Europe

Asian and African traders introduced Plasmodium to Europe around 1000 BCE, infecting Carthage by the time of Christ. By 400 BCE, Plasmodium had ravaged ancient Greece. For the Greek poet Homer, staving off malaria was as pointless as rearranging the stars. The “harbinger of fevers,” he wrote, is “Sirius…the evil star…which dominates the night sky at harvest time.”

The people of the Roman empire, too, suffered “the shivering of the quartan,” as Dante put it, but the parasite didn’t level its final blow until after the deforested hills eroded in the 1400s. As the dirt washed into the valleys, great marshes formed and malarial mosquitoes multiplied, emerging from the swamps with an explosion of malaria. Their bodies and wills weakened by malarial infection, the Romans were easy prey for the invading tribes, whose northern homes had yet to be invaded by the parasite.

In England, parliament was established in Westminster, across from the malarious Thames river, where Anopheles bred in the sulfurous salt marshes along its banks. The death toll in England’s counties by the sea rivalled those of present-day sub-Saharan Africa. The literary elites from Chaucer to Shakespeare suffered the outbursts of Plasmodium—they called the disease the “ague”—but little could be done besides weaving its fevers into prose and poem, including eight of Shakespeare’s plays.

On the Italian peninsula, the disease reigned supreme, dubbed the “Roman fever” malingering around the notorious Pontine swamps. Every summer, hundreds perished while scores were weakened to the point that they easily sickened and died from other pathogens. The Vatican, whose buildings rose along the banks of the Tiber, was particularly plagued, with Plasmodium regularly felling its leadership. Plasmodium took the life of Pope Innocent VII in 1492; Pope Alexander VI in 1502; Pope Adrian VI in 1523 and Pope Sixtus V in 1590. In 1623, malaria killed Pope Gregory XV. Nobody knew what it was, but it seemed to have something to do with the bad air, they said: the mal’ aria.

English malaria started to subside with the agricultural and industrial revolutions. As better farming techniques allowed for year-round animal husbandry, malarial mosquitoes diverted away from humans and toward livestock, thanks to the local malarial vector’s preference for animals. (When faced with the exposed arm of a human or the flank of a calf, a hungry Anopheles maculipennis will bite the calf four out of five times.) As the industrial revolution clanged into action, peasants fled the malarial villages for urban environs, with their paved-over mosquito habitats.

Malaria hung on in Italy for years more. By the time the Italian state was forged, in 1861, 2 million Italians fell ill with malaria and 15,000 perished every year. “There is a horrid thing called the malaria, that comes to Rome every summer, and kills one,” Horace Walpole wrote in a 1740 letter. (Introducing, at long last, the Italian word “malaria” into the English language.) There was “a strange horror lying over the whole city,” wrote the English critic John Ruskin in 1840. “It is a shadow of death, possessing and penetrating all things… you feel like an artist in a fever, haunted by every dream of beauty…but all mixed with the fever fear.” Traveling across the malarious Roman campagna in 1847, Florence Nightingale wrote, was like “passing through the Valley of the Shadow of Death,” she wrote. The Campagna’s peasants were “the most unhappy, most resigned” people in Italy, the French writer Stendhal wrote in 1829. They were “pale, yellow, sickly,” added Hans Christian Anderson in 1845.

During the revolution that created the Italian state, the wife of the revolutionary Giuseppe Garibaldi died of malaria. Garibaldi carried her dying body across the Roman campagna, an act of romantic heroism captured by a myriad of writers and painters. Malaria also killed the first prime minister of the United Kingdom of Italy, just three months after the new state was declared.

While Italy’s elaborate anti-malaria program, launched in 1900, failed to stanch the spread of the disease, it greatly reduced malaria’s death toll and by building schools, clinics, and distribution and oversight systems, was instrumental in strengthening the new state. On the eve of WWI, malaria deaths in Italy had fallen from 16,000 in 1900 to less than 3,000.

Both World War I and World War II infected tens of thousands of European troops, who brought their parasites home with them, sparking local epidemics, some as far north as Archangel, Russia in the Arctic circle. Malaria control projects continued, from Mussolini’s campaign against malaria, a “cornerstone of the Fascist revolution,” which relied on drainage and screening, and post-WWII DDT-spray campaigns.

The WHO declared Europe free of malaria in 1975, but since the 1980s, population movements, political instability, and environmental disruption have fuelled malaria outbreaks in Azerbaijan, Tajikistan, Turkey, Armenia, Turkmenistan and Kyrgyzstan. Malaria continues to be imported into Europe from Africa, Asia and elsewhere, and in recent years, local transmission of malaria has been reported in the south of France and elsewhere.

For more:
Malaria in the WHO European Region:
http://www.euro.who.int/malaria/ctryinfo/ctryinfotop

Malaria risk in European countries:
http://malariasite.com/malaria/europe.htm

Lewis W. Hackett, Malaria in Europe: an ecological study (London: Oxford University Press, 1937)

Gordon Harrison, Mosquitoes, Malaria and Man: A history of the hostilities since 1880 (New York: E.P. Dutton, 1978)

Leonard Jan Bruce-Chwatt and Julian de Zulueta, The rise and fall of malaria in Europe: a historico-epidemiological study (Oxford University Press/Regional Office for Europe of the World Health Organization, 1980)

Robert Sallares, Malaria and Rome: a history of malaria in ancient Italy (Oxford: Oxford University Press, 2002)

Frank M. Snowden, The Conquest of Malaria: Italy, 1900-1962 (New Haven, CT: Yale University Press, 2006)

Randall Packard, The Making of a Tropical Disease: a short history of malaria (Baltimore, MD: Johns Hopkins University Press, 2007)