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

by Laurie Garrett
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The Coming Plague Analysis

  • The Coming Plague was published at a time when the public was particularly receptive to information about epidemics, given the recent proliferations of AIDS and Ebola.
  • Garrett employs literary techniques to render her historical account more evocative and compelling. These techniques include imagery, metaphor, and the inclusion of individual accounts. The latter technique allows readers to understand the impacts of epidemics at an individual level.
  • Although certain aspects of Garret's book are outdated, many of the trends and lessons she presents remain valid decades after its publication. Humans still have much to learn about how to prevent deadly outbreaks.


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Last Updated on April 24, 2020, by eNotes Editorial. Word Count: 787

In The Coming Plague, Laurie Garrett argues from a public-health and journalistic perspective that humans are unprepared for the emergence of deadly new microbial infections. A quarter century after the book’s publication, some of Garrett’s predictions and medical data are outdated (such as communication methods in the pre-Internet age), but the book’s thesis remains relevant, and its historical examples of epidemic spread and response remain compelling.

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The Coming Plague was published in 1994, on the cusp of the Internet age and a mere three years after the dissolution of the Soviet Union. The same year, Richard Preston’s The Hot Zone had become a bestselling account of deadly viral outbreaks. A film version of Preston’s book was released in 1995, coinciding with an epidemic of Ebola virus in Zaire (now the Democratic Republic of the Congo). While Ebola captured headlines temporarily, the emergence of HIV/AIDS had claimed more lives and required a national response in the United States. In 1987, Ronald Reagan formed the Presidential Commission on the HIV Epidemic. In 1996, Bill Clinton would develop a National AIDS Strategy.

In this receptive environment, Garrett’s work of popular science became a New York Times bestseller. With a background in both journalism and public health, she was able to translate complex scientific concepts for a general readership. Rather than merely presenting a dry account of statistics, she uses individual cases from first-person perspectives to draw in readers. The book’s first chapter, for example, begins in the viewpoint of the deathly-ill Karl Johnson, one of the physicians who eventually solved the mystery of the nature and transmission of Bolivia hemorrhagic fever. By placing readers in his viewpoint to witness first-hand the horrifying symptoms of illness, Garrett leads readers to understand the human impact of an epidemic—and what is at stake if it is not stopped. Other chapters begin similarly, bringing in human stories to deepen the topic at hand.

Garrett often uses rich figures of speech to engage readers. In describing the arrival of medical personnel in Bolivia, she writes, “like a tired old condor, the bomber circled La Paz slowly several times.” When a contingent of investigators reached Yambuku, an area of Zaire ravaged by Ebola, they “immediately felt the sad silence of the place.” She includes personal details on the medical personnel she calls “disease detectives,” including Karl Johnson’s adventurous and cantankerous personality and Uwe Brinkmann’s political fears and bohemian dress. Those who grow ill are also rendered as individual humans, such as early AIDS patient Greggory Howard, whose struggles and idiosyncrasies Garrett renders on the page.

These literary choices enrich Garrett’s central purpose: to tell an exhaustive history of epidemic disease outbreaks from the 1960s to the early 1990s. Garrett documents her sources in great detail, incorporating political and economic trends and cultural traditions relevant to the wider narrative. Without...

(The entire section contains 787 words.)

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