American Murderer

Medical Fiascoes

by Gail Jarrow

What made workers in the American South so tired and feeble during the 19th and early 20th centuries? This exciting medical mystery uncovers the secrets of the parasite hookworm, commonly known as the “American Murderer,” and is the latest title in Gail Jarrow’s (YALSA Excellence in Nonfiction for Young Adults award-winning author) Medical Fiascoes series.

Imagine microscopic worms living in the soil. They enter your body through your bare feet, travel to your intestines, and stay there for years sucking your blood like vampires. You feel exhausted. You get sick easily. It sounds like a nightmare, but that’s what happened in the American South during the 1800s and early 1900s.
 
Doctors never guessed that hookworms were making patients ill, but zoologist Charles Stiles knew better. Working with one of the first public health organizations, he and his colleagues treated the sick and showed Southerners how to protect themselves by wearing shoes and using outhouses so that the worms didn’t spread. Although hookworm was eventually controlled in the US, the parasite remains a serious health problem throughout the world. The topic of this STEM book remains relevant and will fascinate readers interested in medicine, science, history—and gross stories about bloodsucking creatures.

Genres: Nonfiction, History, Science, Middle Grade, Childrens, Disease, Health

160 pages, Hardcover

First published September 27, 2022

About the author

Gail Jarrow is the award-winning author of nonfiction books and novels for readers 8-18. Latest book: WHITE HOUSE SECRETS: MEDICAL LIES AND COVER-UPS. Visit GailJarrow.com.

Reviews

[Paula]

Gail Jarrow is a hardworking, talented genius. This is a book that is roughly 30% about a man who spends most of his time looking at human poop through a microscope yet somehow Gail Jarrow kept me turning the pages and even reading the backmatter. Plus now I understand why my granny would tell me to “put your shoes on, you’ll get worms!”

[Lindsey]

Both amazing and disgusting 🤮🤩.

[Wren]

Jarrow writes an engaging book about a widespread health crisis that affected thousands of Americans in the South--if not a million plus: hookworm infestation in the colon. The book explains how cooperation among scientists, medical professionals, the government, journalists, and non-government organizations (charities funded by wealthy Americans) all worked together to help reduce cases dramatically.

The book is very interdisciplinary! It's fabulous!

I think this is a well-timed publication given the hyperawareness Americans have about issues of public health and how various sectors of society are stakeholders but each has their own perspective, their own methods of taking action.

Because hookworms spread when waste gets into the soil, the book also looks at issues of poverty and race as well as a bit of history about the African slave trade as the route for the type of hookworms present in the US. The solutions for treating hookworms had to be more than just administering oral medication to kill the worms. Big institutions needed to work on improving sewer systems and help educate people about the life cycle of the worms.

The book is well-designed for adolescent readers ages 12 to 17: It has a lot of short sections with clear headings, several images, and clear language that is not patronizing.

The last chapter takes a broader view by not only reporting on the status of hookworms in the US in the last 50 years, it also describes problems with parasites affecting people in other parts of the world.

[Amy]

This was an interesting look at a parasite that plagued the American South for years. It caused many people -- especially children -- to die, develop pica, and become anemic. Also, there was a time when many poor rural Southerners were seen as lazy and dumb, but it turned out to be the side effects of this parasite. Since it was passed through sand and sewage into skin, it took some work to introduce treatment and promote more sanitary conditions so that the affected numbers finally decreased from 60% of the population. The book is an interesting slice of history.

[Alicia]

I will be moderating a panel that will include Jarrow's newest title which is part of her medical fiascoes series and boy, this one does not disappoint. Jarrow's work continues to be succinct, informative, visually powerful, and that reads like a thriller of real life activities and events. I've always billed James Swanson as a nonfiction writer of history (both his adult but particularly his YA adaptions) as reading a thrilling fiction rather than nonfiction. Jarrow does this for science.

In this one, she focuses on the hookworm, a specific Western version that was dubbed the American Murderer. Jarrow takes readers through the history, science, social, economic, medical, and political work that went in to discovering and addressing it. She profiles the people most responsible for its discovery and the work to inform the public and sustain efforts to both treat it and prevent it (training on sanitation in particular).

What you get in this book is a riveting look that includes primary sources and plenty of photographs, that like all her others, make you want to squirm.

[Kristin Towers]

Saw this available after re-listening to a very old “Stuff You Should Know” episode on hookworms and their connection to the perception of (lacking) education in the American South. Commence me being the most annoying person in everyone’s lives about parasites for a few days.

This is clearly written for a younger reading audience, and I would have eaten this up as a 7th-grader as it’s nicely balanced between accessible science and disgusting curiosities. Two gripes: it takes a long time to get out of Wikipedia-level information, and the title is stupidly narrow (though accurate, but this is from 2023).

Overall, a totally fine traffic listen.

[Kristen]

Recently, I was talking to a school librarian friend of mine. I've visited her school often, and she's seen me give many booktalks. I mentioned, "I LOVE sharing a gross fact in my booktalks," and she said, "Yes, that is VERY true."

This, my friends, is DEFINITELY a gross fact kind of book. THERE IS A PICTURE OF A BOY HOLDING A BOARD WITH THE HOOKWORMS THAT CAME FROM HIS BODY TACKED TO IT. And it is not a small amount of hookworms. It is a disturbingly large amount of hookworms.

I think Gail Jarrow loves sharing gross facts as much as I do, and it's why our sensibilities as author/reader are so perfectly matched. This was fascinating and made me want to wear shoes everywhere and gave me the heebie jeebies and I learned so much.

I also think she is excellent at showing why this is still relevant today. So much of politics and reactions to learning about the hookworm problem in the American South (distrust of scientists, an unwillingness to admit the problem, etc.) reminded me of COVID reactions. It was depressingly familiar and felt very much like we don't learn from history, ever, as a species.

However, there is hope! Jarrow walks us through the public campaign to educate people and the (very slow and incremental) eradication of serious hookworm disease. Really fascinating, at times frustratingly relevant feeling, and full of great gross facts. Another excellent medical history from Jarrow.

[Marjorie Ingall]

Gross, fascinating real-life medical mystery that shows how vital public health research, education, and advocacy are. Eminently worth reading and pondering at a time when a presidential candidate is eager to get rid of so much of our social-service infrastructure.

[Victoria Stone]

Listen, I don't know how many of you grew up with boomer parents, but... Was anyone else told as a kid that you'd get "worms" from running around barefoot outside? I assumed for a very long time this was just an old wives' tale, but nope! Hookworms, which enter your body via bare skin, devastated millions of folks in the US for generations. This book is the harrowing tale of the scientific discovery and fight against a worm that sucks the life out of both children and adults, ruining families and livelihoods. A compelling and fascinating read, especially if you're a medical nerd like me.

[Christaaay]

Short, easy to listen to, informative. I knew nothing about hookworms and other parasites. Yikes! Great STEM read for children who don't get nightmares easily 😅 Talks in depth about the specific type of intestinal worm found mainly in North America, how it spreads, what symptoms look like, etc.

[Samantha]

This was a thought-provoking read, complete with plenty of first-hand accounts and great photographs. Jarrow's books are always so interesting and well-written.

[Carol Sente]

A book suggested by a teacher friend in our book club so I forced myself to read it. The subject is an unpleasant yet important to understand health issue that has plagued humans and continues to plague us in various parts of the world - a parasite called the American Murderer. This hookworm tends to live in warmer weather and sandy soil, enters the body through the skin (typically feet), proceeds up the bloodstream and into the lungs, eventually moves into the esophagus and then down into the intestines. Southerners since the Civil War were more often infested due to the soil conditions and their lower economic conditions. Children and adults commonly went barefoot and did not have privies or outhouses. Therefore, feces was carried throughout the soil where the larvae could grow and get absorbed as described above.

I don’t think this needed to be a book. A thorough article about the topic could have addressed this topic sufficiently. The book did have numerous helpful (but a bit disturbing) photos of infected people, article headlines, photos of the parasite, etc. John D. Rockefeller donated $1 M in 1909 to eradicate the disease in the South.

[Peter DiMauro]

Incredibly fascinating read exploring the epidemic of hookworm infections in the US South in the late 19th and early 20th century. It was so interesting to read about the challenges that public health officials faced around education, prevention, and treatment, and the various parallels to the same challenges around modern day diseases.

[Mary]

Very interesting look at how hookworms were discovered in the early 1900's and how it was treated. Lots of interesting historical facts. Perfect for middle grade students and older especially if you are learning about microbiology. Also just fyi hookworms have not been eradicated, even in the states.

[Christine]

I was surprised by how much I enjoyed reading this! The book is about a hookworm epidemic in the American South in the late 19th and early 20th centuries and the challenges public health officials faced as they sought to provide education and treatment for the disease. Hookworm is spread through contact with soil contaminated with an infected person's feces and is diagnosed through a stool sample. Therefore, be warned that there was a lot of discussion about poop in this book.

While I enjoyed learning about the hookworm epidemic of a century ago, I was particularly impacted by the last chapter and author's note, which focused on the topic's relevance today. Hookworm is not eradicated here in the US and continues to affect rural Southerners who live without proper sewage treatment. Jarrow also noted the striking similarities between the hookworm epidemic that occurred more than one hundred years ago and the COVID-19 pandemic today.

[Tiffany Hough]

Disgusting but fascinating.

[Michele]

WoW!! The information here was amazing. Listened as an audiobook and would highly recommend.

[Kim Stuckmeyer]

Disgusting, but well written and surprisingly interesting topic. I don’t think I’ll be walking around barefoot anymore..

[Joyce]

Pretty good. Not as good as Everything is Tuberculosis but still good.

[Hollis]

I look forward to the next few decades where Americans walk barefoot in raw sewage again to own the libs.

[Peter DiMauro]

Incredibly fascinating read exploring the epidemic of hookworm infections in the US South in the late 19th and early 20th century. It was so interesting to read about the challenges that public health officials faced around education, prevention, and treatment, and the various parallels to the same challenges around modern day diseases.

[Harold Hoss]

Concise. Informative. Perfect.

[Cindy Dobrez]

It's hard to admit that you loved a book about hookworms, but I did. Of course, I did. Gail Jarrow wrote it. Her books on medical mysteries and medical fiascoes always leave me turning the pages and learning something new. This one is no exception. The cover photo is just meant for middle school booktalks and displays, but it did gross out my ALA hotel roommate! ;) If you see me going barefoot a little less often this summer, Gail is to blame!

[Karen]

All you ever wanted to know (and maybe didn’t want to know) about hookworms, a parasite more prevalent in warmer climates. Hookworms enter the body through the feet – don’t walk barefoot near a leaking outhouse! – and make their way to the intestines where they attach themselves (with those “hooks” in their mouth) to feed off their host. Full of creepy magnified photographs, this medical history detailing the discovery of hookworms and the campaign to rid people of hookworms is fascinating.

[Danielle]

Incredible research! I’ve never read a nonfiction medical book that captured my attention like this. I’ve also never read so much about 💩 so much in my life either. It definitely gave me a huge respect for the Scientist that did so much work to get information and cures to the public. This book claims to be for grades 5-12. I’d say middle school/high school.

[Mary Frances]

What a fascinating and well written non-fiction middle grade book. Interesting and engaging to read without being dry with lots of historical photographs that make the historical prose that much more accessible. My 8th grader read this book as well and enjoyed it so much he’d like to look into the rest of this author’s medical fiasco series. Great way to diversify reading genre!

[Sandy Brehl]

Subject matter and writing in this book will HOOK readers from cover to conclusion:
"This vampire thrived in the warm summer climate... Invisible to its potential victims, it waited until one of hem passed by. Undetected, it hitched a ride, burrowed in through the skin...and hid deep...[inside]... anchored by sharp, fang-like mouthparts."
Paired with photographic images of zombie-like victims, the writing weaves an irresistible account of the murderer (hook worms), the pivotal scientist with a personality that undermined his efforts to eradicate these killers, other scientists and leaders who helped to achieve his goal, and a range of community responses that both welcomed interventions and denied the need for them. STEM enthusiasts will find every element of that acronym embedded in these pages, with compelling text, scientific drawings, photographic examples, and data accounts of the dramatic changes wrought by this ubiquitous murderer and the steps taken to eliminate it from tropical and subtropical populations. Examples of engineering proposals to improve sanitation, especially in rural and impoverished areas, ranged from Rube Goldberg-ish complexity to simply convincing people to wear shoes. Social, economic, and political forces participated in the decades-long movement to educate doctors, government officials, schools, families, and church leaders. It's no spoiler to report significant success in this country, but several chapters also reveal ways in which other countries have and have not been able to accomplish the same levels. Conversations may be sparked about parallels to current patterns within science and variations in community responses. Readers of this engaging book will be eager to find more titles in the MEDICAL FIASCO series by Gail Jarrow.

[Valerie McEnroe]

I've read quite a few Gail Jarrow books and I've found them to be a mixed bag. Some are more entertaining than others. My favorites are Red Madness and Fatal Fever. I found both Bubonic Plague and Spooked to be more textbooky in that the facts overpower the story. In my opinion, this book, about the hookworm crisis in the South, falls in line with the second, less enjoyable group.

There's no doubt that it's fascinating history. It's humbling to see how far we've come. The pictures in the book greatly enhance the story. The problem is just too much factual information. Steve Sheinkin would have zeroed in on several families and told their personal history like a mystery novel. This is the perfect story for that type of narrative.

The book unfolds chronologically, first talking about the early disease experts and how they discovered the cause of the anemia plaguing the southern poor, then moving on to the lifecycle of the hookworm with humans as a host. From there, it explains the medical campaign to educate and eradicate the parasite. There's a lot of interesting stuff. Yet again we have an example of how people, in this case doctors, are reluctant to embrace new ideas. We also see how politics plays a role in how we process information. Southern states wanted to ignore the problem because it was an embarrassment and they certainly didn't want northern philanthropist John Rockefeller helping them out. In the end, we learn that hookworm is easily treated, but for poor people in the early to mid 1900s, when proper sanitation and shoes were too costly, prevention was a whole nother story.

Get the book if you have a solid group of students who love reading about diseases. Otherwise, I'd pass on this one and get one of Jarrow's other books mentioned above.

[Kim]

American Murderer describes how a group of scientists and community members gathered to educate, cure, and improve the lives of millions of southern suffering from hookworms. Throughout the book, audiences come to learn about the nature of hookworms, the importance of clear and effective communication, the power of community, and the wonders of the scientific process.
The book includes chapter titles, subtitles, and plenty of pictures to help guide students who tend to struggle while reading nonfiction. Several of the more important concepts are repeated throughout the book (maybe a little too much), to support the reader’s understanding. Although there are some words students in grades 5-8 may stumble on, they also include context and clear parentheticals of essential vocabulary to assist. There are no additional text features within the main text, so it is easy to navigate. However, there is a glossary and timeline at the back of the book for reference.
This would be a wonderful book to include on a summer reading list for 7th – 9th grade students. The information in the book can be referenced in several content-areas including science, social studies, and ELA. Students could complete literature circles or group discussions about some of the main ideas, power dynamics, and/or socioeconomic implications in the book.

[Roben]

Informative. Tragic. Creepy. I wish I was still doing book talks because this book would fly off the shelves after kids learned about it. I would bring along something about the size of the worm. And show lots of the pictures. That picture of the kid in Brazil who had mounted his worms.... yikes. And the man that had 2500... double yikes. It took me a while to catch on to exactly how large the worms were... I think an actual size fold out picture would be a wonderful addition to the book. Why did the victims have protruding bellies? Because their small intestine was filled with huge hookworms.

The true tragedy, of course, was that it was so curable. And the way it impacted generations. And regions throughout the world, not just the American South. Though it was clear some of the people in power really could not grasp how poor some of the people were. "Buy your kids new shoes every year! Build a new expensive outhouse!" Fortunately, there were philanthropists willing to take up the cause. And educators who rallied behind it.

I liked the comparisons the author drew to COVID - the naysayers and deniers existed back then, also.
Lots and lots of bibliographic information in the back of the book. Well done!