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The Fever Trail: In Search of the Cure for Malaria
Part science, part riveting historical adventure about one of the great scourges to afflict mankind
Every year malaria kills 1.5 to 2.7 million people -- more than half of those deaths are children -- and 300 to 500 million people fall ill with the disease. As of yet, there is no cure. Malaria is a deadly virus with a vicious ability to mutate; it has, over the centuries, changed the course of history as epidemics swept through countries and devastated armies.
Until the middle of the seventeenth century, little was understood about the nature of the disease, or how to treat it. But there was a legend about a beautiful Spanish countess, the Condesa de Chinchón, who was cured of malaria during her stay in Peru by drinking a medicine made from the bark of a miraculous tree. This is the story of the search for the elusive cinchona tree - the only source of quinine - and the trio of British explorers who were given the task of transporting it to the colonies. On a quest that was to absorb the rest of their lives, Spruce, Ledger and Markham endeavored to rid the world of malaria.
But although quinine, and its chemical successors, managed to control malaria for a time, no method of prevention has been proven to be 100% effective. In laboratories and research facilities, the hunt continues - this time for a vaccine.
The Fever Trail is a story of courage, of geopolitical rivalry, of the New World against the Old, of the fabled curse of the cinchona tree - and of a disease that eludes all efforts to contain it.
Every year malaria kills 1.5 to 2.7 million people -- more than half of those deaths are children -- and 300 to 500 million people fall ill with the disease. As of yet, there is no cure. Malaria is a deadly virus with a vicious ability to mutate; it has, over the centuries, changed the course of history as epidemics swept through countries and devastated armies.
Until the middle of the seventeenth century, little was understood about the nature of the disease, or how to treat it. But there was a legend about a beautiful Spanish countess, the Condesa de Chinchón, who was cured of malaria during her stay in Peru by drinking a medicine made from the bark of a miraculous tree. This is the story of the search for the elusive cinchona tree - the only source of quinine - and the trio of British explorers who were given the task of transporting it to the colonies. On a quest that was to absorb the rest of their lives, Spruce, Ledger and Markham endeavored to rid the world of malaria.
But although quinine, and its chemical successors, managed to control malaria for a time, no method of prevention has been proven to be 100% effective. In laboratories and research facilities, the hunt continues - this time for a vaccine.
The Fever Trail is a story of courage, of geopolitical rivalry, of the New World against the Old, of the fabled curse of the cinchona tree - and of a disease that eludes all efforts to contain it.
328 pages, Hardcover
First published January 1, 2001
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Displaying 1 - 16 of 16 reviews
October 31, 2020
Not something I would typically read, (had to for AP euro) but it was far from boring. Gave an insightful look into malaria and the search for a cure, dating way back and even went into the early 2000s
May 13, 2022
I learned some interesting things and A LOT of uninteresting things from this book.
May 27, 2022
I've just finished reading the book "El Dorado": the search for the legendary "Golden Man " or the mother lode of the South American gold that the Incas seemed to have in such abundance. And the plant hunters described in this current book actually covered much the same ground in the Andes and in Venezuela, Colombia, Peru, Equador and Brazil. And the themes are similar: rain, mosquitos, heat, freezing cold, and terrible fevers and disease problems. The botanists don't seem to have had quite the same issues with headhunters and starvation as the Spanish gold seekers .......but they also seemed to be much more civilised. (The Spanish modus operandi was to live off the land......looting villages and taking slaves as bearers as they went). But certainly the fevers were a problem.
And I find this interesting because one of the themes of the current book is that the Americas were free of malaria and yellow fever prior to the arrival of Colombus. The theory is that Malaria was endemic in Seville and Barcelona .....the departure points for Colombus and that both malaria (different strains) and yellow fever were imported with African slaves. Sounds plausible ...certainly for the yellow fever: but both must have spread very rapidly in the Americas if it IS true. Columbus arrived in 1492. Cortez invaded Mexico in 1519 and Pizzaro was busy invading and conquering the Incas around 1529.....and they seemed to have been aided by the virulent spread of smallpox. Probably smallpox spread faster than the conquistadores.......certainly that's what happened with the European invasion of Australia. And if it happened with smallpox.......spread person to person...then, presumably, the fevers......spread by mosquitos (and infected hosts) could move even faster.
The gold seekers wasted no time and were active in the period from about 1530 (Nicolaus Federman in Venezuela)...to 1617 (Walter Raleigh in Orinoco). The Cichona plant seekers described in this book were active much later, in the 1800's ...and mostly in the period 1830-1860. The book is split fairly much between the activities of the plant explorers trying to smuggle live plants of cinchona out of South America and into plantations in India (British) and Indonesia (Dutch).
I was especially interested in the debunking of the famous story of the Viceroy's wife being saved by the infusion of the bark of the South American tree and then becoming a champion to introduce the cure into Europe. The fact that she was the Contessa de Chinchon gave the tree its European name. But, much to my confusion......and apparently many others....Linnaeus misspelled Chinchon and named the tree Cinchon. Actually, I have many very fond memories of great lunches with friends in the wine cuevas at Chinchon (which is not far from Madrid). And the town retains the almost medieval square and it's own castle. A lovely place.
Apparently the Jesuits introduced the bark to Europe in 1632 and it became known as the Jesuit's bark...and hence deprecated in protestant Britain....where people refused to use it. Clearly the genus is complicates with some botanists maintaining that there are 23 species and others that there are 15. The basic problem is that (apart from environmental differences which cause differences in growth habit) the plant does not self-fertilise and naturally hybridises. Hence the taxonomy is a mess and the medicinal quality/quantity of the quinine derived from the bark can vary greatly between species.
One of the things that fascinated me about the labours of the various botanists trying to collect cinchona and other new species of plants was the extraordinarily difficult circumstances under which they laboured and the number of collections (the result of years of work) that were lost to shipwreck or other disasters.
. La Condamine about 1742 lost a whole collection of cinchona saplings when a wave washed over his boat near the mouth of the Amazon after a journey from Mt Cajunama in the Andes....Probably about 3000km.
. Joseph de Jussieu spent years (from about 1737...at least until about 1743) collecting botanical specimens and experimenting with different species of cinchona. He entrusted his collection to a servant who disappeared with the lot and was never found.
. Hipolito Ruiz and Jose Pavon spent 7 years penetrating the forests of Peru and Chile collecting specimens; lost their journals and specimens (possibly a local collection) in a fire in 1786 but their main collection was in a ship that was wrecked off the coast of Portugal.
. Hugues Weddell in 1851 ..after 5 months of work danger and expenditure .. found most of his plants dead in the Wardian cases and sickly survivors that were unlikely to make it back to Europe,
. Richard Spruce 1859 after about a year's work in the Andes had 637 plants in Wardian cases. He was coming downriver from Lemon towards Guayaqui when the boat hit a mass of overhanging branches creating chaos but his cases survived.
. Clements Markham in 1860 took charge of Spruce's collection in 15 cases and another 6 for Pritchett's collection....a total of 450 plants. The original plan was for them to go straight to India from Panama but no such luck. They eventually went to India via Southampton (270 plants alive) then Egypt and Red Sea heat plus one case dropped into the sea. By the time they reached the hill station in India all plants were dead.
. Alfred Russell Wallace....after 4 years of work ....with his collection of natural history objects, skins, plants etc. sailed down the Amazon to Manaus and set sail for England in 1852. But 1,000 km from Bermuda his ship caught fire and all his collections were lost. How did these guys recover mentally from these sort of disasters?
Eventually, some of the specimens were grown successfully in plantations in Indonesia and India and elsewhere..and some of the pharmacology worked out ...though the English collectors and plantation managers slipped up with the most potent of the C. calisaya species and were growing a much less potent variety.
There is a big leap in the story then to the production of synthetic drugs for combatting malaria and more recently, molecular and DNA manipulation to develop vaccines.
One thing that the author makes clear is that the plasmodium causing malaria has a complex life cycle that makes it difficult to attack; it occurs in a range of different species and is transmitted by different species of mosquito. And every treatment has been thwarted by the ability of the plasmodium to develop resistance and morph it's genetic makeup. It truly is a tough nut for the medical establishment to crack. And malaria has been a hughe problem on battle fields where malaria has often killed more people than the soldier's guns.
I really enjoyed the book. Was going to give it 4 but on consideration, I give it 5 stars.
And I find this interesting because one of the themes of the current book is that the Americas were free of malaria and yellow fever prior to the arrival of Colombus. The theory is that Malaria was endemic in Seville and Barcelona .....the departure points for Colombus and that both malaria (different strains) and yellow fever were imported with African slaves. Sounds plausible ...certainly for the yellow fever: but both must have spread very rapidly in the Americas if it IS true. Columbus arrived in 1492. Cortez invaded Mexico in 1519 and Pizzaro was busy invading and conquering the Incas around 1529.....and they seemed to have been aided by the virulent spread of smallpox. Probably smallpox spread faster than the conquistadores.......certainly that's what happened with the European invasion of Australia. And if it happened with smallpox.......spread person to person...then, presumably, the fevers......spread by mosquitos (and infected hosts) could move even faster.
The gold seekers wasted no time and were active in the period from about 1530 (Nicolaus Federman in Venezuela)...to 1617 (Walter Raleigh in Orinoco). The Cichona plant seekers described in this book were active much later, in the 1800's ...and mostly in the period 1830-1860. The book is split fairly much between the activities of the plant explorers trying to smuggle live plants of cinchona out of South America and into plantations in India (British) and Indonesia (Dutch).
I was especially interested in the debunking of the famous story of the Viceroy's wife being saved by the infusion of the bark of the South American tree and then becoming a champion to introduce the cure into Europe. The fact that she was the Contessa de Chinchon gave the tree its European name. But, much to my confusion......and apparently many others....Linnaeus misspelled Chinchon and named the tree Cinchon. Actually, I have many very fond memories of great lunches with friends in the wine cuevas at Chinchon (which is not far from Madrid). And the town retains the almost medieval square and it's own castle. A lovely place.
Apparently the Jesuits introduced the bark to Europe in 1632 and it became known as the Jesuit's bark...and hence deprecated in protestant Britain....where people refused to use it. Clearly the genus is complicates with some botanists maintaining that there are 23 species and others that there are 15. The basic problem is that (apart from environmental differences which cause differences in growth habit) the plant does not self-fertilise and naturally hybridises. Hence the taxonomy is a mess and the medicinal quality/quantity of the quinine derived from the bark can vary greatly between species.
One of the things that fascinated me about the labours of the various botanists trying to collect cinchona and other new species of plants was the extraordinarily difficult circumstances under which they laboured and the number of collections (the result of years of work) that were lost to shipwreck or other disasters.
. La Condamine about 1742 lost a whole collection of cinchona saplings when a wave washed over his boat near the mouth of the Amazon after a journey from Mt Cajunama in the Andes....Probably about 3000km.
. Joseph de Jussieu spent years (from about 1737...at least until about 1743) collecting botanical specimens and experimenting with different species of cinchona. He entrusted his collection to a servant who disappeared with the lot and was never found.
. Hipolito Ruiz and Jose Pavon spent 7 years penetrating the forests of Peru and Chile collecting specimens; lost their journals and specimens (possibly a local collection) in a fire in 1786 but their main collection was in a ship that was wrecked off the coast of Portugal.
. Hugues Weddell in 1851 ..after 5 months of work danger and expenditure .. found most of his plants dead in the Wardian cases and sickly survivors that were unlikely to make it back to Europe,
. Richard Spruce 1859 after about a year's work in the Andes had 637 plants in Wardian cases. He was coming downriver from Lemon towards Guayaqui when the boat hit a mass of overhanging branches creating chaos but his cases survived.
. Clements Markham in 1860 took charge of Spruce's collection in 15 cases and another 6 for Pritchett's collection....a total of 450 plants. The original plan was for them to go straight to India from Panama but no such luck. They eventually went to India via Southampton (270 plants alive) then Egypt and Red Sea heat plus one case dropped into the sea. By the time they reached the hill station in India all plants were dead.
. Alfred Russell Wallace....after 4 years of work ....with his collection of natural history objects, skins, plants etc. sailed down the Amazon to Manaus and set sail for England in 1852. But 1,000 km from Bermuda his ship caught fire and all his collections were lost. How did these guys recover mentally from these sort of disasters?
Eventually, some of the specimens were grown successfully in plantations in Indonesia and India and elsewhere..and some of the pharmacology worked out ...though the English collectors and plantation managers slipped up with the most potent of the C. calisaya species and were growing a much less potent variety.
There is a big leap in the story then to the production of synthetic drugs for combatting malaria and more recently, molecular and DNA manipulation to develop vaccines.
One thing that the author makes clear is that the plasmodium causing malaria has a complex life cycle that makes it difficult to attack; it occurs in a range of different species and is transmitted by different species of mosquito. And every treatment has been thwarted by the ability of the plasmodium to develop resistance and morph it's genetic makeup. It truly is a tough nut for the medical establishment to crack. And malaria has been a hughe problem on battle fields where malaria has often killed more people than the soldier's guns.
I really enjoyed the book. Was going to give it 4 but on consideration, I give it 5 stars.
March 10, 2010
Informative and interesting? Yes, I'll grant you that.
"Reads like a nineteenth century thriller set in South America, filled with high adventure and botanical wonder, crisscrossing snowcapped mountains and jungle valleys"? Uh, not so much, Los Angeles Times.
I learned a lot from this slow to get going and at times rather dry history of malaria and quinine. And I admit, at times it almost got exciting. Almost. But I can only assume that the LA Times reviewer has never read an actual nineteenth century thriller, because those are quite a bit more interesting. There was certainly a lot of high adventure involved in the quest for the cinchona tree. Sadly, much of it is lost in this rather dry narrative.
Unless you are especially interested in malaria, epidemiology, or Andean history, you can skip this one. (If you are especially interested in any of these things, I actually recommend this book, but don't expect a thriller, per se.)
P.S. Packing every sentence with multiple place names? This may be more precise, but makes a book a bit rough-going. Thanks.
"Reads like a nineteenth century thriller set in South America, filled with high adventure and botanical wonder, crisscrossing snowcapped mountains and jungle valleys"? Uh, not so much, Los Angeles Times.
I learned a lot from this slow to get going and at times rather dry history of malaria and quinine. And I admit, at times it almost got exciting. Almost. But I can only assume that the LA Times reviewer has never read an actual nineteenth century thriller, because those are quite a bit more interesting. There was certainly a lot of high adventure involved in the quest for the cinchona tree. Sadly, much of it is lost in this rather dry narrative.
Unless you are especially interested in malaria, epidemiology, or Andean history, you can skip this one. (If you are especially interested in any of these things, I actually recommend this book, but don't expect a thriller, per se.)
P.S. Packing every sentence with multiple place names? This may be more precise, but makes a book a bit rough-going. Thanks.
July 29, 2015
WHERE WERE THE WOMEN?
January 11, 2016
Malaria is a scourge of mankind. Till a few centuries back, it afflicted all parts of the globe with equal severity, but is now confined mainly to the Third World. Millions of children die every year in sub-Saharan Africa due to this illness and the drain on the economy caused by the incapacitation of healthy individuals is considerable. It has killed 60 times more people than AIDS. The book presents a detailed historical narrative of the search for finding a cure for malaria. It tells the story of finding a natural cure in the bark of the cinchona tree in its natural habitat of South America and the epic struggle by a few spirited explorers to get its seeds out to the whole world for starting cultivations elsewhere. The book ends with a brief description of the state of the art in finding a vaccine for it. Mark Honigsbaum is a medical historian and journalist with a long standing interest in the history and science of infectious diseases. He is a regular contributor to British newspapers and has authored four books.
The cinchona plant is a miracle, in the sense that its bark contains the cure for malaria. The case of a single plant being the only effective remedy for a killer disease is rare. It is equally miraculous that man found out about the tree and its gift, as historians suggest that malaria was not endemic to South America. The disease came with the conquistadores from the Old World. The question of who discovered the febrifugal property of the plant may never be answered, but urban legend associates its widespread use with Dona Francisca Henriquez de Ribera, the fourth Countess of Chinchon in Spain, who was the vicereine of Peru. Legend has it that she became ill with malaria and the viceroy despaired of her life. When all else failed, a local Jesuit priest suggested the dried bark of a tree called ayac cara (bitter bark) or quinquina (bark of barks). The lady was cured after administering the bark and the story spread like wildfire. When Carl Linnaeus, the father of taxonomy was faced with the task of naming the species, he settled on cinchona, somehow omitting the first ‘h’ of the lady’s estate. The plant’s original habitat was South America. The finest cinchonas were very particular about the region in which they thrived. The best trees were found on the slopes of Cajanuma Mountain in the Loja province of Ecuador. Honigsbaum don’t keep the reader in suspense of how malaria came to the New World. He ascribes this with the slave trade, in which tens of thousands of Blacks were transported forcibly from the malaria-infected river banks of Africa. Some of the Africans have a natural genetic defence against the disease in the form of sickle-shaped cells in their blood stream, but they act as carriers of the sickness. It is notable that Africans were vulnerable to malaria for indeed a very long time that evolution has favoured a group of individuals with the trait of sickle cells, which of course produces other debilitating effects. The mosquitos which flourished in the half-cleared swamps of South America vectored the parasite Plasmodium falciparum among the natives as well as European settlers.
The book tells the story of transplantation of cinchona trees from South America to India and Java. By the 19th century, quinine production had started on an industrial scale. Having the monopoly of the bark, the governments of Peru, Bolivia and Ecuador jealously guarded the trees, forbidding export of live plants and seeds. As the bark grew dearer in price, smuggling rose proportionately. Besides, excessive harvest of bark and indiscriminate felling of trees threatened the existence of the species itself. The British and Dutch governments watched the emerging scenario with growing alarm. The South American republics often fought amongst themselves and were breeding grounds for bloody revolutions and coups. Even though it amounted to looting of the biological asset of a sovereign state, it was in the interest of humanity to transplant the trees to save it from extinction and to produce quinine in large quantities for selling to the public at affordable prices. Several teams tried their luck on the slopes of Andes and its foot hills. Richard Spruce, Clements Markham and Charles Ledger were successful in getting the plants and seeds out of South America. However, while haggling over the price, some of it reached the hands of the Dutch. Soon, large gardens of cinchonas sprouted in Dutch Java and at Nilgiri and Darjeeling in India. The Javan plantations carefully grafted the trees to obtain fine specimens with huge quinine content, while the Indian trees got hybridized due to lack of scientific cultivation. Consequently, the cost of Javan quinine was lesser. The Dutch could sell it with greater profit too. By the 1880s, quinine price had reached rock bottom due to increased production in Asia. The South American bark industry collapsed as a result.
Even though the author gives an exhaustive description of the quest for cinchona trees – even by narrating the day to day incidents during the exploration – he glosses over the heroic search for the vector of the disease and Ronald Ross’ discovery that the mosquito was the medium of propagation of the disease. Common wisdom was that malaria was spread through foul air – miasma – found in the presence of swamps and marshes. This was overturned only in the 19th century when researchers identified the mosquito to be the real culprit. Honigsbaum quotes Susruta, who was an ancient proponent of medical profession that five varieties of diseases are caused by mosquitos. But it is to be noted that Susruta does not identify malaria as such and definitely, this observation was far advanced than the medical line of thought in the middle ages.
The final few chapters of the book are devoted to the quest for finding a synthetic prophylaxis against the disease. Chloroquine is one of the most widely used remedy, but researchers are worried that the malaria parasite is growing resistance to the medicine. This is a terrifying prospect for global society considering the ease with which the malady spreads and it’s long lasting debilitating effects. The falciparum parasite was evolved a very long time ago, conferring on it many genetic traits for survival. A close ancestor of the parasite even has the ability to produce chlorophyll, showing its origin in the remotest antiquity when life itself made its first waddling steps. The book ends with a survey of the quest for finding a vaccine to malaria so that it can be prevented from affecting an individual, rather than as a cure. Researchers are working on the project worldwide, but big pharma’s budget is still not being allocated to it in sufficient measure. Among the researchers in the forefront of the study, the author gives pride of place to Manuel Elkin Patarroyo, a highly influential Colombian researcher. Even though his methodology appears to be a little dubious, his vaccine named SPf66 is still the most efficacious one, though it has much more miles to go before universal adoption. Honigsbaum ends the narrative describing the many initiatives which were projected to be on the verge of bearing fruit. This book was published in 2001, but even now, a vaccine for malaria is still elusive.
The book is very nicely structured with clear text accompanied by good photographic plates and maps. An informative section of foot-notes is given along with an exhaustive bibliography and a thoroughly comprehensive index. The narrative is very lucid and appeals to all classes of readers. The book includes flowery praise for the philanthropic contributions of the Wellcome Trust. However, when we realize that the author is currently working as a Wellcome Research Fellow at Queen Mary University in London, we begin to have doubts on the veracity of the assertion.
The book is highly recommended.
The cinchona plant is a miracle, in the sense that its bark contains the cure for malaria. The case of a single plant being the only effective remedy for a killer disease is rare. It is equally miraculous that man found out about the tree and its gift, as historians suggest that malaria was not endemic to South America. The disease came with the conquistadores from the Old World. The question of who discovered the febrifugal property of the plant may never be answered, but urban legend associates its widespread use with Dona Francisca Henriquez de Ribera, the fourth Countess of Chinchon in Spain, who was the vicereine of Peru. Legend has it that she became ill with malaria and the viceroy despaired of her life. When all else failed, a local Jesuit priest suggested the dried bark of a tree called ayac cara (bitter bark) or quinquina (bark of barks). The lady was cured after administering the bark and the story spread like wildfire. When Carl Linnaeus, the father of taxonomy was faced with the task of naming the species, he settled on cinchona, somehow omitting the first ‘h’ of the lady’s estate. The plant’s original habitat was South America. The finest cinchonas were very particular about the region in which they thrived. The best trees were found on the slopes of Cajanuma Mountain in the Loja province of Ecuador. Honigsbaum don’t keep the reader in suspense of how malaria came to the New World. He ascribes this with the slave trade, in which tens of thousands of Blacks were transported forcibly from the malaria-infected river banks of Africa. Some of the Africans have a natural genetic defence against the disease in the form of sickle-shaped cells in their blood stream, but they act as carriers of the sickness. It is notable that Africans were vulnerable to malaria for indeed a very long time that evolution has favoured a group of individuals with the trait of sickle cells, which of course produces other debilitating effects. The mosquitos which flourished in the half-cleared swamps of South America vectored the parasite Plasmodium falciparum among the natives as well as European settlers.
The book tells the story of transplantation of cinchona trees from South America to India and Java. By the 19th century, quinine production had started on an industrial scale. Having the monopoly of the bark, the governments of Peru, Bolivia and Ecuador jealously guarded the trees, forbidding export of live plants and seeds. As the bark grew dearer in price, smuggling rose proportionately. Besides, excessive harvest of bark and indiscriminate felling of trees threatened the existence of the species itself. The British and Dutch governments watched the emerging scenario with growing alarm. The South American republics often fought amongst themselves and were breeding grounds for bloody revolutions and coups. Even though it amounted to looting of the biological asset of a sovereign state, it was in the interest of humanity to transplant the trees to save it from extinction and to produce quinine in large quantities for selling to the public at affordable prices. Several teams tried their luck on the slopes of Andes and its foot hills. Richard Spruce, Clements Markham and Charles Ledger were successful in getting the plants and seeds out of South America. However, while haggling over the price, some of it reached the hands of the Dutch. Soon, large gardens of cinchonas sprouted in Dutch Java and at Nilgiri and Darjeeling in India. The Javan plantations carefully grafted the trees to obtain fine specimens with huge quinine content, while the Indian trees got hybridized due to lack of scientific cultivation. Consequently, the cost of Javan quinine was lesser. The Dutch could sell it with greater profit too. By the 1880s, quinine price had reached rock bottom due to increased production in Asia. The South American bark industry collapsed as a result.
Even though the author gives an exhaustive description of the quest for cinchona trees – even by narrating the day to day incidents during the exploration – he glosses over the heroic search for the vector of the disease and Ronald Ross’ discovery that the mosquito was the medium of propagation of the disease. Common wisdom was that malaria was spread through foul air – miasma – found in the presence of swamps and marshes. This was overturned only in the 19th century when researchers identified the mosquito to be the real culprit. Honigsbaum quotes Susruta, who was an ancient proponent of medical profession that five varieties of diseases are caused by mosquitos. But it is to be noted that Susruta does not identify malaria as such and definitely, this observation was far advanced than the medical line of thought in the middle ages.
The final few chapters of the book are devoted to the quest for finding a synthetic prophylaxis against the disease. Chloroquine is one of the most widely used remedy, but researchers are worried that the malaria parasite is growing resistance to the medicine. This is a terrifying prospect for global society considering the ease with which the malady spreads and it’s long lasting debilitating effects. The falciparum parasite was evolved a very long time ago, conferring on it many genetic traits for survival. A close ancestor of the parasite even has the ability to produce chlorophyll, showing its origin in the remotest antiquity when life itself made its first waddling steps. The book ends with a survey of the quest for finding a vaccine to malaria so that it can be prevented from affecting an individual, rather than as a cure. Researchers are working on the project worldwide, but big pharma’s budget is still not being allocated to it in sufficient measure. Among the researchers in the forefront of the study, the author gives pride of place to Manuel Elkin Patarroyo, a highly influential Colombian researcher. Even though his methodology appears to be a little dubious, his vaccine named SPf66 is still the most efficacious one, though it has much more miles to go before universal adoption. Honigsbaum ends the narrative describing the many initiatives which were projected to be on the verge of bearing fruit. This book was published in 2001, but even now, a vaccine for malaria is still elusive.
The book is very nicely structured with clear text accompanied by good photographic plates and maps. An informative section of foot-notes is given along with an exhaustive bibliography and a thoroughly comprehensive index. The narrative is very lucid and appeals to all classes of readers. The book includes flowery praise for the philanthropic contributions of the Wellcome Trust. However, when we realize that the author is currently working as a Wellcome Research Fellow at Queen Mary University in London, we begin to have doubts on the veracity of the assertion.
The book is highly recommended.
September 8, 2017
Getting my hands on this book was a bit of a production. It all started a couple of years ago when I decided to wanted to learn more about malaria. As a disease that remains a serious problem in much of the developing world, I figured there would be a good, recent book available written for the layperson. Guess again. After digging around extensively on Amazon, The Fever Trail, written in 2001(!) appeared to be my best option. I added it to my "to read" list and promptly forgot about it.
Fast forward three years, and I decide this will be my next book. I check the Arlington Library. No dice. DC Library. Nothing. The USAID Library. Not even there. According to Amazon, it's out of print. I end up having to get it as an intra-library loan through the USAID Library.
So was The Fever Trail worth the trouble? Yes! I really liked it and learned a ton. Malaria, while obviously horrible, is a fascinating disease.
Stuff I learned:
-Malaria is super super old; evidence of malaria was found preserved in amber from the Paleocene (30 million years ago). It is thought to have co-evolved with humans, which is what makes it such a pernicious disease. People and malaria have basically been involved in a evolutionary chess match for tens of thousands of years. Sickle cell anemia? Thought to be an evolutionary response to malaria. That is bananas.
-Malaria used to be a huge problem in a bunch of places I didn't expect, including coastal England, where its mortality rate was comparable to that of malaria in sub-Saharan Africa today.
-The fact that malaria is not a bacteria or virus, but a protozoa, is what has made a vaccine so elusive. I knew the protozoa thing, but its connection to the vaccine was a serious "aha!" moment.
Probably two-thirds of the book is spent on the race by a handful of adventurous Europeans to find and smuggle the cinchona tree, which yields quinine, out of South America. I knew absolutely nothing about this particular topic, and found it totally gripping. Like "make a movie about it" gripping.
A second glance at Amazon upon writing this review reveals that there are a few more recent books about malaria that have hit the marketplace. I'm sure they are more up-to-date than Fever Trail, which talks about Malarone as a promising new drug still in trials. However, though it might be tough to find, I'd still recommend giving Fever Trail a read. The story of the cinchona race alone is worth it.
Fast forward three years, and I decide this will be my next book. I check the Arlington Library. No dice. DC Library. Nothing. The USAID Library. Not even there. According to Amazon, it's out of print. I end up having to get it as an intra-library loan through the USAID Library.
So was The Fever Trail worth the trouble? Yes! I really liked it and learned a ton. Malaria, while obviously horrible, is a fascinating disease.
Stuff I learned:
-Malaria is super super old; evidence of malaria was found preserved in amber from the Paleocene (30 million years ago). It is thought to have co-evolved with humans, which is what makes it such a pernicious disease. People and malaria have basically been involved in a evolutionary chess match for tens of thousands of years. Sickle cell anemia? Thought to be an evolutionary response to malaria. That is bananas.
-Malaria used to be a huge problem in a bunch of places I didn't expect, including coastal England, where its mortality rate was comparable to that of malaria in sub-Saharan Africa today.
-The fact that malaria is not a bacteria or virus, but a protozoa, is what has made a vaccine so elusive. I knew the protozoa thing, but its connection to the vaccine was a serious "aha!" moment.
Probably two-thirds of the book is spent on the race by a handful of adventurous Europeans to find and smuggle the cinchona tree, which yields quinine, out of South America. I knew absolutely nothing about this particular topic, and found it totally gripping. Like "make a movie about it" gripping.
A second glance at Amazon upon writing this review reveals that there are a few more recent books about malaria that have hit the marketplace. I'm sure they are more up-to-date than Fever Trail, which talks about Malarone as a promising new drug still in trials. However, though it might be tough to find, I'd still recommend giving Fever Trail a read. The story of the cinchona race alone is worth it.
February 4, 2021
The horrible, racist disparities we are seeing in the COVID-19 pandemic are nothing new. European and British colonial powers did not introduce malaria the way US settler-colonists purposely infected Native populations with smallpox. But malaria's high death tolls afflicting people in India, Africa, and the rest of the global South is a story of racist neglect. And the reason we don't hear much about malaria (the author reports that some experts say that, in total, malaria has killed half the humans on earth) is simple: most of the victims are not white. The empires did tackle malaria, mostly because it was killing its occupying armies.
This book is the story of the empires' search for a cure. It's the nature of Euro- and Anglo-centric academic "history" that it is based on written records. Thus only one Indigenous person is featured in the book, Manuel--a converted Christian known only by his first name. The author sees the irony in this, since it was Manuel who provided the most potent seeds and seedlings of the cincona tree, the source of quinine, the only known cure for malaria in the 19th century. And it was Manuel, not his English boss, who was caught and beaten to death for aiding in the smuggling of this coveted national resource.
The book ends with a warning: malaria and other mosquitos born parasitical diseases are moving North with global warming. But it's still killing millions of people of color. Capitalism, of course, does not want to invest in anything that does not yield massive profits. So unless people live in a socialist country (Vietnam provides free mosquito nets laced with synthetic pyrethrins) they are screwed if they can't afford the latest medications. And that's billions of people. Even though it dwells on the sob stories of English malaria cure hunters, this is another grim book that is well worth reading while pandemic consciousness is high.
This book is the story of the empires' search for a cure. It's the nature of Euro- and Anglo-centric academic "history" that it is based on written records. Thus only one Indigenous person is featured in the book, Manuel--a converted Christian known only by his first name. The author sees the irony in this, since it was Manuel who provided the most potent seeds and seedlings of the cincona tree, the source of quinine, the only known cure for malaria in the 19th century. And it was Manuel, not his English boss, who was caught and beaten to death for aiding in the smuggling of this coveted national resource.
The book ends with a warning: malaria and other mosquitos born parasitical diseases are moving North with global warming. But it's still killing millions of people of color. Capitalism, of course, does not want to invest in anything that does not yield massive profits. So unless people live in a socialist country (Vietnam provides free mosquito nets laced with synthetic pyrethrins) they are screwed if they can't afford the latest medications. And that's billions of people. Even though it dwells on the sob stories of English malaria cure hunters, this is another grim book that is well worth reading while pandemic consciousness is high.
May 13, 2012
(this review was originally written for bookslut)
The Fever Trail presents a fascinating story that, in my opinion, could have been better written. I was very excited when my review copy arrived in the mail. I had visited the book's website, which was very well done and it left me eager to read the book. The book promises to be the story of Richard Spruce, Charles Ledger, and Sir Clements Markham, three European men who journeyed to South America in attempts to bring back cinchona, the tree which produces quinine, a drug used to treat malaria -- however, the book is about much more than that. It starts with the South American expeditions, then rambles through the effects of malaria on various battles in military history, then finally ends up by talking about the current efforts to develop a malaria vaccine.
The story itself is very interesting, peopled as it is with so many under-appreciated heroes risking death in order to save the endangered cinchona tree and deliver a reliable source of quinine to the world. At the time during which most of the book is set, cinchona trees grow only high in the mountains of South America. Malaria, of course, is not so confined, being widespread throughout much of Africa, Europe, and Southern Asia. Once the Europeans arrived in the Americas, they introduced malaria to the Western hemisphere as well. Getting cinchona back to Europe not only meant surviving the mosquito-ridden Amazon (at a time when people didn't know that mosquitoes caused malaria, and so didn't take adequate steps to protect themselves), then the trek up into the Andes, and avoiding head-hunting natives, it also meant currying favor with the local governments, who had often outlawed the export of any cinchona plants or seeds. Wars, fires, and theft also had to be avoided. Then, of course, once the plants and seeds had been collected and put on a boat for export, there was the not at all trivial matter of transporting them across the Atlantic alive. The odds were not good. This is gripping stuff.
However many times Mark Honigsbaum's writing left me dreading picking the book up again. From the very beginning his writing style seemed rather random. He defined words whose meaning anyone with a dictionary could have discovered and that he might only have used once, but then phrases like "tertiary fever," which you can't just look up and which appear throughout the book were never explained. The pacing of the book was all over the place, and the jumps back and forth in time and the sheer number of important players in the book often left me baffled. The unfamiliar geography was also a challenge, and though there were maps at the front of the book, I don't recall them ever being referred to in the text, so they weren't nearly as helpful as they might have been.
Overall, I would not recommend this book to someone just looking for an enjoyable popular science book. If that's all you want, read Carl Sagan, or pick up a copy of And the Band Played On. But if you want to know more about malaria and the colonization of South America (as well as much of the Southern Hemisphere), this book is crammed with diverting tidbits and useful information. I do feel smarter for having read this book, and isn't that what we read non-fiction for?
The Fever Trail presents a fascinating story that, in my opinion, could have been better written. I was very excited when my review copy arrived in the mail. I had visited the book's website, which was very well done and it left me eager to read the book. The book promises to be the story of Richard Spruce, Charles Ledger, and Sir Clements Markham, three European men who journeyed to South America in attempts to bring back cinchona, the tree which produces quinine, a drug used to treat malaria -- however, the book is about much more than that. It starts with the South American expeditions, then rambles through the effects of malaria on various battles in military history, then finally ends up by talking about the current efforts to develop a malaria vaccine.
The story itself is very interesting, peopled as it is with so many under-appreciated heroes risking death in order to save the endangered cinchona tree and deliver a reliable source of quinine to the world. At the time during which most of the book is set, cinchona trees grow only high in the mountains of South America. Malaria, of course, is not so confined, being widespread throughout much of Africa, Europe, and Southern Asia. Once the Europeans arrived in the Americas, they introduced malaria to the Western hemisphere as well. Getting cinchona back to Europe not only meant surviving the mosquito-ridden Amazon (at a time when people didn't know that mosquitoes caused malaria, and so didn't take adequate steps to protect themselves), then the trek up into the Andes, and avoiding head-hunting natives, it also meant currying favor with the local governments, who had often outlawed the export of any cinchona plants or seeds. Wars, fires, and theft also had to be avoided. Then, of course, once the plants and seeds had been collected and put on a boat for export, there was the not at all trivial matter of transporting them across the Atlantic alive. The odds were not good. This is gripping stuff.
However many times Mark Honigsbaum's writing left me dreading picking the book up again. From the very beginning his writing style seemed rather random. He defined words whose meaning anyone with a dictionary could have discovered and that he might only have used once, but then phrases like "tertiary fever," which you can't just look up and which appear throughout the book were never explained. The pacing of the book was all over the place, and the jumps back and forth in time and the sheer number of important players in the book often left me baffled. The unfamiliar geography was also a challenge, and though there were maps at the front of the book, I don't recall them ever being referred to in the text, so they weren't nearly as helpful as they might have been.
Overall, I would not recommend this book to someone just looking for an enjoyable popular science book. If that's all you want, read Carl Sagan, or pick up a copy of And the Band Played On. But if you want to know more about malaria and the colonization of South America (as well as much of the Southern Hemisphere), this book is crammed with diverting tidbits and useful information. I do feel smarter for having read this book, and isn't that what we read non-fiction for?
March 8, 2017
Malaria has been a serious disease in Europe, Central Africa and parts of Asia for thousands of years. For most of that time it was untreatable, until quinine was found to reduce the fever and give sufferers a better chance to fight the disease. Quinine is present in cinchona bark and cinchona grows in South America.
Most of the book covers the attempts to identify the correct plant (the botany is complicated), establish the correct way to use it for malaria and get it accepted as a treatment, and then find the trees, collect seeds and cultivate them around the world, wherever they might be needed. Many of the collectors were interesting characters and the author follows the travels and travails with enthusiasm. Some of the most successful were geographers who did a bit of botany on the side; we would now call them environmental scientists. This let to a lot of confusion about differentiating the various species and hybrids, but also meant there was information on the best natural conditions in which to cultivate the plants.
Later stages of the book cover attempts to identify the malarial parasite, find the vector and eradicate the disease. We still have not succeeded in the last of these, but it is no longer the scourge it once was.
The author could have organised his book better, he jumps about with the chronology as he covers the various plant collectors, repeats bits and sometimes gets a bit confused. There is a lot of very interesting material however, and he writes in an accessible way, explaining most of the more difficult aspects clearly.
Most of the book covers the attempts to identify the correct plant (the botany is complicated), establish the correct way to use it for malaria and get it accepted as a treatment, and then find the trees, collect seeds and cultivate them around the world, wherever they might be needed. Many of the collectors were interesting characters and the author follows the travels and travails with enthusiasm. Some of the most successful were geographers who did a bit of botany on the side; we would now call them environmental scientists. This let to a lot of confusion about differentiating the various species and hybrids, but also meant there was information on the best natural conditions in which to cultivate the plants.
Later stages of the book cover attempts to identify the malarial parasite, find the vector and eradicate the disease. We still have not succeeded in the last of these, but it is no longer the scourge it once was.
The author could have organised his book better, he jumps about with the chronology as he covers the various plant collectors, repeats bits and sometimes gets a bit confused. There is a lot of very interesting material however, and he writes in an accessible way, explaining most of the more difficult aspects clearly.
June 28, 2009
On recommendation from a trusted friend in mission work, I purchased and read this story of the search for a cure to malaria. The history was good; it was politics as usual along with petty jealousies and bureaucratic bungling that kept quinine from being widely available for quite some time. The anti-DDT mentality kills thousands of children even today, and the mosquitoes continue to develop resistance to the new drugs. The orginal European adventurers were some hardy fellows.
May 3, 2016
This is a very well written and very informative book on the efforts to find a cure for malaria, covering past as well as current technologies. It is not a book about malaria itself other than what is necessary to understand how cures worked or might work.
It made a good companion to the book about mosquitoes and their natural history that I had read about a year ago.
Recommended.
It made a good companion to the book about mosquitoes and their natural history that I had read about a year ago.
Recommended.
July 22, 2008
great account of the search for a cure for malaria, however it is not a 'flowing' read. The detailed history given for each 'adventure' is neccessary, but results in putting the book down to look up people's names and geographic locations.
January 1, 2014
This book's topic is super-important and fascinating, even if the book wasn't. Interesting perspective on an early case of theft of biodiversity, since I wasn't aware that it was a concern so early in Latin American history.
March 18, 2014
Offers a very comprehensive history on the search for a cure for Malaria.
October 1, 2015
Interesting, if a little dry.
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