We're having a heat wave, a tropical heat wave.

AuthorDesowitz, Robert S.
PositionBook Excerpt - Federal Bodysnatchers and the New Guinea Virus/Tales of Parasites, People and Politics - Excerpt

"Great to see you again"; "nice to meet you after all these years"; "what do you think this meeting is really all about?" -- these are the usual pre-session exchanges. These casual, customary exchanges took place in May 2000 at the elegant Lausanne Palace and Spa where there was a bottle of Pol Roger champagne to accompany the muesli at the breakfast buffet. The fifteen participants in a workshop called "Contextual Determinants of Malaria" had been gathered together by the organizers, Elizabeth Casman and Hadi Dowlatabadi of Carnegie Mellon University's Department of Engineering and Public Policy (a curious but intriguing academic amalgam). Our assignment was to ponder upon the determinant of global warming on the epidemiology of malaria--that is, its global distribution, intensity and anopheline vectors. The fifteen ponderers were a mixed bag of malaria experts from India, South America, Europe, Southeast Asia, the United States and, by proxy, Africa. There were orthodox, field-oriented, general purpose mala riologists; orthodox, field-oriented medical entomologists; administrator-malariologists from the World Health Organization's central casting in Geneva and from regional satellite offices; laboratory research-type, mathematical epidemiology modellers, who may never have seen a malaria parasite under the microscope or a malarious patient, but had the data and knew the numbers; and climate change experts. There were also three representatives from the workshop's major angel, ExxonMobil. Later disclosed in the acknowledgments of sponsorship were the American Petroleum Institute, the Electric Power Institute, along with the National Science Foundation and the National Oceanographic and Atmospheric Administration. That evening at the informal reception, the ExxonMobilites were asked why they were paying for the meeting, They explained that malaria was a health problem for the workers in their tropical operations. And then they said candidly and cryptically: "There is, of course, the problem of emissions". Was the workshop a kind of preemptive legal strike, asking the right question and hoping to get the right answer?

Here we were in Switzerland, modern-day malaria prophets attempting, like the ancient oracles, to divine an impending disaster. When the bones were cast, the tarot cards read and the accepted notions reviewed, the portents were that mosquitoes would flourish in the new warm humid environments, breeding faster, drinking blood more frequently and living longer. Malaria, the epitome of a tropical disease, would surely follow. More infections would be due to the dangerous malaria parasite, Plasmodium falciparum, which requires a minimum of 18[degrees]C (65[degrees]F) to complete its life cycle, whereas the nonlethal Plasmodium vivax can make do with a cooler 16[degrees]C (61[degrees]F). Ergo, as the temperate zones turn tropical, they will become malarious--a killing malaria. The oracle has spoken. Leave your offering at the temple altar.

Then the iconoclast oracles, led by Paul Reiter, the entomologist-historian of the Centers for Disease Control and Prevention's dengue unit in Puerto Rico, presented a different view that was closer to reality (see his comprehensive review: Climate change and mosquito-borne disease in Environmental Health Perspectives, March 2001,109:141-61). It is true that of the approximately 3,500 species of mosquitoes, including the malaria-transmitting anophelines, most are tropic and subtropic. Mosquitoes are almost everywhere, adapting to virtually every habitat that is not permanently frozen. And the most massive numbers are not in the Congo but in the sub-Arctic after the spring thaw. Clearly, malaria is not a tropical disease. One hundred years ago, it was endemic in Sweden to the 15[degrees]C (59[degrees]F) isotherm. Until 1955, Poland was wracked by severe seasonal outbreaks. Turn-of-the-twentieth-century America was malarious in almost all States east of the Mississippi. DDT, better housing, health care and wat er management have eliminated endemic malaria in the United States and Europe.

That is, the parasite has been eliminated. The anopheline vectors remain in place, waiting, waiting. These potential vectors don't need global warming to pioneer their way to the north, although it is possible that their tropical cousins will join them in the warmed-up America and Europe. Any mini-outbreak in an industrialized country would be swiftly contained. The Camegie Mellon meeting concluded...

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