- Paperback: 306 pages
- Publisher: Cambridge University Press; 1 edition (October 17, 2011)
- Language: English
- ISBN-10: 0521186374
- ISBN-13: 978-0521186377
- Product Dimensions: 6 x 0.6 x 9 inches
- Shipping Weight: 1.2 pounds (View shipping rates and policies)
- Average Customer Review: 40 customer reviews
- Amazon Best Sellers Rank: #309,275 in Books (See Top 100 in Books)
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The Origins of AIDS 1st Edition
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"Despite the scientific advances made since the discovery of HIV, questions of the pandemic's origin still trouble us. Why us? Why now? How could this happen? Pepin's remarkable book provides, at last, a comprehensive answer. Three decades of scientific and historical research are distilled into an engaging, highly readable, and sometimes disturbing account of HIV's journey that will interest students and researchers of the virus and its fallible host." Oliver G Pybus, Department of Zoology, University of Oxford
"In this scholarly and immensely readable account of the origin of AIDS, Dr Pepin draws on his personal experience of working in central Africa and his extensive knowledge of African history, as well as his training in infectious diseases, virology and epidemiology. Unlike others who have tackled the subject, he comes to it with an open mind, and this account is likely to be definitive." David Mabey, Professor of Communicable Diseases, London School of Hygiene and Tropical Medicine
"This first major re-assessment of the origin of AIDS since Hooper's The River, delves into the extensive archives on the AIDS epidemic. Weaving together the findings of many researchers currently working on the topic, it will undoubtedly stimulate discussion on a subject of great concern and interest: the historical record of the emergence of new viruses." -William H. Schneider, Professor of History, Indiana University
"The origin and early epidemiology of the Human Immunodeficiency Viruses (HIV) has been perplexing and controversial. Jacques Pepin provides a unique insight as an investigator who has spent years in several African countries and has contributed substantially to our knowledge of routes of transmission. We must learn from this history if we wish to avoid future pandemics." -Allan Ronald, Professor Emeritus, University of Manitoba
"A great book on the evolutionary origin of HIV and the possible role of cultural and medical practices in Central Africa in the dissemination of the virus" -Max Essex, Lasker Professor at Harvard University and author of "Saturdays are for Funerals"
"Extensively referenced, the well-written book reads like a detective story, while at the same time providing a didactic introduction to epidemiology and evolutionary genetics. As far as the origins of AIDS are concerned, unless some completely new evidence emerges, it will be difficult to come up with a better explanation than Pepin's." -Science
"This is a beautifully written book, which explains epidemiological and scientific concepts such as phylogenetic analysis in clear and simple language. Pepin has assembled a vast amount of information from a wide variety of sources, and paints a clear, coherent and convincing account of the origins of AIDS. This book is required reading for anyone with a serious interest in infectious diseases." -David Mabey, Sexually Transmitted Infections
"Superb ... Pépin rightly argues that, apart from social factors promoting HIV spread, inherent properties of the virus must determine its fitness to become pandemic. He also provides the best analysis I have read of the declining HIV-2 epidemic in West Africa." -Nature
"An impressive feat of scientific scholarship ... absorbing throughout, interweaving quantitative data with historical narrative and lively biographies." -The Lancet
"This book is an excellent, fair-minded attempt to elucidate a much-contested story.' -Literary Review
A compelling new account of the origins and development of HIV/AIDS before the disease was first identified in 1981. Jacques Pepin looks back to the early twentieth-century events that triggered the most dramatic epidemic of modern times and presents a synthesis of its historical, political, medical and molecular dimensions.
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Do not be misled by reviews that bash this book because of its rejection of the polio vaccine theory. Though the theory that AIDS originated from the CHAT type 1 polio vaccine is still held strongly by some individual researchers, notably Robert Hooper, author of "The River: A Journey Back to the Source of HIV and AIDS", it is dispensed with briefly in Pepin's book, and the current scientific consensus rejects this theory (see, for example [...]). I would love to get around to reading Hooper's magnum opus and consider more carefully the evidence he offers. Readers who would like to view Mr. Hooper's point of view should consult his website which, while maintaining the polio vaccine theory, offers a balanced consideration of Pepin's book. It must be kept in mind that Pepin is hardly doctrinaire; evidence that is circumstantial or conjectural is identified as such. There is much that we will never know about the origins of AIDS and Pepin's book should be seen as the latest salvo in a continuing debate; a summation of the best evidence at hand.
My point of view is that of a non-specialist/scientist and I recommend "The Origin of AIDS" to all who wish to know more about the origin and spread of this most deadly of modern plagues.
Jacques Pepin – not to be confused with a more famous chef with the same name – is currently a Professor of Microbiology and Infectious Diseases at the Universite de Sherbrooke in Canada. He spent four years working at a “bush hospital,” 500 km northeast of the capital, Kinshasa, (once called Leopoldville) in the Democratic Republic of the Congo. Where did AIDS come from? And how did it spread? These are the essential epidemiological questions. Pepin provides a lucid, solid, well-reasoned account. It is written at a technical level that is suitable for physicians and other specialists in the field of AIDS, but he also takes care to provide explanations of technical terms, as well as his reasoning, so that his account is accessible to educated and concerned non-medical readers. It is a work in the field of public health, and therefore Pepin’s account also provides an outstanding analysis of the historical and social conditions which caused AIDS, which could have existed in humans for hundreds of years, to suddenly explode into a global pandemic, aided, in part, by substantial dollops of human folly.
It started with chimpanzees. In Africa. Not any chimpanzees, but a particular subset, with the rather odd scientific name of “pan troglodyte troglodyte.” Chimps cannot swim rivers, so the geographic area of central Africa was rather well-defined. For hundreds of years certain members of this subset had the simian immunodeficiency virus (SIV) which is identical to the HIV-1 virus. How they got it is “beyond the scope of this course” as they used to say in college, and probably still do. It may have crossed over to humans during that course of time, but met an “epidemiological dead end,” meaning it did not spread, and died out with the host. Pepin calculates that the one “crossover” event for the modern pandemic occurred in 1921, with an error factor of more than a decade. Such estimates are possible by knowing the rate of change in the mutations of the genetic sequence of the virus, and applying some back calculations.
What made it take off? First, there were guns! Chimps are clever, and hard to hunt without guns, and thus the availability made that one crossover event, around the year 1921, much more likely. Then there were two other major factors that made it spread. One involved the unintended consequences of French and Belgian colonial health care policies (the two main areas where the “ptt” chimps lived – the Belgian Congo, and three of the four countries of French Equatorial Africa.) The focus of this policy was the elimination of trypanosomiasis (sleeping sickness) and yaws. In the French areas, they used mobile teams, a concept promoted by one of the “giants” in the field, Eugene Jamot. But both with the French and Belgian approaches was the use and re-use of syringes and needles, without proper sterilization (because its importance was not realized, and even if it was, autoclaves don’t work without electric power). Thus, the source for many a new case was iatrogenic – the word that denotes that a disease was contracted through the health care procedures.
The other major factor was the rise of prostitution. Colonial policy required the “labor” of the natives, for building railroads, and fighting wars, etc. Men concentrated in the cities, creating a huge imbalance vis-à-vis the women, and the former’s sexual needs would be met via a class of women who sold their services, sometimes at the rate of a thousand “clients” a year.
“Globalization” forces presented the opportunities for HIV-1 to spread from central Africa to China and Thailand. One of the unusual modes of transmission was another by-product of Belgian colonial policy: there was no native educated class to take over, after the sudden independence of the Congo in 1960. Thus, the new government had to import many teachers from Haiti, and they brought HIV-1 back to the Western hemisphere. Two other sharply disparate factors: gay sex tourism to Haiti, and the company, “Hemo-Caribbean” which prepared much of the plasma for western countries, and was drawn from poor (infected) Haitians, and was operated by Luckner Cambronne, the head of the Tonton Macoutes (Papa Doc’s secret police), were two enormous vectors that spread the disease beyond this one impoverished country.
There is much else, including the different course of HIV-2, which spread from the epi-center of Guinea-Bissau, former Portuguese Guinea. Pepin’s account is overwhelmingly “dry” and scientific, with numerous graphs, yet he leavens it with wry commentary on social conditions. Concerning Dr. Jonathan Mann, another “giant” in the AIDS field, and who died in the crash of SwissAir 111 in 1998, he says of Mann’s outlook: “Since AIDS was linked to poverty, injustice, exploitation, vulnerability and all kinds of inequities, all these determinants of the epidemic needed to be addressed simultaneously. This was dreaming in technicolour.”
The only statement of Pepin’s that I would take issue with is on page 174: “While soldiers stationed in peaceful countries certainly tend to frequent sex workers and acquire STDs, there is little evidence that such prostitution occurs close to combat areas.” (!) Au contraire, as evidenced by French military mobile bordellos… among much else.
Overall, Jacques Pepin has written an excellent scientific account of the origins of AIDS. He is a mix of scientist, historian, sociologist and detective. For that slender sub-group, the wise, it would be an excellent text to prepare for the next pandemic. 6-stars.