Laurie Garrett

I've been working on this doorstopper for the better part of a year, I think. But totally worth the ride.

In successive chapters, Garrett describes in sometimes novelistic detail the various fights humans and microbes have been fighting, mainly in the second half of the 20th century. Starting with an outbreak of hemorragic fever in Bolivia in 1962, tracking our struggles through Marburg virus, yellow fever, meningitis, Legionaire's disease, Lassa fever and then Ebola - in 1976! - (and that show more only gets us to page 100), she meticulously details the personalities, difficulties, and outcomes of wave after wave of new or newly virulent disease in our time. Inevitably, the story gets out of Africa and South America and the Third world in general, and leads back to North America, hanta virus and AIDS.

But more than just report on this destruction, she tracks origins, causes, how our own hand works against our own survival. As we travel more, destroy more, warm our planet more, build antibiotic resistance more, mix genetic material more either deliberately or accidentally, the microscopic enemies of our lives get smarter, stronger, almost more knowing, and get under our defenses again and again.

I love reading about medicine, but after the heroic tales petered out and the science of mutations became the story, this book made me extremely uneasy. Talk of vectors and reservoirs doesn't disguise the fact that the world is getting ever more dangerous as we change it.

The 'trade paperback' clocks in at 622 pages before the index and the 100 pages of footnotes and references. Fascinating, scary, and now 20 years old - and still happening. show less

This book is easily the most terrifying book I have ever read. Garrett is a great storyteller and makes a subject that could be very dry into a suspenseful journey through the history of epidemics and disease in America and the World.
While the initial chapters, documenting the fight against various virulent diseases around the world are gripping, later chapters detailing politics, bureaucracy, and policy decisions are a little dry in comparison. However, this information is important and show more worth reading. Garrett does an excellent job of explaining how under funded public health, agricultural practices, failed world health initiatives, politics and bureaucracy, poor ecological practices and scientific arrogance have lead to epidemics, disease resistant bacteria, and a world where there is essentially no planned response to the next virulent epidemic.
Overall the book is a crash course in epidemiology and public health. If you ever thought that public health, poverty, third world countries, and global health initiatives weren't something to concern yourself with, this book will make you think twice and, if you're smart, devise a personal plan should the next pandemic arrive in your town. show less

I really enjoyed this book. It was ridiculously huge for a nonfiction, but I enjoyed (almost) every page of it. The book covers 3 aspects of disease: The recent history of deadly disease outbreaks such as Lassa Fever, Marburg/Ebola, and Yellow Fever; Current (as of 1994) outbreaks such as AIDS, Toxic Shock Syndrome, and Hantavirus; and the potential future of infectious diseases. The future is definitely the scariest. You would think that as technology advances the microbes would become less show more and less of a problem, but the book argues that with every technological advance we make, we wind up unleashing the microbes on ourselves. Blood transfusions, megacities, water treatment...heck, even antibiotics have actually strengthened the microbes as they become resistant to the drugs, rendering once benign illnesses untreatable. Laurie Garrett has definitely opened my eyes to the power of the microbes. Suddenly I don't feel so confident in humanities dominance of the planet.

Don't think that the book is all paranoid doomsaying though. While the predictions for the future of disease control can be disheartening, her chapters on humanities scientific advances can instill at least some confidence. The chapters on things like genetic engineering and WHO's attempts at world-wide microbe surveillance help make you think that not all is lost!

Overall, I found this book to be both compelling and very informative. The size might put some people off, but I would highly recommend it to anyone interested in the topic. show less

This is one of those books that is daunting and fascinating all at once. THE COMING PLAGUE contains over 600 pages of fine-print material about the major diseases that emerged in the 20th century, how they were investigated, and what worked to resolve the issue (if anything). The level of detail Garrett employed is quite exhausting; the notes section is about 100 pages, and the books totals 750-pages in all. I read this for novel research, and it took me a month to do it as I read other show more books at the same time. Yes, I skimmed, but it was a slow skim as I jotted notes on sticky tabs throughout.

The sections that intrigued me the most were machupo (which I hadn't even heard of before), ebola, and hantavirus. The book also contains several hundreds pages on HIV/AIDS and the "Thirdworldization" issues of the 1980s and early '90s. It was interesting to see this book, published in 1994, cite how dangerous it was for cows and other farm animals to be given excessive hormones and antibiotic treatments, and lo and behold in the past few years those issues are finally being addressed. The slowness of medical responses is what really appalled me. In many ways, the United States was more ready in the 1950s due to Cold War vigilance and the use of "cowboy" epidemiologists who were willing to muck through the jungles in Africa or Central America to search for scat. As THE COMING PLAGUE points out in the end, the World Health Organization didn't recognize the threat of AIDS until it had already spread to four continents. That's just plain scary.

It all made for a fascinating read, but I am quite thankful to be done with this book! show less