Importation of Fosfomycin Resistance fosA3 Gene to Europe

The attack rate among these soldiers was 53.3% (8/15): 7 P. vivax infections and 1 co-infection with P. vivax and P. falciparum. Mosquitoes were collected 3 months later by using human landing catches during 5 consecutive days. The area had been free of illegal gold mining activities since the 15 soldiers were deployed. A total of 321 Anopheles mosquitoes were collected in this location; 95.6% were identified as the same 4 species as in the Eau Claire mosquito collection (on-line Technical Appendix Table). Only 1 specimen (0.4%, 1/282), An. darlingi mosquito, was infected with P. vivax. These results suggest a high level of malaria transmission involving An. darlingi and other Anopheles species as primary vectors of malaria in the rainforest. The findings probably highlight malaria hyperendemicity in communities of undocumented gold miners, who are often mobile and pose a challenge for controlling malaria and other infectious diseases in the region. Indeed, these gold miners could reintroduce malaria in areas where competent vectors exist in the coastal part of French Guiana and in Surinam and Brazil, which border French Guiana. This potential for transmission could seriously threaten the success of malaria elimination programs in the Guiana Shield. Further studies are needed to better evaluate malaria epidemiology in these undocumented populations to determine how best to adapt strategies to control malaria transmission in this subregion of South America. Acknowledgments We thank military physicians who participated in malaria epidemiologic surveillance in French Guiana and France during 2008–2014, especially E.