Among the United States' proudest 20th-century scientific achievements was the identification and control of many dangerous infectious diseases. But as medical historian Howard Markel reveals in When Germs Travel
, quarantines and other disease-control programs often hid racism, nationalism, and class warfare beneath a veneer of public health. This book focuses on six epidemics to demonstrate how social structures and science can clash--tuberculosis, bubonic plague, trachoma, typhus, cholera, and AIDS. What these diseases have in common is that they were perceived to have been brought to the United States by "outsiders," who found themselves unwelcome even in a nation of immigrants.
In the diaries and memoirs of immigrants arriving during the early twentieth century, one repeatedly encounters evidence of the intense fear of the physicians at Ellis Island, the medical inspection process, and the potential for deportation.
In proving that radical responses such as quarantines are ineffective and not based on good science, Markel applies a personal perspective gained through his family's experiences as Eastern European immigrants as well as his own interactions with 21st century immigrant patients. The six epidemiological histories here are gripping, and Markel's style is reminiscent of Sherwin Nuland or Gina Kolata. Humanity is locked in an eternal war with microbes, Markel writes, and despite all efforts, "contagion cannot be confined to national borders." --Therese Littleton
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From Publishers Weekly
), a professor of the history of medicine at the University of Michigan and a practicing physician, argues that quarantines in the U.S. and other restrictive measures (such as mandatory kerosene baths at the Texas-Mexico border in 1917 to kill typhus-carrying lice) are based more on xenophobia than science. An outbreak of bubonic plague in San Francisco's Chinatown in 1900, for example, resulted in a complete cordon sanitaire around the district; the city's white merchants, however, could move freely within and outside of the area. Similarly in the early 1900s, trachoma, an infectious eye disease that was common throughout the U.S., became associated with Jewish immigrants from Eastern Europe. More recently, Haitian refugees in the 1980s were stigmatized as carriers of HIV, the virus that causes AIDS. Markel argues that though quarantines of immigrant populations may have lessened the chance of major epidemics during the early 1900s, such measures unfairly punish people for being poor and sick. And nowhere is this more important than in developing countries, where rates of tuberculosis, cholera, malaria, AIDS and other deadly diseases are highest. As increased travel continues to shrink distances and bring people together, germs will also travel more easily; the prevalence of infectious disease, therefore, is no longer a merely local issue. As Markel warns in this informative and important book, we must work to prevent and treat infectious diseases throughout the entire world because "in public health terms, every city is a 'sister city' with every other metropolis on earth."
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