Plague Time : The New Germ Theory of Disease

Rating:
Summary: A little too scientific for the average reader
Review: "Plague Time (2000)" and Ewald's earlier "Evolution of Infectious Disease (1994)" advocate a new discipline called 'evolutionary epidemiology.'

One of the big shockers in both books is that: "Application of evolutionary principles does not lead to the conclusion that all parasites [including viruses and bacteria] evolve toward benignness."

Only under circumstances where new hosts are relatively hard to infect (due to a clean water supply or screened windows or condoms) are parasites forced to co-exist in a relatively benign state with their current victims. In both books, Ewald uses cholera as an example of a germ that has evolved to benignness in countries with clean water supplies, but is still a killer in countries with bad plumbing.

"Plague Time" takes this thesis a step further and concludes that many so-called chronic diseases such as atherosclerosis and certain cancers are also caused--or at least triggered by infection.

Peptic ulcers are a case in point. Even though some doctors back in the 1940s realized that antibiotics could heal ulcers, the technique never caught on in mainstream medicine. It was too easy to blame the patient's life-style and stress levels, and besides 'Helicobacter pylori' was hard to find. Four decades later, researchers in Perth, Australia discovered that patients with ulcers and gastritis improved after tetracycline. One of the researchers, Barry Marshall drank an infective dose of 'H. Pylori,' got gastritis, then cured himself with antibiotics. "Still, it was only in the mid-1990s that the medical establishment finally generally accepted the idea that peptic and duodenal ulcers are infectious diseases."

So what will the decisive medical technologies of the future be, if it is indeed accepted that many chronic illnesses are caused by infection? The author believes that, "Vaccines, antimicrobials, and hygienic improvements may control most heart disease, infertility, mental illnesses, and cancers, especially if these solutions are used not just to decimate pathogens but also to direct the evolution of the causative microbes."

"Plague Time" is a fascinating look at what may be the near-future of medicine if physicians can be trained to look at infectious diseases in terms of evolutionary epidemiology.

Rating:
Summary: Really interesting, rather easy reading.
Review: I can see some readers think this book is not easy for the layman, but the truth is if this is your first approximation to evolutionary medicine or evolutionary epidemiology, I think this is a good book for you to start. There are other excellent books out there like "Why do we get sick?" by Randolph M. Nesse and George C. Williams (which I personally recommend too) that may be simpler and broader, but they lack some of the originality Paul Ewald has in this book. The only thing I criticize about this book is that it could have made its point in fewer pages, that aside it was truly great.

Ewald's perspective is original and really logic, I only keep thinking it might be a little exaggerated to think it is going to revolutionize medicine. He surely states really important new axioms, and in this way he is revolutionizing medicine, but I believe the benefits derived by his hypothesis are not going to be that outstanding. The book is great and original, not hard reading but challenge common knowledge (not common sense, be careful).

Rating:
Summary: A little too scientific for the average reader
Review: I found the theories to be very interesting, but found the author tended to repeat himself. I also felt the wording was a little too "scientific" for the average reader. With that said; I still may look read more of his books.

Rating:
Summary: Interesting subject, boring book.
Review: The book is interesting but weaves the theory of evolution into nearly every page. Too preachy on the subject of evolution, genes, etc. Highly sophisticated language, complex scientific jargon used a little too often. Not recommended for the average "unscientifically-trained" reader.

Rating:
Summary: why settle for a century?
Review: The dramatic message of this book is that chronic diseases such as cancer, heart disease, and arthritis, are not necessarily caused by an inherent and inevitable breakdown of the human body, but by the action of infectious agents and by the immune response to those agents. Sooner or later, some bug finds its way through your defenses and settles in. Sometimes you know right away (small pox) BUT sometimes it takes years (AIDS, Lyme) sometimes it takes decades (shingles). This is not a new-agey wishful thinking assessment of risks, but a scientific analysis of disease and its causes, based on experimental data. The companion volume "The Evolution of Infectious Disease" covers much of the same ground but gives much detail to satisfy the sceptics.

I'm a scientist (but not a biologist) and I would bet this is one of the 20 century books that will still be a recommended book a century from now. Ewald's theory is still fighting for recognition, but there are so many factors that are "right" about it that it has to prevail (like evolution.) The big questions are about how effectively we can fight quietly acting micro-organisms whose effects don't show up for years or decades.