Pandemic: Tracking Contagions, from Cholera to Ebola and Beyond-a book review

Author Sonia Shah’s book “Pandemic” explores infection spread and urges awareness of infectious diseases, emphasizing the importance of vaccinations amidst rising global health threats. This post reviews this informative book.

Influenza has arrived in the United States with some areas already experiencing epidemics. We pretty much expect this to happen in the winter despite wide availability of influenza vaccine.

But other diseases that haven’t been seen much in the past 20 years are making a comeback all over the world. The number of measles cases continues to climb, with 5 countries accounting for half of the world’s victims- Congo, Liberia, Madagascar, Somalia and Ukraine.

In 2019 the United States almost lost its measles elimination status because of a nearly year-long measles outbreak in New York, with the greatest number of measles cases since 1992. The New York State Department of Health declared the outbreak over in October, and the Centers for Disease Control and Prevention announced it would maintain the country’s elimination status.

And in a part of the world that conjures up images of a tropical island with sunny skies and pristine beaches, Samoan children are dying of measles due to increasingly low vaccination levels, currently only 31%. Over 5,100 measles cases have been reported since the outbreak, with 74 recorded in a recent 24-hour period alone, according to Samoa’s government. 

The low vaccination rate this year was caused in part by distrust of vaccinations that spread last year after two infants died after a vaccine error- nurses incorrectly mixed vaccines with another medicine. The accident compounded the worldwide spread of misinformation about vaccines. 

The anti-vaccination movement made the list of the World Health Organization’s top threats to global health in 2019

CBS NEWS

I don’t know if anyone has suggested it , but it seems we may be entering a pandemic of measles. Here is a review of a book explaining what that means.

Pandemic by Sonia Shah

Sonia Shah , a science journalist, has built a career  writing about medical science. She explains the “what”  of her book in the subtitle-

Tracking contagions from cholera, to Ebola, and beyond

And she answers the “why” in the introduction-

“By telling the stories of new pathogens through the lens of a historical pandemic, I could show both how new pathogens emerge and spread, and how a pathogen that had used the same pathways had already caused a pandemic.”

Let me back up and define some terms.

Pathogen– any disease producing agent, but especially referring to a living  microscopic organism, such as a virus, bacteria, or  parasite; this includes the organisms that cause Lyme disease, Ebola, West Nile, HIV, bird flu, even the common cold

Epidemic– the rapid spread of infectious disease to a large number of people in a given population within a short period of time, usually two weeks or less.

Pandemic– a disease outbreak that spreads throughout a country, continent, or the world, as opposed to an epidemic, which is localized.

map of the world
In a pandemic, an infectious disease may spread all around the world.

Why infectious disease still matters

With healthcare focus on chronic diseases like heart disease, diabetes, cancer, and dementia, even physicians can get lulled into thinking that infectious disease has been conquered and no long a serious medical threat. This book reminded me that is not the case.

Ms. Shah recounts the history of cholera, which has caused epidemics on every continent except Antarctica, focussing on the epidemics which devastated London, New York City, and more recently Haiti.

Cholera is rare in the United States now, but in the past it has been deadly here and throughout the world. Cholera, an infection due to a bacteria Vibrio cholerae causes severe uncontrollable diarrhea which quickly renders its victims helpless, dehydrated and critically ill. The bacteria lives in and is spread by contaminated water, but for many years physicians did not know this; and even when some doctors recognized this, others refused to believe it. Thus the opportunity to control it and prevent thousands of deaths was delayed .

bacteria under the microscope
photo of the Vibrio cholera bacteria under a microscope; used courtesy of CDC/ Dr. William A. Clark

how disease spreads

The author explains how cholera and other infectious diseases cause so much human suffering by detailing “How disease spreads” in these  chapter titles.

Locomotion– Humans and pathogens travelling from place to place spreads disease.

Filth-Waste management and in some cases mis-management, leads to contamination of drinking water by human waste.

Crowds-People living in crowded slums creates perfect conditions to spread disease person to person.

Corruption– Public officials and business people who place profit and power above public health.

Blame No one willing to take responsibility for making hard choices, and too willing to blame someone else.

Ms. Shah uses examples from her personal life, like her annual family trips to India to visit relatives who lived in less than clean and sanitary neighborhoods. She also shares her and her sons’ battle with skin infections due to  MRSA, a form of staph (staphylococcal) that is resistant to many antibiotics and can be difficult to eradicate.

Pandemic includes extensive footnotes and a glossary of terms used in the book.

If you like history, current events, medical science, or just want to be more knowledgeable about why we should be concerned about infections , antibiotic resistance and vaccine phobia, you should read this book.

Here are other resources about how infections spread and how they can be stopped

For a visual lesson on how pandemics occur, watch this video.Warning: it is rather graphic. 

“How Pandemics Spread”

created by Mark Honigsbaum and animated by Patrick Blower 

 

When Germs Travel: Six major epidemics that have invaded America since 1900 and the fears they have unleashed

by Howard Markel

“Medical historian and pediatrician Howard Markel, author of Quarantine! tells the story of six epidemics that broke out during the two great waves of immigration to the United States—from 1880 through 1924, and from 1965 to the present—and shows how federal legislation closed the gates to newcomers for almost forty-one years out of fear that these new people would alter the social, political, economic, and even genetic face of the nation.”  (quote from Goodreads)

 At this link read how Dr. Gretchen LaSalle

blows the whistle on anti-vax false claims

an excerpt-

“Vaccines are recommended for personal health and required for the greater good. To protect those who can’t be vaccinated and to preserve the health of our communities, many vaccines are required for school entry. If you choose to participate in the community (ie, attend school), you have a duty not to harm those you come into contact with. And if you can’t make that decision for yourself, sometimes the states have to step in and make that decision for you. But still, you always have the choice to keep your kids out of school. The consequence for you is that you are now in charge of educating your own children. The consequence for your child is that their health is at risk and they are deprived of socialization and interaction with their peers. But, hey. You always have a choice! “

exploring the HEART of preventing disease

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Dr. Aletha

Living life, facing death-a review of A Beginner’s Guide to the End

Even as a physician, I was surprised at the claim that only 10% to 20% of us will die without warning. The rest of us will know we have something that will likely take our life. And even if we don’t, we all know we will die eventually, although we tend to think and act as if it’s a well kept secret, and maybe it is.

by B.J. Miller, M.D. and Shoshana Berger

This book’s tag line sums up the content of this book perfectly. I have reviewed other books about death on this blog; they were more biographical, philosophical, and spiritual and touched less on the practical. This book is on the other end of the spectrum; more practical, but also philosophical ,and spiritual. ( And I mean spiritual in a broad sense, not necessarily religious.)

The book begins with a brief biographical section where each author shares their reason for writing a book about death. Dr. Miller, a palliative care physician, had a life-threatening injury. He writes,

I got close enough to see something of death and come back from the ledge, only to realize that it’s in and around us all the time.

Ms. Berger, an editorial director, took care of her dying father. She wrote,

I remember those years as being full of anxiety and grief but also as a time of drawing closer.

an illustration from the book

How the book unfolds

The book consists of 5 sections that mimic the progression from life to illness to death. Even as a physician, I was surprised at the claim that only 10% to 20% of us will die without warning. The rest of us will know we have something that will likely take our life. And even if we don’t, we all know we will die eventually, although we tend to think and act as if it’s a well kept secret, and maybe it is.

The sections are as follows

  • PLANNING AHEAD
  • DEALING WITH ILLNESS
  • HELP ALONG THE WAY
  • WHEN DEATH IS CLOSE
  • AFTER

Although you could read the book straight through, you might want to skip to sections you need at whatever stage you are in. Chapter titles clearly tell you what to expect from their content. Here are some examples-

  • Yes, There’s Paperwork.
  • Can I Afford to Die?
  • I’m Sick
  • Love, Sex, and Relationships
  • Hospital Hacks
  • Care for the Caregiver
  • It’s Your Body and Your Funeral
  • Grief
  • How to write a Eulogy and an Obituary
  • Celebrating a Life

There are no photographs, charts, graphs, or info graphics, but scattered throughout are illustrative sketches that convey helpful information in a non threatening way. I have used some screenshots of a few of them to illustrate this post.

The authors conclude the book with Last Words, Acknowledgments, Resources (an extensive list), Notes, and Index.

Read this book

As much as I hope you don’t need it right now, unfortunately you do need it right now. So whatever stage of living, or dying, you or a loved one may be in, you will find something helpful here.

Find the book at your local library like I did, or get it from one of these book sellers; this would be a good book to keep on hand. (These affiliate links pay a commission to support this blog, while you pay nothing extra. )

Dr. Miller’s TED talk on WHAT REALLY MATTERS AT THE END OF LIFE

Here is another post from this blog about the dying experience

What books teach us about dying

an excerpt-

I reviewed these books  because understanding how other people and their families have faced death may relieve our dread, anxiety, or fear  about dying and death. Often it is not death itself that we fear but the dying process -the pain , disability, dependence, isolation, unfulfilled dreams.

In an essay  for JAMA, Dr. Zachary Sager, a geriatric and palliative care physician in Boston Massachusetts, described his response to  working with dying patients-

“I witnessed how people could be simultaneously resilient and fragile. I was moved by the connectedness between individuals.

I accept that death offers not only the expected reflection on life and mourning but an opportunity for a unique form of growth and healing. ”

The books I reviewed share  common themes, and events yet are each unique as are the people in them who demonstrate both resilience and fragility.

sharing the HEART of life and death

Dr. Aletha