Perched on the low chalk bluff of the Hoo peninsula, offering spectacular views across the Thames marshes, the Kentish village of Cliffe, near Rochester, is these days known for a particularly fine 13th-century ragstone-and-flint church; the remarkable richness of its birdlife, starring Bewick's swans and white-fronted geese alongside gadwall, plovers and godwits; and for a short but fierce tussle with the Blair government, whose aim it briefly was to turn Cliffe into a major international airport. Less well known is that it was the scene of Britain's last recorded outbreak of malaria.
During the closing months of the Great War, a Dr Ronald Ross, winner of the 1902 Nobel prize for medicine for finally demonstrating the link between mosquitoes and malaria, diagnosed the disease in British troops he was tending in Greece and recommended they all be packed off home to Blighty to recuperate. Whoever did the packing failed to follow the good doctor's second recommendation, which was that the soldiers should on no account be billeted in any part of Britain where mosquitoes flourished. Since the marshes of north Kent were positively humming with several million potentially malaria-transmitting mozzies, more than 500 locals duly succumbed to the fevers (though none, happily, died of them).
You might be forgiven, in September 2007, for believing that Cliffe's long and unchallenged reign is about to come to an end. After the floods of July and the heat of August, the winged bloodsuckers are on the warpath, from Norfolk to Devon, Glasgow to Epping. Having drenched ourselves in repellent and successfully evaded their attentions during summer breaks abroad, we are suddenly finding ourselves assailed outside pubs, in our back gardens, even in our bedrooms (worst of all: the incessant, maddening whine in your ear; the nightmarish, three-in-the-morning search-and-destroy mission with rolled newspaper). Itching and scratching like we haven't done since the last time we took a holiday by a windless millpond beside the Med, we are in the midst of a mosquito explosion.
Anecdotally, the evidence seems overwhelming. "My house is overrun with them," says Norwich office worker Mel Tuckwell. "I spend whole evenings swatting them." A Norfolk resident for three years, she says this is "the first time I've seen anything even remotely resembling this. They just don't stop coming." In Poole, Dorset, solicitor Jim Metcalfe reckons he has been "bitten, and bitten viciously, more times in the past fortnight than in the past five years put together. There are lots more of them this year, they seem somehow bigger, and they're certainly cleverer." In Buckhurst Hill, Essex, Mitch Latham, a 28-year-old Australian bar worker who might, you would have thought, be accustomed to insect-induced torment, admits he "started sleeping with a mosquito net last week. My parents couldn't believe it when I told them. I didn't think it would ever come to this in east London, but there are times when it's like Borneo in my bedroom."
Less anecdotally, Ann Grain of NHS Direct reports that in July the organisation's switchboards handled 2,076 phone calls from people inquiring about mosquito bites and how to relieve them (antihistamine for the swelling, hydrocortisone for the itching). In August, the figure soared to 5,374 - a 22% increase on the previous year's 4,179. A sudden sharp rise in cases of myxamatosis, another mosquito-borne disease, in the pet rabbits of Norfolk has also been linked to increased numbers of mosquitoes. And while understandably more circumspect, scientists are prepared to hazard that this summer's level of mozzie activity is, if not unprecedented, at least unusual. "It's the combination of wet weather followed by warmer conditions that has encouraged the greater numbers," says Paul Pearce-Kelly, senior curator of invertebrates at the Zoological Society of London.
Things are likely to get worse. "It depends how the climate actually changes," says Tony Irwin, curator of natural history at the Castle museum in Norwich and an acknowledged expert on Norfolk's fenland and Broads mosquitoes. "But if we are going to be having more wet, warm summers, more pools of stagnant water, that will favour breeding conditions, no question. Likewise, if our winters are going to continue to get milder, then more mosquitoes will survive to breed the following year. The weather could be coming round to favour mosquitoes in a big way, and if we have more mosquitoes, we can probably expect an increase in the diseases they carry."
Those diseases are hardly new to Britain, though for centuries no one imagined they had anything to do with mosquitoes. They feature in Chaucer's Nun's Priest's Tale, and references to the ague, as malaria and its variants - literally "bad air" - were known until the 19th century, litter Shakespeare's plays. Logically, the malady was also called marsh fever, because the unfortunate inhabitants of river estuaries and salt marshes were particularly prone to it. Sixteenth and 17th-century visitors to the Kent and Essex wetlands typically described them as "unwholesome", "unhealthy", the "noxious vapours arising from the marshes subjecting the inhabitants to continued agues". Many also remarked on the swollen stomachs of the children and their sallow, sickly faces.
In fact, according to Dr Mary Dobson's pioneering (and surprisingly readable) Contours of Death and Disease in Early Modern England, malaria was probably endemic along the estuaries of south-east England, the Fens and the marshy coastal areas of northern England by the 15th century, if not earlier. And if it is impossible to say what proportion of deaths were directly attributable to malaria, it is plain the disease was a serious threat to health. With admirable ingenuity, locals developed a range of remedies to suppress the "terrible rigours" of the ague, based principally, it appears, on large quantities of alcohol, and opium made from locally produced poppies. When things got really bad, they combined the two: Kent and Essex hostelries, Dobson notes, were long famed for a spectacularly potent opium-laced beer.
In his 1727 three-volume Tour Through the Whole Island of Great Britain, Daniel Defoe describes the ravages caused by the ague in the Dengie marshes of Essex, where "our London men of pleasure ... go on purpose for the pleasure of shooting [wildfowl]. But those gentlemen often return with an Essex ague on their backs, which they find a heavier load than all the fowls they have shot." Among those unfortunate enough to live on the marshes, Defoe observed, it was "frequent to meet with men that had from five or six, to 14 or 15 wives ... the reason being that they, being bred in the marshes themselves and seasoned to the place, did pretty well with it; but they always went into the hilly country ... for a wife, and when they took the young lasses into the marshes, they presently changed their complexion, got an ague or two, and seldom held it above half a year, or a year at most."
Depending on who you listen to, up to 33 species of mosquito are currently indigenous to Britain, 20 of which bite and just five of which - the anopheles varieties - are potential transmitters of malaria. In parts of the world with a less well-developed social health system than ours, including large swathes of the Americas, Asia and Africa, anopheles-transmitted malaria remains one of the world's deadliest diseases, affecting up to 650 million people every year and killing between one and three million, mostly young children. There is no vaccine currently available, and the preventative drugs that must be taken continuously to ward it off - as well as the treatments to cure it - are beyond the budget of almost everyone who lives in the afflicted areas.
Here, with the exception of up to 2,000 cases each year brought back by returning travellers, the disease has been eradicated, thanks partly to aggressive marshland draining and larvae-clearing operations in the past century, but mainly to the fortunate fact that mosquitoes are not actually born with malaria: in order to transmit it, a female mosquito - the males do not feed on blood - must first bite a human already infected with it. "What that essentially means is that if you have a public health system that can treat malaria in humans, you effectively prevent its spread," says Chris Curtis, professor of medical entomology at the London School of Hygiene and Tropical Medicine. He recently helped both the Royal London Hospital and an old people's home in Dagenham trace the source of mini-plagues that, in the hospital's case, saw one boy bitten 40 times in a single night.
(That we have a cure for malaria at all is, incidentally, largely down to the work of another unsung Briton, Robert Talbor, who boldly abandoned his apothecary's apprenticeship in the late 1660s to develop a patent medicine based on alkaloid quinine, extracted from the bark of cinchona trees introduced into Europe from Peru by Spanish Catholic priests. While quinine was known to be effective in treating the ague, the fact that it was commonly known as "Jesuit's powder" prompted many in Protestant England - including, it is thought, Oliver Cromwell - to reject it as a papist potion, and it took Talbor's secret formula to popularise the treatment. His cure, described in a 1682 tract titled The English Remedy: Talbor's Wonderful Secret for the Curing of Agues and Feavers, earned him fame and fortune; he was knighted after administering it to King Charles II, and also cured Louis XIV of France and Luisa Maria, Queen of Spain.)
But back to our present-day plague. Does it, we wonder, herald a new and apocalyptic invasion triggered by climate change and global warming? Could, as some experts and plenty of tabloid newspapers have predicted, Britain once again become malarial - as, in recent years, have Georgia, Turkey and Azerbaijan? What exactly, in short, are the chances of the mini-epidemic that hit a small Kentish village in the summer of 1918 and spread so rapidly and unstoppably recurring here any time soon? The general feeling among British scientists, fortunately, is: not high. What is clear is that climate change could allow "species that are not native to this country to gain a toehold, and become established here," says Pearce-Kelly.
Nor is malaria the only disease we need worry about. The so-called Asian tiger mosquito, which despite a number of false alarms has not yet reached Britain, is now well established in Italy and has been sighted as far north as Belgium. It can carry Dengue fever, encephalitis and yellow fever. The aedes species of mosquito carries chikungunya, a highly debilitating disease causing fever, headaches and severe joint pain, which last year devastated the French island of La Réunion, affecting 50,000 people and killing, directly or indirectly, 77. And the culex mosquito transmits West Nile fever, which has caused 600 deaths in parts of the United States over the past four years and was recorded in Bucharest, Romania, in 1997.
"All of these species could certainly come to Britain," warns Curtis, "and it's plain that all mosquitoes will thrive in warmer, wetter conditions. So we could well find ourselves coping with a larger mosquito population. But I'm relatively optimistic about the disease aspect - certainly as far as malaria's concerned. Look at Italy, which only eradicated malaria in the 1950s through DDT spraying: its summers are hotter than anything global warming is predicted to hold in store for Britain, yet it's had just five cases of indigenous transmission since then. To me, that indicates that a good public health system is, on the whole, adequate protection." We'll see.
How to avoid getting bitten, in Britain and beyond
There are days when it feels as if every mosquito has your name on it. Your first instinct may be to raid the chemist's or camping store for a spray containing a powerful chemical repellent such as Deet. But there are alternatives, especially in a country such as Britain, where the chances of contracting malaria are infinitesimal, and the greatest danger you face is probably some unsightly bumps and rashes.
"Try heating some citronella oil, if you're sitting outside," says naturopath Michael van Straten. "Eating lots of garlic is also pretty good, and taking a vitamin B complex works too - they hate the yeasty smell [which is why some people recommend eating Marmite]. If you want to soothe the bites, try rubbing a little lavender oil on them."
Johnny Crockett, who runs a survival school, agrees that "mosquitoes are basically attracted to your smell, so anything that masks that is good, such as garlic, for example. If you crush the leaves of elder trees or yarrow, that can help. The only problem is that crushed elder smells a bit like dog poo - that's that masking effect you see."
Once you get into malarial areas, however, forget the herbs. The photographer Don McCullin says you should never sleep without a mosquito net, and that if he had followed his own advice he probably would not have contracted malaria twice. And every seasoned traveller brings out the big chemical weapons, even if some of these repellents have unnerving side-effects. Crockett remembers spraying his legs with one potent concoction and finding that it was eating into the paint on the floor.
The botanist David Bellamy says: "The worst place in the world for mosquitoes is the Kamchatka peninsula in Siberia - that's where they're biggest and nastiest. But I was amazed when I was with the Inuits in Canada: they don't seem to get bitten by them. They told me to take my shirt off and lie down, and try to stay still. But the tickling is too much and as soon as you slap one of them, they all start biting.
"I prefer to use the herbal repellents when I'm in this country, but if you're in malarial country then it's got to be one of the strong chemical ones. And you must keep yourself completely covered too. They don't like wind, and they don't like peat fires, so that's one way of keeping them away."
He confesses to a sneaking respect for the insects. "I have to say, they're nasty little creatures, but they are extremely efficient at what they do."
And sometimes you have got to just get used to it. As explorer and author Benedict Allen says: "When you're on an expedition for six months or whatever, you can't carry that much Deet, and you can't live among indigenous people and keep treating yourself without treating them. If you let the biting get to you, you begin to feel hounded after a while. The most important thing is not to scratch - scratching can go badly wrong in rainforests. If it gets really bad I do take an antihistamine.
"I've come across two different cultures where they use tobacco - in New Guinea they mush up big tobacco leaves in water and then rub it all over themselves.
"It's odd, because I used to get bitten a lot, and then something happened and the mosquitoes just stopped biting me. There are all those folk stories that they like different types of blood, but I can't work out quite what changed. My diet did get better - I started to eat more garlic and onions - partly because rainforests and all the types of places where you find mosquitoes are quite debilitating places."
Most important of all? "A mosquito net impregnated with repellent, which is wonderful because it stops me having to listen to that awful whine at night. It's the worst sound in the world, like a Stuka bomber coming in."
Bibi van der Zee
