- ‘This book focuses on the United States
- ‘Pitted against such nimble competition, the human capacity to evolve ‘may be dismissed as almost totally inconsequential.’ ’ Joshua Lederberg (8)
- ‘Outside a living cell, a virus is a dormant particle, lacking the raw materials for synthesis. Only when it enters a congenial host cell does it explode into action, hijacking the cell’s metabolic machinery.’ (9)
- ‘When a virus picked up a toxin from a deadly Shingella dysenteriae and inserted in into a harmless E. coli, it created E. coli O156:H7, a mean bacterial hybrid that clings to mucosal surfaces in the human intestine and produces toxins that trigger hemolytic uremic syndrome, the most common cause of acute kidney failure in children.’ (10)
- ‘Bacteria don’t attack until their numbers are high enough to establish an infection. This wireless communication system, called ‘quorum sensing,’ enables microbes to coordinate their activities.’ (11)
- ‘A more mysterious class of infectious agents – the newly discovered triggers of animal and human brain diseases such as bovine spongiform encephalopathy (BSE, or mad cow disease) and its human counterpart, new variant Creutzfeldt-Jakob disease – apparently repeal the laws of biology. Called prions, these proteins are folded in an abnormal way; when they come in contact with other proteins, they turn them into prions, setting off a chain reaction that eventually riddles the brain with holes.’ (11)
- ‘Unlike viruses or bacteria, prions can’t reproduce and evoke no immune response. More frightening, they resist heat, ultraviolet light, radiation, and sterilization.’ (11)
- ‘Overwhelmed by unsafe water, poor sanitation, and widespread poverty, tomorrow’s megacities will become cauldrons for new infections.’ (14)
- ‘Bugs themselves are changing, often with a human assist. In 1954 the United States
- ‘Whatever deadly pandemic next sweeps the world, whatever newly christened scourge dominates headlines, it will almost surely have jumped species in this way…Zoonotic infections reach us either directly from animals, or indirectly from animals via insect vector.’ (60)
- ‘As Jared Diamond points out in his book Guns, Germs, and Steel, ‘when we domesticated social animals, such as cows and pigs, they were already afflicted by epidemic diseases just waiting to be transferred to us.’ (61)
- ‘One of the most insistent marketing messages we hear, trumpeted by both industry and regulators, is that the United States has the safest food supply in the world. Yet according to the CDC’s best calculations, each year 76 million Americans – nearly one in four, and that’s a lowball estimate – become infected by what they eat. Most find themselves for a few days dolefully memorizing a pattern of bathroom floor tiles. About 325,000 land in the hospital…More than 5,000 – about 14 a day – die.’ (75)
- ‘Fifty years ago, grocery stores stocked about 200 items, 70 percent of which were grown, produced, or processed within a 100-mile radius of the store. Today, the average supermarket carries nearly 50,000 food items, some stores as many as 70,000.’ (76)
- ‘Meanwhile, more of us are more vulnerable to foodborne microbes. Individuals with impaired immunity – the very young, the very old, and people with cancer, organ transplants, diabetes, AIDS, and other conditions that weaken the body’s defenses; all told, about a quarter of the population – are more apt to succumb to these infections.’ (77)
- ‘Men and women over 65, who in the next three decades will make up one-fifth of the population, produce less acid in their stomachs, eliminating the first line of defense against enteric pathogens; federal officials predict that the aging population could increase foodborne illness by 10 percent in the next decade. Americans are popping more prescription and over-the-counter antacids than ever, and in so doing, giving pathogens entrée to the nether regions of our digestive system where they do the most damage.’ (77-78)
- ‘It’s easy to underestimate the risk of falling ill from food, since the problem is largely invisible – hidden, one supposes, behind the bathroom door. CDC epidemiologists have factored in this cultural aversion by using numerical multipliers that translate the relatively few cases reported into a far higher and more accurate count of victims who never see a doctor. For instance, for every person known to suffer an infection caused by Campylobacter or Salmonella or Cyclospora, there are 38 who have eluded the net of public health officials; for every confirmed case of E. coli O157:H7, there are 13 to 27 doubled-over victims. Keep this in mind when you read news stories about foodborne epidemics. The scores of confirmed cases mentioned in wire service stories may actually represent hundreds or thousands of silent sufferers.’ (79)
- ‘A single patty may mingle the meat of a hundred different animals from four different countries. Or, looked at from another perspective, a single contaminated carcass shredded for hamburger can pollute eight tons of finished ground beef.’ (80)
- ‘E. coli O157:H7, the organism that this endless mixing amplifies, is a quiet tenant in the intestines of the 50 percent or so of feedlot cattle it infects, but a vicious hooligan in the human gut.’ (80)
- ‘The distinctive symptoms of E. coli O157:H7 are bloody diarrhea and fierce abdominal cramps; many victims say it’s the worst pain they ever suffered, comparing it to a hot poker searing their insides.’ (81)
- ‘The sanitary revolution of the nineteenth century – the discovery that the diseases of squalor and overcrowding could be prevented with sewage removal and clean water – was occasioned by fear of cholera, typhoid fever, and other pestilential diseases. Before this transformative event, daily life was unimaginably filthy.’ (85)
- ‘…which is precisely how the animals that become our food live today. And why, at the CDC, officials in the foodborne and diarrheal disease branch long for a sanitary revolution: clean piped water and sewage disposal and treatment – for animals.’ (85)
- ‘A 1999 study from the USDA’s Agricultural Research Service, for instance, found that 7 percent of chickens sampled at slaughterhouses had Salmonella and 30 percent had Campylobacter.’ (87)
- ‘A 1999 study from the USDA’s Agricultural Research Service, for instance, found that 7 percent of chickens sampled at slaughterhouses had Salmonella and 30 percent had Campylobacter.’ (87)
- ‘Found in 1 of every 20,000 eggs, [Salmonella enteritidis] makes French toast, Hollandaise sauce, and raw cookie dough risky culinary excursions.’ (89)
- ‘Salmonellosis is rare in developing countries, where sanitation is poor and diarrheal diseases are endemic, but where food production and consumption.’ Martin Blaser (90)
- ‘All the fruit had come from a Mexican farm on which strawberry pickers had only a few latrines. The only places they could wash their hands were on trucks that circulated through the fields. With bare hands, the pickers severed the strawberry stems with their fingernails. As the CDC’s Rob Tauxe told Nicols Fox, ‘Those are the hands that feed you. And it might actually matter whether they are washed or not of whether they have a latrine. If we are interested in the safety of our food, then we have to be interested in the living conditions of the people who handle it.’ ’ (105)
- ‘There’s political pressure not to bar such imports, since the action could be interpreted as US barries
- ‘Because wages in these jobs are low, and insurance and sick leave nonexistent, ‘people are encouraged to work while they’re sick.’ ’ (113)
- ‘Not long before antibiotics entered our lives, staph in the bloodstream killed 90 percent of its victims. A man who nicked himself shaving could die from erysipelas, a strep infection. Children lost their playmates to scarlet fever, meningitis, osteomyelitis. Bacterial pneumonia, the leading cause of death, killed a third of its victims. Tuberculosis patients were advised to rest and seek clean air, because there was nothing else medicine could offer.’ (118)
- ‘Most resistant infections strike people in hospitals, nursing homes, and long-term-care facilities. That’s no surprise. These are places where antibiotics are used most intensively and so are the natural proving grounds for resistant infections.’ (128)
- ‘Five percent of all US
- ‘Each year, according to the World Health Organization, drug resistance contributes to more than 14,000 US hospital deaths.’ (128)
- ‘Livestock producers hew to the position that whatever drugs they feed their animals are proprietary secrets. Besides, say industry officials, they need antibiotics to produce safe and affordable food. A 1999 report published by the Institute of Medicine
- ‘Antibacterial-containing products are no more effective in cleaning away germs than plain soap and water.’ (144)
- ‘A hyperclean childhood environment may set us up for lifelong medical problems. According to the so-called hygiene hypothesis, early exposure to certain pathogens may actually be healthy…Recent studies demonstrate that a larger proportion of people raised in highly hygienic environments suffer allergies and asthma.’ (144-145)
- ‘At the CDC, researchers estimate that a third of the 150 million annual outpatient prescriptions for antibiotics are unnecessary, either because the illness is not bacterial or because the bacteria aren’t sensitive to the antibiotics.’ (153)
- ‘Managed care groups are trying to save money by cutting back on tests, including microbiologic cultures, because it’s cheaper to prescribe broad-spectrum drugs and wait to see if patients get better.’ (153-154)
- ‘The tension between what’s right for the individual and what’s right for public health becomes especially poignant at the end of life. Should a doctor give last-resort antibiotics to a patient who is sure to die soon anyway – even if it means raising the risk of drug resistance in another patient five feet away?’ (154)
- ‘The biological paradox that antibiotics sow the seeds of their own failure is matched by an economic paradox: if a new antibiotic is food, regulators will ask doctors to use it sparingly and the drug won’t quickly recoup its investment.’ (155)
- ‘The primordial source of all flu strains is migrating aquatic birds. Wild ducks, geese, terns, gulls: these ancient creatures, which have populated the earth for at least 105 million years, harbor the full spectrum of flu viruses.’ (171)
- ‘Through fecal matter in lake water, the flu virus apparently passes among feral ducks and is then transmitted to mammals.’ (171)
- ‘The lesson from Fort Dix [1976 swine flu] has been that before you declare a novel virus pandemic, make sure the microbe has legs and can spread efficiently from person to person.’ (195)
- ‘Huge vaccine-ready flocks – five million birds – must be hatched six months in advance, so that they’re mature enough to lay eggs. It takes at least half a year to prepare the annual flu vaccine.’ (196)
- ‘Our bodies contain at least ten times more bacterial cells than human ones, making us walking Petri dishes, and blurring the line between where microbes end and humans begin.’ (213)
- ‘Yahoo! searches containing the words ‘flu’ and ‘influenza’ have predicted actual illnesses with influenza. When frequency data for Yahoo! searches were fed into statistical models, they foretold flu-positive laboratory cultures one to three weeks ahead of time, and deaths from pneumonia and flu a full five weeks in advance. On Google, influenza-related searches jibed with doctors’ visits for the same illnesses and predicted by one to two weeks CDC regional surveillance reports – a phenomenon that helped launch Google Flu Trends.’ (277)
- ‘Web searches are some of the most timely flu monitoring systems available today, and have given rise to a new public health concept: search-term surveillance.’ (277)
- ‘Within a few years, the HIV/AIDS pandemic may eclipse the 1918 influenza pandemic in its mortality, making it the deadliest emerging disease in recorded history. A UN fact sheet starkly summed up the situation: ‘HIV will kill at least a third of the young men and women of countries where it has its firmest hold, and in some places up to two-thirds. Despite millennia of epidemics, wars, and famine, never before in history have death rates of this magnitude been seen among young adults of both sexes and from all walks of life.’ ’ (281)
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