Crisis Averted: The Hidden Science of Fighting Outbreaks

Johns Hopkins University epidemiologist Rivers debuts with a penetrating exploration of strategies public health experts have used, or failed to use, to prevent catastrophe. Chronicling how the World Health Organization eliminated smallpox in the 1960s and ’70s, Rivers describes how, after mass vaccination campaigns in the countries where the disease still circulated proved insufficient, health workers paid people to report cases so the workers could vaccinate and quarantine anyone exposed. The combination of strategies was successful, and the last natural smallpox case occurred in 1977. Other success stories include how good “old-fashioned... contact tracing, isolation, quarantine, and instructions to the well for how to prevent infection” stymied the spread of SARS in the mid-2000s. Rivers also features a few cautionary tales, as when she discusses how inadequate infrastructure for waste water contributed to Haiti’s devastating cholera outbreak in the 2010s. A chapter describing the origins of tornado warnings in the late 1940s to demonstrate the wisdom of honest communication with the public about potential threats feels tangential given the overall focus on disease, but the case studies offer helpful insights into what it takes to extinguish outbreaks. It’s a rousing testament to health workers’ grit and competence. Agent: Beth Fleming, Brockman. (Oct.)