Book Review

Yellow Fever, Black Goddess: The coevolution of people and plagues

N Engl J Med 1997; 337:1017-1018October 2, 1997

Article

Yellow Fever, Black Goddess: The coevolution of people and plagues
By Christopher Wills. 318 pp., illustrated. Reading, Mass., Addison–Wesley, 1996. $24. ISBN: 0-201-44235-3

The subject of this book has been covered, with varying degrees of alarm, in newspaper stories, fiction, and films. The message has been that exotic viruses are incubating and swarming around the world as “doomsday agents in waiting.” Given the right circumstances of climate, poverty, vulnerability of the population, and media for transmission — let's disregard the fanciful malevolence of demented scientists — these viruses can spread disease anywhere and everywhere at any time, with lethal results.

Two recent books have taken a reassuringly anti-apocalyptic stance in opposition to this popular view. One is Virus Hunter: Thirty Years of Battling Hot Viruses around the World, by C.J. Peters and Mark Olshaker (New York: Anchor Books, 1997). Dr. Peters is a physician-virologist who has had first-hand experience with the Ebola virus, Venezuelan equine encephalitis, and the Argentine Junin virus. Although he views some viral threats with apprehension, it is clear that he opposes headline sensationalism about “glamour viruses” like Ebola and Marburg, which in fact have caused very few deaths.

Christopher Wills, the author of the second book, is a professor of biology at the University of California, San Diego. He too has been in the trenches in the war against plagues and has witnessed epidemics in Peru and India. Some of the most vivid parts of this book are his personal observations of the outbreaks of cholera on the banks of the Amazon in eastern Peru and of the plague in the industrial city of Surat, India, north of Bombay.

Moreover, the author's fine historical sensibility prompts him to look back at earlier rampaging epidemics caused by out-of-control protozoa, bacteria, and viruses. He reports on the bubonic plague in the time of Justinian in the sixth century, the Black Death all over Europe and peaking in 1348, the great London plague in 1665, and the numerous assaults of more modern diseases such as typhus, tuberculosis, and AIDS. He provides a fascinating and comprehensive overview of a wide range of phenomena.

There are special merits in the way Wills traverses this terrain. One is the authority with which he writes. For example, he frequently sums up conflicting investigative reports with phrases such as “We now know” and “There is now no doubt that. . . .” The scientific answers he gives carry the authority of a researcher who has thought long and hard about the problems. Another attractive feature of the book is the author's style. He compares plagues to Uriah Heep, the memorable Dickens character who ingratiates himself when he is in a subordinate position, turns vicious and overbearing when he gets some power, and in the end destroys himself by his own willfulness. He vividly recounts the story of Mary Mallon, the cook who worked in upper-class homes and hospitals all over New York City, spreading typhoid fever wherever she went. Her sad transformation into Typhoid Mary, a bacteriologic pariah, is recounted with a novelist's skill.

The conclusions of this book have to be called moderately comforting. Professor Wills believes that most plagues are surprisingly vulnerable, self-limiting, and controllable. “I am confident that no terrible disease will appear that slaughters us by the billions. The reason is that we can now respond very quickly to such a visible enemy.” One small criticism: it seems quite inappropriate to give the title Yellow Fever, Black Goddess to a book that deals with all kinds of plagues but barely mentions yellow fever.

Richard M. Hunt, Ph.D.
Harvard University, Cambridge, MA 02138