A four-year-old Italian girl has died of cerebral malaria in northern Italy, a region free of the disease, in what doctors see as a very mysterious case.
Sofia Zago died in Brescia on Sunday night, after being rushed to hospital with a high fever on Saturday.
Italy is free of the Anopheles mosquito that carries cerebral malaria, the deadliest form of the blood disease. But after a scorching August, some fear that it might have reached Italy.
A flight could have brought it in.
Sofia had been on holiday with her parents at Bibione, an Adriatic resort near Venice.
"It's the first time in my 30-year career that I've seen a case of malaria originating in Trentino," said Dr Claudio Paternoster, an infectious diseases specialist at Trento's Santa Chiara Hospital.
Since the 1950s, Italy has not had a malaria problem because mosquito-infested marshes were drained.
Trento, where the girl's malaria was diagnosed on Saturday, lies in the foothills of the Alps.
There is speculation that Sofia might have caught malaria from one of two children treated for it at the Trento hospital after 15 August. They had caught it in Africa, and recovered.
Sofia had had treatment there for child diabetes and there was a break before her emergency readmission to the hospital at the weekend.
A Trentino health official, Paolo Bordon, said Sofia had not been in the same ward as the other two children. Sofia had not had a blood transfusion, he added, stressing that the treatments for malaria and diabetes were utterly different.
The Plasmodium Falciparum parasite carried by the Anopheles mosquito can kill a human within 24 hours.
About 438,000 people died of malaria in 2015 in the 95 tropical countries where it is endemic, Italy's Corriere della Sera daily reports.