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
