Abstract
BackgroundThe world is facing an increased threat from new and emerging diseases, and there is concern that climate change will expand areas suitable for transmission of vector borne diseases. The likelihood of vivax malaria returning to the UK was explored using two markedly different modelling approaches. First, a simple temperature-dependent, process-based model of malaria growth transmitted by Anopheles atroparvus, the historical vector of malaria in the UK. Second, a statistical model using logistic-regression was used to predict historical malaria incidence between 1917 and 1918 in the UK, based on environmental and demographic data. Using findings from these models and saltmarsh distributions, future risk maps for malaria in the UK were produced based on UKCIP02 climate change scenarios.ResultsThe process-based model of climate suitability showed good correspondence with historical records of malaria cases. An analysis of the statistical models showed that mean temperature of the warmest month of the year was the major factor explaining the distribution of malaria, further supporting the use of the temperature-driven processed-based model. The risk maps indicate that large areas of central and southern England could support malaria transmission today and could increase in extent in the future. Confidence in these predictions is increased by the concordance between the processed-based and statistical models.ConclusionAlthough the future climate in the UK is favourable for the transmission of vivax malaria, the future risk of locally transmitted malaria is considered low because of low vector biting rates and the low probability of vectors feeding on a malaria-infected person.
Highlights
The world is facing an increased threat from new and emerging diseases, and there is concern that climate change will expand areas suitable for transmission of vector borne diseases
Malaria was once common in marshland communities in central and southern England between 1500 and 1800
The feeding rate is calculated using: a= h u where h is the proportion of mosquito blood meals taken from people and u is the period in days of the gonotrophic cycle - the interval between laying each egg-batch and, generally, each mosquito blood meal
Summary
The world is facing an increased threat from new and emerging diseases, and there is concern that climate change will expand areas suitable for transmission of vector borne diseases. Over the last 30 years there has been a rapid increase in emerging and re-emerging infectious diseases in the human population [1,2,3], with over 175 species of pathogens classified as emerging or re-emerging [4] Emergence of these diseases are frequently associated with ecological changes [1] and many are transmitted by insect or tick vectors [1,4,5]. The last significant epidemic of malaria in England and Wales occurred in 1917 and 1918, with the main focus on the Isle of Sheppey, near the mouth of the Thames Estuary [9,10] During this epidemic, there were 330 cases of locally-transmitted vivax malaria when infected servicemen returning from Macedonia were billeted near salt marshes. All reported cases of locally transmitted malaria in the 1900s were vivax malaria, except for an unusual case of falciparum malaria in Liverpool [11]
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