Nature writer and intrepid traveler Quammen (The Reluctant Mr. Darwin, 2006, etc.) sums up in one absorbing volume what we know about some of the world’s scariest scourges: Ebola, AIDS, pandemic influenza—and what we can do to thwart the “NBO,” the Next Big One.
The author discusses zoonoses, infectious diseases that originate in animals and spread to humans. The technical term is “spillover.” It’s likely that all infections began as spillovers. Some, like Ebola and lesser-known viral diseases (Nipah, Hendra, Marburg), are highly transmissible and virulent, but so far have been limited to sporadic outbreaks. They persist because they are endemic in a reservoir population through a process of mutual adaptation. Finding that reservoir holds the key to control and prevention and gives Quammen’s accounts the thrill of the chase and the derring-do of field research in rain forests and jungles and even teeming Asian cities where monkeys run wild. The author chronicles his travels around the world, including a stop in a bat cave in Uganda with scientists who found evidence that bats were the source of Marburg and other zoonoses, but not AIDS. Quammen’s AIDS narrative traces the origin of HIV to chimpanzee-human transmission around 1908, probably through blood-borne transmission involved in the killing of the animal for food. Over the decades, with changing sexual mores, an ever-increasing world population and global travel, the stage was set for a takeoff. Quammen concludes with a timely discussion of bird flu, which has yet to achieve human-to-human transmission but, thanks to the rapid mutation rate and gene exchanges typical of RNA viruses, could be the NBO. You can’t predict, say the experts; what you can do is be alert, establish worldwide field stations to monitor and test and take precautions.
A wonderful, eye-opening account of humans versus disease that deserves to share the shelf with such classics as Microbe Hunters and Rats, Lice and History.