Book Review – Spillover: Animal Infections and the Next Human Pandemic by David Quammen

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I’ll admit it. Most of my perceptions of the Ebola virus and its effect on people have been based on what I read in ‘The Hot Zone’ when I was in college.

I received the book as a gift and started to read it as I traveled home for Christmas break.  I say ‘started’ because I couldn’t get past Richard Preston’s opening description of an infected patient’s meltdown while traveling on a small plane. Did I mention that I was traveling on a 19-seater airplane? Those images, when combined with my own motion sickness, created a very memorable experience.

While these images might have been memorable, I’ve realized, after reading David Quammen’s Spillover: Animal Infections and the Next Human Pandemic, that they are not that accurate. Quammen’s book centers on spillover events, moments when a pathogen (virus, bacteria, fungus, protist, prion or worms) crosses from one host to another and thrives in the new host. In this book, he details the diseases caused by the Hendra, Ebola, HIV, and SARS-CoV viruses, Plasmodium sp. protists, and Coxiella burnetii and Borrelia burgdorferi bacteria. And, while the symptoms of Ebola viral infections are horrible, most patients do not bleed profusely or meltdown.

Borrelia burgdorferi, the pathogen responsible for causing Lyme disease (Darkfield microscopy magnified 400x). Credit: CDC - PHIL #6631
Borrelia burgdorferi, the pathogen responsible for causing Lyme disease (Darkfield microscopy magnified 400x). Credit: CDC – PHIL #6631

Quammen’s updated reporting on several zoonotic infections was one of my favorite parts of the book. It’s been several years since my virology class in college so I enjoyed getting caught up on the latest (as of the 2012 publication date) research and knowledge for several viruses. This was especially true for Quammen’s chapters on HIV. Quammen does an excellent job of summarizing HIV research and the AIDS pandemic – human clinical discoveries, SIV research, and the search for the spillover event that merges the human and non-human primate diseases. I had followed HIV research while in college but hadn’t kept up with the big picture of the how, where, and when of the HIV infection timeline.

HIV budding out of a human immune cell. Credit: NIH - PD-USGov-NIH
HIV budding out of a human immune cell. Credit: NIH – PD-USGov-NIH

Another part that I liked about this book was the fact that Quammen traveled to the sources of the spillover events. In the HIV chapters, Quammen follows a proposed route through Cameroon and the Congo that brought HIV into the human population. When discussing Ebola, Quammen opens by describing a previous trip to Gabon while chronicling Michael Fay’s Megatransect for National Geographic; two of Fay’s crewmen has been present during an Ebola outbreak in a Gabonese village in 1996. The level of detail from this on-the-ground approach helps the reader visualize how these spillover events can and do occur.

Quammen concludes ‘Spillover’ with a discussion on the big question, ‘What’s next?’ What will be the next big disease outbreak and when will it happen? Quammen’s response – it depends – is followed by a list of all the activities that humans currently engage in that can contribute to the next spillover event. “…We visit monkey temples in Asia, live markets in India, picturesque archeological sites in New Mexico…and then we jump on our planes and fly home.” However, Quammen counters that this book isn’t meant to be a harbinger of doom but is meant to educate us and make us smarter about the choices we are making. When it comes to infection rates, any choice that an individual makes can have an impact on the infection rates for a population. “An individual human may choose not to…have unprotected sex with the prostitute, not to share the needle in a shooting gallery…not to board a plane while feeling ill…” It is through education that individuals will have the information necessary to make the type of decisions that will reduce the infection rates for everyone.

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