The Deadly Truth: A history of disease in America by Gerald Grob, Harvard University Press, $35/£22.63, ISBN 0674008812
WESTERNERS, and especially Americans, are rattled about infection these days. We thought we had the old killers, such as smallpox and tuberculosis, beat – and now it seems we don’t. New ones, from anthrax attacks to mad cows, keep taking us by surprise.
Some people are scared silly. Very silly. When West Nile virus was recently found in Florida alligators, a reporter asked a health official whether you could catch it from an alligator bite. He was drily reminded that being bitten by an alligator would probably be your more serious problem.
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In reality, of course, people in rich countries now suffer less from infectious disease than at any time in history. But as Gerald Grob, professor of the history of medicine at Rutgers University in New Jersey, reminds us: to think disease would ever be completely beaten was even sillier than the present paranoia. His “deadly truth” is that there will always be disease in America.
And there always has been, despite a venerable myth that America was always somehow less plagued by disease than the Old World. In fact, dysentery and typhoid attacked those wagon trains rolling west far more often than the few Indians who had survived the wave of smallpox that came with the first Europeans.
This history is most salutary. But some is confusingly written, and some is wrong. Anthrax is not a native American, malaria is not necessarily tropical, smallpox was not benign before 1630. Most odd is the assertion that Native Americans were somehow extra susceptible to Old World diseases because they were unusually genetically homogeneous. They may be now, but surely that is the effect, not the cause, of the massive human die-off European disease wreaked on the Americas.
Grob is surer with more recent disease history – though the history is hard to explain. It will be news to some that the precipitous decline in mortality from infectious diseases in the rich world after 1900 had virtually nothing to do with medicine. Grob can find no simple explanation, even in improved nutrition, sanitation or public health for why most major infections have simply stopped killing us lately.
Worryingly, we cannot, therefore, predict when they might start again. Grob doesn’t try – but you suspect he will not be surprised.