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on May 18, 2000
I read this book two years ago and thought it was a great read. I just finished reading it again and have to say that I liked it even more the second time around. I should warn you however, that if you're looking for lighthearted summer reading that'll lull you into complacency and make you feel all warm and fuzzy about the world- stick to Oprah's book list. The only warm fuzzies you'll find in this very informative and well-written book are the microbes and viruses that make up the subject matter.
Laurie Garrett has done a masterful job of chronicling the spread of infectious diseases over the last 50 years. The book is divided into sections that give the history of the rise (and in one or two cases- the fall) of the major pandemics of this century. The chapter on AIDS is worth the price of the book alone and should be required reading for political science students. It's the perfect case study on how apathy, intolerance, ignorance and political infighting foster the spread of infectious diseases.
The underlying message of The Coming Plague is that we are at war with oodles and oodles of really small things whose survival instincts are much better than ours. In short- we're losing! These pernicious little buggers seem to be able to adapt much quicker than we can find new ways to kill them.
The Coming Plague reads like a detective story. And Garrett does a fine job of making it human and personal by giving us a peek into the lives of the scientists who are heading up the fight to solve the mysteries -and the victims who suffer from them.
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HALL OF FAMEon June 12, 2000
With recent news blurbs concerning the possible threat from strains of the West Nile virus in the northeastern part of the country this summer, the urgent importance of this book is quietly being reinforced. This important effort by journalist Laurie Garrett is a whopper; a long, carefully documented and quite readable text giving an overview of the worldwide efforts of the "insect fighters' at the Center for Disease Control (CDC) of the U.S. Public Health Service and other agencies ranging from the U.N to state, university and local agencies to combat a panoply of both new biological agents like HIV, Ebola, and the West Nile virus as well as new and much more virulent and drug-resistant strains of old enemies like tuberculosis, bubonic plague, a number of venereal diseases, and complex new public health concerns like Toxic Shock Syndrome.
Ms Garrett's highly detailed and exhaustively documented thesis, written while on a graduate fellowship at Harvard, is both frightening and hard to ignore. She posits that through our environmental arrogance and stupidity, the general medical strategies of the western societies, and our consistent overuse of antibiotics, we are quickly losing the continuing fight to keep the general public of both the postindustrial nations and the less developed world safe from the wild panoply of microbiological agents that are out there in the environment, and we are, through our encroachment on wilderness areas never before populated by humans, unnecessarily introducing segments of the population to new microbiological agents who then find a vector or path into human habitation and resultant infection. Moreover, the increasing levels of world commerce and concomitant travel among the nations of the world mean that someone infected in the jungles of South America or equatorial Africa can be in a restaurant in New York City or at the beach on Martha's Vineyard several days later as the agent starts its formidable and often highly contagious microbiological attack. This is truly scary stuff.
One becomes increasingly concerned about the safety of the general public and for our relative lack of public health preparedness as one winds through the pages of this long book. The approach is one of individual story telling, and while this makes the book much more readable and entertaining, it also tends to repeat a lot of information that one could otherwise avoid. Yet this is truly a minor quibble with a facintaing and fact-packed book that often made me feel like I was taking a graduate seminar in "Current Issues in Infectious Epidemiology". It's tone is both approachable and yet scholarly, a rare treat to enjoy, and Ms Garrett's obvious intelligence and ability to communicate shines here, as she makes complex environmental, infectious disease, and human issues converge in an understandable and compelling way.
Finally, she makes an excellent case for increased public awareness as well as immediate political action to restore and reinvigorate the vitality and capability of our local, state, and national public health agencies, and certainly has increased my own awareness and concern for the ongoing scientific effort to battle the microbes. If her argument that many of the gains of the 20th century in public health (and the healthy longevity we enjoy as a result) are increasingly at risk is correct, we must take action to combat the wide range of problems she discusses to avoid a serious long-term breakdown in our public health system. This is an important book that has sparked a serious national and international public debate about some critically important issues that could literally potentially affect billions of people across the globe. I recommend it, hope it will be even more widely read, and hope you read it, too.
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"The Coming Plague" is 620 pages of densely-packed text on humanity's war against its deadliest enemies. Throughout the twentieth century and into the new millenium, we've given our microscopic enemies glorious new opportunities to exploit us, whether it be through war, slash-and-burn agriculture, or stagnant water in an air-conditioning system. Laurie Garrett has written a fascinating and frightening account of some of the battles we almost won (measles and polio) and some where we appear to be in full retreat (AIDS, drug-resistant tuberculosis). Her book is especially compulsive reading when she describes the individual skirmishes in the war, e.g. a journey into the African bush to identify and treat a disease that was killing 80% of its victims, or the discovery that cholera vibrio could live inside of algae and didn't require person-to-person transmission.
Even if you live in the middle of the Canadian tundra and have sworn off eating mollusks for the rest of your life, this book hammers home the fact that you're still not safe from what used to be called 'Third World diseases'. Even as I write this review, there is a woman in an isolation chamber of a hospital in Hampton, Ontario who is gravely ill with an unknown hemorrhagic fever. The doctors don't think its Ebola Fever, but they're not sure what it is, or whether any of the other passengers on the plane from Nigeria to Canada could also have been infected.
You can conclude (as I did) from "The Coming Plague" that many of us who expected to die from age-related conditions such as heart failure or cancer, may now well perish from infection. This book manages to combine the heroics of "Men against Death", the grim prophecy of "Silent Spring", and descriptions of several hair-raising, near-tragedies akin to the "Hot Zone". I highly recommend it.
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on May 20, 2005
Scares me more than any terrorist, earthquake, comet or meteor from space ever could!

As a med student and son and nephew of military doctors this book frightens me much more than my uncle's stories of Viet Nam casualties, or my father's dealings with injury victims in a big city hospital.

The Coming Plague deals with our inability to truly comprehend a global disater out there just waiting to strike. With recent occurences such as Marburg's grip in Africa as well as SARS, AIDS continued spread, and Bird Flu in Asia, ordinary citizens and especially governments around the world had better wake up ...

Seems that isn't happening. Even the CDC and WHO according to some of the early pioneers in the fight against infectious disease, are today filled with pencil pushers, bureaucrats and people that have no field experience. They have lost touch with the real world of microbes. Compare them to generals that have never been in any real combat abroad, but are commanding troops.

This sobering book reveals that with all of our scientific knowledge and skill, we are not ready for a pandemic in the 21st century. That no we cannot totally fend off every serious microbe that comes our way, but that we'd better be prepared!

Suspenseful, heroic, mysterious, unsettling and painfully sad at times, this book is very difficult to put down. The Bible of infectious diease. Full of astounding information. It is a must read for anyone curious about this monumentally important subject.
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You want to be truly frightened about your health? Read The Coming Plague: Newly Emerging Diseases In A World Out Of Balance by Laurie Garrett. A friend loaned me his copy of this book after I had read a book about the flu epidemic in the early 1900's. This book, written in 1994, covers a number of diseases from all over the world, as well as the stories of the individuals who constantly risk their lives to combat the deadly viruses.

Although the book is over 700 pages and the information is over a decade old, it's still a compelling read. The stories of the CDC doctors who fought bureaucracy and ignorance are inspiring. To go into countries and cultures where the per capita health care expense is $2 and try to conduct research is mind-boggling. In many of the stories, every common health care practice we take for granted is nonexistent. Syringes are reused without sterilization 100's of times each day as it's the only needle they have. Highly contagious cases are placed in the same room as common injuries, and soon everyone is infected and dying. And logistically, there's no way to prevent any of this. Garrett tells of whole countries where the majority of the inhabitants are infected with diseases like AIDS, and the numbers go nowhere but up. She does an excellent job of telling the stories of how diseases like Ebola, Marberg, and the hanta virus outbreak started, were researched, and how they are currently fought. Even more frightening is learning how quickly these viruses develop resistance to the common drugs used to treat them, sometimes in as little as one generation of the outbreak. And as the treatment choices become fewer and more expensive, the outlook becomes more grim for both third-world countries and our own system.

The passage of time hasn't made the picture any brighter, and many of the views put forth in the book are still well on their way to fulfillment. After reading this book, it's easy to understand how such diseases like SARS and avian bird influenza strike fear into the medical establishment. It's a wonder we're not all dead already.
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on October 1, 2005
This large but highly readable work covers the history and context of emerging or re-emerging communicable diseases affecting the world today. As a physician with a Masters in Public Health I could appreciate the challenge this author faced in presenting this complex and important topic. She has made remarkably few minor technical errors while presenting fields as diverse as virology, immunology and disease ecology in a clear and compelling manner. She places the emerging diseases in the social, economic and political context that helps to explain why diseases occur where and when they do and why and how they impact individuals and societies. Although the jacket copy seems to imply a sensationalized account, the story the author tells is a balanced and highly professional one. In a world grown ever smaller and more tightly connected the issue of communicable disease and public health will impact all our lives and deserves the attention of every citizen.
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"The Coming Plague" is 620 pages of densely-packed text on humanity's war against its deadliest enemies. Throughout the twentieth century and into the new millenium, we've given our microscopic enemies glorious new opportunities to exploit us, whether it be through war, slash-and-burn agriculture, or stagnant water in an air-conditioning system. Laurie Garrett has written a fascinating and frightening account of some of the battles we almost won (measles and polio) and some where we appear to be in full retreat (drug-resistant tuberculosis). Her book is especially compulsive reading when she describes the individual skirmishes in the war, e.g. a journey into the African bush to identify and treat a disease that was killing 80% of its victims, or the discovery that cholera vibrio could live inside of algae and didn't require person-to-person transmission.

Even if you live in the middle of the Canadian tundra and have sworn off eating mollusks for the rest of your life, this book hammers home the fact that you're still not safe from what used to be called 'Third World diseases'. Even as I write this review, there is a woman in an isolation chamber of a hospital in Hampton, Ontario who is gravely ill with an unknown hemorrhagic fever. The doctors don't think its Ebola Fever, but they're not sure what it is, or whether any of the other passengers on the plane from Nigeria to Canada could also have been infected.

You can conclude (as I did) from "The Coming Plague" that many of us who expected to die from age-related conditions such as heart failure or cancer, may now well perish from infection. This book manages to combine the heroics of "Men against Death", the grim prophecy of "Silent Spring", and descriptions of several hair-raising, near-tragedies akin to the "Hot Zone". I highly recommend it.
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on January 13, 2005
I read this a few years ago and re-read it last month. It gives a very compelling view of microbes and their evolution and how humans have responded to these threats.

The section on AIDS is especially good as it shows the challenges facing scienctists when politics, religion and bigotry get into the mix and complicate how to best address serious health issues.

This book is sobering as we often find ourselves buried amidst our technological hubris, we fail to recognize that the natural world is out there evolving and changing, not at our commands, but often times in reaction to our actions. We complex creatures are still made up of billions of cells and are vulnerable to single cell organisms and viruses.

I highly recommend this book.
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on May 14, 2003
This immense book is one I'm now reading for the fourth time, cover to cover. Ms. Garrett presents some complex ideas about virology, microbes, and the science of disease investigation - but presents it in a reader-friendly way. Her audience is exposed to what we see today with SARS, when we wonder what, exactly, the CDC and WHO are doing out there. It describes them nearly in the terms of an NTSB go-team, which is a concept most aren't aware of.
Beyond the factual interest in diseases, Ms. Garrett also delves - quite successfully - into the policy arena. She points out, better than anyone else I've read so far, how things we think don't matter to us in fact really do. If you've ever skimmed through the world section of your news, thinking ah, what do I care, some third world people are diseased. In this age of travel, urbanization, and other very simple things - it DOES potentially affect you. There is a trickle down effect that is amazing to watch unfold, and Ms. Garrett does a wonderful job of taking readers, step by step, from one epidemic to another, until it dawns on the reader - this doesn't end the way we want it to.
I'd call it recommended reading for anyone interested in the subjects addressed, in foreign policy, in getting a better grasp of our world...in short, for everyone.
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on August 28, 1999
I bought "The Coming Plague" thinking, Oh, this will be incredibly depressing, but I should know about this stuff...." Instead, what I found was one of the most exciting, can't put it down books, I've ever read, in the same vein as my aunt's "Milestones in Medicine", "Great Women of Medicine", the Landmark books I cut my teeth on as a child! All the excitement of a really good detective novel, the suspense of a really good thriller, and the informational content of at least three college level biology courses, and the "wake-up" factor of a "Silent Spring!" It was horrifying to learn that the Reagan administration quietly dismantled the most significant and effective world health tracking and control system in the history of mankind, the Center for Disease Control, leaving but a hollow shell, and that no epidemiologists of the type profiled in the book, the multi-disciplinary "cowboys" are being produced by the world's universities, because all scientific fields are now so narrow and specialized!
If you liked this, you'll love "In the Hot Zone!"
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