[Increase of malaria among migrants in Amsterdam-Zuidoost]. / Toename van malaria bij migranten in Amsterdam-Zuidoost.

In a general practice in Amsterdam Southeast in 1998 a delayed first attack of Plasmodium ovale infection was diagnosed in a 13-year-old girl from Ghana, malaria tropica with a low parasitaemia index in a 43-year-old Ghanaian man and a 8-year-old Ghanaian girl, and Plasmodium vivax infection in a 44-year-old Surinam woman. The Ghanaian patients had visited their native country, the Surinam woman had contracted the infection during a visit to India. All patients responded well to antimalaria medication. These patients were among a total of 6 patients of non-Dutch origin diagnosed with malaria in 1998 in this general practice. Four patients had not taken any prophylactic drug and two had not used the drugs properly. A relative increase of malaria in immigrants has been seen in the Netherlands and elsewhere in Europe in recent years. Underestimation of the risks and lack of knowledge of malaria and of the changing epidemiology make people of ethnic minorities travel without taking appropriate precautions. New, creative ways of communication and information will have to be explored to reach these migrant communities.

[Progressive myelopathy caused by human T-cell lymphotropic virus type I (HTLV-I) in 3 patients in The Netherlands]. / Progressieve myelopathie veroorzaakt door humaan T-cellymfotroop virus type I (HTLV-I) bij 3 patiënten in Nederland.

One man and two women (aged 30, 44 and 46, respectively) were seen between 1987 and 1992 with a myelopathy caused by the human T-cell lymphotropic virus type I (HTLV-I). The first symptoms were impaired gait in the man and micturition disorders in the women. Diagnosing took 2 to 4 years, possibly due to the fact that many Dutch physicians are unfamiliar with the disease. The diagnosis was based on originating from an endemic area (i.e. Surinam and the Caribbean basin), the clinical picture and the presence of antibodies against HTLV-I in blood and CSF. The disease in a number of years leads to spastic paraparesis, incontinence for urine and dependence on a wheelchair.