The death of a five-year-old girl could have caused hysteria throughout the country. Although people did not actually panic, an atmosphere of anxiety could be felt. Little Pallavi Purmah of Tranquebar died of cerebral malaria at Jeetoo hospital. Another two-year-old girl, living in the same area, is still at Jeetoo Hospital, suffering from the same disease. Fortunately, her case was dealt with in time and she is said to be recovering very well.

Malaria is an acute, recurring or chronic blood infection caused by one of four parasites transmitted by anopheles mosquito bites. The gravity depends on the species of the parasite. Of the four species (Plasmodium falciparum, P. vivax, oval P. and P. malariae), the falciparum is fatal if not treated within 3 days. Pallavi Purmah bore the brunt of the latter.

The authorities have striven to reassure the population since she died. They have made it clear that there is no risk of an epidemic throughout the country if the population takes the usual precautions. All necessary measures have been taken to prevent the disease from spreading. The authorities have also declared that there is no endemic malaria in Mauritius, but that all the cases have been imported. The origin of the recent cases could be a little Comorian girl, who was treated in a private clinic.

This was precisely the subject of the Opposition leader?s Private Notice Question in Parliament. The opposition wanted to know how the disease could have come into the country if controls are made regularly. The minister of Health, Ashok Jugnauth, explained that controls are systematically made on people coming from countries at risk . Dr Ragavoodoo, adviser in public health, pointed out that the population also has an important role to play. People who have travelled to countries at risk, should cooperate with the authorities and do the tests to make sure they are not carrying the disease.

Actually, the authorities report an average of 50 cases of non-fatal malaria each year, which are not made public since they are imported cases that have been treated. Dr Ragavoodoo explained that the public was informed of the recent cases because there could have been transmitted. They wanted to promote transparency.

After the two cases detected in Tranquebar, a mass blood survey was made on one thousand people of the area, of which 600 have already been examined and only one case has been detected. The authorities are thus confident that there will be no epidemic but will go on with the survey of the whole area. There will also be a follow-up of the infected people, as the parasite can remain in the human body for three years.

<B>Credit for malaria eradication</B>

Dr Ragavoodoo highlights that the authorities do not wait for a problem to start the controls. ?There is a monitoring system at all times.? For instance, a person who has been to Africa, has to fill in a form that is transmitted to the health monitoring office. Two or three days later, a health officer visits his/her home to be sure that he/she has no symptoms and takes a blood sample if the person agrees.

Mauritius is the only country, which has a special laboratory for malaria. Those who work there, know the disease very well and how to treat it correctly. Around 50 000 blood tests are made each year as prevention. As soon as a case is detected, the area health office is informed and treatment administered to the patient.

Malaria needs a specific treatment. Private clinics and chemists do not always have the means to identify the disease and give the right treatment. Everyday (including Saturday and Sunday) officers from the health monitoring office visit the patients to make sure they take the medicine to prevent the disease from spreading.

A whole prevention system exists. The authorities take a census of foreign workers, tourists in hotels and businessmen or politicians, who come to Mauritius for international conferences. There is also a specific office for the ?census? of anopheles, the specific mosquito responsible for propagating the disease.

Everything seems to be done to prevent malaria. The rare cases that still occur are imported from other countries. The World Health Organisation awarded the label for having eradicated malaria to Mauritius in 1973. Since then, two large campaigns against malaria have been launched: the first in 1982 where 668 cases were recorded (of which 13 were severe ones) and the second in 1994 where 66 cases were recorded but all were imported cases.

Could the satisfaction of having eradicated the bacteria in the past have led the authorities to relax their vigilance? It could be the case. The Pallavi case brought to light some flaws that must be eliminated if we want to keep the laurels of our so far efficient control. The system, which consists in looking for passengers at random is risky and should be revised, just as the isolation of infected persons should be done more effectively. The officers who do not apply the correct procedures should be severely sanctioned. In the health sector, more than in any other, black sheep cannot be tolerated.