Malaria was introduced to Europe from the southeast during the Neolithic period and subsequently became established throughout the continent, due to the combination of favorable geomorphological and climatic conditions with the presence of adequately sized human and competent vector populations. Plasmodium vivax, P. malariae and P. falciparum all occurred in various areas of the continent, transmitted by numerous Anopheles species, mainly An. atroparvus in the northwest, An. labranchiae and An. sacharovi in the south. The height of malaria endemicity in the Early Modern Age was followed by decline in the twentieth century, particularly in the northwest, owing mainly to man-made contraction of vector breeding sites and improvement of living standards. Eradication was accomplished in 1974 through widespread drug treatment and residual insecticide spraying. Since then, despite the sustained presence of competent vectors and numerous malaria cases imported by travelers and immigrants, autochthonous transmission has been sporadic in Europe, probably due to prompt diagnosis and treatment afforded by robust healthcare services. Current and projected climatic conditions are conducive to malaria transmission, particularly vivax malaria, in several areas of Southern Europe. Moreover, the continuing immigration crisis may facilitate the buildup of an infectious parasite reservoir in the area. Although malaria resurgence is currently unlikely particularly in northwest Europe, it is of crucial importance to maintain disease awareness, diagnostic and clinical competence and robust public health infrastructure for surveillance and vector control to diminish the possibility of malaria transmission in Europe’s most vulnerable areas.
Part of the book: Towards Malaria Elimination