In May 1993, a cluster of cases of a lethal disease among healthy young people brought the attention of the world to the southwestern deserts. A previously unknown disease was killing up to 80% of the people it infected.
The reaction in the area and across the nation mixed fear, lack of information, and the struggles of doctors to save the victims of an unknown killer with hard science and the age old rhythmns of the desert. What came out was the story of a virus that had been killing since man arrived in the American continents, Hantavirus, with deadly relatives across the Americas and across the world. This book explains why and how the virus kills, and why it is still killing today. Why all of the science aimed at a virus identified back in 1993 has not brought a vaccine or a cure is part of the story, as is how that killer virus fits into the story of "new" diseases across the world.
The story of hantavirus disease, what has happened since that first outbreak, and what the real risks are is laid out by an experienced scientist and an award winning journalist living and working in the area of the 1993 outbreak.
Covers the full story of the recent hantavirus outbreak
Includes interviews with survivors, and local reaction
Presents the science in lay terms
Places the event in the broader context of emerging diseases worldwide
The only account which takes the reader beyond the initial outbreak in 1993-1994, bringing them up to late 1998
Discusses hantavirus disease in the U.S., Argentina, and Canada
From The New England Journal of Medicine
In the northern part of South Korea lies the Hantaan River, and during the Korean conflict in the 1950s, 3000 United Nations troops near the river became affected with fever and myalgias associated with renal disease and ecchymoses. The disorder was initially called Korean hemorrhagic fever and was later termed hemorrhagic fever with renal syndrome. Local residents with outdoor exposure, especially those who farmed, were found to be at increased risk. Fortunately, with funding from the Department of Defense, the cause was shown in the 1960s to be a filterable agent, later called Hantaan virus -- the first hantavirus.
A similar but milder syndrome was later identified in Scandinavia and traced to exposure to a rodent, the bank vole. The causative agent was the Puumala virus, named for an area in southeastern Finland. Subsequently, in the 1980s, a very curious Carleton Gadjusek, using the newly developed polymerase-chain-reaction technique for gene amplification, examined meadow voles near his home in Maryland and found a similar virus, which he named Prospect Hill virus and which is not known to cause any disease in people. Both Puumala virus and Prospect Hill virus were found to be members of the hantavirus family.
What caught the attention of the world was an explosive outbreak of adult respiratory distress syndrome in 1993 that primarily affected Native Americans in a corner of New Mexico near an area called Muerto Canyon. Those affected had fever, tachycardia, tachypnea, and elevated white-cell counts, and 70 percent of persons with the disease died very rapidly. Outdoor exposure and exposure to deer mice were strong risk factors. Serum samples that were screened contained evidence of hantavirus infection, and genetic-fingerprint analysis, surprisingly, showed similarities between the infectious agent and Prospect Hill virus. Originally called hantavirus pulmonary syndrome, the disorder was caused by a newly recognized hantavirus, now called Sin Nombre (meaning "without a name"). This was the first demonstration of a hantavirus that caused pulmonary and not renal signs.
In their clearly written book, Of Mice, Men, and Microbes: Hantavirus, Harper and Meyer examine the history of the identification of hantaviruses and describe the pathogenesis of the illnesses they cause and their worldwide influence. It is perhaps the ecologic relations of the viruses -- in particular, between El Nino and the unusual growth of pinon nuts, food of rodents, leading to a rodent "bloom" -- that are most interesting and provocative. Readers will finish the book realizing that no infections are new; it is only our recognition of the causes that is new. Readers will also realize that disease and epidemics follow chance encounters among men, mice, and associated microbes. Despite their focus on hantaviruses, the authors take readers on a journey to understand the origin and biology of viruses, the coevolution of viruses and their hosts, and humans' fear of new outbreaks and their eventual conquest with new knowledge.
The shortcoming of this book, which is an "easy read," is that its target audience is a general one. Internists, and certainly specialists in infectious diseases, will find it slow moving. For example, petechiae are defined as "skin hem orrhages... the markers of hemorrhagic fever"; platelets are defined as "the specialized cell fragments that control blood clotting," the numbers of which decrease during infection "as they react to the damage, trying to stem the leaks that will develop unless they can contain it." In general, the language is at a level appropriate to college students, and at times readers may wish for a fast-forward button. There are more basic details and more words used to explain them than most physicians need. In addition, although the book is accurate, it has no references and will thus not appeal to scholars.
The language and tone of the book also vary. At times the tone is lyrical: the Four Corners region of the United States "is a place where change is marked in natural rhythms rather than on any human calendar, and sometimes only the broadest cycles -- the eons, the epochs -- are visible to the casual observer"; at times it is enigmatic: "if a million monkeys with a million typewriters can write Hamlet, then a billion viruses with a billion of the random changes called mutations can write influenza, Ebola, or nothing at all"; and sometimes the language is turgid, as noted above.
Despite its shortcomings, anyone interested in hantaviruses will find that this book tells a very complete story. The host, agent, vector, geography, climate, psychology, and cultural responses of the people who are infected are all described. There is much to learn.
"...In their clearly written book, Of Mice, Men, and Microbes: Hantavirus , Harper and Meyer examine the history of identification of hantaviruses and describe the pathogenesis of the illnesses they cause and their worldwide influence... Readers will finish the book realizing that no infections are new; it is only our recognition of the causes that is new. Readers will also realize that disease and epidemics follow chance encounters among men, mice and associated microbes. Despite their focus on hantaviruses, the authors take readers on a journey to understand the origin and biology of viruses, the coevolution of viruses and their hosts, and humans' fear of new outbreaks and their eventual conquest with new knowledge... anyone interested in hantaviruses will find that this book tells a very complete story. The host, agent, vector, geography,climate, psychology, and cultural responses of the people who are infected are all described. There is much to learn." --Richard Wenzel, M.D., in NEW ENGLAND JOURNAL OF MEDICINE, 2000
"An essential book of those interested in emerging diseases." --P.C. Radich, University of Indianapolis, in CHOICE, 2000
"The authors, one a scientist, the other a journalist, have produced an excellent read for the expert and non-expert alike." --R.C. Spencer in JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 1999
From the Back Cover
In May, 1993, a lethal disease brought the attention of the world to the southwestern deserts of the United States. That year, against the harsh backdrop of the red deserts, the previously unknown disease was to kill 60% of its victims. What came out of the fierce struggle to find and control this new disease was the story of a virus that had been killing since humans arrived on the American continents. It is still out there, and still killing. The story of the disease-what has happened since that first outbreak and what the real risks are-is told by an experienced professional scientist writing with an award-winning journalist living and working in the area of that first outbreak. Fully illustrated with stunning color photographs, the book also contains full CDC guidelines for prevention and sources of further current outbreak information.
About the Author
David R. Harper is currently a Lecturer in Molecular Virology at St. Bartholomew's and the Royal London Medical and Dental School. He has worked with viruses since leaving college in 1981, and has authored three textbooks and one laboratory manual. He has also worked as Research Director for Biocontrol Ltd., and has a wide range of teaching experience.
Description:
In May 1993, a cluster of cases of a lethal disease among healthy young people brought the attention of the world to the southwestern deserts. A previously unknown disease was killing up to 80% of the people it infected.
The reaction in the area and across the nation mixed fear, lack of information, and the struggles of doctors to save the victims of an unknown killer with hard science and the age old rhythmns of the desert. What came out was the story of a virus that had been killing since man arrived in the American continents, Hantavirus, with deadly relatives across the Americas and across the world. This book explains why and how the virus kills, and why it is still killing today. Why all of the science aimed at a virus identified back in 1993 has not brought a vaccine or a cure is part of the story, as is how that killer virus fits into the story of "new" diseases across the world.
The story of hantavirus disease, what has happened since that first outbreak, and what the real risks are is laid out by an experienced scientist and an award winning journalist living and working in the area of the 1993 outbreak.
From The New England Journal of Medicine
In the northern part of South Korea lies the Hantaan River, and during the Korean conflict in the 1950s, 3000 United Nations troops near the river became affected with fever and myalgias associated with renal disease and ecchymoses. The disorder was initially called Korean hemorrhagic fever and was later termed hemorrhagic fever with renal syndrome. Local residents with outdoor exposure, especially those who farmed, were found to be at increased risk. Fortunately, with funding from the Department of Defense, the cause was shown in the 1960s to be a filterable agent, later called Hantaan virus -- the first hantavirus.
A similar but milder syndrome was later identified in Scandinavia and traced to exposure to a rodent, the bank vole. The causative agent was the Puumala virus, named for an area in southeastern Finland. Subsequently, in the 1980s, a very curious Carleton Gadjusek, using the newly developed polymerase-chain-reaction technique for gene amplification, examined meadow voles near his home in Maryland and found a similar virus, which he named Prospect Hill virus and which is not known to cause any disease in people. Both Puumala virus and Prospect Hill virus were found to be members of the hantavirus family.
What caught the attention of the world was an explosive outbreak of adult respiratory distress syndrome in 1993 that primarily affected Native Americans in a corner of New Mexico near an area called Muerto Canyon. Those affected had fever, tachycardia, tachypnea, and elevated white-cell counts, and 70 percent of persons with the disease died very rapidly. Outdoor exposure and exposure to deer mice were strong risk factors. Serum samples that were screened contained evidence of hantavirus infection, and genetic-fingerprint analysis, surprisingly, showed similarities between the infectious agent and Prospect Hill virus. Originally called hantavirus pulmonary syndrome, the disorder was caused by a newly recognized hantavirus, now called Sin Nombre (meaning "without a name"). This was the first demonstration of a hantavirus that caused pulmonary and not renal signs.
In their clearly written book, Of Mice, Men, and Microbes: Hantavirus, Harper and Meyer examine the history of the identification of hantaviruses and describe the pathogenesis of the illnesses they cause and their worldwide influence. It is perhaps the ecologic relations of the viruses -- in particular, between El Nino and the unusual growth of pinon nuts, food of rodents, leading to a rodent "bloom" -- that are most interesting and provocative. Readers will finish the book realizing that no infections are new; it is only our recognition of the causes that is new. Readers will also realize that disease and epidemics follow chance encounters among men, mice, and associated microbes. Despite their focus on hantaviruses, the authors take readers on a journey to understand the origin and biology of viruses, the coevolution of viruses and their hosts, and humans' fear of new outbreaks and their eventual conquest with new knowledge.
The shortcoming of this book, which is an "easy read," is that its target audience is a general one. Internists, and certainly specialists in infectious diseases, will find it slow moving. For example, petechiae are defined as "skin hem orrhages... the markers of hemorrhagic fever"; platelets are defined as "the specialized cell fragments that control blood clotting," the numbers of which decrease during infection "as they react to the damage, trying to stem the leaks that will develop unless they can contain it." In general, the language is at a level appropriate to college students, and at times readers may wish for a fast-forward button. There are more basic details and more words used to explain them than most physicians need. In addition, although the book is accurate, it has no references and will thus not appeal to scholars.
The language and tone of the book also vary. At times the tone is lyrical: the Four Corners region of the United States "is a place where change is marked in natural rhythms rather than on any human calendar, and sometimes only the broadest cycles -- the eons, the epochs -- are visible to the casual observer"; at times it is enigmatic: "if a million monkeys with a million typewriters can write Hamlet, then a billion viruses with a billion of the random changes called mutations can write influenza, Ebola, or nothing at all"; and sometimes the language is turgid, as noted above.
Despite its shortcomings, anyone interested in hantaviruses will find that this book tells a very complete story. The host, agent, vector, geography, climate, psychology, and cultural responses of the people who are infected are all described. There is much to learn.
Reviewed by Richard Wenzel, M.D.
Copyright © 2000 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
Review
"...In their clearly written book, Of Mice, Men, and Microbes: Hantavirus , Harper and Meyer examine the history of identification of hantaviruses and describe the pathogenesis of the illnesses they cause and their worldwide influence... Readers will finish the book realizing that no infections are new; it is only our recognition of the causes that is new. Readers will also realize that disease and epidemics follow chance encounters among men, mice and associated microbes. Despite their focus on hantaviruses, the authors take readers on a journey to understand the origin and biology of viruses, the coevolution of viruses and their hosts, and humans' fear of new outbreaks and their eventual conquest with new knowledge... anyone interested in hantaviruses will find that this book tells a very complete story. The host, agent, vector, geography,climate, psychology, and cultural responses of the people who are infected are all described. There is much to learn." --Richard Wenzel, M.D., in NEW ENGLAND JOURNAL OF MEDICINE, 2000
"An essential book of those interested in emerging diseases." --P.C. Radich, University of Indianapolis, in CHOICE, 2000
"The authors, one a scientist, the other a journalist, have produced an excellent read for the expert and non-expert alike." --R.C. Spencer in JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 1999
From the Back Cover
In May, 1993, a lethal disease brought the attention of the world to the southwestern deserts of the United States. That year, against the harsh backdrop of the red deserts, the previously unknown disease was to kill 60% of its victims. What came out of the fierce struggle to find and control this new disease was the story of a virus that had been killing since humans arrived on the American continents.
It is still out there, and still killing.
The story of the disease-what has happened since that first outbreak and what the real risks are-is told by an experienced professional scientist writing with an award-winning journalist living and working in the area of that first outbreak.
Fully illustrated with stunning color photographs, the book also contains full CDC guidelines for prevention and sources of further current outbreak information.
About the Author
David R. Harper is currently a Lecturer in Molecular Virology at St. Bartholomew's and the Royal London Medical and Dental School. He has worked with viruses since leaving college in 1981, and has authored three textbooks and one laboratory manual. He has also worked as Research Director for Biocontrol Ltd., and has a wide range of teaching experience.