Five Good Books About Plagues

05.04.09 | Comment?

The news stories from the past week are awash in stories and statistics about the spread of Swine A/H1N1 Flu. The number of confirmed cases is rising; the number of deaths as well. The cases are appearing in more countries and more states. Some people are wearing masks, which others scoff. In other places, the reactions are much more extreme, from mass pig slaughters in Egypt to alleged incarceration of Mexican nationals in China.

Nobody knows what will become of this new flu strain. Will it become another 1918 pandemic? I certainly hope not. Regardless of what happens in the next year, it is instructive and interesting to review how other diseases have ravaged us in the past and how we have responded. This has been a subject I enjoy (right word?) reading about for some years, so I figured I would share a few of the best I've read.

  1. Flu: The Story Of The Great Influenza Pandemic by Gina Kolata.

    There are a number of decent books about the 1918 Flu Pandemic, although I found this to be a satisfying but not overly burdensom read. Kolata covers not only the story of the pandemic, from the early days at Fort Dix and its baffling habit of afflicting the young and healthy to the public health disaster that was Philadelphia's reaction and beyond, but also looks at what lessons we can take from those experiences. This feels particularly relevant given than the 1918 flu was also a strain of A/H1N1.

  2. The Coming Plague: Newly Emerging Diseases in a World Out of Balance by Laurie Garrett.

    I can't believe this book was written 15 years ago; I must be getting old as I read it shortly after it came out. Rather than focusing on a specific epidemic or pandemic, Garrett gives a survey of a wide variety of unpleasant illnesses, including Ebola, Hanta, and Marburg. (I remember the descriptions of the German gentleman who contracted Marburg very clearly after all this time. It is not a pretty disease.) If you want to get a feel for both what might be coming down the pike and what the people fighting them go through, this is a good, if long, read.

  3. The Forgotten Plague: How the Battle Against Tuberculosis Was Won – And Lost by Frank Ryan.

    Now here is a depressing read. In 21st century America, tuberculosis doesn't feel like a serious problem, but it really is. While the days of posh (and not so posh) sanitariums might be past, there are still over 10 million Americans living with TB today and any one of us could still catch it. And the scary part is that drug-resistant forms are starting to appear. Ryan goes over a lot of the history of our fight against this nasty bug and how many times we almost won and then were beaten back by its resourcefulness. If there is a lesson to be learned about how hard it is to fight against the fast evolution of bacteria and viruses, it can be learned from the history of TB (and the flu, of course).

  4. The American Plague by Mary Caldwell Crosby.

    Kicking it old school a little here with a horrifying read about yellow fever, with a focus on the epidemic in Memphis in 1878. Between the sickness and people fleeing it, half the city was emptied. Now, this particular bug is ugly with a capital "ug". Think bleeding skin and black projectile vomitting. The good news is that there is a vaccine for yellow fever that seems to be safe and keeps you good for about ten years. The bad news is that there is no cure if you do get it and the fatality rate is between 5% and 50% depending on the data you go by (WHO and CDC have different numbers). Oh, a last note: while this book gives a lot of attention to the Memphis outbreak, there was a worse one in Philadelphia in 1793. You'd think after that they would have been more vigilant in 1918.

  5. The Ghost Map: The Story of London's Most Terrifying Epidemic–and How It Changed Science, Cities, and the Modern World by Steven Johnson.

    This is the newest book on the list but looks the furthest back to the cholera epidemic in London in 1853. Cholera is another walk in the park, with uncontrollable diarrhea, called 'rice water stool' because of little white flecks in it. I hate to spoil the surprise, but the flecks are made from epithelial cells of the small intestine. Nothing like a disease that makes you poop out your insides. The descriptions of the London neighborhoods will make you cherish the wonders that are modern sanitation and sewer systems. The interesting thing about this particular epidemic is that it seems to be one of the first cases in modern times where clue triumphed over superstition. Due to the efforts of Dr. John Snow, the outbreak was halted by simply removing the pump handle that allowed people access to the contaminated water. Given that the dominant theory of the day was that disease was caused by smells, this was a significant victory.

    Johnson also has an insightful epilogue showing how the lessons from Victorian London apply to the burgeoning third world cities today and even touching on the not very popular but nonetheless true idea that cities have a smaller environmental impact per capita than people living in the mountains. A good read.

  6. So that's my little list. Will any of these books change your life? No. Will they protect you from Swine Flu? Only if you spend your time inside reading instead of going out and (ever so slightly) risking exposure. But they can give you some perspective on the current pandemic threat and how concerned you should or shouldn't be.

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