Thread by @n00rdung

People often ignore that a lot of aspects in which Europe (and to a lesser extent, North America) look especially hospitable is usually not something that was intrinsic to the region, but achieved through organized effort to fix things

Let's look at the example: malaria

Malaria (= Italian for "bad air") is fairly well documented from classical Greek and Latin sources, connection to marshes seemed to work well with miasma theory but mosquitoes specifically were not recognised as vector

Malaria (as "marsh fever") was also documented in England; even throughout the Little Ice Age – but seemingly drying of the marshes slowed down transmission enough for the disease to phase out. Similar is probably true for large parts of northern Europe after river regulation

But what about southern Europe? Let's look at the case of Yugoslavia. WW1 contributed to another wave of malaria spread in Europe

At the front already 80% of french troops were hospitalized, 1% casualty rate

Returnees brought malaria back to northern Europe where many already considered malaria a thing left behind with progress; there were large outbreaks in Emden; in Arkhangelsk (!); as it turns out well heated housing actually means mosquitoes can winter easier

In Yugoslavia as a whole, there were 800k-1200k infections yearly (~10% population), with most concentrated in Macedonia where infection rates were up to 100% in some villages – it is noted that ~25% of men were unfit for military service because of chronic childhood malaria

Total numbers of infected in Macedonia was in 250k-300k yearly
Skopje recorded 18679 hospitalized cases 1921-29, corresponding to half the city's population
Some rural parts recorded over 80% mortality for hospitalized cases, but military hospitals recorded much better recovery.

Situation was similar for Kosovo, Montenegro, Sandžak regions ("Zetska banovina") – infection rates were up to 80% around Skadar lake, and the region in general recorded ~60-70% as "malaria tropica" (quotidian malaria – with daily paroxysms, the worst type)

Situation was slightly better in Dalmatia (already recorded as affected before WW1). In 1921 the infection rates were 25%. Epicenters were river (especially Neretva) and karst floodplains but also hinterlands without running water that relied on rainwater collection.

Serbia and Bosnia also showed endemic malaria but infection rates stayed below 10%. Beograd specifically had malaria rate of 20% in 1924, mostly working class, here water regulation helped slowly decrease malaria rates.

Malaria was present in some parts of Slavonia (e.g. Slavonski Brod with ~25 hospitalized yearly) due to swampy terrain. Habsburgs started draining the swamp to get rid of malaria in 18th century already
The island Krk is also noted as a hotspot for malaria, comparable to Dalmatia

The records for Slovenia show: ~100 infections yearly in Ljubljana around 1830, but notes that draining the swamp worked
After WW1 malaria had a resurgence on Drava and Mura plains, and Bela Krajina, but noted as mostly tertian (= paroxysms every other day)

Yugoslavia's plan of malaria management, based on a 1931 law, split the country in 3 zones: healthy, anophelic (presence of anopheles mosquitoes, no endemic malaria) and malaric, and involved quinine prophylaxis & draining the swamps

Andrija Štampar put a lot of effort on proactive treatment: doctor looking for sick and not the other way around.
In Macedonia swamp draining was constant: Ohrid lake outflow was constantly being deepened, & Paris green was used every spring wherever draining was not possible

Here I should mention that, internationally, those efforts were often suported by the Rockefeller Foundation; they were also involved in Yugoslavia, but mostly just administratively, collecting information for the League of Nations which had a malaria task group since 1925

Dalmatia & Krk took similar efforts in the 1920s already: split into water management regions, prophylaxis with quinine, draining the swamps, Paris green, but also augmented with Gambusia affinis introduction (who feed on mosquito larvae)
Malaria was eradicated on Krk by 1927

While all those efforts (& similar also in Italy, where swamp draining took shape in large scale projects, entire cities like Latina constructed on drained marshes) greatly lowered malaria infection rates, the gamechanger came after WW2: the DDT

DDT was already used with British & American military during WW2 (used by advancing troops in Italy, but also in North Africa and Middle East), Yugoslavia applied DDT since 1947, with rates quickly going down (3240 recorded in 1956), considered eradicated by 1973

Why was DDT not that successful elsewhere?
In Europe, DDT use was applied after ~20 years of coordinated efforts
Many other countries used DDT as a Hail Mary & discovered resistance buildup after 10 years, as well as not taking effort to plan, simply using it indiscriminately

In addition, DDT has been regulated since the 70s due to environmental reasons – yearly use as general pesticide became a general threat to wildlife. This came in US and Europe after malaria was already eradicated here, but dwindling DDT use elsewhere meant a cessation in efforts

We now take Europe without malaria almost for granted; and if not, the spread of mosquitoes is usually taken as a new introduction to Europe by "climate change" – because "it's a tropical disease duh, such things don't happen in Europe normally".

And, are Aedes mosquitoes now spreading in Europe simply because we first eradicated Anopheles mosquitoes too successfully, and now that we let down our guards and forget about how we already fixed this problem, the spread is no longer impeded?

To conclude;
- Europe is hospitable *because we made it such*
- we don't have gruesome endemic diseases *because we eradicated them*
- we take those things for granted but *it can easily spill over again*
- all this *can be done with right effort elsewhere too*

Main source used: ojs.inz.si/pnz/article/vi…