The Coming Plague: Newly Emerging Diseases in a World Out of Balance

by Laurie Garrett
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The Coming Plague Summary

The Coming Plague by Laurie Garrett is a 1994 nonfiction book about the history of global epidemic diseases from the 1960s to the 1990s.

  • The book describes a number of key cases that have shaped how humans handle epidemics, including hemorrhagic fever in Bolivia, Marburg in Germany, and AIDS across the globe.
  • Garrett uses case studies to detail the multi-disciplinary, international approach required to combat modern epidemics.
  • New epidemics tend to arise from changes in how humans interact with their environments. New environmental conditions, such as urbanization, result in new outbreaks.


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Last Updated on April 24, 2020, by eNotes Editorial. Word Count: 1223

Laurie Garrett’s The Coming Plague is a nonfiction account of historical disease epidemics. It covers the causes of epidemics, many of which are related to human actions, human responses to epidemics, and the biology of microbe evolution and adaptation. Social movements such as urbanization and gay rights are also put into the context of disease development. Some accounts are success stories; others are cautionary tales.

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In 1962-64, Bolivia experienced a new type of hemorrhagic fever with a horrifying fifty-percent mortality rate. An international team of medical personnel set up makeshift facilities in an environment with no utilities. Through extensive lab testing and examination of animal specimens, they identified the infectious agent as a virus that passes through mouse urine. A campaign of mouse-trapping ended the epidemic and created a new method of fighting disease: the deployment of a team with diverse skills in medicine, science, and detective work.

Another example of success is the coordinated global effort to eradicate smallpox that concluded in 1980. A corresponding failure was the effort to eradicate malaria, which is mosquito-borne and more difficult to diagnose. When US-led funding for malaria eradication ended in 1963, the disease had been nearly vanquished around much of the globe, but it soon returned in a form resistant to known methods of treatment.

In 1967, Germany experienced a new viral infection called Marburg that was eventually traced to ill monkeys imported for lab use. The virus jumped to the humans studying monkey cells and spread outward from there. The World Health Organization (WHO) recommended new guidelines for the importation and quarantine of test animals, but the precise cause and origins of Marburg remain mysterious. Other unsolved epidemic origins include antibiotic-resistant meningitis in Brazil in 1974 and yellow fever in Nigeria in 1970.

Several epidemics originating in Africa were amplified by medical practices such as reuse of syringes. Lassa fever first appeared in 1969, and Ebola appeared simultaneously in Zaire and Sudan in 1976 and again in Sudan in 1979. Communication difficulties slowed contact between teams and limited their ability to get needed supplies. Moreover, poverty and equipment shortages made the recurrence of these diseases inevitable.

The United States contended with two potential outbreaks in 1976: Swine Flu and Legionnaires’ Disease. While Legionnaires’ Disease was investigated with scientific rigor, Swine Flu was handled disastrously. Politicians adopted alarmist language about a coming pandemic, and in March 1976 President Gerald Ford requested funding for mass vaccination. When manufacturers refused liability for a rushed vaccine, Congress passed legislation that allowed the government to absorb liability for any adverse effects. This irrevocably changed the relationship in the United States between vaccinations, the public, and the judicial system: where once the public good took priority over individual rights, now the individual’s right of choice was paramount.

Diseases have always evolved in relation to people, especially as urban centers...

(The entire section contains 1223 words.)

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