Table of Contents

   Preface     xiii

Chapter 1: Introduction: our debt to disease     1

   Epidemics select genetic alterations     4

   Every cloud has a silver lining: our debt to disease     6

   Crowding and culling     8

   The message of this book     11

 

Chapter 2: Where did our diseases come from?     13

   Africa: homeland of mankind and malaria     13

   Many human diseases originated in animals     17

   Are new diseases virulent to start with?     24

   Diseases from rodents     29

   Leprosy is a relatively new disease     30

   What goes around comes around     32

 

Chapter 3: Transmission, overcrowding, and virulence     33

   Virulence and the spread of disease     33

   Infectious and noninfectious disease     34

   Many diseases become milder with time     40

   Development of genetic resistance to disease     47

   Hunting and gathering     56

   How do microorganisms become dangerous?     60

 

Chapter 4: Water, sewers, and empires     67

   Introduction: the importance of biology     67

   Irrigation helps agriculture but spreads germs     68

   The class system, water, and infection     69

   The origin of diarrheal diseases     70

   Cholera comes from the Indian subcontinent     71

   Cholera and the water supply     72

   The rise and fall of the Indus Valley civilization     74

   Cities are vulnerable to waterborne diseases     76

   Cholera, typhoid, and cystic fibrosis     78

   How did disease affect the rise of Rome?     81

   How much did malaria contribute to the fall of Rome?     83

   Uncivilized humans and unidentified diseases     86

   Bubonic plague makes an appearance     90

 

Chapter 5: Meat and vegetables     93

   Eating is hazardous to your health     93

   Hygiene in the home     96

   Cannibalism is hazardous to your health     97

   Mad cow disease in England     99

   The political response     101

   Mad cow disease in humans     102

   Fungal diseases and death in the countryside     103

   Fungal diseases and cereal crops     104

   Religious mania induced by fungi     106

   Catastrophes caused by fungi     109

   Human disease follows malnutrition     110

   Coffee or tea?     111

   Opportunistic fungal pathogens     112

   Friend or enemy     113

 

Chapter 6: Pestilence and warfare     115

   Who kills more?     115

   Spread of disease by the military     116

   Is it better to besiege or to be besieged?     118

   Disease promotes imperial expansion     120

   Protozoa help keep Africa black     122

   Is bigger really better?     123

   Disease versus enemy action     125

   Typhus, warrior germ of the temperate zone     126

   Jails, workhouses, and concentration camps     129

   Germ warfare     130

   Psychology, cost, and convenience     131

   Anthrax as a biological weapon     132

   Amateurs with biological weapons are rarely effective     132

   Which agents are used in germ warfare?     134

   World War I and II     136

   Germ warfare against rabbits     137

   Germ warfare is unreliable     138

   Genetic engineering of diseases     139

 

Chapter 7: Venereal disease and sexual behavior     141

   Venereal disease is embarrassing     141

   Promiscuity, propaganda, and perception     144

   The arrival of syphilis in Europe     145

   Relation between venereal and skin infections     148

   AIDS is an atypical venereal disease     149

   Origin of AIDS among African apes and monkeys     150

   Worldwide incidence and spread of AIDS     151

   The Church, morality, and venereal infections     154

   Moral and religious responses to AIDS     155

   Public health and AIDS     156

   Inherited resistance to AIDS     158

   The ancient history of venereal disease     159

 

Chapter 8: Religion and tradition: health below or heaven above?     163

   Religion and health care     163

   Belief and expectation     165

   Roman religion and epidemics     166

   Infectious disease and early religious practices     167

   Worms and serpents     168

   Sumerians, Egyptians, and ancient Greece     169

   Hygiene and religious purity     171

   Protecting the living from the dead     173

   Diverting evil spirits into animals     175

   Cheaper rituals for the poor     177

   Vampires, werewolves, and garlic     178

   Divine retribution versus individual justice     179

   The rise of Christianity     181

   Coptic Christianity and malaria     184

   Messianic Taoism during the collapse of Han China     185

   Buddhism and smallpox in first-millennium Japan     186

   The European Middle Ages and the Black Death     187

   The Great Plague of London     189

   Loss of Christian faith in industrial Europe     190

   Cleanliness is next to godliness     191

 

Chapter 9: Manpower and slavery     193

   Legacy of the last Ice Age     193

   The New World before contact     194

   Indigenous American infections     195

   Lack of domesticated animals in America     197

   The first epidemic in the Caribbean     198

   Epidemics sweep the American mainland     200

   The religious implications     202

   Deliberate use of germ warfare     203

   Slavery and African diseases     204

   Exposure of islands to mainland diseases     205

   Cholera and good intentions     206

   The issue of biological isolation     207

   Spotted fevers and rickettsias     208

   The origins of typhus are uncertain     209

   What about the Vikings?     211

 

Chapter 10: Urbanization and democracy     213

   Cities as population sinks     213

   Viral diseases in the city     214

   Bacterial diseases in the city     215

   The Black Death     216

   Climatic changes: the “Little Ice Age”     217

   The Black Death frees labor in Europe     218

   Death rates and freedom in Europe     219

   The Black Death and religion     221

   The White Plague: tuberculosis     223

   The rise of modern hygiene     224

   The collapse of the European empires     226

   Resistant people?     227

   How clean is too clean?     228

   Where are we now?     229

 

Chapter 11: Emerging diseases and the future     231

   Pandemics and demographic collapse     231

   The various types of emerging diseases     232

   Changes in knowledge     233

   Changes in the agent of disease     233

   Changes in the human population     234

   Changes in contact between victims and germs     235

   The supposed re-emergence of tuberculosis     236

   Diseases are constantly emerging     237

   How dangerous are novel viruses?     239

   Transmission of emerging viruses     241

   Efficient transmission and genuine threats     242

   The history and future of influenza     243

   The great influenza epidemic of 1918—1919     243

   Disease and the changing climate     245

   Technology-borne diseases     246

   Emergence of antibiotic resistance     247

   Disease and the food supply     250

   Overpopulation and microbial evolution     251

   Predicting the future     252

   Future emerging diseases     254

   Gloom and doom or a happy ending?     254

 

Further reading     257

Index     261