Malaria is the most common infectious disease worldwide with an annual incidence of about 400 million and an annual mortality of about 2 million. 500—1000 cases are imported into Germany each year. It has been suggested that air-transport may contribute to the spread of infectious diseases. Unusual transmission routes include baggage malaria and airport malaria caused by mosquitoes that have been transported by aircraft to non-endemic areas. These are rare incidents with 89 cases in western Europe between 1969 and 1999, primarily in countries and in the vicinity of airports with frequent flights to the main endemic areas in sub-Saharan Africa. Even though the risk of infection in this way is extremely low, this type of malaria should be taken into account in the differential diagnosis of fever of unknown origin even in patients without a history of travel to areas where malaria is endemic.
