INSIDE THE OUTBREAKS

Pendergrast (Mirror Mirror: A History of the Human Love Affair with Reflection, 2003, etc.) provides an exhaustive account of the “shoe-leather epidemiologists” who trek to the world’s troubled spots when a serious or unusual disease strikes.

The author digs deep into the archives of the Centers for Disease Control and Prevention (CDC) to produce an impressive, occasionally awe-inspiring narrative about the CDC’s Epidemic Intelligence Service. The organization is comprised of idealistic young men and women who sign up for two years of training and field work, postings during which they can face Ebola in Africa, bird flu in Asia or other more routine clusters of salmonella food poisoning in America. When EIS was founded in 1951, it was a haven for doctors seeking to avoid the draft for the Korean War, and EIS recruits were envisioned as first responders in the case of biowarfare. The early EIS decades were largely devoted to infectious outbreaks—bat rabies, Asian flu, oyster-borne hepatitis, etc.—and EIS sleuthing then and now looks at patient histories and environmental clues, often conducting case-control studies. Pendergrast does not gloss over the moral shortcomings of the early years—the infamous Tuskegee study, vaccines tested on prisoners or institutionalized children—nor does he ignore the role of bureaucratic in-fighting and politics. The author celebrates EIS’s successes and occasional triumphs—like the eradication of smallpox—and the commitment, intelligence and passion of its trainees and alums.

Fans of medical mysteries will find scores of EIS case histories to slake their appetites in this meticulous history.