I can hardly believe it tbh. Even if the Netherlands don't have specialized personel, Hamburg is just a 5 hour drive away.
Kind of similar to rabies. If you get bit by a rabid animal in an area with lots of rabies, the doctors know what to do and you get meds immediately for cheap.
In the US it's a few thousand dollars for the treatment.
It's really not. I use a little cash-pay clinic in a MCOL area and mostly spend <$100, never over $200, per visit. Also, my wife recently had some major dental work done, and it was about $350. All of this without getting insurance involved.
There are definitely ways to rack up big bills fast, though.
It's wildly inconsistent. Surgeries, hospitalizations and specialists are mostly ridiculous. You can find affordable general/nurse practitioners if you know where to look and what to ask for.
Call around and ask "What is your self cash pay cost?".
Most people don't know to ask that and if you don't speak the magic phrase then you get billed at the rate the office would normally charge insurance. Not all places have self pay discounts.
Some states have special programs for hospitals but they vary wildly by state and you have to know how to navigate that particular program and be very patient. Some are need based so if you are above a pretty low income threshold you won't qualify.
It isn't a homogeneous experience, so you will get different stories. Most Americans get their healthcare provided by their employer, so their company determines what is covered and their financial exposure.
My United Healthcare plan limits my out of pocket expenses to $2,000 per year.
Like most Americans, "United Healthcare" is just the company that does the billing and adjudication. My Employer sets policy and pays for treatment at the end of the day.
I have a feeling this is exactly what happened in Frankfurt. It very glaringly points to some failure in the healthcare system.
Healthy working adults with access to healthcare don't just die of malaria. Two deaths means it's not some unique susceptibility in one individual either.
The more interesting investigation would be how the system let two people die of malaria, not how malaria got there.
> It very glaringly points to some failure in the healthcare system.
Does it? "Have you been near the equator recently?" is a rather common question that GPs ask when you go see them with high fever. Doctors in Germany are absolutely aware of malaria, given how much we like to travel to all those beautiful, but unfortunately malaria-ridden countries.
The only thing, of course, is: That question wouldn't have helped here. However, this[0] source says airport staff are made aware of the possibility of contracting malaria and are told to watch out for symptoms.
I don't think so. The Frankfurt University Hospital is used to weird shit like Ebola. There is a fuck up somewhere in here, but I don't think it's this detail. Frankfurt had airport malaria before as well.
Similar story from an academic that developed symptoms upon return to the US. First hospital brushed him off. Second one, got the right infectious disease doctor/professor to diagnose and treat it. Professor had as many med students/residents as he could come by to see what someone with malaria looks like. "See this man? He has malaria, don't miss it" was burned into his mind by the end.
Probably depends on where the plane is coming from. Source: me who just returned from Europe last week, no spraying. And have traveled internationally several times in the last few years and also no spraying.
I was interested in this because it happened the last time I returned to NZ, but I hadn't seen it before. There are several approved methods and it depends on the airline. The method that doesn't involve spraying with you onboard is more expensive so tends to be used by budget airlines, and also airlines who might rotate their planes and crew around routes more often because it is a treatment that lasts for weeks.
As a kid (in the early 70s) I remember the air hostesses walking down the isles with a spray can. They don’t do that any more, but I wonder if or why they don’t add lower concentrations of the aerosol to the air conditioning at the end of the flight.
You could spend tens or hundreds of millions building an automatic system (certification for aircraft is not cheap or easy) or just hand the flight attendant a can of spray.
Sure, but I can imagine the more expensive airlines worrying that the ‘optics’ of spraying your passengers down aren’t great (to be clear - I’m not objecting and I’d rather they do it). I wasn’t suggesting they retrofit to existing aircraft of the period, but rather just build it in as they design the next generation airflow system. Or do you think it would still be way too expensive even then?
Cockpit announcement: "The authorities here require us to have flight crew spray for mosquitos upon landing using aerosol cans before opening cabin doors. you will now see the attendants walk down the aisle spraying so we can unload you as soon as possible."
It would still be expensive for next gen too. Having to design an entire system that has never existed before that can operate under aerospace conditions is expensive as hell even before you get into certification. A sibling comment points out all of the design certification issues you need to think about
I can not say anything about this incident, but what I have noticed
in the last some years is that mosquitos have become much more annoying
even in larger cities of mediate temperature. That has not been the case
say 30 years up to 10 years ago or so, give or take. The range of mosquito
attacks has definitely increased in every axis. Kind of almost miniature
mosquitos too - really small, like barely 0.5 cm at max in length or perhaps
0.6 cm, but annoying to no ends and very hungry for blood. One can speculate
but I think the increased temperature range induced this for the most part.
I'm pretty sure mosquito populations have been evolving in response to those electrified tennis rackets. Mosquitos now are much faster, more evasive, and smaller.
Got it as well a couple years ago, it was no joke. :/
Luckily we could get vaccinated a year later. If you’ve had it and catch another variant mortality rate jumps to 10%. But usually those variants don’t overlap, it’s region based.
> Im Zusammenhang mit den bereits bekannten sechs Fällen von Malaria tropica bei Personen, die am Flughafen Frankfurt am Main tätig sind, sind zwei Erkrankte verstorben
And a quick search says that this is the most dangerous one. Of course it had to be...
Want to know the real tragedy here? Those deaths could be prevented if the hospital had better software and procedures. Like some other people noticed, malaria is rare in Germany. Doctors would not think of this diagnosis until it's too late.
But...
Malaria can be detected by modern hematology automated analyzers. I'm talking about ordinary hematology analyzers, not the ones specialized for malaria. All hospitals do at least one CBC+DIFF for all patients. If anyone cares to look at the warning flags and scattergrams [1], they could have seen that something's wrong, do a blood smear and confirm malaria in 30 minutes. It is a bit difficult, to be honest. Only a lab doc/tech would know how to interpret a scattergram, and some of the flags are extremely unreliable (not iRBC), but that doesn't mean they can be simply ignored.
Unfortunately, in most labs, doctors who check and validate results, do that from the lab software app, not directly from the analyzer, and - devs, take notes! - most hospital/laboratory software I saw (and I saw many) ignore all flags and graphics send by the analyzers. They just take the numbers and that's it. When doctors look at a report, they don't see flags or scattergrams, just the numbers. Can't even tell if the numbers are reliable or not. And this is how malaria diagnosis, and lots of others, are missed.
Yep. The system in general is great for treatment, but fails for diagnosis. It takes them a long time to diagnose, sometimes years. But once they manage to do it, then they bring in all the heavy artillery and the health care machine works at it's best.
Sadly, it's often too late. Looks to be the case here, appears clearly a diagnosis delay. It does not take much for a skilled system to connect "airport worker" and the right lab readings together.
I can't imagine what these people would have gone through. They would have been given the "just a flu" treatment for some days, and then waited many more days for appointments. RIP.
PS: What you've said is pretty eye opening! This would amplify a lot of the diagnosis problems.
That's because lots of investment money go in treatments, not diagnosis. Diagnosed patients are captive consumers. They will pay to get better.
AI has the potential to help a lot with diagnosis, but considering that many relevant data don't even enter the system, I have doubts about how effective it could be. On the other hand, I would not trust a cloud AI (or cloud in general) to process my medical data. The temptation to abuse that access for marketing, profiling, insurance prices, etc. would be irresistible.
65 comments
[ 0.24 ms ] story [ 13.6 ms ] threadA concerted effort to treat cases and reduce habitat can prevent it, too. The US wiped it out in the 50s; new cases largely come from travel.
https://www.eurosurveillance.org/content/10.2807/1560-7917.E...
There was a good story of a Dutchman living in Mali who got malaria a few times (everyone does). It’s manageable with the meds.
Anyway he flies home, then develops symptoms. Goes to hospital and they freak. Full hazmat suits, isolation, doctors visiting from all over because they’d never seen it. Guy ends up dying because they wouldn’t give him the meds, because they didn’t know if it was safe, or what the right thing to do was.
Moral of the story is that for anyone spending time in malaria zones, take the meds home with you. If you get symptomatic, take the meds and maybe not go to hospital in the developed world. Meds I took was “coartem” and an injectable.
Usually, it is through shipping containers where unwanted insects cross borders. That's how murder hornets and flying cockroaches got into the US.
In the US it's a few thousand dollars for the treatment.
There are definitely ways to rack up big bills fast, though.
Call around and ask "What is your self cash pay cost?".
Most people don't know to ask that and if you don't speak the magic phrase then you get billed at the rate the office would normally charge insurance. Not all places have self pay discounts.
Some states have special programs for hospitals but they vary wildly by state and you have to know how to navigate that particular program and be very patient. Some are need based so if you are above a pretty low income threshold you won't qualify.
My United Healthcare plan limits my out of pocket expenses to $2,000 per year. Like most Americans, "United Healthcare" is just the company that does the billing and adjudication. My Employer sets policy and pays for treatment at the end of the day.
Healthy working adults with access to healthcare don't just die of malaria. Two deaths means it's not some unique susceptibility in one individual either.
The more interesting investigation would be how the system let two people die of malaria, not how malaria got there.
Does it? "Have you been near the equator recently?" is a rather common question that GPs ask when you go see them with high fever. Doctors in Germany are absolutely aware of malaria, given how much we like to travel to all those beautiful, but unfortunately malaria-ridden countries.
The only thing, of course, is: That question wouldn't have helped here. However, this[0] source says airport staff are made aware of the possibility of contracting malaria and are told to watch out for symptoms.
[0]: https://www.tagesschau.de/inland/regional/hessen/malaria-am-...
https://www.epa.gov/mosquitocontrol/aircraft-disinsection
"Benefits of entering a voluntary formal arrangement include:
* disinsection methods are undertaken while passengers are not on the aircraft."
Used to see someone wandering down the aisles with spray cans on arrival - but not on the last several trips to Oz.
It would still be expensive for next gen too. Having to design an entire system that has never existed before that can operate under aerospace conditions is expensive as hell even before you get into certification. A sibling comment points out all of the design certification issues you need to think about
I don't know why immigration for humans and mosquitoes is so lax in Germany. Germany is also the country of the Marburg Virus.
https://www.n-tv.de/panorama/Zwei-Tote-durch-Flughafen-Malar...
Luckily we could get vaccinated a year later. If you’ve had it and catch another variant mortality rate jumps to 10%. But usually those variants don’t overlap, it’s region based.
> Im Zusammenhang mit den bereits bekannten sechs Fällen von Malaria tropica bei Personen, die am Flughafen Frankfurt am Main tätig sind, sind zwei Erkrankte verstorben
And a quick search says that this is the most dangerous one. Of course it had to be...
[0]:https://frankfurt.de/de-de/aktuelle-meldung/meldungen/gesund...
But...
Malaria can be detected by modern hematology automated analyzers. I'm talking about ordinary hematology analyzers, not the ones specialized for malaria. All hospitals do at least one CBC+DIFF for all patients. If anyone cares to look at the warning flags and scattergrams [1], they could have seen that something's wrong, do a blood smear and confirm malaria in 30 minutes. It is a bit difficult, to be honest. Only a lab doc/tech would know how to interpret a scattergram, and some of the flags are extremely unreliable (not iRBC), but that doesn't mean they can be simply ignored.
Unfortunately, in most labs, doctors who check and validate results, do that from the lab software app, not directly from the analyzer, and - devs, take notes! - most hospital/laboratory software I saw (and I saw many) ignore all flags and graphics send by the analyzers. They just take the numbers and that's it. When doctors look at a report, they don't see flags or scattergrams, just the numbers. Can't even tell if the numbers are reliable or not. And this is how malaria diagnosis, and lots of others, are missed.
[1] https://www.mdpi.com/2075-4418/13/22/3397
Sadly, it's often too late. Looks to be the case here, appears clearly a diagnosis delay. It does not take much for a skilled system to connect "airport worker" and the right lab readings together.
I can't imagine what these people would have gone through. They would have been given the "just a flu" treatment for some days, and then waited many more days for appointments. RIP.
PS: What you've said is pretty eye opening! This would amplify a lot of the diagnosis problems.
AI has the potential to help a lot with diagnosis, but considering that many relevant data don't even enter the system, I have doubts about how effective it could be. On the other hand, I would not trust a cloud AI (or cloud in general) to process my medical data. The temptation to abuse that access for marketing, profiling, insurance prices, etc. would be irresistible.