The Pandemic Century: A History of Global Contagion from the Spanish Flu to Covid-19

by Mark Honigsbaum

A Financial Times Best Book of the Year

The most timely and informative history book you will read this year, tracing a century of pandemics, with a new chapter on COVID-19.

Ever since the 1918 Spanish influenza pandemic, scientists have dreamed of preventing catastrophic outbreaks of infectious disease. Yet, despite a century of medical progress, viral and bacterial disasters continue to take us by surprise, inciting panic and dominating news cycles. From the Spanish flu and the 1924 outbreak of pneumonic plague in Los Angeles, to the 1930 'parrot fever' pandemic and the more recent SARS, Ebola, Zika and – now – COVID-19 epidemics, the last 100 years have been marked by a succession of unanticipated pandemic alarms.

In The Pandemic Century, Mark Honigsbaum chronicles 100 years of history in 10 outbreaks. Bringing us right up-to-date with a new chapter on COVID-19, this fast-paced, critically-acclaimed book combines science history, medical sociology and thrilling front-line reportage to deliver the story of our times.

As we meet dedicated disease detectives, obstructive public health officials, and gifted scientists often blinded by their own expertise, we come face-to-face with the brilliance and medical hubris shaping both the frontier of science – and the future of humanity’s survival.

Genres: Nonfiction, History, Science, Medicine, Health, Medical, Audiobook

384 pages, Paperback

Published June 4, 2020

Reviews

[Charlene · Rating 4 out of 5]

Each time humans have faced a pandemic, they have been woefully underprepared. A year ago, Mark Honigsbaum published this book to serve as a warning for the coming "germ x". In order to help society understand how important it is to prepare for pandemics, Honigsbaum detailed the last 100 years of pandemics that caught humans all over the globe by surprise. He did an excellent job of illustrating the biology happening in the animal body as well as the political and social scene that played out around each pandemic. The epilogue served to remind readers that if society did not do a good job of preparing for the next unforeseen pandemic, we could be almost as bad off as humans were in each of the pandemics encountered over the past 100 years. He highlighted the efforts put forth by Bill and Malinda Gates as well as Mark Zuckerberg and Priscilla Chan to help  equip the entire world for the pandemics that were not just probably to come, but *surely* to come. Honigsbaum made no mention of the fact that Trump fired the U.S. pandemic response team in 2018 to cut costs. 

Oddly, and quite enjoyably, Honigsbaum began his discussion of pandemics by demonstrating how they can sometimes act like unpredictable wild animals. For example, no one predicted the shark attacks of 1916 that occurred in the cool waters of the Jersey Shore because up to that point, the experts agreed that sharks enjoyed the relatively warmer waters from North Carolina and Southward. The same was true for the germs that cause Ebola. Those germs, like sharks, enjoy a warmer climate; so, no one expected Ebola to leave Central Africa in 2014 and travel to the colder climates of Europe and the United States. It caught everyone as much off guard as the 1916 shark attacks did. But it was not simply the warmer climates that helped ebola become a more successful virus. When the rain forests, where it lives, were left undisturbed, the virus was only as successful as it could be by infecting the local bats and chimps that lived atop the trees. However, when humans disrupted the rain forests, they did not simply displace the species of animals living in those forests, they displaced, and freed, the species of virus that was once largely contained. 

When humans came into contact with the bats or chimps who had the virus, the virus was able to spillover into humans. Both humans' immune systems and hospitals were underprepared for the encounter. Every time the immune system encounters something new, it suffers a learning curve. Its immune cells do not know how to hunt down and effectively attack a novel enemy. Hospitals treat the same illness each year. They are prepared for those illnesses. Doctors and nurses can get flu shots that help inoculate them from the flu and other illness. The immune systems of health care workers have encountered all the usual contagious illnesses. Workers are able to recognize the signs of familiar contagions. When something new makes its way through that hospital door, workers and other patients are extremely vulnerable because if you cannot recognize what type of illness is occurring, right away, you are unable to contain and treat it. Take for example the doctor who infected many many people with SARS. He walked into the hospital, was given a nebulizer for his shortness of breath (a very common treatment for shortness of breath), and ended up expelling infected air each time he breathed out the nebulizer mist. That mist carried the SARS virus through the entire wing. A virus that is unfamiliar to humans has a huge advantage. 

All of the pandemics were extremely interesting. I will detail a few. 

In 1918, the Spanish flu (so named only because the Spanish were the only ones being honest and not trying to cover up the fact that they had a dangerous flu circulating), was caused by the H1N1virus that was normally confined to birds, spilled over into humans and triggered the same type of deadly cytokine storm Covid 19 is causing presently. 

BTW, it is worth relaying what I just heard on Fox News from Kellyanne Conway this morning. Conway: "This is Covid 19, not Covid 1 folks, and so you would think....." the WHO would be on that, able to deal with that....... You know, since it's the 19th version of the virus. That would be hilarious if she and her scientifically illiterate colleagues were not in charge of our country. She actually thinks is the 19th version, despite that it's called the *novel* coronavirus. How can these people be in charge of anything, let alone an entire country?

In the 1920s, the Bubonic Plague hit CA. By the 1920s, researchers knew a thing or two about disease, and so they were certain it was being caused by those dirty rats and the fleas who suck their infected blood and inject it into humans. But, as they tested rat and after rat, not a single rat tested positive for plague. The culprit ended up being fleas who were feasting on squirrels, not rats. So squirrels became public enemy number one. You probably look at those cute little squirrels today and don't worry too much about them harming you. Turns out, there are still about 17 deaths from plague a year. So, watch out for those squirrels. 

In 1929, humans were enamored with another cute set of animals. Who doesn't love a love bird, a finch, a beautiful and brilliant parrot, or a cute little parakeet? Certainly in 1929, there was no better way to say, "I love you," than to present your lover with a love bird.... and you know, the deadly Parrot Flu that came along with it. Birds in cages, who got sick, had diarrhea that often dried fairly quickly and turned to dust. When the birds flapped their wings, they sent the dust flying into the air and into human lungs. During this time, one theater group used a parrot in their play. During one scene, each actor took a turn petting the parrot. Only one actor survived. 

Interestingly, captive birds were at higher risk for catching and spreading psittacosis (Parrot Fever). This is because when birds in the wild catch it, the acquire life long immunity. However, when a bird is in captivity it causes extraordinary stress, which in turn compromises the immune systems of captive birds, making them no longer have immunity to something they previously had immunity for. For this reason, captive love birds, parrots, and parakeets caught the illness at higher rates than birds in the wild. Being caged with other birds also caused the rapid spread from bird to bird, and then to the humans with which the birds came in contact.

I have been enjoying Ed Yong's Covid 19 articles published in The Atlantic. This book included similar information to what Yong has been sharing. I would love for Yong, who wrote, "I Contain Multitudes," to eventually write about Covid 19 and about pandemics in general. He is an exceptional writer. I recommend his articles. 
The Chapter on AIDS was pretty informative. Better than other chapters/books I have read about AIDS. However, the chapter on Ebola was not nearly as good as David Quammen's Spillover. So, if you have not read that yet, I highly recommend it. 

One thing I found interesting is that NYC often served as the epicenter of pandemics when they reached the United States. That makes perfect sense, considering its role in America. It's a hub of business, travel, etc. Of course it would be hard hit in the past and now with Covid 19 spreading through our country. It is unfathomable to me that Trump, Kushner, and colleagues made it seem like it was NYC's fault for being so hard hit. Did NYC fire the pandemic readiness team? Kushner suggested that the federal stockpile of ventilators was not for states. As if to say, 'Duh, it's for the *federal* people!!" Um, Kushner, the federal stockpiles are for its people and should be distributed to those in need when a pandemic hits. 

**Added note: Considering the fact that China covered up Covid 19, it was interesting to read what lengths they went to in order to try to cover up SARS. Chinese citizens who wanted to get a true count had to sneak into different parts of China and secretly take samples to determine how many people were infected. There is a serious problem when a secretive government is in charge of funding part of the WHO. Trump has now taken from WHO the 400-500 million dollars of funding that is needed to fight a virus that is killing many Americans. Fight corruption (maybe fight his own corruption of calling Covid 19 a hoax!), work with world leader to put more trust worthy people in charge of WHO, or work to have the WHO rely less on Chinese funding. But, to defund WHO during a world health crisis is absurd! Trump has got to be one of the worst human being in history.

[Andy · Rating 2 out of 5]

Thoroughly unnecessary. The intro promises some kind of a new paradigm for understanding pandemics, but opportunities to explore important new angles are merely hinted at. For example, on the very last page, the author mentions in passing that the WHO was accused of "faking" the 2009 "pandemic." Huh?! That's something that's not in the old flu books and would be worth investigating, particularly for the advertised focus of "panic, hysteria, and hubris."

Instead, the author just keeps echoing the bio-thriller themes familiar since Alfred Crosby's 1976 book about influenza. The content is like a series of long summaries of other books.

The writing is clunky with sentences like "If SARS was a calamity for Toronto, for Hong Kong it was a disaster."

The logic too is clunky with lots of internal contradictions. For example, we're told that we have made huge progress in understanding why the 1918 influenza was so virulent, but on the same page we learn that we have no idea why the 1918 flu was as deadly as it was or how to predict/prevent the recurrence of another pandemic. If you parse the individual sentences, the author is accurately parroting what experts have said, but he doesn't seem to connect the dots for the big picture of what is relevant for public health. This is symptomatic of a general confusion about the differences between germ/infection vs. person/illness vs. population/pandemic. All of that is pretty standard for the genre so not a particular weakness of this writer.

Some better books for this general topic:
The Great Manchurian Plague of 1910-1911: The Geopolitics of an Epidemic Disease
Evolution of Infectious Disease
The Origins of Human Disease
Rats, Lice, and History: Being a Study in Biography, Which, After Twelve Preliminary Chapters Indispensable for the Preparation of the Lay Reader, Deals With the Life History of Typhus Fever
The Making of a Tropical Disease: A Short History of Malaria

[Amy · Rating 2 out of 5]

I'm interested in public health, so when I spotted The Pandemic Century on the new book display at my local library, I picked it up. I have to say, though, my view of the book is mixed at best. I have read a bunch of other books about two of the epidemics that chapters of The Pandemic Century focused on: the 1918 flu epidemic most commonly known as the Spanish flu and the little known early 1900s plague epidemic in California. Neither portrayal/explanation of these two epidemics were particularly well done, and I would go as far as to say that, in some places, they are extremely misleading.

For the first chapter with the 1918 flu, the author gives very strange and hard to follow explanations of flu spread. He claims to get these from John Barry's The Great Influenza, a fairly comprehensive dissection of the medical history, military history, science history, and (admittedly to a lesser extent) cultural history associated with World War I and the almost simultaneous spread of a very virulent flu into a pandemic. I have read that book, I can definitively say Honigsbaum's explanation and Barry's are nothing alike. For one, Barry's explanation is significantly more detailed and makes reference to military documentation, the best source of documentation available for the time. For two, Barry's explanation, though a bit long-winded, was significantly clearer and easier to understand. I came into The Pandemic Century with the background information provided by other books on the 1918 pandemic, and still couldn't follow what information the author was trying to convey about the flu's spread, and that's not a good sign.

Additionally, Honigsbaum repeatedly makes the claim that no knows anything about various important information about the flu, such as why it was so virulent, why young adults (in their twenties and thirties) were the hardest age group hit, why it caused cyanosis, where it originated, and so on. This makes it sound like 1918 flu is big medical blind spot, and no one has any clue as to any of these and other topics, and that is simply not the case. How do we know this? Why, the author himself tells us so shortly after making this claim, telling readers a bit about some hypotheses and theories about some of the aforementioned topics, while then going on the say that there isn't medical evidence and all of those supposed explanations are just supposition. What the author does not tell readers is that, while medical evidence from a century ago is hard to come by and may not be entirely trustworthy, some of the theories mentioned are supported by the preponderance of evidence available from the time period and from other known medical facts/research. They are not the daydreams of doctors and researchers, and should not be treated as such. I felt that the author did a very poor job in his treatment of the 1918 pandemic on a whole, and an extremely poor job in his treatment of modern medical research about the 1918 pandemic in particular. For a better understanding of the 1918 pandemic, I highly suggest reading John M. Barry's The Great Influenza: The Story of the Deadliest Pandemic in History (found here: https://www.goodreads.com/book/show/2...) or, for an easier read, Kenneth C. Davis' More Deadly Than War: The Hidden History of the Spanish Flu and the First World War (found here: https://www.goodreads.com/book/show/3...). Both are significantly better than Honigsbaum's sad excuse for an explanation as presented in The Pandemic Century.

For the second chapter, on the 1900s plague outbreak, the author presents in the confusing timeline that simultaneously skips around and ignores the primary population affected by the plague. Honigsbaum begins the chapter by telling readers about the sickness and subsequent funeral of a Mexican family, using this is a storytelling device. Not terrible, except this ignores that plague outbreaks had begin years later, and began in the Chinese quarter; by the time this funeral had taken place, dozens of death of Chinese from plague had occurred, were continuing to occur, and that population had been under threat of racism-driven quarantine and destruction of their homes for years. The author takes a moment to tell readers this, then promptly goes back to ignoring the Chinese population and using Hispanic populations and sections of city as storytelling devices, despite the fact that they were victimized by the plague relatively late and did not make up most victims of the epidemic. This very narrow focus on the Hispanic population/sections - and later the white population/sections - presented a skewed and misleading picture of how the plague outbreak progressed and maintained itself in a major city over the course of literally decades. It was very disappointing and infuriating. For a better understanding of the early 1900s plague, I highly suggest David K. Randall's Black Death at the Golden Gate: The Race to Save America from the Bubonic Plague (found here: https://www.goodreads.com/book/show/4...) for the same reason as cited in the above paragraph.

With both the first and second chapters - and their many, many flaws and misrepresentations in mind - I read the rest of book. I would say it was informative, though it focused too much on a how narrative rather than the why dissection promised by the title, except for the fact that I do not trust what I've read. That is not a good place to be in for a nonfiction work. With that in mind, The Pandemic Century is not a book that I would recommend. It is a book that would actively dissuade someone from reading, actually. If you are still considering reading it after this review, I highly suggest going for one of the three other books referenced here - The Great Influenza, More Deadly Than War, Black Death at the Golden Gate - as they will give you a more informative reading experience than Honigsbaum's book.

[Stephen · Rating 3 out of 5]

thanks to netgalley and the publishers for a free copy copy in return for an open and honest review

This book has been updated since the hardback edition to include Covid19 virus which is currently spreading around the world. found this book interesting to learn about different pandemics since the spanish flu of 1918 and hows humans interact with ecology and nature which can created new virus to test the human body from Sars, Hiv, Aids, Parrott fever and man continual fight against new virus. The book itself was detailed with facts and being highly topical as well.

[Kimba Tichenor · Rating 3 out of 5]

I had hoped for a book that moved beyond the medical paradigm to explore how pandemics impact the social, political, and cultural sphere. This is not that book. Although there are a few interesting discussions about how technological advances have left us vulnerable to new diseases and how media coverage impacts scientific research of disease outbreaks both positively and negatively, such topics are never fully explored. The human dimension of pandemics hinted at in the book's subtitle never materializes as a topic in its own right. This omission is unfortunate, given the COVID-19 pandemic has made abundantly clear that much more is at stake during a pandemic than the ability of medical science to respond: Lives and jobs are lost; racial inequities are exposed; political careers are broken and made; the educational and social network system are both placed under huge strains; tensions between nations ebb or rise depending on the level of global cooperation in fighting the pandemic -- to name just a few of the ways that pandemics redefine a society and the relations between societies.

Equally problematic for me was that it was unclear how the author was defining pandemic. While certainly the 1918 influenza outbreak and the AIDS crisis fit the standard definition of a pandemic, that is, an epidemic that spreads to multiple countries or continents, the 1976 Philadelphia Legionnaire's Disease outbreak, covered in chapter 3, does not meet that criteria. Moreover, even in covering true pandemics, the author largely focuses on events within the United States. Admittedly he does reference medical discoveries from other parts of the world relevant to each pandemic; yet still the primary focus remains on how the US medical community responded to these outbreaks.

[Alyssia Cooke · Rating 2 out of 5]

Non-fiction isn't something I frequently read, but this seemed highly topical and a way to introduce myself back into reading non-fiction. However, whilst there are some really interesting facts in here, and it covers the main pandemics of the century in detail, it suffers significantly from a few crucial flaws that heavily impacted on my enjoyment of the book as a whole.

Firstly, the vast majority of the book is completely US-centric, with other countries getting barely a mention in passing even when they were the originating point of the pandemic or significant scientific advances were made there. Second, the timelines throughout the chapters are often choppy, moving backwards and forward at will with a lot of technical jargon, making it difficult for a layman to follow. This wouldn't be such an issue if the book were aimed at an academic audience who are already literate in the subject, but I doubt there is anything new here for that audience. Instead it is more of an overview, and aimed squarely at the interested layperson. Finally, the title makes it seem more sociologically based than it really is. In reality, this is a summery of the epidemiology, the medical advances and the history of the diseases. I was expecting far more of an exploration of the politics, the media reporting and the social reactions to the various pandemics than I actually got.

To use a handful of the chapters to illustrate my points; the first chapters cover Spanish Flu and the Pneumonic Plague 'epidemic' in Los Angeles. I use the word epidemic deliberately, because there is a single line in the entire chapter dedicated to stating that the disease made it out of Los Angeles and into Europe. Both chapters are entirely focussed on the USA, and if I hadn't known how badly Spanish Flu crippled Europe, I would be none the wiser for having read this book. The same can be seen in the third chapter dedicated to Parrot Fever, where there is approximately a paragraph about other countries, and whilst Legionaires may have been a pandemic, the entirety of chapter four is focussed on the Philidelphia outbreak, which certainly wasn't. When Honigsbaum finally gets around to acknowledging the rest of the world exists in chapter five, it's a single sentence about Spain. I did find that the second half of the book was less US centric, and it worked very much to it's favour. The chapters on AIDS, SARS, Ebola and Zika were therefore some of the strongest in the book, simply because they widened the scope so heavily without losing the close up picture of the disasters in human lives.

The issues with the confusing timelines is an issue present in every chapter to one degree or another, but is most notable in the first two chapters and the Ebola chapter. This is compounded by how many different names and individuals are involved throughout. This was necessary as research was being done on multiple fronts, but because of the structure, you lose sight of individuals until they pop up again pages later with no additional explanation. Considering the complexity of some of the scientific rationale and epidemiology, the skipping timelines just added an additional and completely unnecessary complication to the book. The only points where this really sticks to a straight forward timeline is in chapter four leading into chapter five, where the Philly outbreak was a precursor to the later Legionaire's pandemic. But because of that, chapter four was almost entirely superfluous and Honigsbaum spent a significant amount of time in chapter five referring back to chapter four. These chapters could have been condensed into one without any issues.

Finally, I don't think Honigsbaum really captured the balance of scientific and sociological that he intended to. Considering the title includes the words 'Panic, Hysteria and Hubris', I don't think my expectations were unreasonable that this would focus more heavily on the sociological ramifications of the pandemics than it actually did. Once again, there was a notable difference between the first and second half of the novel; there was a heavier focus on the political and social aspects from AIDS onward. Prior to that however, the chapters are almost entirely focussed on epidemiology and scientific research. Likewise, it is mainly in the later chapters that Honigsbaum really starts linking the spread of disease and disease management measures to the impact humanity has had on the natural world over the last century. However, even in these later chapters Honingsbaum's primary focus always seems to be the origins and discovery of the epidemic rather than the social ramidications.

That said, there were some fascinating aspects of this book that I had no understanding or knowledge of previously; the zoonotic origins of many of these pandemics for example and just how they managed to break the species barriers to infect humans. Many of these diseases have originated from animals, whether that be bats, birds, pigs or even civets, and Honigsbaum does a good job at exploring these possibilities and the methods of transmission. Likewise, he explores how misconceptions and assumptions in the scientific world can cause long delays in understanding a pandemic, with clear examples throughout. I also personally found the chapter on Parrot Fever fascinating, partly because I had never heard of this particular pandemic but also because of how much I could read behind the lines about the nature of humanity. Faced with a disease that has no human to human transmission, the solution seems simple; stop buying the damn birds.

I also felt that the final three chapters of the book were by far the strongest, and the reason for that has been touched on above. They are significantly less US centric and focus more on public perception, the struggles of the medical world to gain traction or recognition and the impact of political decisions on ground level medicine. For AIDS, this largely came about in the form of bias and the belief that it was a 'gay disease', making it difficult to find funding or support on the scale that is needed for research. For SARS, there was an exploration of how the Chinese government attempted to cover up the emergence of the virus but also how the pandemic put medical lives in danger, through lack of protective equipment and measures. I also found it interesting that Honigsbaum stresses the importance of the 'draconian measures' put in place to control the disease in China, noting that these would meet resistance in America... which has proven to be true.

The impact of public perception on the safety of medical staff is then stressed further in the Ebola chapter, putting them at risk of beatings and death, and how these fears were compounded by the banning of funeral rites and traditions that are incredibly important in communities. Whilst the Zika chapter highlights the heart-breaking impact on young women left with severely brain damaged infants and a complete lack of support once the initial fervour of the pandemic dies down. In addition, all of these chapters did a good job of exploring how mankind has helped to bring these new pandemics on themselves, through quick and affordable transport across the globe, deforestation and the impact that has on animal behaviour, population spikes in poorly sanitised areas and a lack of education of the affected populations.

So... this is a mixed bag. There's some interesting information here, but it is often poorly presented with a disjointed timeline and dense medical jargon. For all that, it is clearly intended to be a layman's offering rather than a highly academic tome and it doesn't quite manage it, instead trying to straddle both lanes and doing it badly. It isn't specialist or technical enough for anyone actively working in those fields, and yet it's confusing structure and scientific jargon make it a difficult entry level book.

Note: I believe later editions have a chapter on coronavirus. My edition did not include this, so I cannot comment.

Many thanks to NetGalley and the publishers for my free review copy of this title.

Further reading from this and from other reviews on the topic:
- The Great Influenza: The Story of the Deadliest Pandemic in History by John Barry
- More Deadly Than War: The Hidden History of the Spanish Flu and the First World War by Kenneth C. Davis
- Black Death at the Golden Gate: The Race to Save America from the Bubonic Plague by David K. Randall
- And the Band Played On: Politics, People, and the AIDS Epidemic by Randy Shilts
- The Origins of AIDS by Jacques Pepin
- The Hot Zone: The Terrifying True Story of the Origins of the Ebola Virus by Richard Preston
- Zika: The Emerging Epidemic by Donald G. McNeil

- Spillover: Animal Infections and the Next Human Pandemic by David Quammen
- Illness as Metaphor and AIDS and Its Metaphors by Susan Sonntag
- Men Against Death by Paul de Kruif (historical, published 1922)

[Melora · Rating 4 out of 5]

3 1/2 stars, rounded up because I "read' this with my ears and that might have contributed to my attention wandering issue.

There is a whole lot here that's interesting. Governmental and public response to outbreaks of infectious disease apparently don't change much. With each disease, Honigsbaum describes governmental denial, footdragging, and cover-up, and the public's inclinations to latch onto conspiracy theories and resist preventative measures suggested by doctors and scientists. Anti-vaxxers and snake oil salesmen have been around for quite a while.

Honigsbaum provides a lot of detail, and my mind frequently wandered while I was listening. Not sure if the problem was the book or me, so I'm giving him the benefit of the doubt.

[Leah · Rating 4 out of 5]

This book is massive and really in depth. Too in depth for what I'm interested in but very well written and researched.

It has every plague every doctor every research every scientist every news report about everything lol Which is amazing if you're super interested in the topic. This is why I gave it 4/5 stars, would I read it again? Proooobably not lol it's a bit TMI

Parrot fever was something I had never heard about so that was pretty interesting

[Brenna Rosso · Rating 4 out of 5]

Well written. Definitely a bummer.

[Babbs · Rating 4 out of 5]

"Whether familiar or not, however, each of these epidemics illustrates how quickly the received medical wisdom can be overturned by the emergence of new pathogens and how, in the absence of laboratory knowledge and effective vaccines and treatment drugs, such epidemics have an unusual power to provoke panic, hysteria, and dread."

The longer it has been since I finished this read, the more I find myself thinking about it--particularly in light of current world events. Often when science isn't advanced enough for a causal analysis for the source of an event, the wrong conclusion is decided on. This book chronicle some of those events, and how medical professionals got it wrong, not for lack of trying but mainly due to limitations during their lifetime.

The author also documents that little has changed with regard to the public as a whole and their response to a health crisis, but also peppers the chapters with real changes that occurred over the last century as direct consequence of things we learned the hard way.

It's also full of random facts, like did you know that farmers used to dip produce in raw sewage on their way into the city because urine gave the leaves a fresher appearance? What about that there was a parrot flu spread by door-to-door parrot salesmen? Yes, evidently door-to-door parrot salesman was also a thing. There were also squirrels carrying a form of the plague who hopped the train-lines up and down the west coast before doctors of the time could figure out how it was spreading.

If you have an interest in the history of disease, or more random facts like those listed above, then you definitely want to pick this up.

[Melanie · Rating 4 out of 5]

I have read many books on the different kinds of plagues and pandemics throughout history. This book provides of good summary of many with a large focus on Zika Virus, which was new at the time. Overall, I felt it provided good information and also referenced other books I have read.

[Zulfiya · Rating 4 out of 5]

Yet again, the goodreads rating system does not allow me to give full credit to this book. It is definitely a 3.5, closer to four stars,so four stars it is.
The book offers an interesting perspective on major epidemic breaks that happened within the hundred year span, and it is accessible to anyone who is not a professional but is interested in public health issues.
There are a lot of things I really liked about the book.
a. I liked the historical perspective and the overall trend in treating epidemics that potentially could become pandemic.
b. I liked the personal investigative part of each of the stories.
c. I also like some very scarce but on point political comments that the author deftly left on the pages of his book.
d. I enjoyed that the author was fair when he told us about the potential dangers, successes and failures associated with each epidemics and how the WHO handled them.

With all this in mind, there is still something that prevents me from fully liking this book. Originally, I could not put my finger on it, but having read the reviews from the collective think tank, I concur with some reviewers that it is choppy and does not always flow well. The author focuses more on the origin of the outbreak and the mystery, but does not provide emotional closure, nor does he show the way to success in every described battle the epidemiologists were involved.
I would like to see how some viral outbursts subsided on their own or how epidemiological measures helped prevent its further pandemic spread.

[Miguel · Rating 4 out of 5]

With the Covid-19 crisis in full bloom, The Pandemic Century is a good reminder that we’ve been here before. It’s the story of disease outbreaks of the last 100 years, starting chronologically from the 1918 Spanish influenza outbreak up to the Zika spread in Brazil and. Little known (to me at least) were the bubonic plague scares in San Francisco in the 20’s as well as later that decade with the outbreak of Parrot fever, thus it goes into social as well as biological aspects as apparently owning songbirds and parrots was a 20’s craze. Legionnaires disease in the 70’s gets a look, as does AIDS, with a very good description on the race to locate what caused it – very interesting. Before Zika, the author covers SARS in which he introduces the reader to coronaviruses, which is of course a harbinger of where we are now although this was published a year prior to Covid-19 showing up. Overall informative especially if one is lacking a solid epidemiology / bio-science background.

[Lily Nesbitt · Rating 3 out of 5]

I really enjoyed the premise of this book and it told me a great deal of things I didn’t know already- if you’re interested in public health and history this is for you!

Not sure if it’s because a lot of the science I read is in lectures and in papers but I would have loved to see some comparative graphs and more facts/figures but that’s purely because of how I learn.

[Sam Still Reading · Rating 5 out of 5]

I’ve read a lot of pandemic and infectious diseases books over the last two years, and I have to say that The Pandemic Century is right at the top of the list. What it doesn’t cover in breadth of diseases, it covers in great depth and detail. It’s interesting in the way it combines the science and the public reactions to various outbreaks.

The book opens with the Spanish flu, but it’s the later chapters that really grabbed my interest, simply because they haven’t been covered in other books. There’s the outbreak of plague in California followed by psittacosis and Legionnaire’s disease. (I did not know the story on how it got the name). The other chapters are devoted to more recent and well-known epidemics and pandemics, such as Ebola, SARS, Zika and HIV/AIDS. The chapter on Zika was very interesting because I don’t think it’s been covered in as much detail elsewhere. As is customary with pandemic books these days, this edition (2020) mentions COVID-19 in its early stages. It’s quite encouraging to see how far science has come since then, in terms of research on the disease, vaccines and treatments.

What really sets The Pandemic Century apart is the level of research and detail. If you’re that kind of person, you can entertain friends and family with interesting facts about the diseases and treatment (e.g., Ebola is more likely to cause hiccups than other haemorrhagic diseases, why you should avoid nebulisers with aerosolised disease). The breakthroughs in research as well as the missteps are also well documented, as is the public response to ‘parrot fever’ and the ‘Philly killer’. It can be quite dramatic as the scenario unfolds, but I found this was toned down a lot with the more recent diseases. My only complaint was that my copy has tiny print, so while it was easy to carry round, it was at times difficult to read for long periods. (Although, I did drop the book during chapters to find out more about the diseases – a sure sign of a piqued interest!) This will satisfy the need to read about these diseases in more depth, in an engaging, easy to read fashion.

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[Kevin Whitaker · Rating 3 out of 5]

Read this for obvious newsy reasons, and it was okay. It contains a lot of detail that I didn't really find interesting, and the storytelling was hard to follow in places. I also didn't get a great sense of bigger-picture themes, aside from two that were hammered again and again. But ultimately it did give me a better understanding of pandemics in general and especially the examples covered here.

Three things I learned:
1.The deadliest outbreak of the last century, the Spanish Flu, had an oddly “w-shaped” mortality curve -- in addition to the (normal) higher mortality rates for the very young and very old, the mortality rate was also higher for people aged 20-40 than for everyone else, and still nobody really knows why.
2.Many deadly influenza viruses come from pigs, because they can be infected by both bird and human strains at the same time, allowing them to recombine and result in new strains that can infect humans
3.America was struck in 1929 by "parrot fever", a disease carried by pet birds. The death count was ultimately limited, largely due to the effort of federal researchers (some at the cost of their own lives), and as a result Congress established and funded the NIH.

[Andrew Williams · Rating 3 out of 5]

Interesting history, but you're left wondering what point the author is trying to make. The writing style is also a bit technical for a popular science book (at least for a true non-specialist like me), and I feel like the book could easily be 25% shorter without sacrificing any substance. I did enjoy it though. Bats are deadly, man.

[Florin Pitea · Rating 4 out of 5]

Quite interesting and informative.

[Becky · Rating 5 out of 5]

A fantastic book that covers in detail the pandemics that have taken place over the last 20th century. The chapter on SARS was particularly illuminating given what is now happening with Covid19. The chapter on HIV AIDS too was fascinating. Highly recommend this book.

[Sajith Kumar · Rating 3 out of 5]

Natural and manmade disasters strike human societies every now and then. As the world is just getting back on rails after the disastrous spread of Covid-19, other infectious diseases like monkey pox threaten from some corners. Similarly, when the threat of a major war was ebbing after the last one in 2003 Iraq, Russia invaded Ukraine. War and pestilence have been legendary evils that afflict mankind. This book narrates the major outbreaks of diseases in the century from the end of World War I in 1918. The end of the long drawn-out War coincided with the outbreak of Spanish Flu which killed 50 million people across the globe. The disease’s spread was greatly enhanced by the demobilized soldiers returning home from the warfronts. The book is about the events, processes and the reasons why epidemics strike despite our best efforts to predict and prepare for them. Mark Honigsbaum is a medical historian and journalist specializing in the history of infectious disease. He is a lecturer in the department of journalism at the City University of London.

Influenza struck in 1918 when there was no idea of what a virus was and how it caused diseases. Bacteria were known, but antibiotics lay two decades in the future. Convalescence at a comfortable location, eating good food and avoiding mental tension were the prescribed antidotes to serious illnesses. As such, such an infection was de facto death sentence for the poor who could not afford the cost of recuperation. Concentration of recruits from rural and urban districts in overcrowded barracks led to the pandemic’s unusual characteristics. Contrary to normal, people of the age group 20-40 died most. It was years later that it was understood that it was caused by a virus. Though influenza was a viral infection, bacteria of the Bacillus family were also identified in many people. Mysteriously, these bacteria were not found in other patients. This contradiction baffled many researchers pursuing a cure. It was only later that it was realized that this bacteria was only a fellow traveler. In some cases it caused death, but the primary agent was the H1N1 virus.

Doom-mongers usually cite the occurrence of new and exotic diseases as a corollary to growth in science and technology. Conspiracy theorists allege that all major epidemics are caused by leakage from bio-warfare labs or deliberately spread by high-end pharma companies for commercial gain. Honigsbaum presents a simple but logical explanation for the outbreaks. Humans exert powerful evolutionary pressure on micro-parasites due to their changing social and cultural behaviours or through their impact on the environment of animal and insect ecologies. Sometimes these pressures select for a particularly virulent strain of the parasite or present it with an opportunity to colonize a new host and extend its ecologic range. Technologies and changes to the built environment designed to improve hygiene and ameliorate the conditions of life are giving rise to new threats to health and wellbeing. Legionella pneumophilia has been around for millennia, but it was not until we began building cities and equipping buildings with indoor plumbing and hot water systems that we presented the bacterium with a new ecological niche in which to prosper. This bacterium causes the Legionnaires’ disease which is spread through cooling towers of central air-conditioning systems in large buildings. The part on infections from pet birds and animals warns readers of the risks associated with close intimacy to pets. Parrots and parakeets experience mild infection of psittacosis when young but would never show any symptoms in the wild. In captivity – crowded, filthy and without exercise or sunlight – a flare up of the infection is to be expected. Psittacosis, or parrot fever, can be fatal to humans.

Honigsbaum notes with a touch of warning that new diseases come out all the time and it is particularly ironic when medical science practitioners unknowingly assume that they have obtained all knowledge that is there to know regarding diseases and its aetiological agents. AIDS was the epidemic that drove home the lesson that despite vaccines, antibiotics and other medical technologies, infectious disease had not been banished but posed a continuing and present threat to technologically advanced societies. If AIDS had struck in the 1950s, scientists would not have identified it, as the contemporary understanding of retroviruses was very limited. As such, the epidemic broke out at precisely the moment when scientists working in oncology and retrovirology specialists were inclined to believe that a retrovirus was the cause and possessed the tools and technology to test the hypothesis. This argument is ideal food for conspiracy theorists who claim that the HIV virus leaked out from a research lab. However, we have to keep in mind that coincidence is the one thing these people cannot cope with. This brings us to a discussion on the methodology of science and why existing theories have to be revised occasionally. The author elaborates that there is no such thing as absolute certainty in science. Paradigms are constantly being refined by new observations and if anomalies are found, it may be discarded and a new paradigm may come to supplant it. The best scientists welcome anomalies and uncertainty, as this is the way scientific knowledge advances.

The book discusses several outbreaks of deadly diseases that shook the medical community at a fundamental level and which produced anxious moments for the administrators. All of them affected the developed world or in cases such as Ebola, had the potential to cause infections in the developed world. Diseases that are endemic to the underdeveloped world are not seen here. What is repeatedly stressed however is the ease with which a contagious disease that entered a human body can reach any part of the world in a matter of just three days, helped by air travel and interconnectivity of the various parts of the globe. In the case of the 2002 SARS outbreak in Hong Kong, the disease infected several people in a particular floor of the hotel in which they were staying. Before it affected people in other floors, the disease reached Canada as one person flew there. The book was published in early 2020, so only a brief mention of the arrival of Covid-19 is given. The author expresses his concern at the prospective death toll in India where he assumes that the infrastructure is nonexistent to handle a disease of this magnitude. Left liberal activists of India had raised this concern with false arguments which the author is unable to spot. It contains an opinion piece by noted novelist Arundhati Roy that ‘although Kerala boasts 38,000 government hospitals, the same is not true of other Indian states where the public health system has been starved of funds and few tests are being conducted’ (p.278). If you do a search, you’ll find that Kerala has only 1200 hospitals and would be struck by the disconnect these so called ‘intellectuals’ have with reality and reason. In the end, India ended up doing far better than most developed nations in death toll, hospitalization and vaccination.

The book is recommended.

[Joe Kessler · Rating 3 out of 5]

With a few caveats, this is an informative look at massive disease outbreaks from the 'Spanish' influenza of 1918 through more recent crises like Ebola, Zika, and SARS. The book could have been structured better in terms of an overarching message or narrative throughline, and I wish author Mark Honigsbaum had focused more on preventative measures / recovery rather than just how the individual epidemics spread and were eventually detected. I also don't love how often he emphasizes historical scientific models being wrong or how little we still understand about plague vectors. There's a sense of resignation to the inevitable in how these topics are framed, along with an element of chiding people for their (reasonable!) panic.

But my feelings are definitely influenced by my reading this in the midst of the global COVID-19 situation, and although it's not necessarily the most helpful volume for understanding how we got here, I do feel like I've learned a lot about potentially similar cases from the past. There's not much in this title that's directly actionable for someone trying to survive a pandemic -- or flatten its transmission curve to preserve limited medical resources -- but in fairness to Honigsbaum, that wasn't exactly his goal in writing it.

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[Margaret Heller · Rating 5 out of 5]

I couldn't put this down, but it might just be me.

[Ben · Rating 3 out of 5]

Great book.

New normal. Stay home and read books!

3/5

[Tara · Rating 4 out of 5]

I felt as though this really was a book of two halves. The first few chapters were in my opinion, poorly organised and fairly US Centric. I had also expected there to be more discussion on societal attitudes/behaviours and the impact (or lack of) that these epidemics had on them.

However the final chapters regarding AIDS, Ebola, Zika and Disease X were fantastic. There was a good balance between scientific explanations of the diseases and the socio-economic factors that influenced their outbreak.
This has absolutely prompted me to read more about the topics discussed and serves as a poignant reminder that we as a species are increasingly at risk of a new potential pandemic pathogen emerging.

[Everydayreader1 · Rating 5 out of 5]

The current outbreak of Covid-19 has prompted me to read several titles about pandemics. The subject interests me greatly. This book is the latest one I've read. It has plenty to recommend it. Mark Honigsbaum traces the history of various pandemics and outbreaks around the world, going into much detail about several of them.

What I found particularly fascinating is his exploration of not only the scientific aspect of these outbreaks of disease, but also the politics reflected in the recognition and handling of them. There is a full chapter on Covid-19 also, which I found to be of particular interest. An excellent and informative read, if the topic interests you.

[KB · Rating 3 out of 5]

An interesting cherry picking of the more prolific and puzzling plagues in recent history. Honigsbaum explores a mix of scientific, historical and sociological angles to analyse how the outbreaks of our past collectively point to a future wrought with contagion if serious changes are not enacted. The century-long scope does restrict focus to only a handful of key events, but the novel's moderate size and investigative 'whodunnit' approach make for an engaging, easy introduction to the world of infectious diseases (though don't read this for any real insights beyond initial speculations regarding COVID-19). The Pandemic Century is not by any means a comprehensive chronicle - at times even verging on the overdramatic as inconsequential details 'set the scene' - but it sates a fledgling thirst and sparks a desire to pursue further reading on the subject.

[Tõnu Vahtra · Rating 3 out of 5]

It's a good informative book if you are not familiar with the major pandemics during the past 100 years (1918-19 Spanish Influenza, 1924 pneumonic plague, 1930s parrot fever, HIV, SARS, Ebola, Zika and even COVID is briefly mentioned. The book illustrates how easily viruses are spreading globally today and what are the consequences of under-reacting to an emerging pandemic or not taking enough efforts to limit the spread of a pandemic. Also the role of different animals in carrying the viruses is explained in detail and how the social and economical changes have enabled some of the outbreaks to emerge (i.e. bird flu in Hong Kong). Looking at the previous major pandemics also helps to make sense of the current COVID-19 pandemic (for example Spanish Influenza outbreak is currently used as a case study in predicting how the world might look like after the pandemic is over).

“It is also because of the tendency of medical researchers to become prisoners of particular paradigms and theories of disease causation, blinding them to the threats posed by pathogens both known and unknown.”

[Sue Pirolo · Rating 5 out of 5]

Very interesting/informative, including a couple smaller pandemics I hadn't heard about. Each pandemic Honigsbaum expertly summarizes exposes man's contribution to, and in some cases, responsibility for, the outbreak and spread. We need to do so much more to prevent pandemics from occurring, and to act quickly/appropriately at their onset... but sadly, as we've seen with COVID-19, that takes preparation and leadership which is so frequently lacking. We need to get our act together before the next one ... it's definitely coming.

[Sophia · Rating 4 out of 5]

Super interesting! I love reading about viruses and stuff like that, so this book really didn't disappoint. Learned a lot of new things and I'll definitely have to pick up another book about pandemics to get even more in-depth knowledge on these viruses discussed in this book.

So glad I got that free library membership, I love reading non-fiction and through that membership I can really indulge in that.

[Ruth · Rating 4 out of 5]

Maybe don't read if you're paranoid about getting sick or prone to anxiety; other than that, you might enjoy this engaging overview of 100 years' worth of pandemics, their causes and effects. Plus sharks.