Reviewer: Susanna Von Essen, MD (University of Nebraska Medical Center ) Description: This book covers a number of diseases where epidemiology has made an important contribution to understanding the problem and thereby lessening the burden of disease. The main focus is on the historical perspective and how the lessons of history illustrate key concepts. Purpose: The purpose is to inform all persons interested in how diseases operate in populations and how best to control them. Students of public health, professionals working in healthcare, and lay persons interested in public health make up the target audience. The stated objectives are important and, for the most part, the author has met them. The historical perspective is discussed in an engaging style. However, the book would be more complete if there were a better balance between the description of the history of the disorders with a discussion of current challenges facing those who are working with populations at risk. For example, the history of treatment of tuberculosis in the United States is described very well, but there is little mention of the ongoing challenge of treating latent tuberculosis and how the public health system is dealing with that problem using epidemiology. Audience: The author states that the book is for students of public health and professionals in health science careers as well as others interested in public health. It is not my impression, from reading the author's preface or from my reading of the book, that it is written with a particular medical specialty in mind. I agree that the book is at an appropriate level for students of public health. Health professionals would find it interesting and it would likely help them learn fundamental public health concepts. Lay persons would likely need a strong background in science to appreciate all of the points the author makes. Features: This book covers a variety of topics important in American medicine, from the 18th to the 21st century. These include the early history of the prevention of smallpox, the early days of the treatment and prevention of yellow fever and malaria, information to be learned from the study of mortality statistics, the early approach to the treatment of tuberculosis, the story of the poliomyelitis epidemic, the recognition of the link between cigarette smoking and cancer, lessons learned from the Framingham heart study, and the story of how HIV/AIDS and SARS were recognized as being caused by infectious agents. Using these stories to illustrate the application of statistics and epidemiology is a novel approach. The photographs are well chosen and help make the stores come alive for the reader. Shortcomings include some less than smooth transitions from one topic to another within chapters. Assessment: The reader who knows the topic area will be able to follow where the author is going with his ideas. However, the student who is not familiar with the material may have difficulty appreciating how the content of the various paragraphs in a given chapter is related. Also, there could be a brief discussion at the end of certain chapters to illustrate how statistics and epidemiology are being applied to the public health problems that present ongoing challenges, such as HIV/AIDS.
3 Stars from Doody
The term plague is no longer limited to bacterial or viral infections, but is expanding to include heart disease and cancer in this updated edition of a popular textbook. Gehlbach (Interpreting the Medical Literature), dean emeritus of the School of Public Health at the University of Massachusetts, Amherst, leads a thoroughly engrossing exploration of American medical history across 12 chapters, which range from a Boston smallpox outbreak in 1721 to a measles outbreak at Disneyland in 2014. Gehlbach describes how devastating epidemic diseases have been encountered, misunderstood, understood, and then conquered (smallpox, yellow fever, tuberculosis, polio) or ameliorated (heart disease, AIDS). He also addresses the deadly new problem of multiply antibiotic-resistant infections as well as contemporary medicine’s disastrous bête noire: the anti-vaccine movement. In addition to lauding fine accounts of the great historical studies (the Framingham study of heart disease, the Wynder and Graham study of lung cancer), Gehlbach warns that plenty of research turns up nonsense, and he delivers a painless primer on how to tell good studies from bad. Readers will have little trouble understanding his explanations of bias, contamination, true positives versus false positives, and meta-analysis. Gehlbach’s book is often assigned reading for college-level public health classes, and all textbooks should be as entertaining. (June)
American Plagues: Lessons from Our Battles with Disease is not just a useful text book for any public health or medical student, it is a useful read for anyone wishing to have a better understanding of public health in America and how we have learned to address plagues and epidemics over the years.
Gehlbach provides a vivid picture of life in the United States as extraordinary health events occurred throughout history. Beginning his discourse with the yellow fever epidemic in Philadelphia in 1793, the author describes the scenes in a manner that pulls the reader into the setting, so that he or she can experience the gravity of each episode. The author serves as a ‘health detective’ by exploring the environment, events, and players involved within 11 significant health events, which include more modern scenarios (HIV/AIDS, health-related infections, the recent outbreak of measles, and the misunderstanding of vaccinations). The author recognizes the importance of public health surveillance and data analysis, and chronicles the development of epidemiology, which had an essential impact on health-related proceedings. In addition to a descriptive, insightful narrative, the author uses extensive references and frequent illustrations.
Summing Up: Recommended. All readers.
The updated version of his 2005 volume, American Plagues: Lessons from Our Battles with Disease, succeeds admirably. It conveys Gehlbach’s infectious enthusiasm for his subject so effectively that general readers will also relish the historical detective’s account of medical mysteries stretching back to the founding of the nation…. Gehlbach’s updated edition includes chapters on fresh patterns of infectious disease and their spread, sometimes by the very health care providers and in hospitals dedicated to battling such diseases, a circumstance first identified 170 years ago by Dr. Oliver Wendell Homes…. Gehlbach’s considerable narrative skills are exceeded only by his mastery of how American medicine and public health have progressed incrementally, always ‘gaining from experience.’
Bulletin of the History of Medicine
This new edition of American Plagues: Lessons from Our Battles with Disease is most welcome. Ten years ago I was impressed with how history and clinical medicine was masterfully woven together by Stephen Gehlbach into a coherent narrative that worked remarkably well in the classroom. This edition is no different. More than just a reprinting, this updated version has new chapters on the problem of infections bred by the very professions charged with combating them and the current wave of dangerous misinformation regarding vaccines. Having taught courses in the medical humanities for some twenty years, I can say with confidence that this is one of the best instructional texts I’ve ever used, a verdict rendered not just by me but by my students who used it. Even beyond the classroom, American Plagues has lessons for us all, demonstrating that history and clinical practice are inextricably tied together. This book should be on the shelf of every academic library.
Stephen Gehlbach's book provides a remarkable insight into how we came to understand the critical importance of public health measures as major determinants of disease incidence and mortality. While the book is nominally about the spread of infectious disease, it is really far more than that. Its rich trove of historical anecdotes reveals how we developed our current insights in the origins of diverse diseases and the biological processes that allowed them to flourish in human populations. The ultimate benefit from these stories come from the clear lessons they teach about disease prevention, revealing how reductions in disease incidence will lead inevitably to corresponding reductions in disease-related mortality. In fact, disease prevention has been increasingly pushed off-stage in recent decades, yielding ever more frequently to reports of dramatic advances in medical treatment. However, with every passing year, it becomes increasingly clear that major reductions in various diseases and the mortality that they cause will only come from preventing them rather than treating them once they have been diagnosed. This critical lesson is taught time and again in this highly readable and entertaining tour of the origins of the science of public health.
Dr. Stephen Gehlbach has written an eminently readable and scholarly epilogue to his book of ten years ago then entitled American Plagues: Lessons from Our Battles with Disease. This updated version captures many of the more modern plagues afflicting populations world-wide and complements rather than replaces the earlier volume. Those interested in medical history will surely want to peruse this current volume.
Intrigued by the mysteries of medicine Gehlbach brings to life detective stories of American epidemics from the smallpox outbreak in Boston of 1721 to the Disneyland measles eruption in the 21st century. He takes us to the successes and shortcomings as physicians grappled with causes and cures and battled both the diseases and each other as epidemics raged and differences of opinion counterbalanced each other leaving the layman to ponder. Written with wit and wisdom, peppered with historical vignettes and humorous tales of eccentric physicians, along the way, the readers, both health professionals and laymen grasp the progression of the scientific method and the significance of epidemiology.
I recommend the revised edition of Stephen H. Gehlbach’s American Plagues. Gehlbach’s work has long been a staple text for me to familiarize my students with the history of infectious disease control in my introduction to American Medicine Courses. This new edition updates the chapter on AIDS and other parts while adding two excellent and necessary chapters: one on hospital-borne infections; and one on the consequences of misplaced and ill-informed fears about contagion and disease causation. Gehlbach’s analysis of the consequences of the anti-vaccination movement and the challenge of Ebola transmission in America will provoke excellent discussion in the classroom about the need for evidence and theories of disease. Students of public health or the history of medicine will also find the italicized terminology sprinkled throughout the historical vignettes very valuable for learning basic principles of epidemiology, clinical science, and public health. These features and this book will be of great utility to teachers for that reason as well. I strongly commend this new edition.
Stephen Gehlbach masterfully tells the fascinating stories of major American disease outbreaks over almost three centuries. Each narrative illuminates the passion and intellect needed to solve the epidemic, both infectious and chronic. The historical context and clearly presented data evidence grab the reader. What better way to learn epidemiology than by following the steps, one by one, of resolving these public health threats. This book is a superb addition for public health students, undergraduate and graduate. As well, it is very good read.