Malaria in Europe: A Historical Perspective

Abstract

Endemic malaria, which claimed 229 million new cases and 409,000 deaths in 2019 mainly in Africa, was eradicated from Europe by the mid-20th century. Historical descriptions of intermittent tertian and quartan fever reported in texts of Hippocrates in Greece and Celsus in Italy suggest malaria. A few paleomicrobiology investigations have confirmed the presence of malarial parasite Plasmodium falciparum in 1st, 2nd, and 5th century infected individuals in diverse regions of Italy, and Plasmodium sp. later in Bavaria. The causative Plasmodium pathogens, discovered in the 19th century in Algeria, were controversially used as therapeutic agents in the European pharmacopeia more than two centuries after effective quinine-based treatments had been introduced in Europe. How Europe managed to eradicate malaria and what the history of malaria was in Europe are of medical interest, and this review traces research pathways for a renewed understanding of malaria eradication in Europe through combined historical and paleomicrobiological investigations.

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“…Malaria is a common and life-threatening disease in many tropical and subtropical areas caused by the protozoan parasites Plasmodium falciparum, vivax, malariae, and ovale which are transmitted to humans by female Anopheles mosquitoes. Malaria co-evolved over millennia alongside humans and is documented in ancient Egypt as shown by the surviving evidence of the enlarged spleens from Egyptian mummies [ 78 , 79 ]. A disease characterized by intermittent fevers was described in Corpus Hippocraticum and classified as tertian fever and quartan fever [ 79 ].…”

“…Malaria co-evolved over millennia alongside humans and is documented in ancient Egypt as shown by the surviving evidence of the enlarged spleens from Egyptian mummies [ 78 , 79 ]. A disease characterized by intermittent fevers was described in Corpus Hippocraticum and classified as tertian fever and quartan fever [ 79 ]. Malaria was imported from the African rain forests through the Nile to the Mediterranean in Greece and eventually in Rome in the 1 st century AD, and then spread across Europe over the centuries and to the New World by European colonists and slave trade [ 78 , 79 ].…”

“…A disease characterized by intermittent fevers was described in Corpus Hippocraticum and classified as tertian fever and quartan fever [ 79 ]. Malaria was imported from the African rain forests through the Nile to the Mediterranean in Greece and eventually in Rome in the 1 st century AD, and then spread across Europe over the centuries and to the New World by European colonists and slave trade [ 78 , 79 ]. In 1878 Alphonse Laveran, a French army physician, first identified Plasmodium gametocytes while examining under microscope blood from a young soldier with malaria in Algeria [ 79 ].…”

“…Malaria was imported from the African rain forests through the Nile to the Mediterranean in Greece and eventually in Rome in the 1 st century AD, and then spread across Europe over the centuries and to the New World by European colonists and slave trade [ 78 , 79 ]. In 1878 Alphonse Laveran, a French army physician, first identified Plasmodium gametocytes while examining under microscope blood from a young soldier with malaria in Algeria [ 79 ]. Evidence that malaria was transmitted by Anopheles mosquitoes came less than 20 years later from the work of Robert Ross, a British army physician, and the Italian malariologists Giovanni Battista Grassi, Amico Bignami and Giuseppe Bastianelli, which also elucidated the life cycle of Plasmodium parasites in humans [ 79 ].…”

“…In 1878 Alphonse Laveran, a French army physician, first identified Plasmodium gametocytes while examining under microscope blood from a young soldier with malaria in Algeria [ 79 ]. Evidence that malaria was transmitted by Anopheles mosquitoes came less than 20 years later from the work of Robert Ross, a British army physician, and the Italian malariologists Giovanni Battista Grassi, Amico Bignami and Giuseppe Bastianelli, which also elucidated the life cycle of Plasmodium parasites in humans [ 79 ].…”