It's said that half of all humans have died from one infection -- malaria. But today in many parts of the developed world malaria is just a travel or global health concern. However, it must be remembered that relegating malaria to such a status was a great human achievement as malaria had a much bigger planetary profile in the past -- indeed Washington DC was literally, at one time, a malarious swamp.
A new case of fatal cerebral malaria in northern Italy is a stark reminder that this disease can have a much bigger impact if it is allowed to. Italy was freed of malaria in only 1970 the result of strong eradication campaigns that beat the mosquito back. However, there have been reports of recent possible local transmission in the southcentral part of the country. It is unclear, at this time, how the disease was contracted as the patient had not traveled abroad. An unknown pool of possibly Italian Anopheles mosquitoes is infected with the parasite and just found the right opportunity to transmit to the now deceased four year old child. There is some question whether a contaminated needle may have played a role as well as travel related malaria cases were treated around the same time at the same hospital.
Malaria is a complex infectious disease that has marked the human race and provided a tremendous evolutionary pressure on our species. Alarming rates of drug resistance to artemesinin, if they spread to Africa, could be catastrophic.
The disease, however, can be defeated --but only if humans put all the resources of their mind into the fight. Bed nets, insecticides, vaccines, antimalarials, and genetically modified mosquitoes should all have major roles in this fight for the best chance at success.