WhenGermsTravelSixmajorepidemicsthathave

Thestruggleagainstdeadlymicrobesisendless.Scourgesthathaveplaguedhumanbeingssincetheancientsstillthreatentounleashthemselves;newmaladiesarebrewingthathaveyettomaketheirappearanceintheheadlines;lethalgermsemployedasweaponsofwarfareandterrorismhavereemergedasaworldwidemenace.Regardlessoftheirmodeofattack，microbesexisttomultiply，thrive，andfindnewhosts;theycrossnationalboundariesandsocialclasses，attackingwithoutprejudice.NowmedicalhistorianandpediatricianHowardMarkel，authorofQuarantine!(“Engrossing...Meticulouslydocumented”—SherwinNuland，TheNewRepublic)，tellsthestoryofsixepidemicsthatbrokeoutduringthetwogreatwavesofimmigrationtotheUnitedStates—from1880through1924，andfrom1965tothepresent—andshowshowfederallegislationclosedthegatestonewcomersforalmostforty-oneyearsoutoffearthatthesenewpeoplewouldalterthesocial，political，economic，andevengeneticfaceofthenation.Markelwritesabouttuberculosistoday，themostseriouspublichealththreatfacingthecontemporaryworld.Hewritesaboutbubonicplagueandhowitcametothiscountryintheearlytwentiethcentury;abouttrachomaintheyearsbeforeWorldWarI;aboutEllisIslandandhowanEastEuropeanrabbiwasdiagnosedandtreatedforthedreadedeyeinfection;abouttyphusfeverandanepidemicontheTexas-MexicoborderintheaftermathofPanchoVilla’srevolution;andaboutAIDS，theHaitianexodus，andtheearlyyearsoftheAIDSepidemic.Markelexplainshowimmigrationinthetwenty-firstcenturyischaracterizedbyporousborders，rapidtravel，andscattereddestinations.Whilemorethan75percentofallimmigrantsduringthefirstgreatwaveofimmigrationcamethroughNewYorkHarbor，transportationtodayallowstraveltoallpartsoftheUnitedStatesfromthefarthestreachesoftheglobe，givingpublichealthphysicianslittleopportunitytodefinitivelydiagnoseinfectiousdiseasesthatcanincubatesilentlyinatraveler，makingthespreadofepidemicsfarmorethanatheoreticalconcern.Markellooksatournation’sresponsetothepathogenspresentinourmidstandexaminesourfoolhardyattemptsatisolationandourvacillationbetweendemandingapublichealthsystemsopunitivethatitworsensmattersratherthanprotectsandsettlingforonethatistoolax;howwearefascinatedwithallthingsinfectiousandthenhardlygivemicrobesasecondthought;howtheUnitedStates，acountrythatsinceitsinceptionhasprideditselfonbeinganationofimmigrants，continuesitstraditionofblamingnewcomersforitsphysicalandsocialills;andhowglobalization，socialupheaval，andinternationaltravelrenderusallpotentialinhabitantsoftheso-calledHotZone.Finally，Markelputsforthaplanforagloballyfundedpublichealthprogramthatcouldstopthespreadofepidemics，helperadicatecertaindiseases，andprotectusall.