Klima wandel und Malaria

Goal and Scope

The coastal zones of Lower Saxony (Germany) are former malaria regions. Malaria had finally become extinct in the early 1950s, and subsequently related scientific investigations declined. But from that time until nowadays, the vector in the form of Anopheles mosquitoes has still been present in Lower Saxony. Thus, the question arises, whether a new autochthon transmission could take place due to the monthly mean temperatures of the recent years. Answering this question was one goal of the investigation at hand. Another one was to examine the spatial and temporal structure of potential transmissions in respect to the predicted increase of the air temperatures according to the IPCC scenarios.

Methods

Current information about anophelines and their characteristics within Germany, such as details on historical incidences, breeding preferences, longevity or distribution of the respective species, were collected by literature research. Further, measurement and incidence data had to be collected and processed: temperature values were provided by the Deutscher Wetterdienst (DWD), and recent findings of Anopheles were supplied by the former Niedersächsisches Landesamt für Ökologie (NLÖ) as a data bank. Then temperature maps were calculated for the three periods (1947–1960, 1961–1990, 1985–2004) by means of Kriging. To model areas at risk, the transmission potential for a new vivax malaria spread in respect to temperature was computed using the Basic Reproduction Rate (R₀) formula. It provides the average number of secondary infections produced when a single infected individual is introduced into a potential host population in which each member is susceptible.

Results

The computations corroborate a climate warming between the 30-years interval from 1961 to 1990 and the period from 1985 to 2004. According to the rise of the air temperature as predicted by the IPCC scenarios, the spatial pattern of potential malaria outbreak was calculated for 2020, 2060 an 2100. To this end, for each of these years a best-case-scenario with the lowest reasonable temperature increases (+0.3°C, +0.9°C, +1.4°C) and a worst-case-scenario implying the highest plausible temperature rise (+0.9°C, +3.3°C, +5.8°C) were assumed. While in 2020 the maximum duration of the transmission risk is estimated to last four months, in 2100 the vivax transmission will be likely from May until October.

Discussion

Correlated with the higher monthly mean temperature values, the risk of a vivax transmission is increasing as temperature is the determining variable of the mathematical model. Therefore Lower Saxony is at risk of a new outbreak of vivax malaria assuming no other risk factors are of relevance.

Conclusions

The study could demonstrate that most parts of the country lie within a transmission zone with a duration of two months. The areas containing the highest risk with a transmission length of three months are located around Nordhorn and Hameln, and within the rectangle of Celle, Hannover, Helmstedt and Wolfsburg. These areas match with recent Anopheles larvae finding by the NLÖ, thus, only the pathogen is lacking for a successful transmission. And as Germany is not an endemic malaria zone, the pathogen can enter the country most likely by infected people or imported mosquitoes that transport it in their guts.

Recommendations and Perspectives

The results should be understood as a request for more comprehensive investigations in that field. This would be an essential basis for a successful risk monitoring and precautionary management. Although the chances of a new endemic malaria disease in Germany seem to be considerably low today, it would be better to be prepared than to be suddenly faced with the unexpected.