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Could malaria return to the UK?

August 30, 2001

Millions of tourists now travel between the UK and countries where malaria is endemic. Given this, entomologists from the University of Durham are to undertake a thorough risk assessment of malaria returning to the UK. Speaking at the Royal Entomological Society’s meeting Entomology 2001: “Insects and disease”, to be held at the University of Aberdeen on 10–12 September 2001, Dr Rob Hutchinson will say: “With huge numbers of people traveling to malaria-endemic countries, drug resistance among the malaria parasites, the possible effects of global warming and the presence of mosquitoes in the UK that are capable of carrying malaria, an extensive risk assessment is now justified.”

The UK has five mosquito species that could carry malaria, but Anopheles atroparvus was the main vector of malaria in the UK. According to Dr Hutchinson, of the University of Durham: “This is due to its unique ecology. It breeds in brackish water found in coastal marshes. Its distribution matches areas where malaria used to occur in the UK, and it is the only anophelene that remains active through the winter, living inside buildings.”

Malaria was common in marshy areas of the UK from the sixteenth century until the end of the eighteenth century, caused by A. atroparvus infecting people with the malaria parasite Plasmodium vivax. P. vivax differs from the more dangerous P. falciparum, which kills two million people a year in the tropics, because it can survive at lower temperatures. Former hot spots of malaria in the UK were the Essex and Kent coasts, the Thames estuary, Somerset Levels and the Holderness of Yorkshire. The final outbreak occurred in the Isle of Sheppey in 1917–1918, and Dr Hutchinson has recently found populations of A. atroparvus living in stables and derelict buildings on the Isle of Sheppey.

Malaria can be brought into the UK either by infected people or by mosquitoes, and the UK has approximately 2,000 cases of imported malaria annually. In 1999, UK citizens made 53.9 million visits abroad and 25 million overseas visitors travelled to the UK, 260,000 of whom came from Turkey and areas of the former Soviet Union where vivax malaria is endemic and healthcare is poor. “Countries with poor healthcare are very unlikely to provide effective treatment for malaria and therefore people travelling from these regions are potentially more likely to be carrying parasites,” Dr Hutchinson says.

To assess the risk of malaria returning to the UK, Dr Hutchinson has – for the first time for 20 years – been searching aircraft arriving from parts of Africa. So far he has found 33 invertebrates, most of them alive, including three live mosquitoes that are not found in the UK. He will present his full findings at 15:00 on Wednesday 12 September 2001.


Royal Entomological Society (RES)