From New Scientist
Malaria is Taking Hold Again in Europe's Mosquitoes
BYLINE: Debora MacKenzie
DATELINE: September 18, 1999
SECTION: This Week, Pg. 13
EUROPE faces "a serious risk of an uncontrollable resurgence of malaria", warns
the WHO in a new report. Drainage, drugs and insecticides eradicated malaria
from the whole of Europe by the 1960s. Now civil disorder and irrigation
threaten to bring it back unless controls are stepped up, the report says.
These concerns come hard on the heels of fears that malaria may move north
thanks to global warming.
In a report for health officials from its European region, meeting this week in
Florence, the WHO says that cases in the European Union jumped from 2882
to 12 328 in 1997. Despite access to good medical care, up to 7 per cent of
those people die because European doctors may not recognise the unfamiliar
disease until it is too late.
More European travellers are bringing malaria back from countries where it is
endemic, and the big fear is that local mosquitoes could acquire the parasite
from such travellers and re-establish a local chain of transmission. Three
recent cases in Luxembourg and two in New York have fuelled concern over air
travel as a means of reintroduction. The cases in Luxembourg all occurred
a few kilometres of the country's international airport, and were probably
caused by mosquitoes stowing away on aircraft arriving from the tropics (New
Scientist, 11 September, p 14).
The migration of refugees during regional conflicts, a massive increase in the
1970s in irrigation canals where mosquitoes can breed, and the demise of public
health programmes with the collapse of Communism have led to a "dramatic
resurgence" of the disease, says the WHO. This has particularly affected former
Soviet states bordering endemic areas such as Afghanistan. The report states
that Azerbaijan and Tajikstan are seeing large-scale epidemics, with smaller
epidemics in Armenia and Turkmenistan.
Travellers from those areas probably infected the mosquitoes that gave two
Russians malaria this month in the city of Ryazan, 180 kilometres southeast of
Moscow. The two had never been outside the region. Similar cases occurred for
the first time since the 1960s in Russia last year, and surveys have revealed
infected local mosquitoes as far north as Moscow.
In Turkey, malaria was almost eliminated by 1989. But a major irrigation
in the southeast of the country caused cases to jump nearly tenfold
and 1994. A massive effort to control that epidemic is almost solely
for a fall in the total number of cases in Europe since 1996, but the
tenuous. Turkey's tourist boom means that malaria could start to pose a
The WHO thinks that good medical care, vigilant surveillance and chilly winters
will prevent malaria from re-establishing itself in northern Europe,
existence of mosquito species able to carry it.
But the species that live in southern Europe are better at maintaining the
parasite. There were outbreaks of malaria that were spread by local mosquitoes
in Corsica in 1970, and in Bulgaria in 1995, while in 1997 an Italian
disease from a local mosquito.
"The risk for the reappearance of the disease in some areas of southern Europe,
where more efficient vectors are present, is real," warns the WHO.
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