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When Germs Travel: Six Major Epidemics That Have Invaded America and the Fears They Have Unleashed Paperback – May 10, 2005


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Product Details

  • Paperback: 288 pages
  • Publisher: Vintage (May 10, 2005)
  • Language: English
  • ISBN-10: 0375726020
  • ISBN-13: 978-0375726026
  • Product Dimensions: 5.2 x 0.7 x 8 inches
  • Shipping Weight: 9.6 ounces (View shipping rates and policies)
  • Average Customer Review: 3.8 out of 5 stars  See all reviews (11 customer reviews)
  • Amazon Best Sellers Rank: #95,755 in Books (See Top 100 in Books)

Editorial Reviews

Amazon.com Review

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 --This text refers to the Hardcover edition.

From Publishers Weekly

Markel (Quarantine!), 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."
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved. --This text refers to the Hardcover edition.

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Customer Reviews

3.8 out of 5 stars

Most Helpful Customer Reviews

8 of 8 people found the following review helpful By Tanya Abramovitch on November 12, 2005
Format: Paperback
Markel's book discusses the American reaction to six major illnesses that struck the United States in the last century: tuberculosis, typhus, trachoma, bubonic plague, AIDS, and cholera.

He juxtaposes the extremely egalitarian nature of deadly viruses with the decidedly discriminatory responses they evoke in human societies. The common knee-jerk reaction to the onset of disease is to blame the victims, who often are immigrants or 'Other' in some way . While Markel uses specific historical examples to illustrate this point, everything he discusses applies to current global health challenges, such as AIDS in Africa. This negative and unproductive reaction works against the protection of public health, to the detriment of all.

Markel cites other reponses, namely: public overconfidence in the ability to conquer disease; the fear and worry over relatively rare but frightening diseases versus indifference to the slower moving but more long-running and widespread ones; and the tendency to not think about allocating resources before major outbreaks occur.

The message is crystal clear for all those willing to heed Markel's words: global public health is purchasable, and most effective when bought in a preventative capacity.
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11 of 12 people found the following review helpful By Ricky Hunter on May 19, 2005
Format: Paperback
Howard Markel's When Germs Travel shows what disastrous decisions can be made as fear of the other (often represented by newly arrived immigrants) combines with fear of contagious diseases. The author examines tuberculosis, an early 20th century outbreak of bubonic plague in San Francisco's Chinatown, trachoma at Ellis Island, typhus on the Mexican border, and Haitian refugees with AIDS. He also looks at his own repsonse when a possible case of cholera may be uncovered in Detroit. The author's historical perspective helps make his points all the more clear. We live in a global environment, even more so than in these cases from the past, and the spread of these diseases will have to be tackled at their source through interational coordination financed by the richer nations. Attacking the victims of the disease will be no more effective now than it has been in the past, nor does it go to the root of the problem, such as no access to clean water. This is a powerful little book, particularly the chapters on Chinatown and the Mexican-American border, both in the first decade and a half of the twentienth century. An important read that is both frightening and very cautiously hopeful.
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9 of 10 people found the following review helpful By Kelly L. Norman VINE VOICE on August 27, 2004
Format: Hardcover Verified Purchase
Dr. Markel has written a very interesting book, one that not only enlightens but stirs emotion about policy (which is pretty hard to do, one must admit). This book discusses some of the more famous epidemics, as well as their effect on immigration laws and practices in the US, and vice versa. Dr. Markel is well qualified to discuss these issues: he was highly involved in helping us understand the SARS virus, its etiology and containment. He also speaks of the victims discussed in the book with caring and respect, leading one to believe that if they came down with the next plague, whether foreign-born or not, one would want this man as one's physician.

I have some reservations about the book, however. Its format--discussing each diagnosis separately, in its own chapter--made the book seem choppy. This may be a compliment to the author, rather than a complaint: finishing each chapter left me wanting to know much more about the disease discussed. Also, I did not feel convinced by his argument for policies to contain future epidemics; this could have been flushed out better. And a small thing that didn't figure into my rating but is simply a personal gripe...there is nothing mentioned about the influenza epidemic of the early 1900s. But how many diseases can you fit into a good book?

I work at the hospital where Dr. Markel is based, and my coworkers and I are pleased with his success. We're definitely looking forward to more (and even better) books from his pen.
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5 of 5 people found the following review helpful By Robert C. Thornett on February 6, 2009
Format: Paperback
These medical mysteries are fast paced, vivid stories that are as much about people, especially immigrants and their complicated travels and tribulations, as medicine. Vivid, sympathetic descriptions and memorable characters.
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Format: Hardcover
I opened up When Germs Travel thinking I'd get a more general description about disease, vectors, bacteria, and how human culture influences transmission.

(Obviously I didn't read the subtitle)

What I got was even more interesting, and heart-breaking.

Markel tells the stories of Tuberculosis, Bubonic Plague, Trachoma, Typhus, AIDS and Cholera all through the lens of the immigrant experience.

The two stories that really hit me were the story of Haitians with AIDS caught behind barbed wire at Guantanamo Bay. As Markel details the ways the virus destroys cells from within, forcing host cells to continue replicating the virus making the host susceptible to other diseases, he juxtaposes those images with the story of one Haitian man and the horrible conditions he was forced to endure.

The other story that hit me was Typhus and the immigration and sanitation procedures set up along the Mexican-US Border between Ciudad Juarez and El Paso. Describing the bath mixture of gasoline, kerosene, etc that day laborers were enforced to endure just to cross the border (to kill typhus-bearing lice) was horrible.

So, in reality, this book taught me more about how race and prejudice contribute to questionable decisions about health care and public health more than it taught me about the science of the diseases themselves.

Very readable and engaging for me, a non-scientist, if difficult to read sometimes (not due to writing, but due to the nature of how the U.S. government has forced immigrants into quarantines and denied them needed healthcare or prevented them from entering the U.S. all in the name of public health). There were very few "happy" endings for the individuals in this book Markel chose as the "human face" for each disease.
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