Plague Time: How Stealth Infections Cause Cancer, Heart Disease, and Other Deadly Ailments [Bargain Price] [Hardcover]

Paul Ewald (Author)

Book Description

Publication Date: October 31, 2000

According to conventional wisdom, our genes and lifestyles are the most important causes of cancer, heart disease, and other killer ailments today. Conventional wisdom is wrong. In this bold, visionary book, biologist Paul W. Ewald argues that these serious illnesses are caused by a virtual plague of chronic infections. Acute infections give the sufferer symptoms almost immediately; the flu, cholera, even Ebola are all well-known and easy-to-identify examples of acute illnesses. Chronic infections, however, are stealthy predators that may not produce any symptoms for decades, and so remain almost undetectable, but eventually they ruin the sufferer's life. The netherworld of stealth infections is now opening before us. In Plague Time, Ewald puts forth an astonishing and profound argument that challenges our modern beliefs about disease: it is germs -- not genes -- that mold our lives and cause our deaths. Building on the recently recognized infectious origins of ulcers, miscarriages, and cancers, he draws together a startling collection of discoveries that now implicate infection in the most destructive chronic diseases of our time, such as heart disease, Alzheimer's, and schizophrenia. Acclaimed for years as one of the most important thinkers alive today on the genesis of disease, Ewald now explodes conventional medical thinking with a new comprehensive view of what germs do. Some people worry about dangerous germs "going global." In most cases it is already too late. The most dangerous germs among us have already been disseminated globally. Ewald explains how evolution in this worldwide environment makes some germs turn nasty while some become harmless. Most importantly, he shows how we can work together to master our modern infectious plagues by controlling disease evolution. He reveals that we live in an ecosystem of microbes, and we must understand them to avoid their deadly damage.

--This text refers to an out of print or unavailable edition of this title.

Editorial Reviews

From Publishers Weekly

Could breast cancer be caused, not by genes, but by a pathogen passed to humans from mice? Very possibly, according to Amherst College biology professor Ewald (Evolution of Infectious Disease) in this controversial page-turner that's certain to garner attention. In a cogent defense of our evolutionarily selected genes, Ewald proposes that the true culprits behind chronic ailments and even mental disorders are pathogens. He propels his argument by noting the "biases of human thought" that inhibited scientific growth in the 19th century (when the notion of microbes was first rejected) and those that are, he believes, stifling the research of infectious diseases today. For example, the infectious origin of peptic ulcers wasn't recognized until the mid-1980s, more than 30 years after physicians demonstrated the effectiveness of antibacterial agents in ulcer patients. The reason for this "scientific paralysis" lies in the prevalent misconception that most infectious diseases are like the common cold, acute yet ephemeral rather than chronic. Challenging this popular mindset, Ewald thoroughly examines the calculated attack strategies of a number of chronic, sexually transmitted diseases (such as herpes, syphilis and AIDS). In contrast to the complex task of determining disease origins, however, Ewald's solutions are surprisingly simple: clean water, safe sex, home care when you're ill, awareness of pathogen evolution and more funding. The world of infectious diseases, Ewald makes clear, continues to thriveAand anyone involved in the study or practice of medicine and any scientifically literate reader curious about the origins of disease will want to read this challenging work. Author tour. (Nov. 14)
Copyright 2000 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.

From Library Journal

For many years stomach ulcers were thought to be the product of stress, acid, and spicy foods; now we know they are caused by bacteria. Amherst biology professor Ewald (Evolution of Infectious Diseases) suggests that many other chronic diseasesDincluding clogged arteries, diabetes, cancer, and schizophreniaDare at least partially caused by infectious agents, and here he presents research that bolsters his claims. Beyond this, he argues that studying how infectious agents evolve can lead to techniques for more effective control of killer diseases such as malaria and AIDS through decreasing their virulence. He also discusses some ethical issues related to treating diseases. An example is whether it is best to treat an individual with antibiotics when this may cause problems for a whole population if antibiotic resistance in bacteria is a result. Ewald's ideas are controversial but intriguing and have far-reaching implications. His clear, entertaining, and well-documented style makes the book appealing to a wide variety of readers. Highly recommended for all types of libraries.DMarit MacArthur Taylor, Auraria Lib., Denver
Copyright 2000 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.

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Product Details

• Hardcover: 288 pages
• ISBN-10: 0684869004
• ASIN: B0000C37E8
• Product Dimensions: 9.5 x 6.5 x 1.2 inches
• Shipping Weight: 1.2 pounds
• Average Customer Review: 4.2 out of 5 stars  See all reviews (18 customer reviews)
• Amazon Best Sellers Rank: #1,302,552 in Books (See Top 100 in Books)

Customer Reviews

Most Helpful Customer Reviews

85 of 89 people found the following review helpful:

5.0 out of 5 stars Proposes A Paradigm Shift for Overcoming Chronic Diseases, November 6, 2000

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Donald Mitchell "Jesus Loves You!" (Thanks for Providing My Reviews over 109,000 Helpful Votes Globally) - See all my reviews
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This review is from: Plague Time: How Stealth Infections Cause Cancer, Heart Disease, and Other Deadly Ailments (Hardcover)

This book clearly deserves more than five stars. This is one of the three best books published so far in 2000 that I have read.

Plague Time is an important book for the future health of all. It is the most articulate argument I have seen for improving the basic mechanisms of studying and preventing disease in the most effective ways. And it shows important lessons about what is needed to overcome stalled progress in any field. Professor Ewald is a profound stallbuster! We will only get full benefit from his work though, if this thinking is quickly absorbed by the medical community, as a sort of idea virus.

The perspective of this book will be new to many readers. Evolutionary biology is something that few have learned in school. Basically, the field looks at a germ's eye view of the world.

For example, if a germ kills the host it feeds on too quickly, that's bad for the germ. The germ hasn't yet had time to spread to a new host. On the other hand, if it takes too long to spread to other hosts, that's bad for a germ also. So germs will do best that are able to spread quickly from host to host, and keep the host alive to provide more food. That spells a prescription for the prevalence of many chronic diseases that are associated with long-lived infections from bacteria and viruses.

The germ theory of disease is only about 120 years old. So it is fairly recent that we have been using hygiene (washing between patients and clean water to drink), vaccines (to help the body's immune system prepare for a larger invasion), and antibiotics (to kill bacteria) to control disease-producing agents. From this work, we have learned that acute diseases are almost always linked to a bacterial or virus invasion of our bodies. These invasions can come from other people (sneezes, blood, or germs on a surface) or vectors (agents like mosquitos).

What many will not realize is that many chronic diseases are turning out to be caused by such invasions as well. For example, most peptic ulcers (once thought to be caused by stress and too much stomach acid) are now easily treated by antibiotics. Cervical cancer is also related to an infection. It is estimated that 15 percent of all cancers are now shown to be caused by such infections. Cancer researchers also can account for only about 50 percent of cancer risk from environmental factors. That remaining 35 percent gap could well turn out to be related to unsuspected infection links, working in combination with environmental factors.

Professor Ewald proposes a number of interesting hypotheses that would appear to deserve serious attention. First, the evolutionary biology view would suggest that sexually transmitted infections as a primary source of chronic disease in wealthier countires. These infections live in the host for a long time without immediately killing the host, and are highly contagious. The sites of many diseases also show the presence of these same infections (examples include c. pneumoniae -- related to Chlamydia -- found in the brains of Alzheimer's patients and damaged artery walls experiencing arteriosclerosis). Other sexually-transmitted diseases may also have these effects on other chronic diseases. Further, people are reluctant to talk about having sexually-transmitted diseases so partners are often kept in the dark.

The book also takes an interesting look at the dangers of being ravaged by some new biobomb or spread of disease from one part of the underdeveloped world to the developed world. These problems do not seem to be as great as the popular press would suggest. Basically, anything really virulent tends to extinguish itself by killing the hosts too rapidly.

The fascinating part of the book to me, though, was the description of why we are so slow to look at these hypotheses. Professor Ewald points out that doctors are used to drawing their hypotheses from close associations in frequency and time in their own practices. Minor infections from sexually-transmitted diseases that cause chronic diseases decades later deny doctors that easy association.

His proposal is brilliant: Keep records of everyone who gets better or worse unexpectedly from a chronic disease to find out what other medications or lifestyle factors may be involved. For example, peptic ulcers were being treated with antiobiotics successfully in a few hospitals 40 years before that became common practice. A database that showed that result could have stimulated an NIH study much sooner. If we find that everyone who takes a certain antiobiotic improves in some chronic disease, this may suggest a linkage to a bacterial infection. I hope this idea will get top priority!

The author also takes on the medical model of looking for things that "kill" germs in a "war-like" environment. It turns out to be much faster, simplier and cheaper to adopt treatments that encourage germs to evolve into milder versions. By trying to kill them, all we do is create more virulent versions. So the whole approach to antibiotics needs rethinking along the lines of this book.

By the way, chances are your doctor is unaware of this line of thinking. I mentioned the potential risk of infection causing arteriosclerosis to my primary care physician, and asked what antibiotic I should take. He laughed, and said that if it was that simple, everyone would already know about it. Apparently, he did not know about the peptic ulcer experience.

As the author points out, our tests of medical effectivenesss are too high in some cases. If we find that a certain treatment almost always works, we can begin to use that treatment long before the 14 year study is completed that explains exactly why it works. After all, we are still learning the basics of why aspirin works, but many people use aspirin anyway.

After you have read (and shared this book with everyone you know), I suggest you also think about where causes and effects may not too obvious because of long time lags. What research is not being done in those areas?

Enjoy better health by having health researchers ask better questions today!

33 of 33 people found the following review helpful:

5.0 out of 5 stars "We are their food.", January 29, 2001

By 

Dennis Littrell (SoCal) - See all my reviews
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This review is from: Plague Time: How Stealth Infections Cause Cancer, Heart Disease, and Other Deadly Ailments (Hardcover)

Ewald's startling thesis is that "infection is at the root of the major chronic diseases of our time" (p. 271). These diseases include the two big killers, cancer and heart disease, and possibly Alzheimer's. His thesis is a heresy to a significant part of the medical establishment, and if correct, a revolution in the making. The conventional wisdom believes that cancer and heart disease are caused by a combination of factors including hereditary predisposition (bad genes), environmental catalysts (pollution), bad life style choices (fatty diet, alcohol, cigarettes), stress, etc. But what Ewald is saying is that there is a bacterium or a virus that causes these chronic diseases.

One of the powerful ideas behind Ewald's belief is the growing realization from evolutionary medicine that a major human disease cannot possibly be caused by bad genes since natural selection would have weeded them out long ago (pp. 55-56). Diseases caused by bad genes can only occur in a small percentage of a given population. The only exception would be a "bad gene" that has a compensating adaptive characteristic, such as the gene for sickle cells which confers immunity to malaria. Consequently, "the best bet is that they [chronic diseases] have infectious causes" (p. 56).

The practical evidence, evidence that has been consistently explained away or ignored, is the actual presence of disease agents in the tissues. Thus cervical cancer is now known to be caused by a papillomavirus that hides in the tumors and as such is a sexually transmitted disease. Peptic ulcers are now known to be caused by a bacterium, Helicobacter pylori, and not worry or stress or booze, although these may be contributing factors. Chlamydia pneumoniae bacteria are increasingly being implicated in heart disease. In Chapter Eight, Ewald makes the case for C. pneumoniae being the cause not only of atherosclerosis but Alzheimer's disease as well! Again, if correct, this is a revolution. The interesting (and terrible) thing about the peptic ulcer story is that it was known as long ago as the forties that peptic ulcers could be successfully treated with antibiotics, but that knowledge somehow became lost (!) until the early nineties (p. 99).

There is more: Ewald reports that Japanese researchers found the Borna disease virus "in one third of their patients diagnosed with chronic fatigue syndrome" and that this same virus "has been implicated in schizophrenia and bipolar disorder" (p. 162). I would not be surprised to learn that other chronic diseases of unclear etiology such as fibromyalgia, certain kinds of arthritis, and even unexplained chronic pain are caused or at least initiated by infectious agents, probably viruses. (Actually I wouldn't be surprised to learn that a new kind of infectious agent, something smaller and stealthier than a virus is the cause of some human diseases. But then I used to write science fiction.)

One of Ewald's main arguments is that we can lessen the virulence of pathogens by the way we interact with them. An insight from evolutionary medicine is that a pathogen cannot afford to kill its host before it can spread from that host. However, if it can spread from the dead corpse of its host, then it can be as virulent as it likes. In places in the world where there are no screens and mosquitoes have easy access to their victims, the malaria protozoan tends to weaken its victims so much they can't even swat mosquitoes (protecting its vector!). However in areas where the buildings are made mosquito proof, the protozoan dare not be so virulent since the mosquitoes can only get to the hosts that are still able to be up and out of doors. Similarly, sexually transmitted diseases are more benign in populations that tend to be monogamous or to change partners infrequently. In populations that practice promiscuous sex frequently, the pathogen can afford to be very nasty because it will get transmitted often. But if the host is not going to be having sex with anyone new or soon, the germ must be nice and bide its time without knocking its host out of action. This principle also applies to cholera. If people have access to clean water the cholera bacterium must be relatively benign because it is going to take a long time to get passed on. But if the water supply is befouled with human feces, then the bacterium can be massively virulent, and in fact is rewarded for being so as its progeny come pouring out of the dying bodies of its victims and into the water supply.

One of the highlights of the book is Chapter Four, "The Magnificent Defense" in which Ewald describes the immune system and how it works in language that is vivid and easy to comprehend. In a startlingly apt analogy he compares the immune system to our brain. Both are incredibly complex systems constructed through the laborious trial and error mechanism of evolution. And both are "decision-making systems" (p. 67). I like this analogy and predict that researchers who have knowledge of both systems will make the scientific breakthroughs of the future. I would add that knowledge of the elaborate, brain-like social systems of bees, ants, and termites would also be valuable.

Ewald concludes the book with some guidance on how we might better co-exist with pathogens. One of the ideas is simple: stay home and don't go to work with a cold or flu. Staying home will keep the pathogen relatively benign (p. 210). He insists that we need more education about evolution in our schools, and even in college. I couldn't agree more. In the United States people that approve text books tend to be so terrified of know-nothing "creationist" types that high school biology texts typically mention evolution only as a side note, when in fact it is, as Ewald has it on page 237, "the fundamental unifying principle of biology."

20 of 21 people found the following review helpful:

5.0 out of 5 stars Intriguing Ideas Make For Worthwhile Reading, December 26, 2000

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Michael Lima (Fresno, California USA) - See all my reviews
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This review is from: Plague Time: How Stealth Infections Cause Cancer, Heart Disease, and Other Deadly Ailments (Hardcover)

About halfway through Plague Time, the author notes the reaction of the evolutionary biologist William D. Hamilton to the theory that AIDS was caused by a contaminated vaccine. He states that Hamilton did not say that a contaminated vaccine definitely introduced AIDS into humans, but instead stated that the idea needed to be evaluated rigorously because it was being dismissed without adequate evidence for dismissal. I think that same statement could apply to the ideas presented in Plague Time.

Ewald does a marvelous job of taking the readers through the intricacies of evolutionary biology. He effectively demonstrates how evolutionary biology theories can help explain many of the mysteries surrounding diseases that are currently attributed to a multitude of causes. It should be noted that he never definitively proves that viruses and bacteria are the causes of these diseases. But, he does present enough evidence to justify further exploration of the idea.

The book is not perfect. Some of the language gets a little technical at times. Also, Ewald has a tendency to repeat the same examples, thus giving the impression that there is some "filler" in the book. But, these points don't detract from the fact that this is a very persuasive work. The theories inside it may prove to be invalid, but they are certainly worth further exploration by both the scientific community and the reader attempting to educate themselves on their health.