Beating Back the Devil

Beating Back the Devil: On the Front Lines with the Disease Detectives of the Epidemic Intelligence Service by Maryn McKenna
My rating: 3 of 5 stars

The Center for Disease Control has been on the front lines fighting the effects of war, terrorism, and disease since 1946; this book recounts many of their most important cases.

Beating Back the Devil reads like a collection of true crime stories, rarely pausing to parse its technical terms or explain some of the statistical methods of epidemiologists, but galloping into the mystery of disease.

Tracking a small group of disease detectives in the Epidemic Intelligence Service's (EIS) class of 2002, the case histories range from the successful international efforts to eradicate smallpox, the spread of AIDS-related infections in minority drag queen communities, fighting cholera in Rwandan refugee camps, to tracking the post-9/11 anthrax letters.

There are surprising details here - for example, the U.S. government has a uniformed Commissioned Corps that has a military structure (to which the civilian doctors of the EIS struggle to conform).

My favorite chapter recounts the mystery of how West Nile virus contaminated donated organs, and it hints at the incredible amount of legwork required to come close to controlling an outbreak. There is also an interesting account of organizing a study of pregnant women in Malawi to fight malaria, and the story of efforts to prevent the spread of tuberculosis among the underground drag queens (whose extravagant balls are documented in the film Paris is Burning). The specter of AIDS looms large over many of the stories in the book, since AIDS victims' compromised immune systems are especially vulnerable to infection.

The chapter entitled "War" tells the surprising story of EIS efforts in refugee camps after the Rwandan genocide: CDC doctors made sure relief workers knew how to treat cholera patients and used their research skills to verify food distribution and make sure that women and children were not overlooked. The CDC doctors witnessed the continuation of horrors of genocide (many of the refugees were the perpetrators of the Rwandan genocide), the children without parents, and the privations of an overcrowded refugee camp.

For those interested in the history of disease, be sure to check out Rabid: A Cultural History of the World's Most Diabolical Virus by Bill Wasik and Monica Murphy. There is also a free CDC Solve the Outbreak app for iPad that will teach you the basics of epidemiology, and the CDC Zombie outbreak guide, which is a light-hearted take on disaster preparedness. For more from the front lines of the CDC, check out Level 4: Virus Hunters of the CDC by Joseph B. McCormick.

Rabid

Rabid: A Cultural History of the World's Most Diabolical Virus by Bill Wasik and Monica Murphy
My rating: 4 of 5 stars

Tracing rabies from its primordial beginnings to modern outbreaks, this cultural history is a fascinating introduction to a disease that embodies our deepest fears.

I class this book as horror because rabies is a disease of nightmares, causing aggression and hydrophobia in its hosts before mercilessly killing them 100% of the time. And the perfect host is your trusty dog. Truth can be more terrible than fiction. Though rabies is largely under control in the U.S., 35,000 people still die worldwide every year.

Wasik and Murphy trace the history of rabies and humanity's response to its ravages from Babylon to the European "Middle Rages" to modern times. They discussion other zoonotic plagues (diseases transmitted from animals to humans) like swine flu, Ebola, and AIDS. There is a fascinating chapter on the story of Bali's recent fight against rabies. Controlling zoonotic diseases carries all sorts of cultural implications, embedded as they are within people's attitudes toward dogs and other animals.

2010 article in the Sydney Herald: Rabid dogs bite a chunk out of Bali's tourist trade

My favorite part was the fascinating account of Louis Pasteur's creation of the science of immunology with his breakthrough rabies vaccine. Pasteur is my science hero: he tackled terrible diseases and saved people's lives with careful scientific experimentation paired with intellectual ingenuity. Pasteur and his assistants showed incredible courage, too. The only way to get samples is to take them from live, infected animals: back then, a bite was a terrifying death sentence.

• For horror lovers who also like history and science, this is a great fit. Cujo readers who want a new reasons to shudder will find plenty, plus there are some great examinations of classic monsters, including vampires, werewolves, and modern-day zombie apocalypses.
• Some We Love, Some We Hate, Some We Eat by Hal Herzog explores more of Americans' complex relationship toward animals in more depth, and talks about animal testing as well.
• For more about zoonotic diseases, try Spillover: Animal Infections and the Next Human Pandemic by David Quammen.
• I recommend the iPad app from the Center for Disease control called "Solve the Outbreak". It's fun, and you'll learn a lot about what disease detectives do by playing it. (You could also check out Beating Back the Devil: On the Front Lines with the Disease Detectives of the Epidemic Intelligence Service by Maryn McKenna.)

A paragraph that grabbed my attention (as background, the only way to test for rabies in animals is to examine their brain tissue.):

"Now, after two years of sawing, we feel we have finally finished the job, and are pleased to ship it off to you, the reader. Come to think of it: in the case of a fox, or a cat, or even a toy-breed dog, the severed head might weigh just about the same as the book in your hands right now. Hold it in your outstretched palms, why don't you, and close you eyes. Not very heavy, is it?" - p. 11-12.