Will malaria return to Italy? Experts answer the question after specimens of malaria mosquitoes were discovered in Puglia. “Current conditions do not justify immediate alarm“, because the Anopheles mosquitoes carriers of the infection “are there today, but they are too few to support the transmission cycle of the disease. However, if conditions were to arise that were conducive to an explosion in the population of these insects, then we would certainly have to meet the demand.” So “keep your guard up”, is the biologist's warning Paolo Gabrieli, professor of Zoology at the State University of Milan, a career dedicated to the study of arboviruses. After the Experimental Zooprophylactic Institute of Puglia and Basilicata discovered specimens of malaria mosquitoes in Puglia that had not been detected for over 50 years, the expert explains to Adnkronos Salute why “it is essential to continue to follow the behavior of these insects and control their proliferation”. Especially, he warns, with climate change underway.
Until the 1960s, Gabrieli recalls, Italy was a malarial country and a few Anopheles mosquitoes remained in the country. “We still have mosquitoes belonging to the so-called maculipennis complex, a group of 7-8 species very similar to each other – explains the scientist – which are potential vectors of malaria. They are widespread in various areas of the Peninsula, especially in the coastal areas of Central-Southern Italy and in the islands, where they were once at home, we are therefore currently experiencing what is called 'anophelianism without malaria'”. There are two reasons. The first is that “having the right mosquito is not enough for the disease to also exist”, the second is that the Italian anopheles “today are not enough”.
“In the transmission cycle of pathogens such as malaria – specifies Gabrieli, arguing the first point – mosquitoes only act as vectors. When they are born, they are generally healthy. In order to transmit the pathogen they must first become infected themselves and for this to happen there must be a reservoir of the disease that we don't yet have in Italy if they bit an infected person returning from a malarial country, they could at most give rise to a few cases of local transmission, but certainly not a large-scale epidemic.” As for the second point, the biologist continues, it is linked to “a parameter that is called 'mosquito vectorial capacity'. It is similar to the R0 of infectious diseases and allows us to understand how much a population of mosquitoes is capable of transmitting a specific illness”. This index “depends on many factors, but one of the most important is the actual probability that mosquitoes can encounter (and bite) humans. The less numerous Anopheles mosquitoes are, and today in Italy they are very few, and the less likely it is that the encounter with man takes place”.
In short, few Anopheles mosquitoes on one side, no real human or animal reservoirs on the other. This is why, on the malaria front, according to Gabrieli “at the moment we can be relatively calm”. But in the future? If today “the probability that there could be sustained transmission of the infection in Italy is low – the expert reiterates – it is absolutely important to keep our guard up”.
First of all there is the fact that “we humans – reflects the scientist – tend to create the optimal conditions for the proliferation of mosquitoes without realizing it”: from the saucer on the terrace to rainwater deposits, there are various possible habitats 'tailored to insect' that we risk creating in daily life. And then there's the climate emergency: mosquitoes like “humidity and heat”, as we know, and the tropicalization of the weather even in our latitudes “certainly doesn't help”. The experts gathered in Barcelona for the Congress of the European Society of Clinical Microbiology and Infectious Diseases (Escmid) also raised the alarm: “If carbon emissions and population growth continue to increase at current rates, by 2100 they will be at risk of malaria and Dengue 4.7 billion more people in the world”. Including Italians.
Gabrieli agrees and invites to above all to avoid a danger: the risk of 'repeating' what happened in the past with the tiger mosquito, an alien species that has quickly become invasive throughout Italy. “The concern – concludes the biologist – does not so much concern the Anopheles mosquitoes in our home, because in the end we know them and know how they behave. Rather, we must be careful not to create conditions that favor the spread of new invasive mosquitoes which can bring us diseases from abroad. Including other mosquitoes capable of transmitting malaria.”
“An Anopheles labranchiae mosquito lives in Italy which is capable of transmitting malaria. The fact that Anopheles maculipennis was found in Puglia tells us that we need to be a little more careful but nothing more – he underlines to Adnkronos Salute Massimo Andreoni scientific director of the Italian Society of Infectious and Tropical Diseases (Simit) and full professor of Infectious Diseases at the Tor Vergata University of Rome – This last mosquito is only 'more competent' than the first in transmitting malaria but it should be clarified that some cases of malaria in Italy, mostly imported, there are and have never led to outbreaks or endemic situations. Furthermore, this discovery dates back to two years ago and I don't think anything dramatic happened. The circulation of Anopheles maculipennis must be monitored but without alarms”, says Andreoni, returning to the study by the Experimental Zooprophylactic Institute of Puglia and Basilicata which discovered specimens of malaria mosquitoes in Puglia after over 50 years.
For Matteo Bassettidirector of infectious diseases at the San Martino polyclinic hospital in Genoa, the fact of having found a mosquito of the Anopheles genus in Puglia “should not alarm the population because there is no immediate risk of malaria transmission, however it poses a problem that is part of a discussion global on mosquitoes and climate changes that are favoring their proliferation. However, Anopheles raises the problem of malaria for the future and of mosquito control: I hope that this discovery in Puglia will serve to work better on all kinds of mosquitoes through larvicides and pesticides Whoever says today to let the grass grow without cutting it to defend biodiversity is, I hope, joking because mosquitoes are vectors of Dengue, West Nile, Chikungunya and then, of course, malaria.”
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