Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, January 8, 1995 TAG: 9501130122
SECTION: BOOK PAGE: F8 EDITION: METRO
SOURCE: REVIEWED BY SIDNEY BARRITT|
DATELINE: LENGTH: Medium
\ Plagues go back at least to the book of Exodus.
While this book's title could be a metaphorical one for any of the social ills that afflict us, it isn't. It is a literal title, one that harkens back to Biblical times.
Whether the plague will be AIDS, a likely bet; Ebola virus (see the recent review of "The Hot Zone"); good old-fashioned plague, endemic in the American Southwest and lately epidemic in India; or some obscure newcomer is not clear at the moment. But there are enough suspects and enough plausible scenarios in this era of global travel and global unrest that the likelihood of a wide-spread epidemic grows ever greater.
Laurie Garrett is familiar to many as a voice on National Public Radio where she has been a science correspondent. In this book, she has developed several case studies in infectious disease into the central theme of plague. So, we learn not just of faraway Bolivian hemorrhagic fever and Ebola viruses and the like, but also of tuberculosis in New York City, Legionnaires Disease in Philadelphia and Toxic Shock everywhere in Middle America.
There are lessons in each that we ignore only at our peril.
The medical facts are drawn out clearly, but plagues are seldom solely man vs. microbe. The social and political events that set the situation are equally important, and they are drawn out as well.
The lesson is repeated: an expanding population or a new technology or changing habits put people in touch with microbes that haven't been a threat before. Inattention to matters of public health (immunization, clean water, sewage disposal, nutritious diet, etc.) compound the difficulties. Politics, small scale or large, do little to ease the burden. Both international and national agencies tasked with oversight and response to problems are burdened with bureaucracy and beset with political infighting. Ethnic and cultural clashes are the breeding ground for more woe.
Garrett writes well and more thoroughly than she could report on radio. This is both a strength and a weakness: a strength in that details make the case history even more fascinating, a weakness when the editor's blue pencil is not quite sharp enough. There is needless repetition that diverts the focus from the good story.
The repetitious theme that grated most on this reviewer is the criticism leveled at the Centers for Disease Control and similar agencies. The criticism may be well deserved, but were the facts marshalled and moved to a separate chapter, the annoyance factor would have diminished and the case actually strengthened.
On balance, Garrett has succeeded convincingly. Past is prologue. There is a plague coming.
\ Sidney Barritt is a Roanoke physician.
by CNB