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Medical. Science. Nonfiction. HTML: A masterpiece of science reporting that tracks the animal origins of emerging human diseases, Spillover is "fascinating and terrifying ... a real-life thriller with an outcome that affects us all" (Elizabeth Kolbert, author of The Sixth Extinction).In 2020, the novel coronavirus gripped the world in a global pandemic and led to the death of hundreds of thousands. The source of the previously unknown virus? Bats. This phenomenon—in which a new pathogen comes to humans from wildlife—is known as spillover, and it may not be long before it happens again. Prior to the emergence of our latest health crisis, renowned science writer David Quammen was traveling the globe to better understand spillover's devastating potential. For five years he followed scientists to a rooftop in Bangladesh, a forest in the Congo, a Chinese rat farm, and a suburban woodland in New York, and through high-biosecurity laboratories. He interviewed survivors and gathered stories of the dead. He found surprises in the latest research, alarm among public health officials, and deep concern in the eyes of researchers. Spillover delivers the science, the history, the mystery, and the human anguish of disease outbreaks as gripping drama. And it asks questions more urgent now than ever before: From what innocent creature, in what remote landscape, will the Next Big One emerge? Are pandemics independent misfortunes, or linked? Are they merely happening to us, or are we somehow causing them? What can be done? Quammen traces the origins of Ebola, Marburg, SARS, avian influenza, Lyme disease, and other bizarre cases of spillover, including the grim, unexpected story of how AIDS began from a single Cameroonian chimpanzee. The result is more than a clarion work of reportage. It's also the elegantly told tale of a quest, through time and landscape, for a new understanding of how our world works—and how we can survive within it.… (more)
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The book is absolutely terrifying, even though Quammen takes pains not to oversensationalize his subject (in fact he takes exception to Richard Preston's having done just that in The Hot Zone). It's simply the facts of the case as Quammen lays them out: these diseases are nasty, they're lurking, and sooner or later, one of them is very likely to cause "the next human pandemic." Since I don't follow the professional virological literature, I was astounded to learn about the role of bats (particularly large Asian fruit bats) as reservoir hosts of these nasty bugs; Quammen devotes much attention to this, to great effect.
While Spillover gets just a touch repetitive over the course of the book (the text of which runs to 520 pages), I didn't actually mind all that much, since the repeated bits generally proved a useful refresher. This is a book which I hope will have a large audience: as Quammen notes, humanity is anything but a passive actor when it comes to disease evolution and spread: our actions over the last centuries and decades have laid the groundwork for much of what may come, and we are, whether we like it or not, completely entangled in the ecological processes of our planet.
Terrifying, yes, but read it. You'll learn something.
Spillover: that time point where the disease, which may have evolved through millennia with its animal host, comes in contact with a new host, including humans, and causes their infection.
This is a brilliant book of
Quammen begins his story by recounting a recent zoonotic spillover event—the outbreak of Hendra virus in Australia that killed race horses and the people that work with them. He outlines the epidemiological detective work in determining the virus, its natural animal reservoir and the mode of transmission into racehorses. He speculates why the virus made the jump at this particular time.
And then he does it again with dozens more infectious outbreaks, each a puzzle of its own. Some of these are frightening with high death rates and overly sensational headlines: Ebola, SARS, Influenza, AIDS and the not quite as deadly Lyme disease. Others are less well known but are also killers : Q fever, psittacosis, typhus and even the vector borne malaria.
Each infection has an interesting story to tell by itself. Each one adds to the store of knowledge and we find the patterns:
----The next epidemic is liable to occur from a virus with RNA as its genome rather than DNA due to its high rate of mutation and evolution.
--A human to human disease with no animal reservoir can be eliminated from the planet (smallpox)—but one that lurks within an animal host cannot be eradicated without eliminating all the members of the natural host species.
--The deadly influenza outbreak of 1918 is liable to happen again as influenza has two host species (birds and swine) whose specifically evolved influenza viruses can recombine within a single host into deadly new combinations.
--AIDS/HIV most probably entered humans from a single spillover event from an infected ape in 1908. It sputtered along hidden in humans in the jungles of Africa until certain events made it explode into worldwide prevalence in the 1970’s. It has currently caused tens of millions of deaths. Are the small flares of Ebola evidence that it is following the same path?
Finally, Quammen gives the example of tent caterpillars whose numbers increase dramatically every few years. And then their population plummets when they reach a density where a caterpillar-killing virus wipes out almost-but-not-quite all of their population. When the numbers are low enough to contain viral spread, the population of caterpillars can once more begin to rise.
And at last points out the ubiquity of the human race and their exponential growth rate. As we become more and more mobile, and disturb more and more animal habitat with our increased numbers, is there any way to avoid the caterpillar’s fate?
That statement summarizes the one thing Quammen wants to get across in his
"Zoonotic" diseases, of course, are diseases we get from other animals--like rabies when we are bit by infected dogs or bats, Lyme diseases via ticks, H5N1--aka, the "Avian Flu" that comes from handling birds, etc. We don't often think about it, but the processes that allow an organism or a virus to inhabit one species, then jump (or "spill") over into another and successfully reproduce are complex, rather amazing, and fraught with significance when it comes to understanding our place in this giant ecosystem we call "Earth."
Quammen divides the book into sections, with each section focusing on one particular zoonotic pathogen. Hendra, Ebola, SARS..even Malaria, which turns out to have a complex history, part of which is zoonotic. There is an extensive section on HIV that is thorough, even-handed, and absolutely heart breaking. Each section traces the history of the disease, its first appearance, its most recent outbreaks, and the steps people who track such things take to identify, target, and combat it. The book has a ton of heroes, and not all of them are tramping through the bush looking for sick gorillas. Most of them are wearing white coats and working long hours in unremarkable laboratories at various Schools of Public Health.
Read a little ways in, and the odds are your stomach will go a little queasy over the unflinching description of what a horse infected with Hendra looks and sounds like as it is dying. Read a little further, and you will start to wonder if you shouldn't be stocking up on Purell, disinfectant wipes, and possibly Hazmat suits. But read further still, and something strange starts to happen. Instead of becoming increasingly overwhelmed with fear of the potential lethality of every innocuous bug bite, you become enmeshed in the author's portrayal of our seething and volatile environment. The more you read, the more you understand. The more you understand, the less you fear.
Years ago when I lived in Boston, there was a brief scare about West Nile Virus. A number of townships, responding to the panic, hired pest control companies to come spray the communities--a somewhat futile endeavor for places well-supplied in ponds, streams, rivers and lakes. The result was that many mosquitoes were killed, as we're many small fish in the ponds--the exact fish that normal fed off mosquito eggs. And the following season was the worst mosquito season on record. No West Nile Virus made an appearance, however.
The last section of Quammen's book takes us to task for our simplistic approach to things like disease outbreaks, our desire to find the "magic bullet" that will get rid of malaria, or HIV, or Flu, or even gypsy moths, once and for all. Nature, he makes abundantly clear, does not operate via magic bullets. It is a system of checks and balances, wherein every new "check" we create affects the balance of everything else. But if we can't conquer these zoonotic diseases, we can perhaps control them, minimizing the risk they pose and the damage they can do. Until the next unlooked-for pandemic hits, that's the best strategy we've got.
Which, on a micro level, means that you should go ahead and get your flu shot.
Although the subject is a scary one, Quammen isn't out to add to our fears. He stays with the facts, and by
"Yes, we are all gonna die. Yes. We are all gonna pay taxes and we are all gonna die. Most of us, though, will probably die of something more mundane than a new virus. "
And there are scientists out there trying to find the Next Big One while it is still small.
Zoonosis is an animal infection transmittable to humans. And the main topic of this book. Quammen is not a scientist and admits that readily but he is a science author and he had met a lot of scientists - from all possible sides of the ecology and biology worlds. The book is full of information - some of it easily read and understood, some of it very technical - and in that second part is where the ability of Quammen to boil it down to the important points without dumbing it down shines. Add to this a dark sense of humor shown all through the book in places where you least expect and the book does not read as a dry textbook without loosing the knowledge that you may find in one.
Quammen had spent years chasing the viruses that can and make the leap between animals and humans. He did not just sit in a library somewhere reading about it - he actually went to see the scientists - some of them in their modern offices all over the world; some of them in the middle of a jungle somewhere. And when he needed more materials, he did not even talk to the scientists, he just found a local guide and when down a river somewhere in Africa - going after the story, looking at what may be the next one. Because the goal of the book is to look at what happened and why not as a history or a review but as a basis of an attempt to understand what may happen next. And the scary answer is - noone knows.
The parade of diseases and viruses is going chapter by chapter - some of them popular (Ebola, AIDS/HIV-1, influenza, Lyme) , some of them names that you may have heard in passing(SARS, Marburg), some of them you may not even heard of (Hendra - although if you are from Australia, you may have heard of that one). It's part history of the virus itself, part history of the disease and how it evolved, part history of the scientists that isolated it or died trying (and some names will show almost everywhere), part history of the way Quammen discovered the story. He is a journalist before everything so all this is also sprinkled with descriptions of laboratories and university campuses, interviews and meetings, papers and publications. And even if each chapter talks about a single virus (or a group of related ones), the previous pieces snap into place and the analysis uses everything to keep driving the same things over and over in your mind - the animal kingdom has a lot of viruses that we do not know about and any of them can come out and get us - not because it is a malicious little thing but because this is how the nature works.
It is chilling to read how much of what is happening is caused by what we had done. HIV-1 most likely dispersed as fast and as wide partially because of the political situation in Africa - all those expats that were expelled from the new countries and the numerous number of people that went into the countries post independence to help moved and brought viruses with them - and partially because of the state of medical science at the time and the poverty of people in certain countries. One of them ended up being HIV. Just a question of bad luck. But that is just the tip of the iceberg. the ecology is changing so the animals need to change their behaviour and where they live - and this leads to the viruses that are harmless for them to look for new places to thrive... and a virus that is safe in one species is a killer in another. Or sometimes it is still harmless in that second species but then when it jumps one more time, it becomes really bad (Hendra for example).
One thing that this book will do as well is to never look at a bat at the same way you did before - first because there are way too many types of them and second because they seem to carry a lot of those bad viruses. Quammen makes the point that with the number of their species, it was inevitable but still - a bat is a bat... I am pretty sure that by the middle of the book I had lost track of which species caused what exactly but it is not that important unless if you are a scientist. The same for the different kind of monkeys (both in Asia and Africa) - keeping them straight in your head is important to see the connections but Quammen is pretty good at reminding you what else they did.
And as a journalist, he does not presume knowledge. Every time when he goes very technical (and he needs to in a few places), he breaks the barrier and talks directly to the reader - yes, this is hard to understand but it is kinda important... and there isn't too much of it. When he did for math topics, I smiled (my background is there), when he did it for biology themes, I could agree with him - my head hurt from just reading that particular passage.
The book is a bit uneven - the first and last chapters are smoothly running even when they cover a lot of ground but in the middle, the book stalls a bit. There is only so many ways to say that RNA viruses are bad and why; that bats are causing issues and why. And it piles on top of the previous section - it does not make it boring or unreadable but it slows down - it feels as if too many details on the same topics had been crammed. I suspect that it is because he did talk to way too many scientists and decided to go through their stories anyway but maybe a summary of some of those would have worked better. The book picks up its pace though - when there is enough theories to go around. Maybe the problem in that middle section was that there are no theories left there - nor there were too many to start with in that particular topic and there are not so many non-science things to say - so things repeat themselves.
One place where Quammen fails is when he tries to be a fiction writer and imagine how HIV-1 moved from the isolated village where the spillover happened and conquered the region. His prose is flat and boring... he tries to create characters and he fails to - miserably so. The conjecture of what might have happened could have been great in someone else's hands but in his, it just does not work. Thankfully it is just a couple of sections (out from 115) and they are so easily marked that you can just skip them without reading them (well... I did... but wish I had skipped them). Which does not make the book weaker at the end - but it would have been a lot stringer without them.
Considering the topic, calling it a wonderful book is probably not such a great idea but it is. It is the proper mix between adventure and science and history to work - and it lacks ANY of the paranoia that similar books tend to contain. It is reporting - from decades of work and centuries of history with one question at the end - what will be the next one. And as I already mentioned, that is the answer that we may never find until it actually happens.
My rating system is as follows:
5 stars - Excellent, Worth Every Penny, Made It Into My Personal Library!
4 stars - Great book, but not a classic.
3 stars - Good overall, generally well written.
2 stars - Would not recommend based on personal criteria.
1 star - Difficult to read, hard to finish, or didn't finish. Wouldn't recommend purchasing or reading.
In accordance with the FTC Guidelines for blogging and endorsements, you should assume that every book I review was provided to me by the publisher, media group or the author for free and no financial payments were received, unless specified otherwise.
For instance, it never occurred to me that bats could be a huge, huge vector for types of viruses. But they do explain the spread of Nipah, Marburg, and possibly Ebola (very mobile, large population density, and when they poop it goes everywhere). Part historical view, part travelogue shadowing scientists in the field makes for a comprehensive picture of what is known and where to look next.
In the epilogue Quammen considers the word 'outbreak'- a giant population influx in a short amount of time, often used for disease but also for insects (like the cicada one due any time on the east coast). Insect outbreaks are usually kept in check by viruses. As we speed past 7 billion humans, we're certainly in the middle of our own outbreak on the planet so... are we due for a pandemic? The answer is probably yes, but we can be smart about our habits and practices to prevent a larger toll.
Whether dealing with interviews, history, hard science, journeys to unravel questions re. hosts or nature, or speculation about what's to come, each moment of the text is frighteningly readable, and moves so quickly that the book is difficult to walk away from. This is an impressive work, and well worth reading--for anyone.
Absolutely recommended.
problems which are coming faster and faster.
The writing is long-winded and here and there is inclining toward gossip and fiction more than science reporting
On the narrative/writing style, it was better "Congo" by Crichton (the book often make you think to that predecessor).
Nonetheless, it is
In Italy, it resulted also in a new edition of the book (I read the English version).
Anyway, if you liked "Guns, Germs, and Steel" by Diamond, probably this book (albeit also in this case I liked more Diamond's writing style) could add some few ideas and points.
Beside the obvious reason for reading the book now (COVID-19), it is interesting to read it also as a framework of ecological systemic thinking.
So, forgetting that it is about viruses and their cross-species lifecycle, it could be useful for other purposes and conceptual analyses
Therefore, if boring at times, worth reading
[Review released on 2020-06-06]
Written before COVID19, this book is