Microbe: Are We Ready For The Next Plague?

by Alan P. Zelicoff and Michael Bellomo

When we've become used to a world where death by infectious disease is relatively rare in the West, the prospect of a deadly epidemic is chilling. In this book Alan P. Zelicoff and Michael Bellomo take a somewhat sensationalist look at the theme of America's capacity to deal with a microbial onslaught. Using case studies of some of the most fearsome diseases, the authors examine what they can teach us about preparing for outbreaks, and what remains to be done.

The book covers a number of zoonotic diseases (ones spread by animals), and explains why they can be so much more serious than those passed on by humans. It also covers purely human diseases, and explains why they don't always obey the general trend of becoming less severe over time. The authors argue convincingly about the need for closer communication between health professionals and vets in different fields when it comes to spotting and heading off an outbreak. It's no coincidence that Zelicoff happens to have created a computer system for syndrome reporting designed to do just that. He's blowing his own trumpet, but that doesn't invalidate what he has to say.

On the topic of SARS, the book explores the Chinese government's attempts to cover up the scale of the outbreak, and the effect this ultimately had on infection rates. There's a lot about politics because disease control is unavoidably linked to the way governments respond. The chapter on smallpox goes further, detailing an outbreak in Aralsk in the 1970s that the authors believe points to the existence of a Soviet bioweapons programme. With suggestions of more cover-ups we're getting into the realm of shocking conspiracy theories. However this sensationalist treatment of the subject matter, combined with a very accessible writing style, does mean the book is a fast, captivating read.

The scares continue with information about the prions that cause BSE and other diseases. Prions don't even have DNA or RNA, so they're very strange pathogens indeed. There are also details of the hardy and unusual bacteria responsible for Legionnaire's disease. The stories of these and other infectious diseases are illustrated with a good deal of historical depth, making for some colourful accounts.

The middle chapters are devoted to the flaws in diagnosing infections, fixing the public health system, and methods of surveillance and reporting. These sections are a little repetitive. The authors then go on to discuss the pros and cons of different vaccination methods. They then illustrate what might happen in a real outbreak, using a couple of fictional scenarios. These are perhaps a little redundant given the wealth of real-life examples there already are in the book, but they drive the authors' points home.

Microbe: Are We Ready For The Next Plague? is a suitable introduction for non-scientists to the issue of disease control. In spite of the slightly alarmist tone it takes it's got plenty of practical ideas for limiting the spread of disease, and it explains all the basics clearly. This is a useful, highly readable book.