We don’t actually know how the swine flu outbreak started. It was first discovered in the Vera Cruz region of Mexico, and the earliest known victim was a five-year-old who lived near a factory pig operation partly owned by Smithfield Foods. But there’s no proof that the virus originated there. Knowing that, it seems a bit precipitous to ban pork imports, or to slaughter every last pig in your country (300,000 of them), as the Egyptian government has ordered.

Phillip Acabes, a professor of public health at Hunter College, writes in his provocative (and incredibly timely) new book, Dread: How Fear and Fantasy Have Fueled Epidemics from the Black Death to Avian Flu, that in many cases fear of pestilence is irrational, far from justified by the actual threat, and manipulated for political purposes.

Take the case of SARS. Traffic accidents routinely kill 40,000 people annually in the U.S. SARS killed 774 worldwide in 2002 and 2003 (349 of them in China), but the New York Times, reflecting reader interest, ran more than 200 articles on it, and Canada’s Globe and Mail published 300. PBS was all over it, too.

That’s just one case among many. The seasonal West Nile reports of infected dead birds always get coverage, and Richard Preston’s The Hot Zone -- about the rapid spread of the horrific Ebola virus, with a “can-it-happen-here frisson -- was a huge bestseller in 1994. By the way, it didn’t happen here, at least not yet.

Huge epidemics such as the influenza outbreak of 1918-1919 (which killed 500,000 people in the U.S. alone) do occur, and it’s the chance of history repeating that sometimes pushes people into unwise and unnecessary behavior. Certainly, the banning of pork imports to forestall the current outbreak of swine flu (when the virus has long since left its porcine host) is one example of that.


Dread is very readable. For a scientist, Alcabes is a lucid writer who never loses his audience in medical jargon. He takes us through many recent and not so recent public health scares. The response to the Black Death in Europe is a particularly vivid example. With no scientific evidence suggesting otherwise, there was widespread belief in medieval times that plagues were a message from the Almighty.

A strain of the self-abnegating religious philosophy that informed our Puritan fathers (see Sarah Vowell’s The Wordy Shipmates) also dictated the response to a plague. “This is an example of the wonderful deeds and power of God,” said ibn Khatimah, writing in Moorish Andalusia, Spain in the fourteenth century about the coming of the plague to Europe. In 1562, the German Jesuit Dominique Mengin expressed gratitude for the plague because it kept Munich’s residents away from the “pleasures of this world and delights of the flesh” -- and pushed them toward the Good Book.

Blaming the Jews was always a popular option in Europe, and they were accused of well poisonings and other heinous acts in relation to plague. A mass hysteria resulted in widespread anti-Jewish pogroms, including 12,000 murdered in the German city of Mainz in 1349. Later that year, all the Jews in Antwerp and Brussels were killed.

In this case, the Catholic Church discouraged the slaughter, but its admonitions went unheeded. The Holocaust ended only “because the flames ran out of fuel,” Alcabes writes. “It might well have continued had there been Jews left to target.”

But Dread is not just a history book. It explicates many modern outbreaks, and doubts the reality of some of them. In a passage that is sure to set off some impassioned dialogue, Alcabes proclaims, “To claim, as many do, that more children are born autistic today than ever before is to make an assertion no data can support.” Autism is more common today because we recognize and diagnose it, he writes, not because it occurs more often.

We bring our deepest anxieties to the table when we talk about, or think about, mass disease outbreaks. Our deep concern about swine flu -- currently the most popular blog topic on MNN -- is part of a continuum. “The way we have responded to epidemics like polio, AIDS and SARS and the way we are currently responding to obesity, autism and addiction, reveal that we bring fears to the prospect of any sort of epidemic, deadly or not,” writes Alcabes in this invigorating troll through public health science.

Related on MNN: Our complete swine flu coverage.