Background
On the 21st of July 2021 Cairo Directorate of Health was informed of a patient with high fever and malaise recently returned from Nigeria. The patient was quarantined at infectious disaeses hospital for investigation. He was a member of Egypt five-a-side ball participated in the African Cup of Nations, informed of other teammates with similar symptoms. Outbreak investigation initiated to identify possible causes and implement preventive and control measures.
Methods
Active case finding among team members and their neighborhood performed. Data collected through patients’ interview, hospital records review, contacting surveillance units and Ministry of youth. Descriptive data analysis performed to identify size of the problem and risky group. All team members provided blood specimens for malaria and dengue fever testing, and throat swab for SARS-CoV-2 testing by PCR. Entomological investigation and vector control performed.
Results
Of26 team members, 18(69.2%) were symptomatic, their mean age was 34.2±11.6, all of them were males. Symptoms included fever 9(50.0%), body ache 10(55.6%), headache 10(55.6%), nausea 5(27.8%), and 2(11.1%) unconsciousness. Laboratory confirmed that 12(66.7%) patients had Falciparum malaria, 3(16.7%) mixed Falciparum and Vivax, a patient with Falciparum and SARS-CoV-2 and a patient with dengue and SARS-CoV-2. Of 18 lab-confirmed patients 1(5.6%) died. Mosquito spry and larvae destruction near team residential areas implemented. Investigation indicated that team did not receive malaria prophylaxis and were sleeping in tents near forest and were exposed to mosquito bites.
Conclusion
Mixed outbreak of Malaria Falciparum and Vivax and dengue occurred among Egypt Five-a-side ball team recently returned from Nigeria. Outbreak contained through patient early detection, isolation, treatment, and vector control. Defective prophylaxis, inadequate health education prior to departure, and inadequate onsite prevention measures contributed to the outbreak. Travelers to malaria and dengue-endemic areas especially sports teams should have health education, medical prophylaxis and apply protective measures against mosquito bites to prevent similar outbreaks.