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Malaria once ravaged Britain. Could it come back?

Malaria once ravaged Britain. Could it come back?

As recently as the 20th century, a major killer disease in the UK was ‘marsh fever’ or ‘ague’ – or malaria by another name

Historical black-and-white print showing construction workers assembling a long wooden trestle-like structure in an open field, with laborers below carrying tools and timber while a steam locomotive emits smoke in the distance

Jonny Wilkes

Published: October 22, 2026 at 3:00 PM

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According to the World Health Organisation (WHO), there were 263 million cases of malaria and 597,000 deaths around the world in 2023. The life-threatening disease, spread by infected mosquito bites, is most associated with sub-Saharan Africa, but it used to be a scourge in the UK.

From the 15th to 19th centuries, the marshland areas of southeast England, the Fens and up the Yorkshire coast were ravaged by malaria, although under names like ‘marsh fever’ and ‘ague’. Spread by the Anopheles mosquito, it came with high levels of mortality. Parishes in marshland areas in the 1600s and 1700s recorded deaths rates from ague at between 60 and 80 per 1,000 people, or two or three times as much as non-marshland parishes.

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This was also a time when people believed in the miasma theory, which claimed that diseases spread through foul-smelling air. So, even though it is extremely rare for malaria to be passed from person to person, there was a fear that once someone came down with ague, the whole community could be in danger.

How widespread was malaria and what were the cures?

Ague was so prevalent that it merited mentions in literature throughout the centuries, from Geoffrey Chaucer’s The Canterbury Tales to Daniel Defoe’s Robinson Crusoe. William Shakespeare referred to the disease in a number of his plays, including Julius Caesar, Macbeth and The Tempest. In King Lear, he even coined the term, “ague-proof”.

Vintage color illustration of a despondent man sitting hunched over in a rustic room with his arms crossed, while a dark dog rests its head affectionately on his lap

Robinson Crusoe ill with ague in Defoe's novel. The illness was so common that it featured in many fictional works | Credit: Getty Images

Not only the poor living on marshland perished, either, since malaria could be found along the length of the River Thames, bringing it to the capital of London. James VI and I contracted the disease as his health finally failed in 1625, and Oliver Cromwell succumbed to malaria in 1658.

Common remedies included opium and alcohol, although they didn’t prove to be overly effective. The treatment of malaria truly improved with the introduction of quinine, found in the bark of the cinchona trees of South America. It was called Jesuit’s Bark, as it had been brought to Europe by Jesuit missionaries.

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This association with Catholics, however, meant that physicians in Protestant England were initially reluctant to administer the medicine. After its first use in England, attributed to Robert Brady in 1660, quinine grew in popularity after being used to treat Charles II.

Why did malaria die out in the UK?

Malaria gradually died out in England, helped by better healthcare, sanitation and housing, along with the drainage of marshlands. Larger livestock populations may have also distracted mosquitoes from biting humans, too.

The disease remained a threat until the 20th century, though. The last outbreak in the UK occurred in the years after the First World War, when British soldiers serving in the Balkans, where malaria was endemic, fell ill in huge numbers. When they were brought back to the UK for recuperation, especially to areas with lots of mosquitoes, such as the Isle of Sheppey in Kent, the infection spread quickly.

Historical black-and-white photograph of a long line of soldiers wearing pith helmets digging a trench with shovels across a flat, grassy landscape.

Soldiers work to drain marshes to prevent malaria in Salonika (now Thessaloniki), 1917. Returning soldiers caused the final outbreak of malaria in the UK | Credit: Getty Images

It is thought that there were nearly 500 cases between 1917 and 1921, although this paled in comparison to the Spanish Flu that wreaked havoc in Europe at the same time.

Could malaria return?

The last indigenous case of malaria in the UK came in the 1950s, and by 1975 WHO declared the eradication of the disease in Europe.

While highly unlikely to be endemic once more, scientists have suggested that climate change and the volume of traffic with areas where malaria remains a serious risk could bring new types of mosquitoes to the UK.

Authors

Jonny WilkesFreelance writer

Jonny Wilkes is a former staff writer for BBC History Revealed, and he continues to write for both the magazine and HistoryExtra. He has BA in History from the University of York.