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The Robert S. Cohen Forum: Contemporary Issues in Science Studies, Monday, February 23, 2 p.m., The Castle, part of the Boston Colloquium for Philosophy of Science

Week of 20 February 2004 · Vol. VII, No. 21

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MED prof's new book
The smallest enemies are the deadliest

By Brian Fitzgerald

Wards full of patients in iron lungs, such as this one in the Los Angeles County Hospital in the early 1950s, were a common feature of hospital life before Jonas Salk developed the polio vaccine in 1955. Photo courtesy of the Immunization Action Coalition/Warren F. Collins, Inc.


Wards full of patients in iron lungs, such as this one in the Los Angeles County Hospital in the early 1950s, were a common feature of hospital life before Jonas Salk developed the polio vaccine in 1955. Photo courtesy of the Immunization Action Coalition/Warren F. Collins, Inc.

Elinor Levy's new book on 30 new deadly diseases that have arisen since the 1970s — along with 20 old diseases that are reemerging — might not cause readers to walk around with surgical masks on their faces.

But it might make them start washing their hands more. And some of them certainly will stay away from salad bars after reading about a variant of E. coli bacteria that killed three-year-old Brianna Kriefall in 2000 after she ate some watermelon from a fruit bowl at a Milwaukee steakhouse. The outbreak also sickened 60 other diners at the restaurant.

Levy, a MED associate professor of microbiology, wrote The New Killer Diseases: How the Alarming Evolution of Mutant Germs Threatens Us All (Crown Publishers, 2003) with veteran science writer Mark Fischetti, a contributing editor to Scientific American. The title may be the most menacing since Don't Touch That Doorknob, the 2001 book by Jack Brown that had lots of people thinking twice about the germs that lurk in elevators, at cocktail parties, and in supermarket checkout lines — never mind in their kitchens and bathrooms.

And if the title of Levy's and Fischetti's book isn't frightening enough, consider the text on the jacket: “All around us — in our homes, workplaces, and public spaces — bacteria and viruses are evolving at a feverish rate, and our best defenses against them are in danger of being overwhelmed. The threat posed by emerging infectious diseases is as formidable as any challenge the human race has ever faced, and the evolutionary scales may be tipping in favor of the microbes.”

Are microbes actually threatening to make humans an endangered species? “Our intention isn't to scare people,” Levy says, “but to inform them, empower them. We want to teach readers how infectious diseases operate, and how the immune system works, and what needs to be done to beat these diseases.” Levy is an expert in immunology: she has conducted research on how antioxidants inhibit HIV, and seven years ago she teamed up with science writer Tom Monte to write The Ten Best Tools to Boost Your Immune System (Houghton-Mifflin).

Levy says that Killer Diseases started as a book about the tricks pathogens use to get around the immune system, but the authors expanded it to include information about today's most serious infectious disease threats, especially SARS, which she says is a warning of many such possible outbreaks to come.

Killer Diseases states that “we are in the midst of an evolutionary war” with microbes. But can microbes actually win in the long run? “I think it's too early to say that the fight is tipping in their favor,” Levy says, “We have always been in a battle, but no one knows which direction the battle will go. The outcome is uncertain.”

She says that we are increasingly vulnerable because of the growing number of people residing in urban areas, which makes person-to-person spread of infectious microorganisms easier. Travel is another major factor. International travel is more widespread — and faster — than ever. In fact, the leading theory about West Nile virus outbreaks in this country is that a virus-carrying mosquito had stowed away on an airplane to the United States.

Elinor Levy Photo by Fred Sway

Elinor Levy Photo by Fred Sway


Levy writes not only about the multitude of new deadly diseases such as mad cow, SARS, and Ebola, but also the old ones that have seen a resurgence. “Tuberculosis infects one-third of the world's population, and kills about three million people a year,” she says. “That disease was actually under control in the United States, but came back in the 1980s partially because the public health system cut back on detection and treatment programs.” TB also returned with a vengeance because drug-resistant strains of the disease emerged, she adds, and an increasing number of immuno-compromised people were contracting it.

Diseases have infected people since there were people. The first great plague pandemic began in 541 in Egypt and spread across the globe in four years, killing 50 to 60 percent of the world's inhabitants. And then in 1346, the second plague pandemic erupted and within five years more than 13 million in China and 20 to 30 million in Europe were dead. Levy points out that the possibility of another pandemic with widespread death and suffering isn't an idle worry. The CIA, she writes, “had become so concerned by the pathogen threat by 2000 that it produced a report that sternly stressed that today's pathogens could seriously weaken the American people, their military, even their way of life.”

The book is filled with graphic stories of people who have contracted bizarre new afflictions, along with profiles of researchers and medical professionals who are introducing the latest scientific developments.

Levy says that there are several ways to maximize our ability to beat infectious diseases, including a commitment to boost the U.S. public health system, which is badly in need of improvement because the United States has chronically underfunded public health for decades.

On February 10, however, the Bush administration announced its intention to seek the largest expansion ever of the U.S. Public Health Service. Surgeon General Richard Carmona says that the goal is to recruit thousands of doctors, nurses, and health officers to handle potential national health emergencies. Levy says following through with these plans would be a step in the right direction, although state and local health departments are still stretched pretty thin.

A few more positive measures, she says, would be increasing medical research funding, improving hygiene at hospitals, and doing a better job of enforcing food safety guidelines to reduce food-borne diseases such as E. coli 0157, salmonella, and listeria. “Our food supply is nowhere near as safe as it should be,” she says.

The early 1900s saw devastating scourges of smallpox, TB, polio, and influenza. The flu pandemic of 1918 killed 675,000 people in the United States. Levy says that considering the way pathogens are constantly evolving new mechanisms to fight the drugs we make to stop them, there is no telling what's in store for us in this new century.

“The threat of bioterrorism,” she writes, “and the recent experience with West Nile virus make it crystal-clear that we need to have a strong public-health infrastructure in place if we want to be able to respond effectively when natural or unnatural outbreaks occur.”


20 February 2004
Boston University
Office of University Relations