WHEN GERMS TRAVEL

The author of Quarantine! (1997), which showed eastern European Jews being blamed for typhus and cholera outbreaks in 19th-century New York, chronicles six immigrant-associated epidemics of the 20th century.

Covering tuberculosis, bubonic plague, trachoma, typhus, AIDS, and cholera, Markel (History of Medicine, Pediatrics and Communicable Diseases/Univ. of Michigan) provides for each disease a description of its characteristics, how it’s spread, its effects on the human body, and how it’s treated; he also makes good use of personal stories to illuminate the responses that the appearance of each disease has elicited from health officials and the general American public. The experiences of Alejandro, an illegal alien from Ecuador, and Abdul, a native of Ethiopia, illustrate the unpredictability of tuberculosis and the stigma it still bears today. Markel shows how the fear and panic that struck San Francisco in 1900, when Chick Gin was found to have died of bubonic plague, led to a full-scale quarantine of Chinatown, the burning of Chinese property, and an attempt to enforce compulsory inoculations of an experimental vaccine. The 1916 typhus riots along the Texas-Mexico border reveals the difficulties of trying to halt the spread of communicable disease from Mexico, one unintended consequence of which has been the rise in illegal immigration from that country. The story of Tomas, one of thousands of HIV-positive Haitian refugees detained at the Guantánamo Bay Naval Base in Cuba, demonstrates the commitment of the US to protecting itself from the worldwide AIDS epidemic. The final episode involves Markel himself in a diagnostic fiasco when reports of cholera outbreaks in Rwanda lead him to assume that he is seeing the disease in some recently arrived refugees. An epilogue sums up the author’s thoughts on safeguarding public health in a world where globalization and international travel ensure that infectious diseases cannot be confined by national boundaries.

Solid information on a serious subject, delivered with great assurance and style. (27 b&w illustrations)