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Pandemic: Tracking Contagions, from Cholera to Ebola and Beyond Paperback – February 14, 2017
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Praise for Pandemic
"Shah's book should be required reading." ―The New York Review of Books
"The world’s ability to put the lid on pandemics has come a long way since the days when the plague, cholera and smallpox ravaged unchecked. Ms Shah’s book is a superbly written account of how we got here and what might await us." ―The Economist
"[Shah] has succeeded in producing a lively, rigorously researched and highly informative read." ―The Wall Street Journal
“Investigative science journalist Shah (The Fever, 2011) is at it again, and if the words, and beyond, in her latest book’s subtitle don’t grab a reader’s attention, they should . . . Yes, Shah is back and in rare form. And this time it’s personal.”―Donna Chavez, Booklist (starred review)
“Shrewdly articulated . . . thought-provoking and well-documented” ―Nature Microbiology
“[A] grounded, bracingly intelligent study” ―Nature
“Shah proves a disquieting Virgil, guiding us through the hells ruled by [infectious diseases] . . . the power of Shah's account lies in her ability to track simultaneously the multiple dimensions of the public-health crises we are facing.” ―The Chicago Tribune
“In this absorbing, complex, and ominous look at the dangers posed by pathogens in our daily lives, science journalist Shah (The Fever) cautions that there are no easy solutions . . . Shah’s warning is certainly troubling, and this important medical and social history is worthy of attention―and action." ―Publishers Weekly
Praise for The Fever
“An often rollicking read . . . Shah has put together an engrossing cast of doctors, malariologists and historical figures.” ―TIM MORRISON, Time
“Sonia Shah ’s tour-de-force history of malaria will convince you that the real sound track to our collective fate [is] the syncopated whine-slap, whine-slap of man and mosquito duking it out over the eons.” ―ABIGAIL ZUGER , M . D ., The New York Times
“This insightful book explores the human struggle with malaria not just from a scientific angle, which is cogently detailed without being overwhelming, but also from sociological and anthropological perspectives . . . Shah is to be commended.” ―DENNIS ROSEN, The Boston Globe
“The lessons of history should give us pause . . . Many [issues] are brilliantly exposed in Ms. Shah’s book .” ― W. F . B YNUM, The Wall Street Journal
“Meticulously researched and passionately written . . . One of this year ’s most significant science books for the general reader.” ―DAVID WALTON, The Plain Dealer (Cleveland)
“A fascinating history . . . Insightful, even revelatory.” ―WENDY ORENT , The New Republic
About the Author
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A note here before I continue. I am in upper management of a mosquito control district, so I am quite informed about mosquito disease issues that are problematic here in the United States. With that said, some issues with her research include her information on West Nile virus and dengue in Florida.
Her discussion of West Nile virus early in the book is a mixture of fact and conjecture. No one is really sure how West Nile first got started in this country (in Queens, New York), but most experts believe that the most likely scenario was either mosquitoes that hitch hiked aboard commercial airline flights, cargo flights or it was introduced through the illegal trade in rare and exotic birds.
The author makes the claim that the disease had probably been introduced by way of migratory birds along the Atlantic flyway. The big problem is that, while these birds do get together during the summer in the Arctic, their migration routes take them over New York as the mosquitoes that can transmit West Nile (Culex sps.) are heading into winter hibernation. In addition, the birds most susceptible to West Nile are not birds found along this flyway. Birds that summer in the Arctic are geese, ducks, etc. and they are very resistant to this virus. It is pretty uncommon to find the virus in their blood, and if it is, it is at a very low threshold. Crows and other corvids, which are heavily affected y the disease and are the reservoir for it don't winter there and commute south, making this an unlikely method of transmission.
Her treatment of the dengue outbreak in South Florida is also riddled with inaccuracies. Yes, there were a number of abandoned pools in the housing meltdown at about the time of the dengue outbreak. And, swimming pools were allowed to go "green", which means the water turns fetid. Her claim that they are out of sight of mosquito control experts is ludicrous, however. Most mosquito control districts use either images from satellites or aerial photography. The "green" pools stand out like a sore thumb and the districts can them treat them. In addition, neighbors tend to squeal when there is a large influx of mosquitoes.
What makes this a particularly erroneous section, however, is that the species of mosquito that likes to breed in fetid water is the Culex sps., which can transmit West Nile disease and a number of other disease, but cannot transmit dengue. That requires the Aedes sps. which has been present in South Florida (and a lot of the rest of the country) for years. That particular type mosquito hates fetid water and likes to breed in containers, tires and other places where clean rainwater collects. In a roundabout way, the foreclosure crisis may have been to partially to blame, but not because of the swimming pools, but rather because people being evicted tend to leave junk on the property, such as tires, old pots and containers.
The dengue outbreak was likely caused by a lot of factors, including weather, but also by the arrival of infected people into the South Florida region. Dengue is endemic in numerous Caribbean islands, as well as most of Central and South America. If visitors to the country that were infected with dengue came in the right numbers, the disease would flourish.
Finally, she chastises the scientific community for not searching for new diseases more quickly. And while that may sound valid, remember that there are thousands, if not millions, of diseases living in animals around the world that have not spread to humans. The majority of time spent looking for new diseases in a given area is spent looking for diseases known to be transmitted to man and to cause death and disablement A good example would be the Zika virus now making the news. This was first identified decades ago in Africa, but it never caused any harm to humans, so it was ignored. It was only when it started to appear in South America that humans became seriously impacted. Now it is on the watch list and testing is being done to locate it.
Overall, I think she tried to write a valid book, but entered into areas where she had no expertise and failed to consult specialists in those fields. It is one thing to read papers on disease, but another to talk to someone who works with it day in and day out. An expert can give you the consesnus science pretty quickly, but you need to read a lot of different papers to find a good mix of information.
My recommendation would be to pass this over. There are other, better books out there, and given the problems found by me and others with expertise, it makes me question all of the science in the book..
The reviewer, Laurie Garrett, isn’t some unqualified crank. She is a science journalist who received a Pulitzer for her work on the 1995 Ebola outbreak.
“Pandemic” has a wandering and disjointed feel to it as though the author never quite settled on the core of the story. I asked myself more than once if the book was about cholera? A random tour through the influenza viruses? Or evil governments?
It was hard to find an original point in “Pandemic”. This genre is saturated with books that have already covered our own species’ culpability in increasing the spread of infectious diseases. One such book is David Quammen’s, “Spillover”. It is superbly researched and written.
In contrast, “Pandemic” contains errors, mis-statements, and oversights. Not all are major, but together they diminished my reading experience. Here are a few, drawn from the first pages of the book:
1. On page 10 the author writes, “scores of MRSA bacilli”. Pairing the term, “bacilli” with MRSA is wrong, as “bacilli” is another name for rod-shaped bacteria as well as bacteria in the genus Bacillus. The MRSA bacterium (Staphylococcus aureus) is neither. S. aureus is spherical, the general term for which is “cocci”. Nor is S. aureus in the genus Bacillus. (This error is especially surprising as the author experienced MRSA).
2. On page 15, referring to the virus that would later be named SARS, the author writes that the virus started infecting people in November 2003. But then on page 109 we learn that in 2002 the Chinese withheld information about SARS. So when was the first infection? The SARS timeline of the CDC, as well as Quammen’s coverage in “Spillover”, are consistent with one another. Both peg November 2002 as the time that SARS started infecting people. Shah should have taken advantage of over a decade’s worth of post-SARS epidemiological research to get the story right.
3. On page 18 we are introduced to copepods, tiny marine organisms that harbor the bacterium causing cholera. Shah tells us that copepods “can’t swim”. But copepods are a huge and diverse group of organisms. It took a few seconds of Googling to find that whole orders of copepods do indeed swim. So do the copepods that carry cholera swim? I still don’t know.
These problems (and more) made me wonder about the accuracy of other material in the book in which I have less background.
The “I’m-a-clever-muck-raker-journalist” persona of the author grated at times. The description of trying to find a wet market in China reads like a predictable “gotcha” as did parts of the section on Haiti. It took away my sense of suspense about what would happen next. If you like reading these types of descriptions, those in “Spillover” are more engaging and realistic. Quammen inserts himself far less into the story, and relies on scientists and locals in his vignettes of places and diseases.
Near the end of the book, still looking for a thread to link the smattering of sometimes-facts in the narrative, the author writes some overly-speculative passages. One, which goes on (and on), insists that pathogens have pretty much single-handedly determined the course of human evolution. This is preposterous. It’s also wrong, as consulting any modern textbook on human evolution would reveal.
The “us versus them” frame of the author leads her to a lop-sided and erroneous view of the human immune system. New science over the past decade shows that the microorganisms indigenous to our bodies are critical for the human immune system to function properly. In many cases their genes act like a puppeteer, regulating (or not) the expression of genes critical to our well-being.
A spate of well-researched popular books explore the findings from this new area of science, called the human microbiome, and how it is rapidly re-shaping old ideas about human disease, health, and evolution. Among them are “Missing Microbes” by Martin Blaser and “An Epidemic of Absence”, by Moises Velazquez-Manoff.
But like me, if you do enjoy reading about the disease-causing microbes, I would recommend “Spillover” by David Quammen. It does not suffer from shoddy research leading to speculative passages. And most of all, it is a good read.
What the author explains in layman terms is how the genetic structure of a virus can adapt as it moves horizontally between species as with SAR that moved from bats to civit cats to humans in the Chinese wet markets that have thousands of live wild animals packed closely together which insures disease transmission across species and can increase its lethality with each move.
What I not known and so did not appreciate is how the improvements in public health as measured by infant deaths and overall life expectancy increased from 1870 to 1970 thanks nearly entirely to the middle class pushing for public-health infrastructure and staffing. From Ronald Reagan and his successors there have been public-health funding cuts that have put the country back to where it was in 1870 and our mistaken belief in a magic bullet or the private medical establishment is killing tens of thousands during a "good" year and many more will die from Covid-19 in the coming years.
If you want to understand why we are where we now find ourselves then this book is the place to start. Another book I highly recommend that if more focused on public-health is the one written by Laurie Garrett, "Betrayal of Trust".