Malaria in the UK

"Prepare for outbreaks of malaria," government agencies warn hospitals in the UK (Prince). Malaria is often considered a minor problem for the UK in modern times, but outbreaks are not unheard of and may become increasingly likely as global warming expands mosquito breeding grounds.

Hospitals must prepare for epidemics as they have been the site of malaria transmission in the past. In 1999 "two patients...contracted malaria while being treated at a hospital in Nottingham." The disease was transmitted from an infected patient in the hospital to the two other patients via a mosquito. That was "the second time there has been an outbreak of the tropical disease in a British hospital" (Malaria).

In 2008 reports of 1370 cases and 6 deaths from malaria were published in the UK (HPA). "A high likelihood of a major heat wave" may lead "to as many as 10,000 deaths, hitting the UK by 2012" warns the government (Prince). In coming years "the UK is to be hit by regular malaria outbreaks, fatal heat waves and contaminated drinking water within five years because of global warming, the Government has warned the NHS [National Health Service]" (Prince).

Malaria has been endemic in the UK before. "Malaria has been seen in these islands in the past" (Prince). "The marshlands of coastal southern and eastern England had unusually high levels of mortality from the sixteenth to the nineteenth century. The unhealthiness of the environment aroused frequent comment during this period and it was attributed to an endemic disease known as "marsh fever" or "ague"." This "marsh fever" is considered to be "malaria transmitted by anopheline mosquitoes. Malaria, once endemic in the coastal marshes of England, had a striking impact on local patterns of disease and death" (Dobson).

Malaria is present in the UK and outbreaks are not impossible. Heat waves from global warming may cause flooding and encourage mosquito breeding, but mosquito havens exist now. "The Thames Estuary has been identified as the likeliest place for a new outbreak of malaria, following an investigation by insect experts" (Thames). An outbreak of malaria may be possible even without the feared heat wave if such mosquito habitats are not addressed effectively.

"A spokesman for the Health Protection Agency said: Our work is based on what is likely to happen if we do nothing to prevent" the development of mosquito breeding grounds, "and it could well be that we see an increase in diseases such as malaria" (Prince).

The idea of a modern malaria epidemic in the UK is horrifying but preventable. "Better management and control of man-made sites where malarial mosquitoes may easily reproduce - such as water wells and bore holes - may help reduce malaria breeding close to human settlements" (Vector). Furthermore, home and land owners should take responsibility to prevent standing and stagnant water on their property. Fountains can be installed into ponds and lakes to agitate the water so that mosquitoes cannot breed. Even small amounts of standing water can serve as a nursery for the mosquitoes that transmit deadly malaria.

Sources:
Dobson MJ. Malaria in England: a geographical and historical perspective. 1994 August.
"Malaria outbreak at UK hospital" BBC. 29 March 1999.
Prince, Rosa. "Malaria Warning as UK becomes warmer." Telegraph.co.uk. 12 Feb 2008.
"Thames marshes 'perfect breeding grounds for malaria'." Evening Standard, The. 1 Feb 2002.
"Vector Control Tools..." The Health and Environment Linkages Initiative. http://www.who.int/heli/risks/vectors/malariacontrol/en/index3.html

Microchip detects malaria in Glasgow

"Scientists from Glasgow University claim they have created a device which can detect malaria within minutes." A microchip has been created to detect the malaria parasites in a blood sample. After the "blood samples are placed in the microchip" the device detects "the strain of disease. This means the best drug can be used to treat it." This method of detection is much better than previous methods because it is more accurate and faster (BBC).

"The current way of diagnosing is using a blood smear on a slide and examining it on a microscope," said project-leader Dr Ranford-Cartwright. "That will take a good microscopist a good hour to reach a diagnosis, it's extremely difficult to make that diagnosis accurately." This microchip "can give us a result in as little as half an hour."

Although malaria is less prevalent in the UK than in tropical regions of the world, it is not absent. "Last year a study revealed more cases of the most dangerous type of malaria than ever before are being brought back to the UK from trips abroad." Most malaria infections are imported, but the number of detected cases is rising. "The Health Protection Agency study identified 6,753 cases of falciparum malaria diagnosed between 2002 and 2006" (BBC).

Correct diagnosis is only one step toward malaria eradication. Another involves the development and use of effective drugs in the fight against the parasite. Ranford-Cartwright leads several research programs at the University of Glasgow including studies that examine the genetic markers for drug resistance. She says, "For this work we maintain different species of Anopheles mosquitoes in insectaries, and we infect them with P. falciparum sexual stages grown in culture. We use genetic techniques to study complex traits such as the interaction between the malaria parasite and its mosquito vector. We are also involved in work to identify factors important in the spread of anti-malarial resistance" (Ranford-Cartwright). "There is" further "need for a specific, sensitive, robust, and large-scale method for diagnosis of drug resistance genes in natural Plasmodium falciparum infections" (Abdel-Muhsin).

Sources:
Abdel-Muhsin, AM. LC Ranford-Cartwright, et al. "Detection of mutations in the Plasmodium falciparum dihydrofolate reductase (dhfr) gene by dot-blot hybridization." Am. J. Trop. Med. Hyg., 67(1), 2002, pp. 24-27

BBC News. "Doctors welcome Malaria Microchip." 24 April 2009.

Ranford-Cartwright, Lisa. "Research Interests." University of Glasgow. 7 August 2009.