The Risk of Malaria Reemerging in Temperate Climate Zones

"Could malaria return to Europe?" This was the question posed by Dr. Eskild Petersen of the Department of Infectious Diseases (Aarhus University Hospital) at the beginning of the fourth Global Health Lecture in the series organised by the ISGlobal alliance to provide a platform where global health issues are discussed by international experts.

At the beginning of the last century, the parasite responsible for vivax malaria was still endemic in many temperate regions, including Europe. Its disappearance from the continent did not occur until between 40 and 60 years ago: Germany was declared free of malaria in 1950, Spain in 1962, and Portugal and Greece in 1973. Dr. Petersen went on to explain that the elimination of malaria at that time was not related to a change in temperature but rather to improvements in social and economic conditions and the success of certain control measures. Therefore, the possibility that malaria may be reintroduced into temperate European regions depends less on climate change and more on other factors, including population movements from endemic to non-endemic areas.

According to this expert in infectious diseases and tropical medicine, "Plasmodium vivax can be reintroduced into an area if several conditions are met:  an uncontrolled reservoir, a high probability of transmission, and major movements of infected individuals". He went on to cite the example of the Democratic People's Republic of Korea (North Korea), the only temperate country where P. vivax is still endemic today. "Although we do not have access to much information about the current situation in North Korea, the reappearance of P. vivax in South Korea, especially in the demilitarized zone along the North Korean border, is an indication that the parasite is not under control there. The fact that a large number of refugees from North Korea are entering China and South Korea leads us to suppose that there is a serious threat of reintroduction of malaria in those countries."