Spillover: Animal Infections and the Next Human Pandemic Info

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"[Mr. Quammen] is not just among our best science
writers but among our best writers, period." ―Dwight Garner, New
York Times

The next big human pandemic―the next
disease cataclysm, perhaps on the scale of AIDS or the 1918 influenza―is
likely to be caused by a new virus coming to humans from wildlife.
Experts call such an event “spillover” and they warn us to brace
ourselves. David Quammen has tracked this subject from the jungles of
Central Africa, the rooftops of Bangladesh, and the caves of southern
China to the laboratories where researchers work in space suits to study
lethal viruses. He illuminates the dynamics of Ebola, SARS, bird flu,
Lyme disease, and other emerging threats and tells the story of AIDS and
its origins as it has never before been told. Spillover reads
like a mystery tale, full of mayhem and clues and questions. When the
Next Big One arrives, what will it look like? From which innocent host
animal will it emerge? Will we be ready?


Average Ratings and Reviews
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Reviews for Spillover: Animal Infections and the Next Human Pandemic:

5

September 30, 2012

Gripping stories with good science
The jargon of diseases can be boring, tedious. There are a lot of acronyms and big words. Worse, we often don't know as much as we'd like -- and usually we aren't very certain of what we do know. Telling a good story given those constraints is hard. But Spillover repeatedly provides gripping stories that still impart a good understanding of what we know about zoonotic (animal-origin) diseases. Even better, the author ties disparate stories together to describe some general trend and possible causes for seemingly new infectious diseases. But I don't want to summarize the conclusions: I want you to go read it. You won't be bored and you'll learn a lot (most definitely even if you've read books like The Hot Zone or the Coming Plague).

Some other notes:
* The author has a less human-centric attitude and a lot of sympathy for the animals, like horses or apes, who sometimes are actually the first animal a disease spills over into only to later infect humans.
* He has a wry tone. When noting the euthanasia of a large number of monkeys (even ones likely not infected with a disease), he notes no humans were euthanized despite equal exposure.
* He provides full references. Some of those papers are quite readable by a non-expert such as this review ([...]) of the importance of bats as reservoirs for infectious diseases.
* The stories are often told from the perspective of the scientists trying to figure out what the heck is really going on. The author is also not afraid to explain when scientists just don't know -- and how they might figure it out more.
* The author went on several field collections where he might have been exposed to a disease being investigated.

If I had any criticisms I would have two:

* The author notes the problem of calling African hunted wild meat "bush meat" which has unsavory connotations to many Europeans and Americans despite Europeans and Americans also hunting wild animals for food. And then he still calls it that repeatedly for the rest of the book (hunted animals are a major source for new infections). I realize this makes it easier to read but it was a bit jarring.
* There is a long, imagined story in the chapters on the origin HIV that is, essentially, imagined entirely with details about a possible river fisherman who gets infected with HIV early on and brings it downstream to the (then) Belgian capitol of the Congo. Elsewhere in the book when the explanation for the origin of a disease required some imagination to fill in a plausible sequence of events, the imaginary stories were a lot less elaborate. I don't think the story detracts from the accuracy of the book: something like that had to have happened to explain the origin of HIV (specifically HIV-1). I was also perfectly entertained and learned a bit about the cultures in the region, but it stood out. It might annoy some so I note you can safely skip ahead when you hit it.

I call these two things out, but even so the book is still excellent. I have some interesting papers I want to read. I also feel I know more about how infectious diseases "work". Best of all, I am less fearful of them as well.
5

Aug 17, 2018

This book is a very detailed look at zoonoses, diseases that cross from animals to people. If it hadn't been quite so detailed, it would have been a 10 star. What I have learned:

1. There are three sorts of host. There is the reservoir host that the disease resides inand may or may not cause disease. Then there is the amplification host where if the original host infects it, or if a vector (like fleas that carry it) does, it will the disease-causing pathogen will multiply to very large numbers. This book is a very detailed look at zoonoses, diseases that cross from animals to people. If it hadn't been quite so detailed, it would have been a 10 star. What I have learned:

1. There are three sorts of host. There is the reservoir host that the disease resides inand may or may not cause disease. Then there is the amplification host where if the original host infects it, or if a vector (like fleas that carry it) does, it will the disease-causing pathogen will multiply to very large numbers. Then there is us! We are often the final host.

2. The biggest natural reservoirs of zoonotic diseases are bats. Especially fruit bats and flying foxes. If you touched a rock that an infected bat did, ate some fruit one shit on, or got bit by the dog that the bat got first, you are at risk. Avoid bats at all cost. Very large numbers of vectors are fleas, mosquitos, flies, lice and ticks.

Now it may seem like bats are more dangerous than other creatures because so many carry diseases but it's not necessarily so. 25% of all mammal species are bats, and it's not known if the same percentage of zoonoses as other mammal groups or if they really are dangerous. Bats breed and live in huge numbers and no one minds if they are caught and their blood sampled or even killed for necropsies. Doing that to, say, large numbers of lions, monkeys, elephants or other much-loved mammals is another issue entirely. But they might be as zoonotic pathogen-ridden as bats, we just don't know. So if you like bats (I do) they should be our friends from a distance.

2. Lyme Disease. If you like rambling in the woods where this is present, choose a year when there haven't been many acorns and go to a big wood rather than a little copse. In little copses there may not be many mammals but there will probably be the white-footed mouse which is a reservoir of the disease. In a good acorn year it will breed like crazy, unchecked. In a bad acorn year, there will be less of them and in a big wood there are many predators for whom they are a major food source. Fleas breed on these mice who are not very good at grooming them away. The suck bite the deer as they need the blood to breed (much as mosquitos do on us), but are not really relevant in Lyme Disease as just one deer could supply enough blood for millions of ticks to suck on. It is keeping down the sweet little mice that keeps down Lyme Disease in an area.

3. Zoonoses are in general pretty rare, there are only 150 known ones and they don't cause major epidemics these days although they do cause small, limited but extremely newsworthy outbreaks like Ebola, rabies and dengue. Bubonic plague, the Black Death, is a zoonotic disease that was perhaps the worst disease the world has ever faced. But these days, antibiotics cure it quickly.

I've had dengue. There is no treatment for it and it isn't nicknamed bone break disease for nothing. I moved house with it. Easiest move in my life. I just lay there while all around me packed and moved, then they lifted the mattress into the van and transported me to my new house. By the time i was well enough to walk to the bathroom by myself, everything was spick and span. It was about ten days start to finish. Very nasty.

Very interesting book, I had to skim bits at times because it was as detailed and repetitive as a text book although, mostly, considerably less dry. I learned a lot and for that it's definitely a 5 star read.
____________

Notes on reading the book. (view spoiler)[This is as good as The Boilerplate Rhino: Nature in the Eye of the Beholder, a book I read years ago. I'm learning a lot ab0ut zoonotic diseases, which are very common, and why, because the only host is the human, polio and smallpox could be wiped out. I love science books about subjects I know very little. I love writers that can make writing about science a page-turning experience. (hide spoiler)] ...more
4

Oct 01, 2012

You have to understand. I have my phobias. So it makes for awkward social encounters. Like: “Mommy,” said the little girl in the elevator, “Why is that man holding his breath the whole way down from the 16th floor?” I have been known to say things like, “Will you please stop sneezing in the direction of my beer?” I went to a doctor’s office a few years ago. Nothing ultimately serious, but possibly so, so that I went for the quickly scheduled appointment even though I was already nursing a bad You have to understand. I have my phobias. So it makes for awkward social encounters. Like: “Mommy,” said the little girl in the elevator, “Why is that man holding his breath the whole way down from the 16th floor?” I have been known to say things like, “Will you please stop sneezing in the direction of my beer?” I went to a doctor’s office a few years ago. Nothing ultimately serious, but possibly so, so that I went for the quickly scheduled appointment even though I was already nursing a bad cold. He wouldn’t have to touch my face, I safely predicted. It was a doctor I had never seen before, and after the usual 15-minute wait in solitary, he came in to the examination room with a game show-host smile and extended his hand, like, you know, we were soon to become new best friends. So I put up my hands defensively and said, “Sorry, but I have a cold and it’s better not to shake hands.” I figured, as a doctor, he would appreciate my candor and consideration for him and the many patients to follow. Well, he kept his hand out for a minute, as if I had slapped him, clearly thinking about what I had said. Then, with a busy officiousness, he strode to the sink and vigorously washed his hands with some anti-bacterial goo. This gave me pause. Why was he washing his hands after I declined shaking his hand and not before he offered it?

I share this because the last thing I really need is to read a book about Animal Infections and the Next Human Pandemic. Like going to see an obvious Horror movie, I know I will be scared. Yet, we plunk down our money, watch the predictable script and wait for the creepy Pavlovian organ music to raise the hair on the back of our necks. So, scare me shitless, David Quammen. I gots to know.

It is not until page 511 of this 520-page book that Quammen raises the question that he is often asked by those learning he is writing such a book: “Are we all gonna die?” And the answer is: Yes, we’re 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 lately emerged from a duck or a chimpanzee or a bat.

Most, but not all of us.

This is a book about zoonosis, animal infections transmissible to humans. AIDS is one. Rabies. Ebola. Marburg. Influenza. Beware the animal reservoir. That would be the animal that ‘hosts’ the virus, safely unto itself, but potentially lethal when it jumps, when there’s a Spillover to humans. So don’t nosh on raw monkey or ape bushmeat, no matter how prized that delicacy is in the culture you’re visiting. Don’t place your pigsty under the mango tree. And don’t under any circumstances drink the palm sap. If you happen to crawl into an African cave, you know, for the experience of being underground with stale air, no natural light, thousands of bats peeing on you from above and a few cobras slinking through your feet, all without a biohazard suit, do not under any circumstances reach down for balance and touch the bat guano with your bare hand. Trust me, bad shit happens.

I learned more reading this book than I did in two semesters of indifferently-attended college biology classes. Not that I can articulate the difference between microbiology and molecular biology, or other things unnecessary to get through the day. But how about this? Of all the mammals in the world – every dog, every deer, every kittycat – every freaking mammal, one in four is a bat. That’s: 1) a lot of bats ; and 2) a bad thing. Also, if you go to the Dominican Republic or some other exotic island and one of the locals comes along the beach to put a macaque on your head for a cute picture to send home to the family, resist the tourist urge. You may be bringing home something more than a Kodak moment.

Quammen has found the right level of transmission to get these notions of science and math across to an idiot like me. And, even if I failed him, I was nevertheless entertained.

Here is the way to start a chapter:

In late February, 2003, SARS got on a plane in Hong Kong and went to Toronto. But soon we are learning more about bats, three species in particular carrying SARS-like virus: the big-eared horseshoe bat, the least horseshoe bat, and Pearson’s Horseshoe bat. Waxing smart-alecky, Quammen quips, “If you ever notice these animals on the menu of a restaurant in Southern China, you might want to choose the noodles instead.

But I like smart-alecky.

So I was scared, entertained and enlightened. Sometimes a single sentence would send me happily to both a dictionary and Google, such as this description of his first meeting with a researcher in Guangzhou: I suppose the durian should have been my first signal that he was a temerarious eater.

One last, lingering piece of advice I will share:

If your husband catches an ebolavirus, give him food and water and love and prayers but keep your distance, wait patiently, hope for the best—and, if he dies, don’t clean out his bowels by hand. Better to step back, blow a kiss, and burn the hut.

Wise words. Which I pass along, like a reservoir host, as a public service.
...more
5

May 24, 2015

Click here to watch a video featuring this book on my channel, From Beginning to Bookend.

5

Dec 02, 2014

https://clsiewert.wordpress.com/2015/...

David Quammen is prescient. He appears to have predicted the 2014 Ebola outbreak and ability to country jump years before it happened. Alright, maybe he isn’t a diviner; maybe he merely pays attention to the scientists around him. After all, there’s a reason he is has been given an Academy Award in Literature and is a three-time winner of the National Magazine Award. Spillover: Animal Infections and the Next Human Pandemic explores the science behind human https://clsiewert.wordpress.com/2015/...

David Quammen is prescient. He appears to have predicted the 2014 Ebola outbreak and ability to country jump years before it happened. Alright, maybe he isn’t a diviner; maybe he merely pays attention to the scientists around him. After all, there’s a reason he is has been given an Academy Award in Literature and is a three-time winner of the National Magazine Award. Spillover: Animal Infections and the Next Human Pandemic explores the science behind human pandemics, and is a culmination of decades-long interest in animals, biology and travel. It is also an intelligent, thoughtful, and occasionally humorous book about the intersection between humans, disease, public health and the animal kingdom.

"Made no mistake; they are connected, these disease outbreaks coming one after another. And they are not simply happening to us; they represent the unintended results of things we are doing. The first crisis is ecological, the second is medical."

The writing is excellent and well-researched, with a list of citations for each chapter. While clearly well versed in biological concepts and the professional scientific field, Quammen writes with an eye to description, creating a liveliness in his stories. When I looked up his biography, it was with no real surprise that I learned he studied William Faulkner on a Rhodes scholarship–like Faulkner, he clearly has a deep love and respect for the natural world. The writing conveys complicated biological concepts in a way that captures the essence without oversimplifying, leaving both the novice and the more knowledgeable reader satisfied. If I have one complaint, it is that the humor present in his short stories isn’t as present; a fitting approach for the somberness of the subject, but I miss it nonetheless. Most of the humor here acknowledges journalistic license but a fair amount relates to the research process:

"If you read the recent scientific literature of disease ecology, which is highly mathematical, and which I do not recommend unless you are deeply interested or troubled with insomnia, you find the basic reproduction rate everywhere."

What takes this book a step beyond the ordinary is that Quammen goes to where the science happens. Interviewing scientists in person, their anecdotes give the research the human touch, and are both instructive and amazing. I found myself deeply wishing my career had taken a different track–but I’m not courageous enough to be a field scientist. The scientists who are looking for the Ebola reservoir are particularly adventuresome: when they collect samples, they do their exploring in full haz-mat gear, including a personal respirator, which leads to interesting challenges. As Quammen summarizes:

"Wait a minute, lemme get this straight: You're in a cave in Uganda, surrounded by Marburg [virus] and rabies and black forest cobras, wading through a slurry of dead bats, getting hit in the face by live ones...the walls are alive with thirsty ticks, and you can hardly breathe, and you can hardly see, and... you've got time to be claustrophobic?'

'Uganda is not famous for its mine rescue teams,' [Amman] said."

Dude. Skydiving and cliff-jumping are for wimps. Trying being a field scientist studying disease.

Just fantastic stuff. If you were ever in doubt about why to get an influenza shot, the information is right here. And why you should be very, very careful about what you eat, particularly game and bushmeat.

**********************************************************


Specific chapter summaries and key points continued at the blog--- just follow under the asterisks
https://clsiewert.wordpress.com/2015/... ...more
5

Jan 29, 2015

"A zoonosis is an animal infection transmissible to humans. There are more such diseases than you might expect. AIDS is one. Influenza is a whole category of others. Pondering them as a group tends to reaffirm the old Darwinian truth (the darkest of his truths, well known and persistently forgotten) that humanity IS a kind of animal, inextricably connected with other animals; in origin and in descent, in sickness and in health." This is what David Quammen preaches in Spillover: Animal Infections "A zoonosis is an animal infection transmissible to humans. There are more such diseases than you might expect. AIDS is one. Influenza is a whole category of others. Pondering them as a group tends to reaffirm the old Darwinian truth (the darkest of his truths, well known and persistently forgotten) that humanity IS a kind of animal, inextricably connected with other animals; in origin and in descent, in sickness and in health." This is what David Quammen preaches in Spillover: Animal Infections and the Next Human Pandemic. Some have already given him credit for predicting the recent Ebola outbreak. If this sounds unappealing, it's my fault. Quammen is a researcher who writes with style and substance. He isn't the type who stays in his cubicle reviewing journals and online information. He is out in the field with his buddies and compatriots giving us a front line perspective on this serious issue.

To say this was an eye-opener for me probably understates its impact. I now think I know that every disease must have a reservoir. Smallpox basically resides in humans and is transmitted only among humans. Other diseases have either living or non-living reservoirs. Tetanus comes from a bacterium that resides in the soil. Cholera comes from a bacterium that resides in contaminated water. "A disease must have a portal of exit from the reservoir and a portal of entry into the host. This is how diseases are spread and new cases of infection occur. Examples of portals of exit are respiratory, the digestive tract, urinary, skin," etc. "Diseases can spread by three different, modes of transmission: contact transmission, vehicle transmission, and vector transmission." Let's remember the title of this book. Quammen is focused on "animal infections and the next human pandemic." A pandemic is an epidemic of infectious disease that has spread through human populations across a large region; for instance multiple continents, or even worldwide.

Quammen points out (and I am surprised as usual) that zoonosis isn't rare. In fact, "about 60 percent of all human infectious diseases currently known either cross routinely or have recently crossed between other animals and us...Ebola...bubonic plague...Spanish influenza...bovine tuberculosis, Lyme disease, West Nile fever...rabies, hanta virus pulmonary syndrome, antharx"...etc.

A lot of this book reads like a mystery. Some one or some thing has died unexpectedly and there is no immediate explanation for it. Quammen takes us along on these investigations. I came to like and respect this writer. He admires good science and points out with disdain efforts that fall short. His writing is intimate, filled with humor (often dark), and engaging.

"Most people aren't familiar with the word 'zoonotic,' but they have heard of SARS, they have heard of West Nile virus, they have heard of bird flu. They know someone who has suffered through Lyme disease and someone else who has died of AIDS. They have heard of Ebola, and they know that it's a very terrifying thing (though they may confuse it with E. coli, the bacterium that can kill you if you eat the wrong spinach). They are concerned. They are vaguely aware. But they don't have the time or the interest to consider a lot of scientific detail. I can say from experience that some people, if they hear you're writing a book about such things---about scary emerging diseases, about killer viruses, about pandemics---want you to cut to the chase. So they ask: 'Are we all gonna die?" I have made it my little policy to say yes."

Quammen is on the lookout for the "Next Big One." Some say his discussion of Ebola gives him a lot of "street cred." He states that few disagree that that Next Big One will be zoonotic. So it behooves us to understand what he is talking about. It's a longish book, but you can get a lot out of a little at a time.

I will leave you with a sample of how he passes on advice: " If your husband catches an ebola virus, give him food and water and love and maybe prayers but keep your distance, wait patiently, hope for the best — and, if he dies, don’t clean out his bowels by hand. Better to step back, blow a kiss and burn the hut.” ...more
5

November 29, 2014

Better than The Hot Zone
I have a weird interest in reading about diseases, and this book is one of the very best in the genre. Quammen writes for National Geographic, and he goes *everywhere.* If there was a disease outbreak in the Central African Republic in 1987, chances are, he has interviewed the doctor who first spotted the disease, the locals whose family members died, and the BSL-4 researchers in Virginia who analyzed it, and he probably also climbed down into a cave where the bat that spreads the disease roosts. This book is better than The Hot Zone. It dispels some of the over-blown language used in that book (people do not dissolve inside from Ebola.) and it is arguably just better writing.

Quammen keeps the balance between travel and adventure writing on the one hand, personal interviews (of the "His desk is piled high with papers, and he's wearing blue corduroy slacks and a black turtleneck and wire-rim glasses" type), and real science writing. You learn a lot about diseases from the microscopic level to the human story of what it's like to have the disease, to the incredible courage and dedication of the people who fight the diseases, whether in the clinic or in the lab.

Realistically, most of us are at essentially zero risk of dying of Ebola, but Quammen balances that with insight into things that might really harm us--SARS, AIDS, and the good old flu, which could still come roaring back as a killer.

I was sorry when it ended.
4

May 01, 2018

Quamman explores zoonotic diseases, infectious diseases caused by pathogens that “spillover” from animals to man. The pathogen may be a virus, bacteria or parasite. Zoonotic diseases include well known ones like Ebola, Lyme disease, SARS, and AIDS, lesser known ones like Hendra virus, Marburg virus and Q fever, and ones just being recognized as zoonotic such as some forms of malaria. Zoonotic diseases require a reservoir animal, an animal that sustains the virus without serious complications. Quamman explores zoonotic diseases, infectious diseases caused by pathogens that “spillover” from animals to man. The pathogen may be a virus, bacteria or parasite. Zoonotic diseases include well known ones like Ebola, Lyme disease, SARS, and AIDS, lesser known ones like Hendra virus, Marburg virus and Q fever, and ones just being recognized as zoonotic such as some forms of malaria. Zoonotic diseases require a reservoir animal, an animal that sustains the virus without serious complications. Reservoir animals feed a cycle of epidemics. The virus can be eliminated from all humans and still come back. Non-zoonotic infectious diseases like polio, smallpox and measles can be eradicated once the pathogen is eliminated from every human. Some non-zoonotic diseases may have originally jumped from an animal, for example measles from goats or sheep.

Zoonotic diseases may require a vector like a mosquito. A pathogen may jump from a bat or monkey to a human and then from human to human. Or it may jump to an intermediate animal that reproduces it in large quantities sufficient to infect humans. The reservoir animals for the Hendra virus are fruit bats, which pass it to horses, which are “amplifier” animals that pass it to humans. Fruit bats are suspected as the reservoir animal for Ebola. Gorillas and chimpanzees are susceptible to Ebola just like humans and many thousands have died from it. Outbreaks in humans have been caused by eating infected gorilla and chimpanzee meat.

It is important to consider the ecosystem of the animals and organisms involved in spreading infection. Lyme disease is a good example. Deer ticks infect humans and deer are often blamed as the reservoir but they are not. Adult ticks that feed off deer and humans fall off never to bite again. Both humans and deer are dead ends. They don’t spread the disease. Larval ticks feed off of small mammals such as shrews, chipmunks and particularly mice which are the reservoir animals for the Lyme disease bacterium. Larval ticks become infected from animals that have been bitten by infected nymphal ticks. To control the spread of the disease culling deer won’t work, the mice must be controlled, a near impossible task. The best way would be to encourage natural predators such as owls, foxes, weasels and the like. Unfortunately, woodlands today have been divided into ever smaller patches that don’t support these carnivores.

Zoonotic pathogens can be parasites, bacteria, DNA viruses or RNA viruses. RNA viruses like the flu, West Nile, Hendra, HIV and Ebola can quickly mutate turning into new infectious agents. Flu viruses are especially prone to reassortment, a process in which viruses of different subtypes exchange components creating new subtypes. Thus we regularly see new versions of the flu. Retroviruses like HIV are particularly sinister. HIV uses the invaded cell to turn its RNA into DNA which it inserts into the host cell’s DNA, producing more viruses and replicating every time the cell divides. There are a dozen variants of HIV in humans and each is believed to be the result of a separate spillover. Thus the Simian virus, SIV, spills over regularly to the human virus, HIV. While only the main variant of HIV is responsible for most deaths, a new dangerous one could cross over anytime. In contrast DNA viruses such as herpes viruses (only some zoonotic) self-correct errors in replication and have larger genomes. They cannot mutate so quickly and must be persistent in order to sustain themselves. A great example is the chickenpox virus (not zoonotic) that infects children causing an itchy rash. The virus remains after the rash is gone and ramps up late in life causing shingles. Transmission methods for viruses and other pathogens include airborne, oral-fecal (water and food contamination), blood-borne, sexual, vertical (mother to child), or the bite of an animal.

Modern animal husbandry densely packs large numbers of animals in close confinement. For example in the Netherlands dairy goats are housed in huge barns holding thousands of animals creating perfect conditions for the bacteria causing Q fever to grow. Q fever bacteria were spread everywhere when the infected manure was used to fertilize crops. When the fields dried out the wind picked up the loose soil. People downwind breathed in dust full of the highly contagious and lethal bacteria. SARS was spread in China from the markets that sold wild animals (some raised on farms) for food. The animals were crammed together and not cared for by the marketers. These conditions undermine their immune systems making it easier for the virus that had been held in check to spread. Another example is parrot fever carried particularly by parakeets and cockatoos that many breeders keep in close dirty confines allowing latent infections to erupt.

Statistical analysis can reveal the requirements for an epidemic. There must be a critical mass, a sufficient number of susceptible individuals in sufficient density. Then a virulent pathogen will quickly spread. But those who die and those who recover (now immune) are no longer susceptible. When the number and density of those susceptible falls too low the epidemic is over until the susceptible population is replenished, an endless cycle. Concentration and number of pathogens and their infection rate also have required parameters, different for each disease. A good analysis of these factors can predict which measures to control the outbreak will work and which won’t.

Quammen’s book consists largely of descriptions of outbreaks, each crafted as a detective story. People get sick, die and nobody understands it. Tenacious doctors, veterinarians and scientists come to investigate. Some work in labs identifying the pathogen. Others track the associations of the victims. Still others figure where to look for animal hosts, collect samples and get them to the labs. Quammen embellishes these stories with frightening descriptions of the disease spread and the victim’s plight. He details the many hurdles the investigators must overcome. Their aim is prevention. Too often there is little that can be done for the victims. After typically years of work and false leads they identify the reservoir animal and the means of transmission. It is a repetitive story and one doomed to repeat time and again.

As human population expands and encroaches on natural environments and as wild species adapt to human presence and expand into human habitat, we will see evermore spillover. The increasing number and density of both people and the animals they eat favor the spread of zoonotic diseases. Poor countries with limited resources are particularly prone to epidemics. Wherever disease breaks out, modern day frequent travel and extensive global supply chains can quickly spread it to distant locations. Quammen expresses particular concern about the flu virus given its ability to reassort potentially mixing highly infectious and lethal subtypes. But whether flu, HIV or something new we can be sure we will be facing many more epidemics. The good news is that modern science gives us many tools to contain these outbreaks. However, the current wave of science bashing, nationalism, politicizing and underfunding government agencies is troubling. We need the institutions defending us against communicable diseases such as the CDC and its counterparts to have the resources, science based direction and international cooperation that are essential to be vigilant and responsive. ...more
5

Oct 10, 2012

Full disclosure first, I'm a fan of this type of non-fiction. Laurie Garret - The Coming Plague, Richard Preston - The Hot Zone, Randy Shilts - And the Band Played On... the list goes on and on. I love this stuff. But having said that, this is truly the best thing I've ever read on the subject of infectious agents spilling over from their host species into humans. Brilliant, readable and absolutely spell-binding, Quammen's description of mutation, illness and the effect of human encroachment Full disclosure first, I'm a fan of this type of non-fiction. Laurie Garret - The Coming Plague, Richard Preston - The Hot Zone, Randy Shilts - And the Band Played On... the list goes on and on. I love this stuff. But having said that, this is truly the best thing I've ever read on the subject of infectious agents spilling over from their host species into humans. Brilliant, readable and absolutely spell-binding, Quammen's description of mutation, illness and the effect of human encroachment into different environments turns science into art. Without a doubt this guy knows his stuff and how to write about it. Highly recommended! ...more
5

Aug 18, 2012

Disclamer: I received this book from the Goodreads First Reads Giveaway program.

I'm very grateful that I did. I happen to be a physician, specializing in Public Health and Preventive Medicine. I work in an environment where epidemiology underlies everything I do. Therefore, I feel that I can give an especially educated evaluation of this book.

The first thing I would like to comment on is the cover. It's an eye-catching blurred photograph of a screaming mandrill. Everywhere I carried the book Disclamer: I received this book from the Goodreads First Reads Giveaway program.

I'm very grateful that I did. I happen to be a physician, specializing in Public Health and Preventive Medicine. I work in an environment where epidemiology underlies everything I do. Therefore, I feel that I can give an especially educated evaluation of this book.

The first thing I would like to comment on is the cover. It's an eye-catching blurred photograph of a screaming mandrill. Everywhere I carried the book (which is everywhere at work; I could not put it down) people looked at it and asked me what I was reading. Beautiful and suitable, the artwork sets the stage for the gripping narratives contained within.

This is a book written for the intellectually curious. Quammen, as a journalist, understands that some of the material covered in this book can be esoteric for those not trained in the subject. He explains complex subjects clearly, and this is the important part, does not condescend or dumb it down. This makes the content accessible to everyone who may be interested, and the material is fascinating.

As a public health physician, I thought I was fairly well-informed on the subject of zoonoses. I was delighted to find that this book is chock full of new, up-to-date information, and I had never even heard of some of the diseases he discussed. For example, I had though the reservoir for SARS was the civet cat. I had no idea that it was...well, you have to read the book. This book is as gripping and suspenseful as any thriller or mystery, and more terrifying, to boot, since this is non-fiction. As I am typing this, Hanta virus is affecting visitors to Yosemite National Park, Ebola is breaking out in Uganda and The Congo, and who knows what other mystery illnesses have yet to be identified and are lurking for the opportunity to breakout into the greater population.

David Quammen has a delightfully sardonic sense of humor, and as he spins his tales, backed with a tremendous amount of field work on his part, one feels as if they are right there in the field with him and the researchers collecting bat piss (yes, really) or strolling the Hong Kong markets, or munching on Bamboo Rat hot-pot (apparently mild and sweet, quite tasty).

I found myself reading the book like a good, no, excellent, novel. Normally with non-fiction, I pick it up and put it down in spurts. This book is so engrossing, though, that I found myself even walking down the street from the train station to work while reading this (a substantial hardcover, mind you). Quite a few of my co-workers want to read it, particularly the epidemiologists and physicians, but please don't hold back if you haven't got the background. This book is written so as to be accessible to anyone who has the interest. Everyone should be interested. The next big outbreak is inevitable because of human manipulation of climate, habitat and overcrowded conditions and intrusions into the wild, bringing us more and more in contact with potential pathogens. This book is a sobering look at the changing conditions in the world and how they leave us very, very vulnerable. This is easily the most frightening book I have read in a long, long time. Thank you, David for the work of love that produced this.

Note for Goodreads: the page count is wrong; please correct it. The correct page number is 520 pages of text, plus a long reference section. ...more
5

Sep 28, 2013

A "spillover" occurs when a microbe crosses over from an animal to humans, as an infectious disease. David Quammen describes many examples of this: SARS, ebola, HIV, influenza, marburg and hendra.

Each chapter is a detective story--scientists, veterinarians and medical researchers are detectives searching for the source of a disease. The source is usually a reservoir--an animal that carries the microbe, but is not usually harmed by the microbe.

And--now here's the best part--Quammen is not a A "spillover" occurs when a microbe crosses over from an animal to humans, as an infectious disease. David Quammen describes many examples of this: SARS, ebola, HIV, influenza, marburg and hendra.

Each chapter is a detective story--scientists, veterinarians and medical researchers are detectives searching for the source of a disease. The source is usually a reservoir--an animal that carries the microbe, but is not usually harmed by the microbe.

And--now here's the best part--Quammen is not a stay-at-home researcher. He visits the scientists and interviews them over extended periods of time. And better yet--he accompanies scientists on research expeditions all over the world, in search of the reservoirs for terrible diseases. Quammen describes, in detail, what it is like to hunt for elusive viruses in bats, chimpanzees, monkeys, and horses. Often, the researchers must take special precautions to avoid being infected themselves. Sometimes these precautions fail, with awful consequences.

Quammen investigates why spillovers occur when and where they do. It's a combination of ecology and evolution. A microbe is carried by an animal reservoir, and usually in equilibrium where the animal is unharmed. Then, some dramatic change to the environment occurs, usually it is caused by humans impinging on the local ecology. The microbe mutates and jumps either to a vector (like a mosquito or a rat) or directly to a human. Further mutations then allow the microbe to jump from one human to another, causing an epidemic.

Researchers agree that in the future, there will be lethal epidemics like AIDS and the influenza pandemic of 1918. Such epidemics are totally unpredictable, because of the diversity of human behavior.

David Quammen is an excellent writer--he has a wonderful style. It is obvious from his enthusiasm and from his extensive travels, that this book represents his life-long efforts. Spillover is a sequence of detective mysteries and adventure stories, all rolled up into one. I highly recommend it!
...more
5

November 11, 2015

Simply the best
Gripping, fascinating science written in a flowing, easily digested style. To say I enjoyed this book would be an understatement. I was utterly enthralled by this book. You'll find the familiar subjects here; Ebola, HIV, etc. But you'll also find viruses you've likely never heard of, learn how biological reservoirs work (as much as they are understood at least), and the vital role of amplifiers in the lives of certain viruses. The various viruses are almost characters in and of themselves as the author delves into how, and why, they do what they do. Even the largely speculative chapter on how HIV might have gotten out of rural Africa and into the cities is fascinating.

If you loved The Hot Zone, this is that book's bigger, brainier sibling. If you are at all interested in biology and physical science, you MUST read this book.
5

Dec 07, 2012

(4.5) This exposé of zoonoses (diseases passed from animals to humans) is top-notch scientific journalism: pacey, well-structured and entirely gripping. Although it’s a rather sobering topic, this is not scare-mongering for the sake of it; indeed, Quammen frankly concludes that we are much more likely to die of heart disease or fatal car crashes: “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 much more (4.5) This exposé of zoonoses (diseases passed from animals to humans) is top-notch scientific journalism: pacey, well-structured and entirely gripping. Although it’s a rather sobering topic, this is not scare-mongering for the sake of it; indeed, Quammen frankly concludes that we are much more likely to die of heart disease or fatal car crashes: “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 much more mundane than a new virus lately emerged from a duck or a chimpanzee or a bat.” Still, you can’t help but wonder: what will be the next major pandemic? When, where and how will it happen; how severe could it be?

(See my full review at Nudge.) ...more
3

Dec 04, 2012

This book was an exciting and informative tour of zoonotic diseases, but the fragmented style diminished my enjoyment. Quammen practices an annoying form of gonzo journalism in which he needlessly inserts himself into the narrative because he is too lazy to do otherwise.

There are numerous throwaway chapters that are included for no other reason than because Quammen made a trip or did the interview. For instance, many pages are devoted to the unenlightening tale of a scientist who accidentally This book was an exciting and informative tour of zoonotic diseases, but the fragmented style diminished my enjoyment. Quammen practices an annoying form of gonzo journalism in which he needlessly inserts himself into the narrative because he is too lazy to do otherwise.

There are numerous throwaway chapters that are included for no other reason than because Quammen made a trip or did the interview. For instance, many pages are devoted to the unenlightening tale of a scientist who accidentally pricks herself with an Ebola-carrying needle. We learn of this woman's childhood, educational background, family life, the cleanliness of her home, etc. We learn of the boredom of her long quarantine and how she and her friends shared unfunny jokes via email about how her quarantine diet is high calorie. One may think that Quammen is building up to some sort of cliffhanger in which this poor woman ends up showing Ebola symptoms, but it is clear from the start (as he describes his visit to her house and the interview) that this didn't happen. This whole ordeal could have been omitted or replaced with one sentence, but Quammen must feel that every interview he conducts deserves many pages of text. (After a few minutes of reflection, I now realize the author's intent with this Ebola-quarantine section. He is de-sensationalizing Ebola by telling a tale of potential laboratory-borne infection completely lacking any excitement or exploding bodies, in stark contrast to THE HOT ZONE.)

While these aren't direct quotes, the book is strewn with needless editorializing along the lines of "I think the guy who first discovered the cause of malaria is one cool dude," and there are way too many one word sentences like "Boring" or "Neato." Seriously.

Worst of all, near the end of the book Quammen takes a novelistic turn and tells an entirely fictional account of a patient zero carrying AIDS from the jungle of central Africa into the city. While this perhaps is demonstrating a plausible scenario for the first cases of human to human transmission of the virus, the level of trivial detail is infuriating. Should we applaud Quammen for so humanizing his fictional character and eagerly await the publication of his first novel? Or should we be upset that so many pages of a 700 page book are wasted on an Introduction-to-Creative-Writing-quality novella?

Nonetheless, most of the book is enthralling. But I dread the approaching day in which all journalistic nonfiction will be told in this short-attention-span, MTV-News-inspired format. ...more
5

Nov 20, 2013

Pure class from beginning to end - the best science journalism I've read.

It was completely coincidental that I read this just before the 2014 Ebola outbreak... but that did sort of reinforce why this is essential reading!

Plenty of other goodreads reviews have given superb summaries of the content of the novel, so I'll only touch on that briefly - but here's why I personally loved it:

I originally put this on my long-list as research reading. There's a novel I want to write (one day!) that is set Pure class from beginning to end - the best science journalism I've read.

It was completely coincidental that I read this just before the 2014 Ebola outbreak... but that did sort of reinforce why this is essential reading!

Plenty of other goodreads reviews have given superb summaries of the content of the novel, so I'll only touch on that briefly - but here's why I personally loved it:

I originally put this on my long-list as research reading. There's a novel I want to write (one day!) that is set in a an alt-history where humanity was ravaged 18th/19th century by an incredibly contagious but slow killing parasite that crosses from a fictional type of domesticated chimps to mankind.

So... I aced high-school Biology, I've seen Outbreak, I've read the Andromedus Strain and I've played the Plauge Inc app and the Pandemic boardgame - I have a higher than average interest in the mechanics of contagious diseases - but I'm certainly no pro. There were plenty of question marks in my plot regarding how my fictional plague functioned. This book sounded like the perfect, broad spectrum primer for what kinds of diseases had spread from animals, how that worked, and how it could (plausibly enough for spec fic) work.

So that's why it got on my long-list.
Every time I saw a review flash past from a goodreads friend, it was invariably positive.

For the last few years I've been diligently focused on my reading lists - working through all the major sci-fi/fantasy award winners since 1980. It hasn't left a huge amount of space for books which sounded interesting, but weren't award winners. So I created a new reading list called the 'Cup of Tea List' for books that hadn't won awards but sounded like my cup of tea! I picked 10 top books for the list - and this was one of them.

So I eventually got my chance to read it!
And I loved every page.

I love learning new stuff and I thought this was all fascinating and presented in an incredibly accessible way. It's not dumbed-down, but Quammen never talks in the stilted, precise vernacular of the true scientist. He's a damn-fine writer, who happens to really know his science.

At the end of every chapter I wanted to report it all back to my wife. She's kind of squeamish about sickness, so she didn't totally appreciate that, but even she found it interesting.

I've spoken about it so glowingly every since I finished it, that I've loaned it out twice already. If a friend's looking to borrow a book and they have any science leanings at all, I'm there, "dear friend, have you by chance read Spillover yet? No? Let me find where I've put it..."

In football (soccer) rhetoric, there's a running joke that club managers don't have the broadest vocabularies, and a good player is often described as "a top lad". If he's an exceptional player he might be a "a top, top lad" - with each subsequent, more emphatic "top" being reserved for the elite, the world-beaters, etc. With this in mind, I say that Spillover is a top, top, top read, and it'll only set you back a fiver.

Don't wait as long as I did - get yourself a copy now, then lend it to friends!


After this I read: Falling Free ...more
3

Nov 14, 2012

Is it possible to "really like" a book like this? I think I may have shortchanged this book with the three star rating. Hmmm.

But I digress.

It is official- I now know too much. Most of us have probably spent some amount of time thinking about a pandemic. How could we not? Reading this book will not ease said fears. It is unsettling to read how easy it is for an infection to *spillover* (sorry) from animal to human. This book reveals just how easy it is and gives you enough information to scare Is it possible to "really like" a book like this? I think I may have shortchanged this book with the three star rating. Hmmm.

But I digress.

It is official- I now know too much. Most of us have probably spent some amount of time thinking about a pandemic. How could we not? Reading this book will not ease said fears. It is unsettling to read how easy it is for an infection to *spillover* (sorry) from animal to human. This book reveals just how easy it is and gives you enough information to scare the daylights out of you.

Enjoy. ...more
5

May 27, 2014

I found this book fascinating. When I originally got it out of the library, some of my friends were a biiiit concerned that given my GAD was health-focused, this would just make me have a panic attack. I'm happy to report that I was simply happily curious, digging around with great enthusiasm, stopping to google things, etc.

In terms of the level this is at, it's perfectly comprehensible to anyone, I would say. Granted, I do have a background in reading plenty of popular science, an A Level in I found this book fascinating. When I originally got it out of the library, some of my friends were a biiiit concerned that given my GAD was health-focused, this would just make me have a panic attack. I'm happy to report that I was simply happily curious, digging around with great enthusiasm, stopping to google things, etc.

In terms of the level this is at, it's perfectly comprehensible to anyone, I would say. Granted, I do have a background in reading plenty of popular science, an A Level in biology, and various science/medical courses online, but I don't think that puts me much above the layman, really. Where something needs explaining, Quammen does so quite clearly. (Although if you do find this fascinating but a bit dense for you, this course on Coursera might be worth a look the next time it runs. I enjoyed it, anyway.)

So, granted I already find this topic fascinating, but I think this was a good read. It avoided sensationalism, aside from the couple of chapters where Quammen imagined the life of the Cut Hunter from the cut-hunter theory of the origin of HIV, which were a little much for me. That goes beyond adding a bit of human interest into a flight of fancy, which jars with the rest of the book. If you want to think delightedly of Ebola victims as being a sack of liquefied matter, I gather you want to read The Hot Zone (Richard Preston).

It's well-structured, taking us through various different zoonotic pathogens and their implications. The search for the "Next Big One" (the next pandemic) isn't the primary focus, despite the title, and instead Quammen focuses on how the diseases are tracked, particularly how they are tracked to the reservoir species that safely harbour the pathogens until they spill over into other species. It's not hysterical about the fact that there will be another pandemic, but treats it in a matter of fact way. Of course there'll be another pandemic: we're overcrowded, highly connected, highly social, and fairly careless.

I know there are people out there who will be complaining about Quammen's bias when he notes that we are, to a great extent, making the problem worse. We destroy habitats, bring animals into closer contact with us, and thus bring ourselves into closer contact with their pathogens, which may spill over into humans. Not biased, and not hard to understand, just a fact. ...more
1

October 3, 2014

This guy is Anti American. He made a public ...
This guy is Anti American. He made a public statement that America should continue to allow visitors into America from Liberia during the 2014 Ebola epidemic, because of slavery.
5

Nov 09, 2018

This is informative, interesting and entertaining. Parts of it read as a detective story, as the author describes the quest to identify pathogens, and the routes that can lead those pathogens to cause human disease. The approach encompasses the ecological as well as the evolutionary factors that lead to zoonotic diseases.
As I read, I took copious quotes from every chapter. As David Quammen says it much better than I can, I am going to copy some of them here. I will use spoiler tags for my This is informative, interesting and entertaining. Parts of it read as a detective story, as the author describes the quest to identify pathogens, and the routes that can lead those pathogens to cause human disease. The approach encompasses the ecological as well as the evolutionary factors that lead to zoonotic diseases.
As I read, I took copious quotes from every chapter. As David Quammen says it much better than I can, I am going to copy some of them here. I will use spoiler tags for my summary notes about what the reservoir host etc. are for viruses, so if you want to read it for yourself, it will come as a surprise.
The passages in italics are tidbits that show the author’s sometimes sarcastic humour which made the book even more enjoyable.

I Pale Horse (Hendra virus) (view spoiler)[Australia, fruit bat as reservoir, horse as amplifier (hide spoiler)]

A zoonosis is an animal infection transmissible to humans. There are more such diseases than you might expect. AIDS is one. Influenza is a whole category of others...This form of interspecies leap is common, not rare; about 60 percent of all human infectious diseases currently known either cross routinely or have recently crossed between other animals and us.

Human-caused ecological pressures and disruptions are bringing animal pathogens ever more into contact with human populations, while human technology and behavior are spreading those pathogens ever more widely and quickly.

II Thirteen Gorillas (Ebola) (view spoiler)[unknown reservoir, gorillas and chimpanzees affected (hide spoiler)]

Like other zoonotic viruses, ebolaviruses have probably adapted to living tranquilly within their reservoir (or reservoirs), replicating steadily but not abundantly and causing little or no trouble. Spilling over into humans, they encounter a new environment, a new set of circumstances, often causing fatal devastation. And one human can infect another, through direct contact with bodily fluids or other sources of virus. But the chain of ebolavirus infection, at least so far, has never continued through many successive cases, great distances, or long stretches of time. Some scientists use the term “dead-end host,” as distinct from “reservoir host,” to describe humanity’s role in the lives and adventures of ebolaviruses.

Advisory: If your husband catches an ebolavirus, give him food and water and love and maybe prayers but keep your distance, wait patiently, hope for the best—and, if he dies, don’t clean out his bowels by hand. Better to step back, blow a kiss, and burn the hut.

III Everything Comes from Somewhere (Malaria)

Hamer was especially interested in why diseases such as influenza, diphtheria, and measles seem to mount into major outbreaks in a cyclical pattern—rising to a high case count, fading away, rising again after a certain interval of time. What seemed curious was that the interval between outbreaks remained, for a given disease, so constant. The logic of such cycles, Hamer suspected, was that an outbreak declined whenever there weren’t enough susceptible (nonimmune) people left in the population to fuel it, and that another outbreak began as soon as new births had supplied a sufficient number of new victims. Furthermore, it wasn’t the sheer number of susceptible individuals that was crucial, but the density of susceptibles multiplied by the density of infectious people. In other words, contact between those two groups is what mattered.

The four (kinds of malaria) known for targeting humans are transmitted from person to person by Anopheles mosquitoes. These four parasites possess wondrously complicated life histories, encompassing multiple metamorphoses and different forms in series: an asexual stage known as the sporozoite, which enters the human skin during a mosquito bite and migrates to the human liver; another asexual stage known as the merozoite, which emerges from the liver and reproduces in red blood cells; a stage known as the trophozoite, feeding and growing inside the blood cells, each of which fattens as a schizont and then bursts, releasing more merozoites to further multiply in the blood, and causing a spike of fever; a sexual stage known as the gametocyte, differentiated into male and female versions, which emerge from a later round of infected red blood cells, enter the bloodstream en masse, and are taken up within a blood meal by the next mosquito; a fertilized sexual stage known as the ookinete, which lodges in the gut lining of the mosquito, each ookinete ripening into a sort of egg sac filled with sporozoites; and then come the sporozoites again, bursting out of the egg sac and migrating to the mosquito’s salivary glands, where they lurk, ready to surge down the mosquito’s proboscis into another host. If you’ve followed all that, at a quick reading, you have a future in biology.
This elaborate concatenation of life-forms and sequential strategies is highly adaptive and, so far as mosquitoes and hosts are concerned, difficult to resist. It shows evolution’s power, over great lengths of time, to produce structures, tactics, and transformations of majestic intricacy. Alternatively, anyone who favors Intelligent Design in lieu of evolution might pause to wonder why God devoted so much of His intelligence to designing malarial parasites.

IV Dinner at the Rat Farm (SARS) (view spoiler)[reservoir bats, coronavirus (hide spoiler)]

The very name coined during that early period, SARS, reflects the fact that this thing was known only by its effects, its impacts, like the footprints of a large, invisible beast. Ebola is a virus. Hendra is a virus. Nipah is a virus. SARS is a syndrome.
A superspreader is a patient who, for one reason or another, directly infects far more people than does the typical infected patient.
One further factor, possibly the most crucial, was inherent to the way SARS-CoV affects the human body: Symptoms tend to appear in a person before, rather than after, that person becomes highly infectious. The headache, the fever, and the chills—maybe even the cough—precede the major discharge of virus toward other people..This was an enormously consequential factor in the SARS episode—not just lucky but salvational."

V The Deer, the Parrot, and the Kid Next Door (Q fever, Psittacosis, Lyme disease)

Q fever, or “abattoir’s fever”. It wasn’t a virus, though in some measure it behaved like one. It was a bacterium, but unlike most other bacteria.
First of all, it’s an intracellular bacterium, meaning that it reproduces within cells of its host—as does a virus, though by dissimilar mechanisms—not out in the bloodstream or the gut, where it could be more easily targeted by immune response. Furthermore, it exists in two forms of bacterial particle, one large and one small, each with different characteristics suited to different phases of its life history. The large form replicates prolifically inside host cells and then transmogrifies to the small form, which is tougher and more stable. The small form, almost like a spore, is packaged for survival in the external environment.

Psittacosis. “Parrot fever” a culprit had been identified. It was a small bacterium with some unusual properties, seemingly similar to the agent that causes typhus (Rickettsia prowazekii) and therefore given the name Rickettsia psittaci. (Renamed later Chlamydophila psittaci.)
“If the young cockatoo, after capture, is kept under good conditions,” he and his coauthor wrote, “it remains healthy and presents no danger to human beings.” Likewise, the wild bird populations might carry a high prevalence of infection but suffer little impact in terms of damaged health or mortality. “When, on the other hand, birds are crowded into small spaces, with inadequate food and sunlight, their latent infection is lit up.” The bacterium multiplies and “is excreted in large amounts.” It floats out of the cages along with downy feathers, powdered dung, and dust. It rides the air like a Mosaic plague. People inhale it and become ill.

Lyme disease Part of what makes it problematic is that the life history of Borrelia burgdorferi is very complex, involving much more than ticks and people.
Related to the unchanging fact of noninheritability is a variable that Ostfeld and others call “reservoir competence.” This is the measure of likelihood that a given host animal, if it’s already infected, will transmit the infection to a feeding tick. Reservoir competence varies from species to species, most likely depending on differences in the strength of immune response against the pathogen. If the immune response is weak and the blood teems with spirochetes, that species will serve as a highly “competent” reservoir of B. burgdorferi, transmitting infection to most ticks that bite it. If the immune response is strong and effective, damping down the level of blood-borne spirochetes, that species will be a relatively less competent reservoir. Studies by Ostfeld’s group, involving captive animals and the ticks feeding on them, showed white-footed mice to be the most competent of reservoirs for the Lyme disease spirochete. Chipmunks were a distant second in reservoir competence, with shrews close behind them.

VI Going viral

Expert opinion even divides on the conundrum of whether viruses are alive. If they aren’t, then at the very least they’re mechanistic shortcuts on the principle of life itself. They parasitize. They compete. They attack, they evade. They struggle. They obey the same basic imperatives as all living creatures—to survive, to multiply, to perpetuate their lineage—and they do it using intricate strategies shaped by Darwinian natural selection. They evolve. The viruses on Earth today are well fit for what they do because only the fittest have survived.
R0 = βN/(α + b + v)
In English: The evolutionary success of a bug is directly related to its rate of transmission through the host population and inversely but intricately related to its lethality, the rate of recovery from it, and the normal death rate from all other causes. (The clunky imprecision of that sentence is why ecologists prefer math.) So the first rule of a successful parasite is slightly more complicated than Don’t kill your host. It’s more complicated even than Don’t burn your bridges until after you’ve crossed them. The first rule of a successful parasite is βN/(α + b + v).
And why are RNA genomes so small? Because their self-replication is so fraught with inaccuracies that, given more information to replicate, they would accumulate more errors and cease to function at all. It’s sort of a chicken-and-egg problem, he said. RNA viruses are limited to small genomes because their mutation rates are so high, and their mutation rates are so high because they’re limited to small genomes. In fact, there’s a fancy name for that bind: Eigen’s paradox.

VII Celestial Hosts

From where do these viruses jump? They jump from animals in which they have long abided, found safety, and occasionally gotten stuck. They jump, that is, from their reservoir hosts.
And which animals are those? Some kinds are more deeply implicated than others as reservoirs of the zoonotic viruses that jump into humans. Hantaviruses jump from rodents. Lassa too jumps from rodents. Yellow fever virus jumps from monkeys. Monkeypox, despite its name, seems to jump mainly from squirrels. Herpes B jumps from macaques. The influenzas jump from wild birds into domestic poultry and then into people, sometimes after a transformative stopover in pigs. Measles may originally have jumped into us from domesticated sheep and goats. HIV-1 has jumped our way from chimpanzees. So there’s a certain diversity of origins. But a large fraction of all the scary new viruses I’ve mentioned so far, as well as others I haven’t mentioned, come jumping at us from bats.

Epstein was talking, in an understated way, about the two distinct but interconnected dimensions of zoonotic transfer: ecology and evolution. Habitat disturbance, bushmeat hunting, the exposure of humans to unfamiliar viruses that lurk in animal hosts—that’s ecology. Those things happen between humans and other kinds of organism, and are viewed in the moment. Rates of replication and mutation of an RNA virus, differential success for different strains of the virus, adaptation of the virus to a new host—that’s evolution. It happens within a population of some organism, as the population responds to its environment over time. Among the most important things to remember about evolution—and about its primary mechanism, natural selection, as limned by Darwin and his successors—is that it doesn’t have purposes. It only has results. To believe otherwise is to embrace a teleological fallacy that carries emotive appeal (“the revenge of the rain forest”) but misleads. This is what Jon Epstein was getting at. Don’t imagine that these viruses have a deliberate strategy, he said. Don’t think that they bear some malign onus against humans. “It’s all about opportunity.” They don’t come after us. In one way or another, we go to them.

VIII The chimp and the river (AIDS, HIV-1, HIV-2, SIV)

As the new century began, AIDS researchers pondered this roster of different viral lineages: seven groups of HIV-2 and three groups of HIV-1. The seven groups of HIV-2, distinct as they were from one another, all resembled SIVsm, the virus endemic in sooty mangabeys. (So did the later addition, group H.) The three kinds of HIV-1 all resembled SIVcpz, from chimps. (The eventual fourth kind, group P, is most closely related to SIV from gorillas.) Now here’s the part that, as it percolates into your brain, should cause a shudder: Scientists think that each of those twelve groups (eight of HIV-2, four of HIV-1) reflects an independent instance of cross-species transmission. Twelve spillovers.
In other words, HIV hasn’t happened to humanity just once. It has happened at least a dozen times—a dozen that we know of, and probably many more times in earlier history. Therefore it wasn’t a highly improbable event. It wasn’t a singular piece of vastly unlikely bad luck, striking humankind with devastating results—like a comet come knuckleballing across the infinitude of space to smack planet Earth and extinguish the dinosaurs. No. The arrival of HIV in human bloodstreams was, on the contrary, part of a small trend. Due to the nature of our interactions with African primates, it seems to occur pretty often.

Throughout the rest of the world you see AIDS-education materials crying out: Practice safe sex! Wear a condom! Don’t reuse needles! Here the message was: Don’t eat apes!

IX It depends (Influenza) (view spoiler)[reservoir wild aquatic birds (hide spoiler)]

Influenza is caused by three types of viruses, of which the most worrisome and widespread is influenza A. Viruses of that type all share certain genetic traits: a single-stranded RNA genome, which is partitioned into eight segments, which serve as templates for eleven different proteins.
Two of those molecules become spiky protuberances from the outer surface of the viral envelope: hemagglutinin and neuraminidase. Those two, recognizable by an immune system, and crucial for penetrating and exiting cells of a host, give the various subtypes of influenza A their definitive labels: H5N1, H1N1, and so on. The term “H5N1” indicates a virus featuring subtype 5 of the hemagglutinin protein combined with subtype 1 of the neuraminidase protein. Sixteen different kinds of hemagglutinin, plus nine kinds of neuraminidase, have been detected in the natural world. Hemagglutinin is the key that unlocks a cell membrane so that the virus can get in, and neuraminidase is the key for getting back out. Okay so far? Having absorbed this simple paragraph, you understand more about influenza than 99.9 percent of the people on Earth. Pat yourself on the back and get a flu shot in November.
One of the things that makes influenza so problematic, Webster said, is its propensity to change. He explained. First of all there’s the high rate of mutation, as in any RNA virus. No quality control as it replicates, he said, echoing what I’d heard from Eddie Holmes. Continual copying errors at the level of individual letters of code. But that’s not the half of it. Even more important is the reassortment. (“Reassortment” means the accidental swapping of entire genomic segments between virions of two different subtypes. It’s similar to recombination, as occurs sometimes between crossed chromosomes in dividing cells, except that reassortment is somewhat more facile and orderly. It happens often among influenza viruses because the segmentation allows their RNA to snap apart neatly at the points of demarcation between genes: those eight railroad cars in a switching yard.) Sixteen available kinds of hemagglutinin, Webster reminded me. Nine kinds of neuraminidase. “You can do the arithmetic,” he said. (I did: 144 possible pairings.) The changes are random and most yield bad combinations, making the virus less viable. But random changes do constitute variation, and variation is the exploration of possibilities. It’s the raw material of natural selection, adaptation, evolution. That’s why influenza is such a protean sort of bug, always full of surprises, full of newness, full of menace: so much mutation and reassortment.
The steady incidence of mutations yields incremental change in how the virus looks and behaves. Ergo you need another flu shot every autumn: This year’s version of flu is different enough from last year’s. Reassortment yields big changes. Such major innovations by reassortment, introducing new subtypes, which may be infectious but unfamiliar to the human population, are what generally lead to pandemics.

If you have read through my admittedly long review, or just scrolled through, I have a few words of advice:
Don’t go into a bat cave without a hazmat suit.
Don’t feed the monkeys in shrines, generally keep your distance from them.
Don’t eat apes.
Practice save sex, and take your yearly flu shot. ...more
3

October 16, 2014

Lots of information but index doesn't work for Kindle!
Comment on Kindle edition only: As soon as I received this lengthy book I went to the index, searching for specific information. It appears to be a well-constructed index, unlike many to be found, and in a book of this scope it is needed. Unfortunately, the index does not work with the Kindle version. The electronic page numbers don't actually appear, but by scrolling along the bottom one can see what "page" is displayed. Useless, though, because these numbers are not consistent with page numbers of the printed book--and (understandably!) there are hyperlinks only at the table of contents. A huge disappointment. Although I will read and undoubtedly enjoy the book anyway, I wish I had purchased a hard copy for future reference.
5

December 12, 2016

Enjoyable read with a warning - we are doing this to ourselves
Quammen makes the stories of viral discovery tangible and understandable. He manages to convey a great deal of complexity about the nature, transmission and evolution of viruses in simple and enjoyable terms. This book weaves through many narratives of mystery and intrigue - none of which have a fully complete picture yet. In a way, Quammen urges us all to keep discovering or to keep reading about those discoveries, the same way we might keep up with our favorite characters on a television show.

Spillover also makes two things very clear. First, viruses can be lethal and frightening. Second, *humans* are causing this sudden tidal wave of spillover (or zoonosis) of viral infections from animal reservoirs to the human population. The book seeks not only to enlighten us to thrilling tales of discovery but also urges us to examine our role in these emerging viruses. As a part of the root cause of increased spillover, what can we, as humans, do to prevent it?
5

Oct 14, 2012

Thrilled to see that David Quammen had a new science book, I snatched this up. It’s been 15 years since his book "Song of the Dodo” about island biogeography, which remains at the top of my favorite non-fiction.

Can one *enjoy* a book about infectious disease? Anyone who's read Richard Preston's “The Hot Zone” will guiltily admit, yes (interestingly, he takes Preston to task for overplaying descriptions of Ebola infection. “Bleeding out" is not accurate.)

There is inherent narrative drama in the Thrilled to see that David Quammen had a new science book, I snatched this up. It’s been 15 years since his book "Song of the Dodo” about island biogeography, which remains at the top of my favorite non-fiction.

Can one *enjoy* a book about infectious disease? Anyone who's read Richard Preston's “The Hot Zone” will guiltily admit, yes (interestingly, he takes Preston to task for overplaying descriptions of Ebola infection. “Bleeding out" is not accurate.)

There is inherent narrative drama in the question of when the Next Big One (NBO) will hit and in the epidemiological sleuthing to identify viruses and their host animals when an epidemic breaks. What will turn a local outbreak into a pandemic? Do scientists think there IS a NBO lurking? Quite possibly. And if so, it will assuredly originate in animals, as has almost all human infectious disease. Influenza, SARS, Marburg, Lyme disease - Quammen covers them all and more, and turns up startling facts. For one, the subtitle of his book could just as well be, "From Bats to Humans."

But what put the book over the top in excellence and dramatic page-turning was the penultimate chapter on the origin of AIDS. In some ways the whole book was moving toward this chapter. The origins of HIV can now be pinned to a year (much earlier than you’d think) and a single spillover event; chimp to human. And Quammen makes the poignant and chilling case that lest you wonder why we should care about exotic diseases such as Marbug, consider the exponential trajectory and devastation of AIDS. It too is a zoonotic disease, but one that has moved more slowly than an airborne NBO will surely do.

Despite the theme – lively and buoyant writing. In other words, it’s readable. Quammen remains a master of science journalism.
...more
3

December 3, 2014

It's a good book that capably communicates fascinating information but i don't ...
It's a good book that capably communicates fascinating information but i don't feel it justified its length. By attempting to communicate virtually every point, no matter how minor, through some illustrative story, the author taxes our patience as readers and ends up needing 50 pages to draw conclusions that the reader has already made.

I'm sure the author would be open to critique of failing to include sufficient detail, or being too dry if he simply used more direct explication and fewer stories but for a young and busy person like myself, that would have been preferable.

The material was still fascinating and many of the stories were too. I enjoyed the book and all the things i learned from it but it ended up feeling too much like some old man constantly saying, "did i ever tell you about the time..."
4

February 19, 2014

Meticulous and clearheaded despite the cover
I was expecting to be frightened by this book. Look at the cover for goodness sake!

But unlike say, The Hot Zone (different genre I know), and DESPITE its cover, Quammen's Spillover is an incredibly calm and objective look at diseases and infections caused by zoonotic microbes, mostly viruses, but some bacteria. Quammen introduces us to the terminology we'll need in the early chapters, then takes us on an case by case tour of the various outbreaks and misses by which we humans have been plagued.

And Quammen knows his stuff. Unlike the frantic handwringing I see regarding this subject regularly, Quammen is concerned, yes, but is more interested in TEACHING us where these zoonotic infections come from in order that we might avoid them, or treat them more quickly in the future. That said, this is a BIG book, and Quammen goes into SIGNIFICANT scientific detail in each chapter. On several occasions, he actually tells us he's holding back some of the more complex stuff! I can only imagine.

Quammen's thesis is this: zoonotic infections and the next big one are not things that are "happening" to us, but rather, the result of things that we're DOING. He enumerates these things all at once in the final chapters of the book, but refers to them in isolation throughout. I appreciated the way Quammen put across this thesis---it wasn't in order to preach, per se, or to condemn modernity. Indeed, Quammen says that some of things we're "doing" can't be undone. But a few can, and we're better off knowing about them.

This book was fabulous. Dig in.
5

Apr 24, 2015

Superb! David Quammen brings to life the stories of a wide variety of infectious diseases and their spillover from animals to humans. David is a great writer, his narrative drive and prose are magnificent. He does this while presenting the science in a very accessible yet amazingly informative way.

What is astounding is the amount of work and research that must have gone into this book. David conducted a seemingly endless amount of interviews with scientists, researchers, doctors. To say he took Superb! David Quammen brings to life the stories of a wide variety of infectious diseases and their spillover from animals to humans. David is a great writer, his narrative drive and prose are magnificent. He does this while presenting the science in a very accessible yet amazingly informative way.

What is astounding is the amount of work and research that must have gone into this book. David conducted a seemingly endless amount of interviews with scientists, researchers, doctors. To say he took it to the next level, well that is a vast understatement. This is science journalism/writing at its pinnacle.

My particular favorite was the section on the ecology of borrelia (lyme). This is a subject that hits close to home for me.

The section on malaria was very intriguing, learned a lot. The coolest thing was learning that a form of malaria had been used as therapy to treat syphilis (a form of therapy known as pyrotherapy). That blew my mind. If you're curious, here's an article on the subject: http://blogs.discovermagazine.com/bod...

I was also fascinated by the HIV chapter. Could have done without his hypothesizing and reimagining of the original patient 0 story, I saw what he was trying to do, but that seemed a bit clunky and unnecessary. But that's a minor quibble with an otherwise outstanding book.

Dang, the ebola chapter was incredible as well... so much good stuff in here. ...more

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