- 09:30
A few days ago, the Ministry of Public Health reminded the medical profession to think of “malaria” in the face of any unexplained fever, to perform blood smear and thick smear promptly, and to report without delay any suspected or confirmed case. This is Beirut looked into this circular and its implications, as the ministry did not specify on what exact basis it was issued. Stated objective: detect early, treat quickly, avoid any chain of transmission.
The aim is to include malaria in the differential diagnosis even without recent travel, to perform blood smear and thick smear, to use a rapid test if needed to save time, to notify cases to the Malaria Control Bureau and to apply therapeutic protocols strictly. This nudge serves as a reminder within a shifting regional context and heightened attention to exposures related to healthcare procedures.
Where Does Lebanon Stand?
Lebanon has been free of local transmission since 1963: the recorded cases are almost all imported. In 2012, the country reported 115 imported cases, half of them due to Plasmodium falciparum. In 2019, a case reported in Saida was the subject of investigations; the source of infection could not be determined (local or imported) for lack of additional data. In other words, we are not facing endemicity, but a residual risk linked to travel, unsecured invasive medical practices and, in summer, to the sporadic survival of Anopheles in certain micro-habitats.
What the Study Published in December 2024 Showed
At the end of 2024, Lebanese clinicians reported a locally acquired case of malaria in a 27-year-old woman without recent travel: blood smear positive for Plasmodium falciparum, moderate parasitemia, recovery under artesunate then oral relay. Two plausible scenarios were raised: blood exposure during an invasive procedure in an insufficiently secured setting, or a punctual bite from an Anopheles mosquito in warm season. The article did not establish sustained community transmission, but called for maintaining a high level of clinical suspicion.
Environments Favorable to Mosquitoes
Environmental control remains decisive. In areas where water management is deficient, larval habitats proliferate: stagnant water not drained, open-air water storage, waste retaining water after rains. It is possible that situations of this kind have been observed in certain refugee camps or precarious neighborhoods in Lebanon, favoring punctually the presence of Anopheles. The right lever is not individual hygiene but sanitation: drainage, covering of reservoirs, regular waste collection and elimination of persistent puddles.
Quick Reminder — What Is Malaria?
Malaria is a parasitic infection due to Plasmodium, transmitted mainly by the nocturnal bite of infected female Anopheles mosquitoes. Five species infect humans; Plasmodium falciparum is the most severe (can be fatal), Plasmodium vivax and Plasmodium ovale can relapse. The clinical picture most often combines fever, chills, sweats, headaches, muscle pain and fatigue, and digestive disorders can occur. The appearance of impaired consciousness, respiratory distress, frank jaundice, bleeding, or hypoglycemia requires urgent management.
How to Confirm and Treat?
Diagnosis is based first on the blood smear and the thick smear, which make it possible to see the parasite and estimate its quantity. A rapid test can guide in the meantime, and PCR can specify the species if necessary. On the treatment side, the key idea is to act fast: for severe forms, injectable treatment straight away then tablets; for uncomplicated forms, oral antimalarial combinations validated by the physician. For certain species capable of “sleeping” in the liver, an additional treatment is added after a specific blood test. The essential point, for the public as for caregivers, comes down to two words: speed and follow-up.
In practice, any unexplained fever, with or without recent travel, warrants a prompt consultation. Anti-mosquito measures remain common sense: mosquito net, approved repellents, covering clothing at dusk, elimination of stagnant water around the home. Before traveling to an endemic area, a pre-travel consultation makes it possible to assess appropriate prophylaxis and avoid a false sense of security.
Lebanon does not have endemic malaria, but it is not immune to sporadic episodes. The message is simple: diagnose early, report without delay, sanitize larval habitats. A fever treated today prevents a cluster tomorrow.
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