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Contagious: Cultures, Carriers, and the Outbreak Narrative
How should we understand the fear and fascination elicited by the accounts of communicable disease outbreaks that proliferated, following the emergence of HIV, in scientific publications and the mainstream media? The repetition of particular characters, images, and story lines—of Patients Zero and superspreaders, hot zones and tenacious microbes—produced a formulaic narrative as they circulated through the media and were amplified in popular fiction and film. The “outbreak narrative” begins with the identification of an emerging infection, follows it through the global networks of contact and contagion, and ends with the epidemiological work that contains it. Priscilla Wald argues that we need to understand the appeal and persistence of the outbreak narrative because the stories we tell about disease emergence have consequences. As they disseminate information, they affect survival rates and contagion routes. They upset economies. They promote or mitigate the stigmatizing of individuals, groups, locales, behaviors, and lifestyles.Wald traces how changing ideas about disease emergence and social interaction coalesced in the outbreak narrative. She returns to the early years of microbiology—to the identification of microbes and “Typhoid Mary,” the first known healthy human carrier of typhoid in the United States—to highlight the intertwined production of sociological theories of group formation (“social contagion”) and medical theories of bacteriological infection at the turn of the twentieth century. Following the evolution of these ideas, Wald shows how they were affected by—or reflected in—the advent of virology, Cold War ideas about “alien” infiltration, science-fiction stories of brainwashing and body snatchers, and the HIV/AIDS pandemic. Contagious is a cautionary tale about how the stories we tell circumscribe our thinking about global health and human interactions as the world imagines—or refuses to imagine—the next Great Plague.
564 pages, Kindle Edition
First published December 19, 2007
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May 12, 2021
The Story of the Deadly Virus
We think containing the spread of infectious diseases is all about science. In fact, more than we care to admit, our perception of disease contagion is shaped by fictions: blockbuster movies, popular novels, newspaper headlines, and magazine articles. These fictions frame our understanding of emerging viruses and the response we give to global health crises. Call it the outbreak narrative. It follows a formulaic plot that goes through roughly the same steps of emergence in nature or in labs, human infection, transnational contagion, widespread prevalence, medical identification of the virus, epidemiological containment, and final eradication. It features familiar characters: the healthy human carrier, the superspreader, the virus detective, the microbe hunter. It summons mythological figures or supervillains from past history: the poisonous Typhoid Mary from the early twentieth century, the elusive Patient Zero from the HIV/AIDS crisis. Through these fictions, new terms and metaphors have entered our vocabulary: immunodeficiency, false negative, reproductive rate, incubation period, herd immunity, “flattening the curve.” We don’t know the science behind the concepts, but we easily get the picture. Outbreak narratives have consequences: they shape the reaction to the health crisis by leaders and the public, they affect survival rates and contagion routes, they promote or mitigate the stigmatizing of individuals and groups, and they change moral and political economies. It is therefore important to understand the appeal and persistence of the outbreak narrative in order to design more effective and humane responses to the global health crises that lie ahead of us.
The outbreak narrative
Another consequence of living immersed in fiction is that usually you only remember the last episode of the whole drama series. Published in 2008, Priscilla Ward’s book begins with a reference to “the first novel infectious disease epidemic of the 21st century, caused by a brand-new coronavirus.” The contagion epidemic was of course SARS, not COVID, and the “brand-new” coronavirus of the early 2000s was named SARS-CoV-1 as opposed to the more recent SARS-CoV-2. But it is difficult not to read Contagious in light of the ongoing Covid-19 epidemic, and not to apply its narrative logic to our recent predicament. Covid-19 rewrote the script of past epidemic outbreaks but didn’t change it completely. It built on past experience, both real and imagined or reflected through fiction. The scenario of disease emergence was already familiar to the public, and it shaped the way countries responded to the epidemiological crisis. It demonstrated that living in fiction leaves us fully unprepared to face the real thing: the countries that achieved early success in containing the virus were those most affected by past outbreaks and especially by SARS, which mainly spread in East Asia. By contrast, the United States is the country from which most fictions originate, but where response to Covid-19 outbreak was disorganized and weak. We need more than fiction to prepare us to the health crises of the future; we also need better fictions than the conventional outbreak narrative that casts the blame on villains and invests hope in heroes to provide salvation.
As Priscilla Ward reminds us, there was an earlier wave of fictional scenarios in the 1990s that popularized the outbreak narrative in its present form. Blockbuster movies, medical thrillers, and nonfiction books reached a wide public and dramatized the research results that infectious disease specialists were discussing at the time in their scientific conferences and publications. They include the novels Carriers (David Lynch 1995), Contagion (Robin Cook, 1995), The Blood Artists (Chuck Hogan, 1998), as well as the movies Twelve Monkeys (dir. Terry Gillian, 1995), The Stand (dir. Mike Harris, 1994), Outbreak (dir. Wolfgang Petersen, 1995), and the nonfiction bestsellers The Hot Zone (Richard Preston, 1994), The Coming Plague (Laurie Garrett, 1994), and Guns, Germs and Steel (Jared Diamond, 1997). Priscilla Ward use the movie Outbreak, starring Dustin Hoffman and Morgan Freeman, as particularly representative of the genre that came to shape the global imaginary of disease emergence. The opening scene of a desolate African camp decimated by an unknown hemorrhagic virus, as seen through the protection mask of an American epidemiologist, sets the stage for subsequent narratives. The story casts Africa as an “epidemiological ground zero,” a continental Petri dish out of which “virtually anything might arise.” It dramatizes human responsibility in bringing microbes and animals in close contact with (American) human beings and in spreading the disease out of its “natural” environment through the illicit traffic of a monkey that finds its way to a California pet store. It gives the US Army a key role in maintaining public order and makes US soldiers shoot their countrymen who attempt to violate the quarantine. Outbreak fictions often cast the military officer as the villain, sometimes in cahoot with private corporations to engineer bioweapons, and the public scientist as the ultimate savior who substitutes a medical cure for a military solution. Helped by visual technologies such as epidemiological maps, electron microscopes, and close-ups of the virus, experts engage in a race against time to identify the source of the disease and then to determine how to eradicate it. That effort constitutes the plot and storyline of the film: the outbreak narrative.
Healthy carriers and social reformers
The outbreak narrative as it emerged in the mid-1990s builds on earlier attempts to storify disease emergence and contagion. Much like the blockbuster movies and popular novels of the 1990s relied on the work of scientists writing and debating about emerging infections, discussions about disease and contagion in the early twentieth century were shaped by new and controversial research showing that a apparently healthy person could transmit a communicable disease. The idea of a healthy human carrier was one of the most publicized and transformative discoveries of bacteriology. It signified that one person could fuel an epidemic without knowing it or being detected, and it required the curtailment of personal liberties to identify, isolate, and treat or eliminate such a vector of contagion. For the popular press in the English-speaking world, the healthy and deadly carrier took the figure of “Typhoid Mary,” an Irish immigrant who worked as a cook and left a trail of contaminations in the families that employed her. She was reluctant to submit herself to containment or incarceration in a hospital facility and repeatedly escaped the surveillance of public-health officials, assuming a false name and identity to disappear and cause new cases of contagion. Typhoid fever at the time was a “national disgrace” associated with dirtiness and filth. It resulted from the ingestion of fecal matter, as many authors liked to explain, and could be combatted by personal hygiene and proper sanitation of homes and urban space. Typhoid Mary’s refusal to cooperate with public health authorities created a moral panic that combined the perceived threat of immigration, prejudices against Irish female servants, fallen-woman narratives, and violation of the sanctity of the family. In response, the Home Economics Movement emphasized “how carefully we should select our cooks,” and made familial and national health a central occupation of the professional housewife.
Communicable disease and the figure of the healthy carrier influenced changing ideas about urban space and social interactions. Focusing on poverty, city life, urban slums, marginal men, migration, deviance, and crime, the Chicago School was one of the first and most influential centers of sociological research in North America. Like other sociologists of his generation, Robert Park began his career as a muck-raking journalist and social reformer. While investigating the outbreak of a diphtheria epidemic in downtown Chicago, he was able to plot the distribution of cases along an open sewer that he identified as the source of the infection. This led him to use the concept of contagion as a metaphor for social interactions and cultural transmission. It wasn’t the first time biology provided models for the nascent discipline of sociology. In the view of early commentators, microbes did not just represent social bonds; they created and enforced them, acting as a great “social leveller” unifying the social body. In France, Gustave Trade and Emile Durkheim argued about the role of contagion and imitation in explaining social phenomena such as suicide and crime. Communicable disease in particular vividly depicted the connection between impoverished urban spaces and the broader social environment. Calling the city a “laboratory or clinic in which human nature and social processes may be conveniently and profitably studied,” Park and his colleagues from the Chicago School of sociology concentrated their analysis on social interactions in urban formations such as the tenement or slum dwelling, the ethnic enclave or the ghetto, as well as nodes of communication such as points of entry, train stations, and quarantine spaces. The particular association of those spaces with immigrants in the United States intensified nativism and anti-Semitism, as preventive measures disproportionately and inequitably targeted Eastern European Jews. The theories and models of the urban sociologists conceptualized a spacialization of the social and the pathological that would play a great role in the outbreak narrative.
Cold War stories
The outbreak narrative is also heir to the stories of viral invasion, threats to the national body, and monstrous creatures from outer space that shaped the imaginaries of the Cold War. The insights of virology were central to those stories. New technologies of visualization implanted on the public the image of a virus attacking a healthy cell and destroying the host through a weakening of the immune system. Viruses unsettled traditional definitions of life and human existence. Unlike parasites, they did not simply gain nutrients from host cells but actually harnessed the cell’s apparatus to duplicate themselves. Neither living nor dead, they offered a convenient trope for science-fiction horror stories envisioning the invasion of the earth by “body snatchers” that transformed their human hosts into insentient beings of walking dead. These stories were suffused with the anxieties of the times: the inflated threat of Communism, the paranoia fueled by McCarthyism, research into biological warfare or mind control, the atomization of society, emerging visions of an ecological catastrophe, as well as the unsettling of racial and gender boundaries. Americans were inundated with stories and images of a cunning enemy waiting to infiltrate the deepest recesses of their being. Conceptual changes into science and politics commingled, and narrative fictions in turn influenced the new discipline of virology, marking the conjunction of art and science. Priscilla Ward describes these changes through an analysis of the avant-garde work of William S. Burroughs, who developed a fascination with virology, as well as popular fictions such as Jack Finney’s bestselling 1955 novel The Body Snatchers and its cinematic adaptations.
The metamorphosis of infected people into superspreaders is a convention of the outbreak narrative. In the case of HIV/AIDS, epidemiology mixed with moral judgments and social conventions to shape popular perceptions and influence scientific hypotheses. Medical doctors, journalists, and the general public found the sexuality of the early AIDS patients too compelling to ignore. In 1987, Randy Shilts’s controversial bestseller And the Band Played On brought the story of the early years of the HIV/AIDS epidemic to a mainstream audience and contributed significantly to an emerging narrative of HIV/AIDS. Particularly contentious was the story of the French Canadian airline steward Gaetan Dugas, launched into notoriety as “Patient Zero” and who reported hundreds of sexual partners per year. In retrospect, Shilts regretted that “630 pages of serious AIDS policy reporting” were reduced to the most sensational aspects of the epidemic, and offered an apology for the harm he may have done. Considering the lack of scientific validity of the “Patient Zero” hypothesis, it is difficult not to see the identification of this epidemiological index case and its transformation into a story character as primarily a narrative device. The earliest narratives of any new disease always reflect assumptions about the location, population, and circumstances in which it is first identified. In the case of HIV/AIDS, the earlier focus on homosexuals, and also on Haitians, intravenous drug users, and hemophiliacs, was an integral part of the viral equation, while origin theories associating the virus with the primordial spaces of African rainforests reproduced earlier tropes of Africa as a continent of evil and darkness. Modern stories of “supergerms” developing antibiotic resistance in the unregulated spaces of the Third World and threatening to turn Western hospitals into nineteenth-century hotbeds of nosocomial infection fuel on the same anxieties.
The narrative bias
The outbreak narrative introduces several biases in our treatment of global health crises, a lesson that is made only too obvious in the international response to Covid-19. It focuses on the emergence of the disease, often bringing scientific expertise into view; but it treats the widespread diffusion of the virus along conventional lines, and has almost nothing to say about the closure or end-game of the epidemic. It is cast in distinctly national terms, and only envisages national responses to a global threat. It presents public health as first and foremost a national responsibility, and treats international cooperation as secondary or even as nefarious. As countries engage in a “war of narratives,” the reality of global interdependence is made into a threat, not a solution. The exclusive focus on discourse and narratives overlooks the importance of social processes and material outcomes. Priscilla Ward’s book reflects many of the biases she otherwise denounces. It is America-centric and focuses solely on fictions produced in the United States. It exhibits a narrative bias that is shared by politicians and journalists who think problems can be solved by addressing them at the discursive level. It neglects the material artifacts that play a key role in the spread and containment of infectious diseases: (...)
We think containing the spread of infectious diseases is all about science. In fact, more than we care to admit, our perception of disease contagion is shaped by fictions: blockbuster movies, popular novels, newspaper headlines, and magazine articles. These fictions frame our understanding of emerging viruses and the response we give to global health crises. Call it the outbreak narrative. It follows a formulaic plot that goes through roughly the same steps of emergence in nature or in labs, human infection, transnational contagion, widespread prevalence, medical identification of the virus, epidemiological containment, and final eradication. It features familiar characters: the healthy human carrier, the superspreader, the virus detective, the microbe hunter. It summons mythological figures or supervillains from past history: the poisonous Typhoid Mary from the early twentieth century, the elusive Patient Zero from the HIV/AIDS crisis. Through these fictions, new terms and metaphors have entered our vocabulary: immunodeficiency, false negative, reproductive rate, incubation period, herd immunity, “flattening the curve.” We don’t know the science behind the concepts, but we easily get the picture. Outbreak narratives have consequences: they shape the reaction to the health crisis by leaders and the public, they affect survival rates and contagion routes, they promote or mitigate the stigmatizing of individuals and groups, and they change moral and political economies. It is therefore important to understand the appeal and persistence of the outbreak narrative in order to design more effective and humane responses to the global health crises that lie ahead of us.
The outbreak narrative
Another consequence of living immersed in fiction is that usually you only remember the last episode of the whole drama series. Published in 2008, Priscilla Ward’s book begins with a reference to “the first novel infectious disease epidemic of the 21st century, caused by a brand-new coronavirus.” The contagion epidemic was of course SARS, not COVID, and the “brand-new” coronavirus of the early 2000s was named SARS-CoV-1 as opposed to the more recent SARS-CoV-2. But it is difficult not to read Contagious in light of the ongoing Covid-19 epidemic, and not to apply its narrative logic to our recent predicament. Covid-19 rewrote the script of past epidemic outbreaks but didn’t change it completely. It built on past experience, both real and imagined or reflected through fiction. The scenario of disease emergence was already familiar to the public, and it shaped the way countries responded to the epidemiological crisis. It demonstrated that living in fiction leaves us fully unprepared to face the real thing: the countries that achieved early success in containing the virus were those most affected by past outbreaks and especially by SARS, which mainly spread in East Asia. By contrast, the United States is the country from which most fictions originate, but where response to Covid-19 outbreak was disorganized and weak. We need more than fiction to prepare us to the health crises of the future; we also need better fictions than the conventional outbreak narrative that casts the blame on villains and invests hope in heroes to provide salvation.
As Priscilla Ward reminds us, there was an earlier wave of fictional scenarios in the 1990s that popularized the outbreak narrative in its present form. Blockbuster movies, medical thrillers, and nonfiction books reached a wide public and dramatized the research results that infectious disease specialists were discussing at the time in their scientific conferences and publications. They include the novels Carriers (David Lynch 1995), Contagion (Robin Cook, 1995), The Blood Artists (Chuck Hogan, 1998), as well as the movies Twelve Monkeys (dir. Terry Gillian, 1995), The Stand (dir. Mike Harris, 1994), Outbreak (dir. Wolfgang Petersen, 1995), and the nonfiction bestsellers The Hot Zone (Richard Preston, 1994), The Coming Plague (Laurie Garrett, 1994), and Guns, Germs and Steel (Jared Diamond, 1997). Priscilla Ward use the movie Outbreak, starring Dustin Hoffman and Morgan Freeman, as particularly representative of the genre that came to shape the global imaginary of disease emergence. The opening scene of a desolate African camp decimated by an unknown hemorrhagic virus, as seen through the protection mask of an American epidemiologist, sets the stage for subsequent narratives. The story casts Africa as an “epidemiological ground zero,” a continental Petri dish out of which “virtually anything might arise.” It dramatizes human responsibility in bringing microbes and animals in close contact with (American) human beings and in spreading the disease out of its “natural” environment through the illicit traffic of a monkey that finds its way to a California pet store. It gives the US Army a key role in maintaining public order and makes US soldiers shoot their countrymen who attempt to violate the quarantine. Outbreak fictions often cast the military officer as the villain, sometimes in cahoot with private corporations to engineer bioweapons, and the public scientist as the ultimate savior who substitutes a medical cure for a military solution. Helped by visual technologies such as epidemiological maps, electron microscopes, and close-ups of the virus, experts engage in a race against time to identify the source of the disease and then to determine how to eradicate it. That effort constitutes the plot and storyline of the film: the outbreak narrative.
Healthy carriers and social reformers
The outbreak narrative as it emerged in the mid-1990s builds on earlier attempts to storify disease emergence and contagion. Much like the blockbuster movies and popular novels of the 1990s relied on the work of scientists writing and debating about emerging infections, discussions about disease and contagion in the early twentieth century were shaped by new and controversial research showing that a apparently healthy person could transmit a communicable disease. The idea of a healthy human carrier was one of the most publicized and transformative discoveries of bacteriology. It signified that one person could fuel an epidemic without knowing it or being detected, and it required the curtailment of personal liberties to identify, isolate, and treat or eliminate such a vector of contagion. For the popular press in the English-speaking world, the healthy and deadly carrier took the figure of “Typhoid Mary,” an Irish immigrant who worked as a cook and left a trail of contaminations in the families that employed her. She was reluctant to submit herself to containment or incarceration in a hospital facility and repeatedly escaped the surveillance of public-health officials, assuming a false name and identity to disappear and cause new cases of contagion. Typhoid fever at the time was a “national disgrace” associated with dirtiness and filth. It resulted from the ingestion of fecal matter, as many authors liked to explain, and could be combatted by personal hygiene and proper sanitation of homes and urban space. Typhoid Mary’s refusal to cooperate with public health authorities created a moral panic that combined the perceived threat of immigration, prejudices against Irish female servants, fallen-woman narratives, and violation of the sanctity of the family. In response, the Home Economics Movement emphasized “how carefully we should select our cooks,” and made familial and national health a central occupation of the professional housewife.
Communicable disease and the figure of the healthy carrier influenced changing ideas about urban space and social interactions. Focusing on poverty, city life, urban slums, marginal men, migration, deviance, and crime, the Chicago School was one of the first and most influential centers of sociological research in North America. Like other sociologists of his generation, Robert Park began his career as a muck-raking journalist and social reformer. While investigating the outbreak of a diphtheria epidemic in downtown Chicago, he was able to plot the distribution of cases along an open sewer that he identified as the source of the infection. This led him to use the concept of contagion as a metaphor for social interactions and cultural transmission. It wasn’t the first time biology provided models for the nascent discipline of sociology. In the view of early commentators, microbes did not just represent social bonds; they created and enforced them, acting as a great “social leveller” unifying the social body. In France, Gustave Trade and Emile Durkheim argued about the role of contagion and imitation in explaining social phenomena such as suicide and crime. Communicable disease in particular vividly depicted the connection between impoverished urban spaces and the broader social environment. Calling the city a “laboratory or clinic in which human nature and social processes may be conveniently and profitably studied,” Park and his colleagues from the Chicago School of sociology concentrated their analysis on social interactions in urban formations such as the tenement or slum dwelling, the ethnic enclave or the ghetto, as well as nodes of communication such as points of entry, train stations, and quarantine spaces. The particular association of those spaces with immigrants in the United States intensified nativism and anti-Semitism, as preventive measures disproportionately and inequitably targeted Eastern European Jews. The theories and models of the urban sociologists conceptualized a spacialization of the social and the pathological that would play a great role in the outbreak narrative.
Cold War stories
The outbreak narrative is also heir to the stories of viral invasion, threats to the national body, and monstrous creatures from outer space that shaped the imaginaries of the Cold War. The insights of virology were central to those stories. New technologies of visualization implanted on the public the image of a virus attacking a healthy cell and destroying the host through a weakening of the immune system. Viruses unsettled traditional definitions of life and human existence. Unlike parasites, they did not simply gain nutrients from host cells but actually harnessed the cell’s apparatus to duplicate themselves. Neither living nor dead, they offered a convenient trope for science-fiction horror stories envisioning the invasion of the earth by “body snatchers” that transformed their human hosts into insentient beings of walking dead. These stories were suffused with the anxieties of the times: the inflated threat of Communism, the paranoia fueled by McCarthyism, research into biological warfare or mind control, the atomization of society, emerging visions of an ecological catastrophe, as well as the unsettling of racial and gender boundaries. Americans were inundated with stories and images of a cunning enemy waiting to infiltrate the deepest recesses of their being. Conceptual changes into science and politics commingled, and narrative fictions in turn influenced the new discipline of virology, marking the conjunction of art and science. Priscilla Ward describes these changes through an analysis of the avant-garde work of William S. Burroughs, who developed a fascination with virology, as well as popular fictions such as Jack Finney’s bestselling 1955 novel The Body Snatchers and its cinematic adaptations.
The metamorphosis of infected people into superspreaders is a convention of the outbreak narrative. In the case of HIV/AIDS, epidemiology mixed with moral judgments and social conventions to shape popular perceptions and influence scientific hypotheses. Medical doctors, journalists, and the general public found the sexuality of the early AIDS patients too compelling to ignore. In 1987, Randy Shilts’s controversial bestseller And the Band Played On brought the story of the early years of the HIV/AIDS epidemic to a mainstream audience and contributed significantly to an emerging narrative of HIV/AIDS. Particularly contentious was the story of the French Canadian airline steward Gaetan Dugas, launched into notoriety as “Patient Zero” and who reported hundreds of sexual partners per year. In retrospect, Shilts regretted that “630 pages of serious AIDS policy reporting” were reduced to the most sensational aspects of the epidemic, and offered an apology for the harm he may have done. Considering the lack of scientific validity of the “Patient Zero” hypothesis, it is difficult not to see the identification of this epidemiological index case and its transformation into a story character as primarily a narrative device. The earliest narratives of any new disease always reflect assumptions about the location, population, and circumstances in which it is first identified. In the case of HIV/AIDS, the earlier focus on homosexuals, and also on Haitians, intravenous drug users, and hemophiliacs, was an integral part of the viral equation, while origin theories associating the virus with the primordial spaces of African rainforests reproduced earlier tropes of Africa as a continent of evil and darkness. Modern stories of “supergerms” developing antibiotic resistance in the unregulated spaces of the Third World and threatening to turn Western hospitals into nineteenth-century hotbeds of nosocomial infection fuel on the same anxieties.
The narrative bias
The outbreak narrative introduces several biases in our treatment of global health crises, a lesson that is made only too obvious in the international response to Covid-19. It focuses on the emergence of the disease, often bringing scientific expertise into view; but it treats the widespread diffusion of the virus along conventional lines, and has almost nothing to say about the closure or end-game of the epidemic. It is cast in distinctly national terms, and only envisages national responses to a global threat. It presents public health as first and foremost a national responsibility, and treats international cooperation as secondary or even as nefarious. As countries engage in a “war of narratives,” the reality of global interdependence is made into a threat, not a solution. The exclusive focus on discourse and narratives overlooks the importance of social processes and material outcomes. Priscilla Ward’s book reflects many of the biases she otherwise denounces. It is America-centric and focuses solely on fictions produced in the United States. It exhibits a narrative bias that is shared by politicians and journalists who think problems can be solved by addressing them at the discursive level. It neglects the material artifacts that play a key role in the spread and containment of infectious diseases: (...)
June 18, 2020
An interesting reading for this troubled times that helps to understand how health proffessionals, sociologists, writers, film-makers, etc. have created a narrative of contagion. From "Typhoid Mary" to "Patient Zero", Wald discusses how this stories were developed to try to make sense of the spread of diseases since the 19th-century, but also how those narratives have been mediated through the worldview of each time and how military and immigration terminology has become part of the "war" against viruses and bacteria. Nevertheless, despite her vast knowledge and the importance of the subject matters she managest to successfully summarize, Wald's writing isn't quite as compelling as the narratives she studies.
December 18, 2021
As a folklorist and narratologist, this book speaks to me on several levels. Priscilla Wald has crafted an extremely engaging view of how the stories we tell shape and are shaped by global health and human interactions and how that in turn shapes (or creates counter narratives to) the stories we tell. Far too often, when medical health crises arise, the narratives of and about them are completely ignored. Wald makes a convincing argument (one that is even more important as we are on the precipice of entering our third year of COVID 19) that stories have the power (and cultural capital) to either exerbate or ameliorate inequities in access to care and healthcare outcomes. For a book published in 2008, it is remarkably prescient today. Wald understands narrative and cultural anxiety, and how those things are intimately related.
If you’re not turned off by overly academic writing and you’re not too exhausted from pandemic living to do some reading, I would highly recommend this book.
If you’re not turned off by overly academic writing and you’re not too exhausted from pandemic living to do some reading, I would highly recommend this book.
September 22, 2020
I would actually give this 4.5 stars because each chapter is at least 10-20 pages too long, but I'm definitely rounding this one up to five stars. It's such an important, interesting, interdisciplinary book, especially in these pandemic times.
October 5, 2020
I loved this book. It was a very interesting read. I have only given it 4 stars because in places it felt repetitive and boring. But I would 100% recommend this book to a friend because it was really good.
July 4, 2018
3.5
Quite boring in parts but generally informational
Quite boring in parts but generally informational
March 5, 2020
What a great writer! This is how analytic public writing should look like!
August 6, 2020
DNF. I found it incredibly boring and very wordy. I didn’t enjoy it nearly as much as I thought I would.
August 13, 2021
The outbreak narrative study stresses how the social discourses form the authority of science and deflect the attention towards the structure problems throughout contagions. 作者整理“爆发叙事”的文本表述并还原其协同形成流行病学话语的经过，析出“零号病人”污名背后的内涵。它不过是基于种族、地域、gender、政治而设的他者恐惧。“伤寒玛丽”的故事生动地反映社会变迁之际对边界外的恐惧如何诠释“传染”如何规训群体内部。作者呼吁，这类话语让人看不到传染病背后的全球不平等、北对南的压迫及社会中的结构性问题，传达出强烈的社会关怀。
March 31, 2023
A great read, many interesting points and dives into outbreak narratives clearly. My fav part was the Healthy Carrier section of the book, as it explores in depth the figure of Tyhpoid Mary.
January 14, 2014
Wald's examination of outbreak narratives is a fascinating journey through discussions of contagious disease, history, media, pop culture, and scientific developments. Throughout the work, the evolution of what is now recognizable as an outbreak narrative comes clearly into focus. One of the most powerful aspects of the work rests in the fact that Wald uncovers various feedback loops in the ways in which we understand and document disease. How film and literature have influenced our understanding and documentation of actual disease, and the way we write about it...how historical experiences with diseases and contagions have influenced the ways in which we now move forward with both research and documentation...how the language we use to document disease has been influenced by pop culture and subsequently influences political and research decisions...how a movie like Body Snatchers reflects and reinforces the (wrong) way we so often analyze and attempt an understanding of disease.
The outbreak narrative, as a form of narrative, is part fact and part fiction, but it has very real consequences in today's society. Wald's work attempts to trace the evolution of this narrative, delving into pop culture, history, film studies, politics, media and journalism, and scientific developments in order to not only follow the convoluted feedback loop created by different narratives related to contagions, but to analyze the various ways (good and bad) that these narratives have influenced, in turn, politics, science, and popular understanding of disease.
For a carefully researched work of nonfiction, Wald's work is incredibly readable, and her endnotes are perfectly balanced--what's there is useful and interesting, but also somewhat tangential...just what belongs in an endnote (as so often seems to Not be the case when it comes to workse like this). Her writing is also clear and detailed, and a useful analysis in the ways science and technology have influenced societal perception, and vice versa.
Overall, absolutely recommended for anyone interested in the subject of contagions or in the ways in which popular narratives have influenced political and scientific developments, or in the ways in which film and literature, as a group of texts, reinforce or influence popular understandings (or misunderstandings) and media.
The outbreak narrative, as a form of narrative, is part fact and part fiction, but it has very real consequences in today's society. Wald's work attempts to trace the evolution of this narrative, delving into pop culture, history, film studies, politics, media and journalism, and scientific developments in order to not only follow the convoluted feedback loop created by different narratives related to contagions, but to analyze the various ways (good and bad) that these narratives have influenced, in turn, politics, science, and popular understanding of disease.
For a carefully researched work of nonfiction, Wald's work is incredibly readable, and her endnotes are perfectly balanced--what's there is useful and interesting, but also somewhat tangential...just what belongs in an endnote (as so often seems to Not be the case when it comes to workse like this). Her writing is also clear and detailed, and a useful analysis in the ways science and technology have influenced societal perception, and vice versa.
Overall, absolutely recommended for anyone interested in the subject of contagions or in the ways in which popular narratives have influenced political and scientific developments, or in the ways in which film and literature, as a group of texts, reinforce or influence popular understandings (or misunderstandings) and media.
March 12, 2010
Using journalistic, literary, and cinematic representations of spreading infectious disease, Wald explores the significance of the “outbreak narrative” to 20th century U.S. conceptions of nation and community. Fear of infectious disease signals apprehension about “place” and “placelessness”, about permeable national borders in the face of easy and available international transportation, and about notions of American-ness. The “outbreak narrative”—characterized by a single carrier who infects an entire population, thereby necessitating “cleansing”—reveals deep ambivalence toward globalization and scientific progress; it becomes a flashpoint for anxieties about immigration, urbanization, and social evolution. Wald develops the implications of the “outbreak narrative” from its mythic roots to its American manifestations, including the creation of scapegoats, like “Typhoid Mary” and AIDS “patient zero.” She highlights the development of public health and epidemiology which shaped changing notions of community, including the development of Urban Sociology (which locates anxiety about disease in changing understanding of public spaces) to Cold War isolationism. Wald argues that while the idea “contagion” maintains its early moral connotations, increasing medicalization and bureaucratization of disease prevention obscures the importance of social responsibility and communal interdependence. Contagious contends that persistent identification of an “infectious other” will result in the perpetuation of social inequity.
December 9, 2014
This book examines the emergence and consequences of the outbreak narrative from Typhoid Mary to the avian flu. It is a well-written study showcasing Wald's skills as a careful and dedicated researcher and artful and clear writer. The book traces the way that narratives about disease have been shaped by emerging fields of virology, immunology, and epidemiology. The adaptation of these metaphors have served to medicalize the social and economic processes through which epidemics emerge. This process of medicalization draws attention away to the inequities in which disease flourishes and put the focus on surviving epidemics over people's overall quality of life. The outbreak narrative, moreover reflects and reproduces society's anxiety about the possibility of the poor to infect the rich. Wald is attentive to the ways such narratives are racialized and gendered, and the way their emergence attends to larger anxieties about social connection and porous borders.
September 22, 2015
This is a fascinating book that wanders off the path a bit too often for my taste. I still give it four stars because the best passages - Typhoid Mary and the untangling of Patient Zero, are superb. The links to social contagion - well, not my cup of tea. I'm very glad I read it - recommended.
Want to read
June 19, 2008abandoned for now, hope to return to it later...
April 27, 2015
Absolutely intriguing book: a must-read for everyone in science studies, and a definite recommendation to everyone else.
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