Newly Emerging Diseases in a World Out of Balance

A classic of epidemiology, cataloging the various parasites, bacteria, and viruses that have been unleashed upon humanity by humanity's own invasion of the biosphere. The book is more than two decades old, but aptly tells the story of humanity's fight against infectious agents, the premature and hubristic belief that we had conquered the microbe (coinciding with the conquering of smallpox and the sword of antibiotics) up until around 1995. I'd love to see an update discussing the more recent history of AIDS and TB, the continuing saga of multi-drug resistant diseases and MRSA, not to mention additional chapters on SARS and the new century's Avian Flu scares. The book mixes explanations of how various microbes function (both in humans and in reservoir species, not to mention how the evolve and cause illness), character studies of the people who sounded the alarm of various plagues and how they did the detective work to figure out the cause, and sensitive and unflinching descriptions of how outbreaks impacted victims. Almost on par with David Quammen's Spillover (though a notch below, partly because his is more recent and spends a good amount of time cataloging the costs of zoonotic diseases in our fellow animals, not just in humans), well worth the time of any epidemiological aficionado.

"The Coming Plague" is 620 pages of densely-packed text on humanity's war against its deadliest enemies. Throughout the twentieth century and into the new millenium, we've given our microscopic enemies glorious new opportunities to exploit us, whether it be through war, slash-and-burn agriculture, or stagnant water in an air-conditioning system. Laurie Garrett has written a fascinating and frightening account of some of the battles we almost won (measles and polio) and some where we appear to be in full retreat (drug-resistant tuberculosis). Her book is especially compulsive reading when she describes the individual skirmishes in the war, e.g. a journey into the African bush to identify and treat a disease that was killing 80% of its victims, or the discovery that cholera vibrio could live inside of algae and didn't require person-to-person transmission.

Even if you live in the middle of the Canadian tundra and have sworn off eating mollusks for the rest of your life, this book hammers home the fact that you're still not safe from what used to be called 'Third World diseases'. Even as I write this review, there is a woman in an isolation chamber of a hospital in Hampton, Ontario who is gravely ill with an unknown hemorrhagic fever. The doctors don't think its Ebola Fever, but they're not sure what it is, or whether any of the other passengers on the plane from Nigeria to Canada could also have been infected.

You can conclude (as I did) from "The Coming Plague" that many of us who expected to die from age-related conditions such as heart failure or cancer, may now well perish from infection. This book manages to combine the heroics of "Men against Death", the grim prophecy of "Silent Spring", and descriptions of several hair-raising, near-tragedies akin to the "Hot Zone". I highly recommend it.

Laurie Garrett has broken the code of the death of the human race. While we look outward to the sky for asteroids, comets and plot scenarios to send nuclear weapons out to meet them in deep outer space, and prepare for the "Big Crunch" four billion years away, right in our own biological backyard is a much more proximate, devious and clever enemy that is relentless in its pursuit of bringing humanity to "heel." Germ warfare is not in Saddam Hussein's mobile units, but at our front, back and side doors, and it is gaining as it learns to overcome every defense that we can throw in its path.

Surprisingly the author makes us aware of an important fact that the best ally of this formidable biological enemy is humans themselves. Our habits of poor health and eating habits, unpurified water, unprotected sex, over use of antibiotics, massive immigration, pollution, deforestation all play into the hands of this relentless and aggressive terrorist.

Diseases such as HIV, Lassa, Ebola, etc. are all opportunistic microbes taking what the human traffic will bear and then learning (ever-learning) how to survive in increasingly more hostile and more complex environments. Microbes have a comparative advantage in adaptation, and for that reason alone will outwit humans in the arms race for survival. Their strategy is a "pure" one: surviving by jumping from one species to another and then consolidating its survival in the new environment through the Darwinian principle of mutation combined with specialization.

Here in one volume is "chapter and verse" of how diseases and viruses have come about and how they are constantly gaining ground, as well as what we have done to enable and promote their survival chances at the expense of our own. It is encyclopedic in scope yet readable and sobering, scary, if not down right terrifying.

It is a battle against a terrorist that we cannot win, nor can we even declare a truce, or call for a peace treaty. As John Lee Hooker says, "we won't get out the blues alive." Four stars

You want to be truly frightened about your health? Read The Coming Plague: Newly Emerging Diseases In A World Out Of Balance by Laurie Garrett. A friend loaned me his copy of this book after I had read a book about the flu epidemic in the early 1900's. This book, written in 1994, covers a number of diseases from all over the world, as well as the stories of the individuals who constantly risk their lives to combat the deadly viruses.

Although the book is over 700 pages and the information is over a decade old, it's still a compelling read. The stories of the CDC doctors who fought bureaucracy and ignorance are inspiring. To go into countries and cultures where the per capita health care expense is $2 and try to conduct research is mind-boggling. In many of the stories, every common health care practice we take for granted is nonexistent. Syringes are reused without sterilization 100's of times each day as it's the only needle they have. Highly contagious cases are placed in the same room as common injuries, and soon everyone is infected and dying. And logistically, there's no way to prevent any of this. Garrett tells of whole countries where the majority of the inhabitants are infected with diseases like AIDS, and the numbers go nowhere but up. She does an excellent job of telling the stories of how diseases like Ebola, Marberg, and the hanta virus outbreak started, were researched, and how they are currently fought. Even more frightening is learning how quickly these viruses develop resistance to the common drugs used to treat them, sometimes in as little as one generation of the outbreak. And as the treatment choices become fewer and more expensive, the outlook becomes more grim for both third-world countries and our own system.

The passage of time hasn't made the picture any brighter, and many of the views put forth in the book are still well on their way to fulfillment. After reading this book, it's easy to understand how such diseases like SARS and avian bird influenza strike fear into the medical establishment. It's a wonder we're not all dead already.

Written in the mid 1990’s this book follows transmittable disease over the last fifty years. Ebola, Aids, and a whole host of others are recounted medically but also how they affected countries politically as well as economically.

The information is still relevant but a few new chapters should be written to update the book.

Really interesting and worth your time.

With recent news blurbs concerning the possible threat from strains of the West Nile virus in the northeastern part of the country this summer, the urgent importance of this book is quietly being reinforced. This important effort by journalist Laurie Garrett is a whopper; a long, carefully documented and quite readable text giving an overview of the worldwide efforts of the "insect fighters' at the Center for Disease Control (CDC) of the U.S. Public Health Service and other agencies ranging from the U.N to state, university and local agencies to combat a panoply of both new biological agents like HIV, Ebola, and the West Nile virus as well as new and much more virulent and drug-resistant strains of old enemies like tuberculosis, bubonic plague, a number of venereal diseases, and complex new public health concerns like Toxic Shock Syndrome.
Ms Garrett's highly detailed and exhaustively documented thesis, written while on a graduate fellowship at Harvard, is both frightening and hard to ignore. She posits that through our environmental arrogance and stupidity, the general medical strategies of the western societies, and our consistent overuse of antibiotics, we are quickly losing the continuing fight to keep the general public of both the postindustrial nations and the less developed world safe from the wild panoply of microbiological agents that are out there in the environment, and we are, through our encroachment on wilderness areas never before populated by humans, unnecessarily introducing segments of the population to new microbiological agents who then find a vector or path into human habitation and resultant infection. Moreover, the increasing levels of world commerce and concomitant travel among the nations of the world mean that someone infected in the jungles of South America or equatorial Africa can be in a restaurant in New York City or at the beach on Martha's Vineyard several days later as the agent starts its formidable and often highly contagious microbiological attack. This is truly scary stuff.
One becomes increasingly concerned about the safety of the general public and for our relative lack of public health preparedness as one winds through the pages of this long book. The approach is one of individual story telling, and while this makes the book much more readable and entertaining, it also tends to repeat a lot of information that one could otherwise avoid. Yet this is truly a minor quibble with a facintaing and fact-packed book that often made me feel like I was taking a graduate seminar in "Current Issues in Infectious Epidemiology". It's tone is both approachable and yet scholarly, a rare treat to enjoy, and Ms Garrett's obvious intelligence and ability to communicate shines here, as she makes complex environmental, infectious disease, and human issues converge in an understandable and compelling way.
Finally, she makes an excellent case for increased public awareness as well as immediate political action to restore and reinvigorate the vitality and capability of our local, state, and national public health agencies, and certainly has increased my own awareness and concern for the ongoing scientific effort to battle the microbes. If her argument that many of the gains of the 20th century in public health (and the healthy longevity we enjoy as a result) are increasingly at risk is correct, we must take action to combat the wide range of problems she discusses to avoid a serious long-term breakdown in our public health system. This is an important book that has sparked a serious national and international public debate about some critically important issues that could literally potentially affect billions of people across the globe. I recommend it, hope it will be even more widely read, and hope you read it, too.

If like most Americans horrified by the events of 9/11/01 and the current anthrex threat, educate yourself on pathogens, epidemiology, virology, the CDC, etc. with this book.
After reading and being horrified by "The Hot Zone," I wanted to learn more about viruses and virology...plus I wanted to have intelligent conversations with a friend who is a virology researcher. This book was new at the time, and I DEVOURED it. It is immensely detailed (if you're a bit of a science geek like myself, don't miss the footnotes), yet reads well due to the fascinating stories of various groups chasing down emerging viruses in the latter part of the 20th Century.
It will probably scare the hell out of you, but you will be able to make far more sense of the.. media is putting out about anthrax. It should also put the bioterrorist threat into a bit of a perspective when you realize what Mother Nature is capable of dishing out on her own. Particularly interesting is the links given between environmental destuction/change, increased urbanization, and planetary mobility and the threat of an emerging virus with the kill rate of Ebola and the transmissibility of the flu.
This book made me into a hobbyist (I'm not a virologist) regarding these issues, and I've read many other since then. While most are interesting (particulary the "aggressive simbiont" theory of "Virus X", this book is still the bible of explaining infectious disease. Educate yourself and read it!

This is a nonfiction work that reads like a Crichton novel. Indeed, if you've read "Andromeda Strain," this would be a good follow up. And it's probably scarier than Crichton too.
Laurie Garrett tells the tale of microbes that get out of control and harm and kill humans. These viruses and bacteria caused the diseases that make life so miserable for people way back in history, though we in the United States today tend not to think much of disease thanks to the science, technology, and sanitation that have left us free to die of cancer and heart disease rather than malaria or bubonic plague. But there are still billions of people in areas of the world where they are vulnerable to debilitating or fatal infectious diseases, and even we in the industrialized world should be aware of the outbreaks that occur elsewhere. The quick spread of SARS across countries shows how, in the age of globalization, disease is not just a local, or third world, phenomenon.
Garrett won't teach you too much about the ins and outs of epidemiology. For that, a textbook would be more appropriate. Her book is more about the people who research and study these diseases and the politics of infectious disease. She is constantly focusing on what is wrong with the systems we have in place and why we need changes. She often repeats the term "iatrogenic" referring to illnesses caused by medical procedures, doctors, hospitals, etc. Our negligence of systematic flaws is dangerous.
You will come away from this book better informed, and with a tremendous amount of appreciation for those who serve public health on the front lines. They are a largely unacknowledged army, equipped not with guns, but with years of training, medical knowledge, and a will to to heal the sufferings of many unfortunate people.

Exciting, comprehensive, and in-depth look at every major epidemic humanity has faced in modern times, with a focus on the 20th century (up to when the book was published in 1994). In each case, Garrett goes over who sounded the alarm bell, personal cases of victims, how the disease spread, what the local and global response was, the aftermath, the death toll and its consequences, and its comparison to other epidemics. By reading a large picture comparison instead of single incidents, I feel like I have a better view on infectious diseases and their effect on humanity--and how prepared, or unprepared, the world population is for future epidemics. Fascinating.

If you live in the comfy West, Third World health issues can seem about as remote as McDonald's on Mars. Laurie Garrett's accessible, passionate book reminds us that despite the cultural, political and economical crevasses that separate nations, humankind is united by a number of factors, and vulnerability to the microbial world is one of them. Disease has no respect for boundaries and complacency is our enemy. The Coming Plague is indeed an elaborate, riveting detective story and Garrett's CDC cowboy heroes who became the cavalry in the most remote and dangerous of locations in their search for the source of contagious disease, became my own. I note that there has been criticism of Garrett for for alleged scientific and research inaccuracies. The message is still crystal clear: the health of humankind needs a global perspective and global policy. It's a weighty subject but Garrett turns it into a thrilling read that I couldn't put down. I came away convinced that no matter who we are, we should be cannily aware of the newly emerging diseases, the formidable power of the microbial world, and our responsibility as individuals in contributing to global health. Garrett explains how health and disease have a domino effect. What goes around, comes around. This is Buddhist philosophy in practice. Single actions have universal ramifications. For example, Garrett shows how misuse of antibiotics in treating tuberculosis in the former Soviet Union impacts on vulnerability to the disease worldwide. Reading of the losing battle against malaria deeply saddened me when winning the battle seemed to be within grasp. It appears that politics and medicine are joined at the hip. Some years ago Rachel Carson's Silent Spring influenced me. The Coming Plague is similarly inspiring. And perhaps McDonald's on Mars doesn't seem so far away after all.

The Coming Plague : Newly Emerging Diseases in a World Out of Balance - Laurie Garrett
This factual history of late 21st century contagious disease or, more accurately, the politics of disease in our time, makes at least one thing clear, the day of the miracle cure is gone. And politicians, of course, are completely missing the point. That is, these tiny predators are a real threat today and neither isolation or ignoring will make it go away.
The antibiotics you routinely take kill most but not all of their intended victims. The tiny percent they can't kill are, by definition, immune to the antibiotic. Since this latter group are as often as not held in check by a competition for resources with the ones that were killed off, they now have no natural competitors in their ecosystem (your body). Consequently, the number of bacterial infections that are now immune to all known antibiotics is growing rapidly. Chillingly, the creation of these super bugs is most fruitful in hospitals, modern or primitive.
This means that some old, terrible acquaintances are back with these resistances; tuberculosis, yellow fever, malaria. Some relatively new ones, like AIDS, Marburg, Ebola, are also settling in for round two in a battle whose rules we only now are beginning to understand. For example, many viruses have shown the ability to swap DNA carried traits with other organisms in their environment (like algae or people), raising their survival capability an order of magnitude. Wait, there's more! Infection's ability to move around the world quickly has also taken a quantum jump. Hantaviruses born in Korea moved killed a dozen Native Americans in the south western US in a matter of months via mice migration. Only unusual cooperation and detecting between native medicine men and field CDC agents stopped this potentially explosive plague. Of course, the U.S. government has begun cutting back on disease identification & control in the past few years.
This book is both eco-text and bio-thriller. It reads like it was written by two people, both named Laurie Garrett. The scholarly one created a reference text for those who want an introduction to one of bio-sciences' greatest challenges. In 750 pages of book she has 104 pages of reference notes! The other writer is a caring journalist with an eye for this human drama and its terrible costs. She slips in and out of the text with brief, introductory tales of real heroes who regularly risk their lives solving the multi-vector puzzles these now global outbreaks represent. She captures heart breaking scenes such as Catholic nuns in Zaire tending their own dying sisters, fully understanding that this guaranteed their own exposure and death. Both authors' conclusions call for such a unified, global effort to stave off this threat, so broad it's difficult for me to find some personal agenda I can adopt. My impression is that we can expect major waves of human die-offs around the planet and this appears to have already started. These, in turn, will impact the U.S. both politically and economically significantly. This will create a loss of faith in our own insulated medical/political system. The one we have been taught to trust. Perhaps then the global effort might begin.
I read this text at bedtime every night for a month. By the end my wife had lost patience with my 'disease of the night' fears. It's concentration of references gives a real sense of credibility, the nameless Boston criticizer notwithstanding, and the human stories it touches are truly gripping. However, its rhythm is irregular, which makes it a harder than normal read. If your psychosis is like mine, you'll enjoy all the nuances of modern killer diseases and the mental exercise. However, if you need something higher speed and less challenging, try Richard Preston's The Hot Zone.
Dan Derby, Tuftonboro, New Hampshire. [email protected]

There is nothing quite so scary as the truth, and this book brings home that fact like no other. The recent history of epidemiology is presented in a comprehensive and fluid account in The Coming Plauge. I read it for the effect these diseases have on international relations- seems like a stretch, but really it is not -and came away fully satisfied. With this in mind the chapters on Africa are very interesting. The strain on those countries' social infrastructure is becoming a crisis- as a recent Security Council meeting of the UN confirms. The HIV & AIDS scares are recounted with a correlation to the plauges of medieval Europe in a way that reminds us how counter productive panic can be. The chapters on HIV & AIDS should be read by all. Garrett also makes this a quasi-thriller with her chapters on the disease 'cowboys' and their adventures hunting down the exotic and sexy viruses of Hanta and Ebola. For someone who is normally afraid of biology and the sciences, I was able to understand and learn a lot in the course of reading this book- so don't be scared off by any lack of professional expertise, this book is for anyone with interest in disease hunting!

Garrett's "The Coming Plague" is a 600+ tome exploring virtually all things infectious -- Ebola, Epstein-Barr, HIV, Escherichia coli, gonorrhea, herpes, Streptococcus, etc. -- and the role that they've played in our evolution and, potentially, our demise. Garrett discusses at length the diseases plaguing the equatorial parts of the world, previous outbreaks, and how a shift in ecology, increased resistance to antibiotics, and inhumane conditions will all but guarantee future outbreaks with a lethality exceeding anything seen thus far. The chapter on HIV/AIDS was particularly illuminating and a great compliment to Shilts' "And the Band Played On" (Shilts explores the emergence of HIV/AIDS in the U.S. and the social and political ramifications of it's emergence). Although the emergence of HIV/AIDS has been a source of intense debate since it swept the world, Garrett notes that in spite of the global scientific effort (as of 1994), nobody had yet "pinpointed a time, place, or key event responsible for the emergence of HIV-1" (pp.389).

Garrett would be remiss if she didn't explore the why and the how of disease emergence, i.e. disease amplifiers. The obvious -- and most destructive -- ones are sexual promiscuity, re-use of syringes, and antibiotic resistance. She draws on the work of a U.Washington epidemiologist, King Holmes, and a mathematical equation he developed to describe the role promiscuity had in amplifying disease, that is, the rate at which infection reproduced (pp.611). The components of the equation (multiplied together) are (1) the mean efficiency of transmission of the microbe per sexual contact (higher is worse); (2) duration of infectiousness (higher is worse); and (3) the mean number of sexual partners per day (obviously, higher is worse). The obvious implication of this equation is that the first two components are microbial characteristics whereas the last component is fully a human behavioral issue...it then follows that for sexually transmissible diseases (e.g. HIV/AIDS), it's emergence into a global epidemic seemed almost inevitable.

Garrett concludes the book on a marginally pessimistic note -- our global neglect of microbes in the last 50+ years has given them the upper hand -- although she rightly declares that if the human race does not learn to cooperate, share resources, and live together in our global village, the predatory microbe will usher in a plague not yet seen.

Laurie Garrett is an excellent writer, she could easily had made this book a novel, as a matter of fact she almost did. With her great detailed narrative she makes you fell inside the history of the modern microbe hunters, I've read several other book in this subject and none of them treats the subject in the professional and "journalistic" way Garrett does. You can easily detect she knows her business, the concepts and the way she makes them all make sense is laudable.

The only drawback I can see in this book is that sometimes it felt a bit long. I must say again she is a great writer, but gives a whole lot of information, sometimes returning to something she already had said before, only that this time adding new information and commentaries. The book is great and the information is top quality, besides she gives great insights that keep you in the right track. I totally recommend this book to anyone interested in emerging diseases or epidemics in the twentieth century (up to 1995, of course).

"The Coming Plague" is 620 pages of densely-packed text on humanity's war against its deadliest enemies. Throughout the twentieth century and into the new millenium, we've given our microscopic enemies glorious new opportunities to exploit us, whether it be through war, slash-and-burn agriculture, or stagnant water in an air-conditioning system. Laurie Garrett has written a fascinating and frightening account of some of the battles we almost won (measles and polio) and some where we appear to be in full retreat (AIDS, drug-resistant tuberculosis). Her book is especially compulsive reading when she describes the individual skirmishes in the war, e.g. a journey into the African bush to identify and treat a disease that was killing 80% of its victims, or the discovery that cholera vibrio could live inside of algae and didn't require person-to-person transmission.
Even if you live in the middle of the Canadian tundra and have sworn off eating mollusks for the rest of your life, this book hammers home the fact that you're still not safe from what used to be called 'Third World diseases'. Even as I write this review, there is a woman in an isolation chamber of a hospital in Hampton, Ontario who is gravely ill with an unknown hemorrhagic fever. The doctors don't think its Ebola Fever, but they're not sure what it is, or whether any of the other passengers on the plane from Nigeria to Canada could also have been infected.
You can conclude (as I did) from "The Coming Plague" that many of us who expected to die from age-related conditions such as heart failure or cancer, may now well perish from infection. This book manages to combine the heroics of "Men against Death", the grim prophecy of "Silent Spring", and descriptions of several hair-raising, near-tragedies akin to the "Hot Zone". I highly recommend it.

This is not a sensationalist book. It is not meant to only scare people (although it is frightening). It lays out a very strong and well-researched theory that the Third World is going to fall further behind as tens of millions of people will fall victim to curable diseases each and every year in Africa, South America, and Asia. Meanwhile, the most popular drugs in the USA and Europe include products for curing baldness, toe fungus, allergies, and erectile dysfunction. We are already seeing this trend take shape. It won't be long before other theories in the book become reality, such as wars for clean water and a continued increase of fatal diseases in the First World. As to the title, I'm sure the publisher wanted to cash-in on the millenium anxiety. But of all the "gloom and doom" books of the 1990's, this one is by far the most relevant and realistic of the bunch. A must read!

I caught an interview with Ms Garrett on NPR awhile back, and I was intrigued by the discussion, so I bought this book. I was at first rather daunted by the 622 pages.

This is a riveting 622 pages. The mystery, the subterfuge, the politics, the sex, the violence, and of course, the massive expansion of my science knowledge is just wonderful. This book will thrill, amaze, shock, revolt, hold you in it's claws and then keep you awake at night all at the same time. A wonderful companion to contemporary political, military, climate and scientific studies, this book is a real eye-opener. I recommend it to anyone wanting to expand their knowledge and view of the world at large.

Whether you are interested in public health or not, this book is a must-read. Garrett does an amazing job detailing the emergence of new diseases, their impact and the reactions of public health officials.

Garrett's writing is fast-paced and the stories she tells are fascinating. Her ability to convey character is such that you will feel as tho' you personally know the epidemiologists whose stories she tells. In fact, you will wish that you did know them---if only so that you could call them up and ask for reassurances!
The book has a few minor errors but these errors are insignificant in the greater scheme of things. What is important is that Garrett is finally telling the general public what epidemiologists and health professionals have known for the last two decades and that is: the war against infectious diseases is far from over---in fact, it will never be over. A chilling message but one which needs to be said as most Americans are highly complaisant about the threats posed by disease.

This book is an excellent book. It explains a little of the history of a disease and a frightening scenario becomes all too common with each disease that is discussed. In almost every case because of rampant and uncontrolled use of antobiotics along with global travel. Many of mankinds worst diseases are on the verge of becoming uncontrollable. We are spiraling toward the use of ever more rare and expensive medicines while the rate that dangerous diseases become immune to the present barrage of medicines is accelerating. The book is very well written. It is not written in a doomsday or alarmist style. It is factual, and answered mamy questions I had on diseases. The unsettling part is the conclusions the reader will draw from the present trends many diseases are taking.

The scientific truths documented and beautifully explained in this novel-like compendium are more frightening than any fiction I have read. Too bad there are not many surviors of the l918 epidemic who could attest to the social import and personal relevance to the reader. Forewarned is foraremed.Read it and weep (for the uninformed). Heed it and sleep (comfortably) because the factual data (a copious bibliography is included)will make your read as edifying as it is enjoyable. Believe me as one who knows...you will never see the world the same after you have read this book.And you shouldn't because everything Ms. Garrett says is absolutely true. (how's that? Do I win the $100 for the best review? If not at least I've given my fellow humans a great source for personal empowerment

The scientific truths documented and beautifully explained in this novel-like compendium are more frightening than any fiction I have read. Too bad there are not many surviors of the l918 epidemic who could attest to the social import and personal relevance to the reader. Forewarned is foraremed.Read it and weep (for the uninformed). Heed it and sleep (comfortably) because the factual data (a copious bibliography is included)will make your read as edifying as it is enjoyable. Believe me as one who knows...you will never see the world the same after you have read this book.And you shouldn't because everything Ms. Garrett says is absolutely true. (how's that? Do I win the $100 for the best review? If not at least I've given my fellow humans a great source for personal empowerment

Laurie Garrett sends chills down your spine!! This book doesn't just focus on the "coming" plagues, but she gives us a good overview of the past. The influensa epidemic, yellow fever, etc. She also looks at the present statuses of Lassa, Ebola, and AIDS. And what is to happen if these diseases mutate together?... become air borne?... what then?! It's like a nightmare... "...a frightning vision of the future" Michiko Kakutani(New York Time) says on the back cover... and WITHOUT A DOUBT, it is frightning and IT COULD HAPPEN! Read it and find out for yourself... Something you do on a daily basis, taken for granted, may cause you your life one day..

In nearly 700 well researched pages, Laurie Garrett has managed to turn a usually dry subject into a gripping tale of disease-warriors combating humanity's oldest enemies. This is only the tip of the iceberg for any respectable medical professional, but for the lay-reader this book contains a wealth of information that is readable and easily digestible.

By turning topics like the Ebola virus, Genetic Engineering and Toxic Shock Syndrome into an easy read, Laurie Garrett transforms complex medical topics into fascinating chunks of information like a true wizard. A must read for anyone with the slightest interest in medicine and science.

This non-fiction book inspired my debut Political Thriller - Patient Zero - about the next avian flu pandemic, which the world is truly bracing for.

Patient Zero - Official ABNA Entrant

I first encountered this highly readable epidemiology treatise in the library in 1995, just after finishing a college immunology course. I read it with intrigue, scientific consideration, and even suspense; I am now reading it for the second time. I write this review as the world reads news headlines about anthrax bioterrorism in the United States (October 2001).
If you are looking for an introduction to public health and how it relates to individual lives, this book will be captivating. If you want the scientific detail that the Harvard School of Public Health and Laurie Garrett can provide, make sure to also read the comprehensive endnotes at the back of the book.
Perhaps the most important knowledge I gained from this book was a profound sense of how history, politics, land redevelopment, and human behavior can affect the emergence of dangerous disease. Garrett clearly identifies specific projects and events that led to emerging epidemics of AIDS, parasitic disease, and tuberculosis, to name a few. My hope is that, if more people knew the contents of this book, we could learn from past errors in order to better prevent future outbreaks.
After you read this book, you will most likely campaign against antibiotics being used without medical need. You will also campaign for water safety, conservation of forests, population control, and programs to improve health in developing nations; plus fair international business practices. (You will probably also want every immunization you do not yet have.)
If you have plenty of time, read the text and endnotes. If not, read the text only and find time later to read the endnotes. No matter where in the world you live, this book will reveal to you the concerns we must all share.

Laurie Garrett has penned a striking compilation of just a few of the incredible number of infectious diseases that stand at the ready to strike down humankind the moment that we let our guard down. Earlier this century, medicine and science declared the infectious diseases beaten and abandoned work on them in favor of chronic conditions such as cancer. As a result, we now have the AIDS pandemic, hemmorhagic fever diseases throughout the world, etc. Ms. Garrett sounds a warning that can be understand and heeded by both the layman and the trained scientist. I credit her with my decision to pursue a career in public health.

Laurie Garrett's _The Coming Plague: Newly Emerging Diseases in a World Out of Balance_, is a _tour de force_ of infectious disease and popular epidemiology. Despite the occasionally overreaching, neo-apocalyptic conclusions Garrett reaches, _The Coming Plague is a must read for anyone interested in health, science, and our understanding of both.
Compared, rightly, to Rachel Carson's _Silent Spring_ (Boston Globe), _The Coming Plague_ raises flags about the ability of science to grapple with the range of viral and bacteriological threats to human health. In the same way _Silent Spring_ alerted readers to the consequences of ignoring the impact of late-twentieth century civilisation on the natural world, _The Coming Plague_ cautions us to the ways old and new threats endanger human health.
Readers should prepare themselves to spend some time with Garrett's text. It is a bit of a tome, and occasionally dry, but well worth persevering through.

Brilliant combination of microbial elucidation, historical context, socioeconomic study and political influence. I have always been daunted by science, but Laurie Garrett writes to provide illumination to complex social, political, historical and microbial situations so that, rather than being bored, I was fully absorbed in the book. She approaches the subject of diseases as an author, creating a story and plot line, providing details and insight that allows the reader to understand the COMPLETE circumstance surrounding the disease.

This is a content-rich book, and her research is so extensive that I would recommend reading the book twice or more to fully understand.
It's a science book, a history book, a political study, a cultural index and economic analyzation that inspires, informs and engrosses the reader.

Highly recommend this book.

This book, when it came out, pointed out the coming problems in our medical system like antibiotic resistance, long before it became common knowledge. But it also suggests that as we continue to transform our environment, new plagues and diseases will continue to threaten our existence.
My only criticism of the book is that it was a difficult read, because it is very densely packed with information. This book requires patience to read, but it is well worth it.

This is a rigorous, thoroughly researched and non-sensationalized book about what we're doing to ourselves by the way we relate to our non-human environment. Garrett is ruthless in her description of the consequences of our actions. If you want a book that makes you think, this is the one. It's not mind candy. It's not exploitive, it contains voluminous endnotes that also should be read. A winner. She deserved the Pulitzer she won for her work in public health education.

I enjoyed the book immensely not only for its outstanding research on the epidemiological and historical overviews of a range of illnesses in history and how scientists identified and attempted to respond, but for some of the biographical and very human, personal perspectives of some of these individuals as they attempted to change the course of the featured diseases in the communities they touched. As if that weren't enough, Garrett does an outstanding job providing insights into the biological mechanisms of many of the diseases reviewed. While clearly data-wise there is more to these stories since the book was originally published, the writing is very good and possessess a timeless relevance for its historical and storytelling narrative; it has found a place amongst my rather large shelf of "favorite reads" amongst a wide range of non-fiction as well as fictional works.

Garrett's "The Coming Plague" is a fine general survey on modern U.S. epidemilogical history and the techniques used by the CDC (Centers for Disease Control and Prevention, Atlanta, GA.) to identify and control pathogenic microorganisms world wide. I read it years ago and it was a formative work in infuencing me to earn my M.D.
I also believe, having read extensively on the subject, that Garrett's book has given rise to a small sub-genre. Many of the author's contemporaries flagrantly take her outline without giving formal recogniton where it is due. Garrett's is the original thought on the subject.
It is written as if it were a riveting mystery but also reveals sound scientific methods as the cornerstone of modern discovery.
The author studied at Harvard's School of Public Health and tends to be quite sensitive to polical correctness, and dedicates too much space to the people who worked on HIV instead of the subject itself. It is only one chapter of an otherwise incredible work, and I skipped most of it since it gets mired in names, dates and political cudos and condemnations. Stick with the science and mystery and you will enjoy it-- Even some of my non-medical microphobic friends loved it.

Chapters trace the epidemiology of a few of the most
deadly diseases. If you're sick of the current slew
of fictitious books capitalizing on epidemics and
sensationalizing diseases, this book is a "must-read."
It's well-researched and gives a historic account of
much of what is known about the "discovery" and progress
of each disease (Lassa, HIV, Ebola, etc.).

I bought "The Coming Plague" thinking, Oh, this will be incredibly depressing, but I should know about this stuff...." Instead, what I found was one of the most exciting, can't put it down books, I've ever read, in the same vein as my aunt's "Milestones in Medicine", "Great Women of Medicine", the Landmark books I cut my teeth on as a child! All the excitement of a really good detective novel, the suspense of a really good thriller, and the informational content of at least three college level biology courses, and the "wake-up" factor of a "Silent Spring!" It was horrifying to learn that the Reagan administration quietly dismantled the most significant and effective world health tracking and control system in the history of mankind, the Center for Disease Control, leaving but a hollow shell, and that no epidemiologists of the type profiled in the book, the multi-disciplinary "cowboys" are being produced by the world's universities, because all scientific fields are now so narrow and specialized!
If you liked this, you'll love "In the Hot Zone!"

I expected this book to be sensationalist copy, full of holes, and misleading info and generally radical in it's views.
However, when I delved into the depths of Laurie Garret's book, I realized that she wrote a wonderful text full of insight about our future as far as our healths are concerned. With the recent rise in Anti-biotic resistant microbes, and newer diseases not native to America popping up(Nile fever), her book has quite a bit to say about the past, present and future of medicine.
Very in depth, including extensive writing and research of AIDs.
All around a great, though lengthy, read.

Laurie Garrett's book The Coming Plague is an absolute MUST READ for all of us who are interested in the future of the world and the human race. It is a tough book to get through (no speed reading here). It is like a 4th year or graduate university course on the interaction of disease and mankind. It is very troubling and shows again the falacy of "the technical fix" that we have used for the past 100 years or so. If you read and ponder this book and thus understand the relationship between man and the microbes then you will, hopefully, be able to help our decision makers at the local, federal and world levels to make the proper decisions to help the people of the world survive.

Outstanding! This book is an excellent read! I read the Hot Zone 2 years ago and this is even better. Garrett gives fantastic insight and detail concerning many deadly viruses that have attacked humankind in the 20th century and continue to threaten us. Not only this, but she goes on to highlight the feats and bravery of the scientist that have gone to battle with these horrific microbes over the past century. A stunning account of how disease is a part of nature, yet we as humans often aid to its spread. A sobering, eye opening book. As unsettling as it is, some nights it was hard to put down. One of the best books I've ever read. Bravo for Ms. Garrett

This book is The Rachel Carsons' "Silent Spring", The Shakespeares' play. It is one of the most important break-throughs in mans' view of history. Its pertinence and importance cannot be overlooked, and one is guaranteed that it has not been. If you have not yet discovered this book, be prepared to be taken on a journey - it shall not end with this. Laurie Garrett will give you the urge to actively seek more knowledge and understanding in this area; and if you already do, then it shall hopefully spur an interest in the interdisciplinary knowledge that can be gained. A MUST !!

Garrett portrays up-and-coming 20th century diseases with fine detail; the stories, the first-hand accounts, the pain, the agony, the success...the ignorance. This book is chocked full of incredible stories and people who are just trying to live their lives and others who are trying to help mankind live their lives. One of the best books I have ever read, not for the scientifically illiterate or weak at heart! Bravo!

Beautiful narrative style. Shows the history and the politics behind some of the most deadly "bugs" out there. Want to know about the diseases up to 1995,then this is it. Huge notes section with indepth index. All this packed into 750 pages.

Who has created this mess? Its about to happen, swine flu may not be the big one, but there is a big one coming as this book clearly shows! This book needs to be read but all concerned persons!

And to help protect yourself, read its twin:

The Poisoned Needle: Suppressed Facts about Vaccination

It will show you how it started and what you must NOT do to stay safe!

Laurie Garrett is good at story-telling, and this fact makes some chapters of The Coming Plague quite interesting. In particular, chapters recounting the history of early experiences with hemorrhagic fevers are good reading. Later in the book, the author's agenda for increased public health initiatives comes into play. This is not all bad, but the book borders on being sensationalistic in the service of this agenda. The world is not the same--socailly, politically, economically--as when the plague wiped out Europe or the flu devastated the US. To say we must be constantly vigilant or will be destroyed by a virus is akin to fighting an ongoing war with Oceania.

Some of the science in the book is out of date now, anyhow.

A good read, but don't vote, change your life, or write papers based on this book.

The first 5 chapters were wonderfully written. After that, it just became preaching. The Yambuku Ebola epidemic and the Bolivian Machupo were the best. Once into the last half, the chapters were nothing more than hot air to take up pages. From a ten year old avid reader (especially of this genre): buy it.

I havent read this book yet but Im seriously thinking about buying it. Another book that I have read which deals with the smallpox virus is "The Demon in the Freezer" by Richard Preston. It is pretty scary in itself.

I wanted a book on pandemics and diseases, not thinly veiled anti-Republican politics. I can say with 99% certainty that the author is a Democrat. If the author happens to read this: how do you think I know that? Do a word search for Reagan or Bush and think whether your commentary is really necessary. Yes, we get that you think Reagan is racist, etc. Not everyone thinks so and it detracts from your story. When talking about AIDS, the author included gems like "Some public health officials critical of the Reagan administration argued that there was a racist subtext to the debate..."

And in some instances, the attempt to interject politics or add a racial component made the reading cumbersome. This is a quote from the book, with the parens included as written:

"It would be more than a year before the Reagan administration's health leadership would accept the idea that AIDS in Africa was primarily heterosexual. The administration would never fully acknowledge that the virus might also be heterosexually transmitted in the United States. Indeed, disputes over heterosexual transmissibility of the virus and the applicability of the African (read: black) experience to the Euro-American (read: white) context would rage within the upper echelons of the U.S. government throughout the eight-year-long Reagan administration and well into the term of his successor, George Bush."

Really? The author had to add in "(read: white)" and "(read: black)" to make the issue about whether AIDS was spreading heterosexually a racist issue?

When I read a science book, the author's political views shouldn't be so obvious.

Good alternatives if you don't want a hefty dose of biased politics mixed in with otherwise good content:

"The Fatal Strain" - an excellent book an H5N1
"Spillover" - another top notch book covering in detail the numerous diseases that are "spilling over" from animals to humans, from Ebola to pandemic influenza
"The Viral Storm"
"The Great Influenza" (which covers the 1918 pandemic in wonderful detail)
"The Demon in the Freezer" (which focuses on Smallpox)
"Biohazard" (an outstanding book about Russia's bioweapons program, written by a defector from their program)
"The Hot Zone" (a slightly dated, but outstanding read about Ebola)

All of the above books are great and they don't have Laurie's liberal politics sprinkled throughout.