Book Review

Viral Pathogenesis

N Engl J Med 1997; 337:285-286July 24, 1997

Article

Viral Pathogenesis
Edited by Neal Nathanson, with six others. 940 pp., illustrated. Philadelphia, Lippincott–Raven, 1997. $159. ISBN: 0-7818-0297-6

Viruses were first identified as causative agents of disease in the late 19th century, and by the summer of 1939, research had progressed to such a point that the first symposium on viruses related to infectious disease could be held at the Harvard School of Public Health. Leading experts gathered, and a compendium of the proceedings, entitled Virus and Rickettsial Diseases, was published (Cambridge, Mass.: Harvard University Press, 1940). Topics discussed at that meeting included epidemiologic problems, the immunobiology of infections, insect vectors, and vaccination against disease. Several viral diseases were discussed, including lymphocytic choriomeningitis, measles, mumps, influenza, Dengue fever, yellow fever, and poliomyelitis. That collection of works represented what was then known about viruses and disease. More than 50 years later, Nathanson and his coeditors have produced an excellent book describing the current knowledge of viral pathogenesis. As was done a half-century earlier, the editors invited internationally known experts on viral pathogenesis and virology to provide inclusive and up-to-date chapters.

The book has four sections, and the chapters fit well into them. Most chapters adhere to a consistent format that makes it easy to find information on particular items of interest. Most contributors follow this format; however, not all do, and in addition, the table of contents is missing page numbers for two of the chapters. But these are minor distractions, and for the most part all the contributors provide well-focused chapters organized around the central theme of pathogenesis. The figures are well designed and help the reader follow viral-replication strategies and virus interactions with the host. These are especially appreciated in the chapters on herpesvirus and tumor virus. Included in the book is a section on experimental pathogenesis, which includes a chapter entitled “An Atlas of Viral Disease Pathogenesis.” This visual presentation was a delightful surprise and a welcome inclusion that previous works on the subject have not provided. The seven chapters in the section entitled “Classic Models of Viral Pathogenesis” are all well written by recognized experts. The exclusion of influenza virus from this section was most likely an editorial decision, and although influenza receives some attention in other chapters, this important infection deserves its own chapter. I appreciated the section on systemic pathogenesis, a summary that would require the exploration of many different sources to obtain the same information. A chapter in this section, which describes the interaction between a virus and its host as an “evolutionary dance in which the virus is the more nimble partner,” is representative of the care contributors took in presenting the material. Authors' strengths and interests are brought out in these chapters.

Overall, this is a well-organized addition to the field of pathogenesis. While most of the models involve animals other than humans, the principles are directly applicable to human disease. Examples are clearly defined, and the inclusion of reviews of the evidence of the involvement of viruses in carcinogenesis is nicely delineated. This excellent stand-alone work on viral pathogenesis would also be a good adjunct in virology, pathology, or infectious-disease courses linking disease with viral agents.

Robert S. Fujinami, Ph.D.
University of Utah School of Medicine, Salt Lake City, UT 84132