After a 40-year hiatus, malaria is returning to Greece.
Some 70 cases have been reported there this year, and at least 12 people appear to have been infected in the country. (The others picked up the disease elsewhere.)
That's a concern for health workers because it means malaria may now be endemic to Greece and not just hitching a ride with travelers.
Plus, the parasite is showing up in regions where it has never been reported, the U.S. Centers of Disease and Prevention said in a statement last week.
What's fueling malaria's comeback?
Budget cuts have been tough on Greece's health services, causing medication shortages and a sharp rise in HIV cases over the past year. Cuts to public health spending could also be contributing to malaria's reappearance, says Dr. Apostolos Veizis, who directs Doctors Without Borders' operations in Greece.
In 2011, the majority of municipalities around Athens did not have enough funds to spray for mosquitoes, Veizis tells Shots. That's why West Nile Virus appeared there this summer. Bednets have not been readily available, either.
But Veizis thinks there's more to the malaria story than just budget cuts alone. "It's a combination of factors that make Greece more vulnerable to the reestablishment of malaria," he says. Warmer winters may be lengthening the malaria season, for one.
Greece fought hard in the 1950s and 1960s to snuff out the disease, and by 1974, the country was declared malaria-free. For decades, Greece had only sporadic cases of malaria each year.
Then a big cluster of cases cropped up in southern Greece in 2011, when 27 people were infected locally.
This spike prompted Doctors Without Borders to set up shop in the Sparta region, where they've been helping local authorities get ahead of the parasite since early 2012.
Veizis says they've been passing out nets and repellents, educating communities about malaria prevention and treating people as early as possible. "Early treatment can allow you to have less spread of the disease," he says. They're even donating microscopes to Greek doctors to help them identify the parasite and diagnose the disease.
The extra efforts seem to be working. "I see a light in the tunnel," he tells Shots. "The interventions they did this year had a very positive impact on the number cases in the area."
Doctors Without Borders treats more than a million people each year for malaria. So this outbreak in Greece is only small blip on their radar.
Nevertheless, when a disease reappears after being gone so long, Veizis says, it can catch a struggling country off guard especially when resources are already stretched thin.