Spillover: Animal Infections and the Next Human Pandemic Hardcover – October 1, 2012

This book is my favorite book of all time. It made me become and epidemiologist specializing in animal and human spillover diseases.

What a timely piece of writing! This has been on my to read list for awhile, but with the current pandemic it seemed to be the right time to put this one at the top of my list.“When a pathogen leaps from some nonhuman animal into a person, and succeeds there in establishing itself as an infectious presence, sometimes causing illness or death, the result is a zoonosis.”“It is a word of the future, destined for heavy use in the twenty-first century.” How prescient is that?This leaping is called spillover, and something like 60% of infectious diseases are from spillover. Examples include the bubonic plague, Ebola, and human influenzas are all zoonotic infections. So is COVID19! We tend to forget sometimes that we too are animals, and susceptible to being fertile ground for viral spillover. We are increasingly affected by spillovers because of our actions. We clear forests, logging and road building, we capture bushmeat and butcher it, and eat it, we engage in mineral extraction, and fly all over the globe, thus exposing these emerging viruses to human populations and spreading them quickly.This book is rich with important topics which I believe we should ponder. Why? Because our behavior predicts how much spillover there will be, and also predicts whether an EID (emerging infectious disease) will go from an outbreak, to an epidemic, to a pandemic. 72% of zoonotic EIDs “are caused by pathogens with a wildlife origin.” What food we eat and how we procure it, or hunt it, makes a difference. If you read about wet markets or even large scale industrial animal operations, you must realize that the crowding and unsanitary conditions put us at risk for spillover. As the author says, “when you shake the tree, things fall out!” How we denigrate science and scientists, so we allow the defunding of programs meant to monitor emerging viruses. All these activities increase the chances of helping to unleash the NBO (next big one). As the authors declares over and over, those studying infectious diseases and zoonotic diseases warned us that this NBO was coming, and they warned about the influenzas, retroviruses (think AIDS), and coronaviruses, which were singled out by many virologists as having deadly potential!What was the last big one? HIV which is the virus causing AIDS, which has already killed 30 million people!We had another coronavirus, SARS-CoV, which erupted in 2003. How are these two outbreaks different? In the way they are spread and in the timeframe of the infection moving forward. HIV moves more slowly and is harder to spread because it is not a respiratory spread. The SARS-CoV was different in that it was symptomatic BEFORE it was very infectious. With COVID19 we have the opposite! It is infectious BEFORE it becomes symptomatic, if it becomes symptomatic at all. This has made a huge difference in outcomes between the two. The author does not mention SARS-CoV2 of course because the book was written before the current pandemic. But the work has a lot to teach us about how we got here and how we could approach the risks of emerging spillovers by research and prevention. We must realize that animals and humans are interconnected, because we are animals. We must realize that we, humans, are “the most serious outbreak on the planet ...the species Homo Sapiens are an outbreak.”We can’t predict with 100% accuracy “But the difficulty of predicting precisely doesn’t oblige us to remain blind, unprepared, and fatalistic about emerging and re-emerging zoonotic diseases.”We must remain vigilant. We must watch virus groups to understand which to watch, and have “the field capabilities to detect spillovers in remote places before they become regional outbreaks, the organizational capacities to control outbreaks before they become pandemics, plus the laboratory tools and skills to recognize known viruses speedily, to characterize new viruses almost as fast, and to create vaccines and therapies without much delay.”These activities could raise alarms if we would but listen, and then we need to realize that what happens after the alarm depends on us. Our response depends on science, politics, public opinion and public will, on human behavior. We could have and should have been ready for this outbreak, and that we were not should give us pause, since these outbreaks cause so much suffering and death. Do we have the will to fund research and prepare for our response next time? Because it will happen again unless we change our behaviors around food procurement, respecting the scientific method, and acting on the knowledge gained!I highly recommend this book for those interested in emerging infectious diseases, and really, we should all be interested by this point. 4.5 stars!

This is the best book I have read in a long time. It is like a mystery thriller played out in various exotic locations around the world, that simultaneously, gives the reader intriguing and accurate knowledge about various exotic but dangerous pathogens that have the potential to forever change life as we know it. In other words, if you would put the Selfish Gene by Richard Dawkins, a travel diary book by Bill Bryson, and an Agatha Christie thriller in the mixer, you would get something like this. It just doesn't get better than this!David Quammen's writing is accessible and throughout the book I was amazed by his ability to explaining difficult scientific concepts in a way that makes the reader understand... even crave science. Though I have read many scholarly articles, no single text I can recall have given me such a deep understanding and appreciation for a scientific subject. I have always been fascinated by bacteria and viruses, however this book multiplied my fascination and my appreciation for the scientists that study viruses and other pathogens in humans as well as in other species.This book is about spillovers (surprise!). A spillover is when a virus or a bacteria which normally live in one species transfer to a different species. Normally this transition spells the end for the pathogen because they evolved to live in their host species and not in the new species, but sometimes the pathogen survive or even thrive in their new host, which is typically bad news for the new host.Think of pathogens such as Ebola, rabies, HIV, SARS, and the Spanish flu, all of which are spillovers from other species, and you will understand that pathogens that have the potential to spillover a.k.a zoonotic viruses can result in disaster.Be assured, you will learn much about these intriguing pathogens, however, this book is not just a review of what we know about zoonotic viruses. On the very first page Quammen takes us to a sunny idyllic farm in Australia. Recently a number of horses have died following under mysterious circumstances. Worse still, several humans that came into contact with the horse also died. What caused these deaths and from where did the horses acquire it? Quammen instantly grips the reader. It was an instant page turner, with real science in it! You must know how these horses and humans died and you gladly, eagerly, follow Quammen when he takes you on a journey in the scientific literature as it develops over time, with frequent field visits that Quammen personally joined to understand the subject better.Quammen cover several different pathogens, including HIV, Ebola, malaria, and SARS, and he travels accordingly. We get to follow scientists (and Quammen) into crowded Asian markets where hundreds of different animal species, each with their own set of nished pathogens, can be bought for that evenings dinner. We get to visit Bangladesh to analyse date-palm-sap to see if bats have pooped deadly virus into this popular drink. We visit the Congolese jungle where Ebola have completely eradicated large populations of gorillas as well as some smaller human populations. We go to caves filled with snakes, bats and guano. Of course we also get to visit high tech laboratories around the world to talk to researchers who try to understand these zoonotic viruses and predict where the next big pandemic will strike - because if or when "the next big one", capable of killing us by the millions, comes, it will almost certainly be a spillover from another species.The human species is vulnerable. We are around seven billion people. We are an urban species meaning that we tend of cluster in large groups (cities), which provides pathogens with the perfect springboard. We travel extensively, and could thus easily spread a virus around the globe in a short amount of time. We also continually mess with new ecological systems which may or may not have a deadly virus just waiting for a new host...Put another way. Human population growth is an typical example of an outbreak i.e., explosive population growth. Just like with outbreaks of crickets that sweep across Africa eating everything it encounter, humans are sweeping across the entire planet, interfering with lots of ecological systems along the way. Indeed the most massive outbreak of any species that the world had ever seen is not a cricket or a larva, it is homo sapiens. And when there is an outbreak of a particular species what typically halts it? You guessed it - pathogens.

Viruses, that conjure dread, jumping species from animal to man and highly infectious from man to man - that is a Spillover or zoonosis. Virulent, often lethal most recent and of limited spread - Marburg (1967), Lassa Fever (1969), Ibola (1971), Avian Flu (1997), Hendra (1994), SARS (2003), West Nile (1999), Swine Flu (2009) . But some are the Big Ones - Spanish Flu killed 20 million in 1918, HIV accounts for 30 million dead and 34 million infected.Why are they happening now? Where do they come from? How do they jump species? What conditions lead to their spread?This is not an alarmist, "end of civilisation as we know it" book. It is informed and balanced but compulsive reading like several detective stories in one. It is rich in the personalities and circumstances of how the epidemics occurred, the stories of the people affected and the race to identify the "reservoir " hosts and the carriers. It is first hand and colourful. David Quammen meets the veterinarians, doctors and nurses who are treating , and often infected by, the dying patients. He goes out with the ecologists and the scientists to search for the reservoir species in the Congolese and Malaysian tropical forests, in the Chinese wild food markets, in the Tanzanian savannah. They take samples for antibody and virus testing from bats , white tailed deer, civet cars, monkeys and chimpanzees - not an easy task. He visits the epidemiologists, virologists. geneticists who wrestle with analysis and interpretation.David Quammen is very positive and complimentary of the organisations and people involved. The work of the well equipped squads sent out from the Disease Control and Prevention (CDC) Centre in Atlanta, USA and that of the medics, scientists, and government authorities in Chinese, Asian, African and Australian countries is interpreted in a very positive and constructive light.The common thread in the detection of each epidemic is partly medical and partly ecological. The virosphere encompasses a realm of organisms that dwarf every other group. Many are probably undiscovered. Many stay dependent but benign in their host species. They may kill some monkeys or birds or bats but we do not notice. The viruses, especially those whose genomes consist of RNA rather than DNA leaving them more prone to mutation, are highly and rapidly adaptive. The disruption to the natural ecosystems at a cataclysmic rate due to man's activities seems to be more and more unloosening the microbes from their natural ecosystem into the wider world. Increasing human population density, new bugs, greater interconnectivity with modern transport systems and new sophisticated medical detection systems are part of the explanation for the increase in epidemics.David Quammen is convinced that the Next Big One will come and kill millions. Read the book to find out his prophecies - it is worth the read.

A great read. Thorough, loads of humanity, superb research, and a lot about viruses - those thing things made up of some RNA and a seemingly determined agenda to get into human cells and reproduce. 'Sorry about the result' they might add. Makes you realise that there are worse things out there than Covid-19.

I was worried that this book would be scaremongering, overly-dramatic, and patronising. I needn't have feared! It tells the stories of spillover cases, explains the science behind them and explores the possibilities going forward. It is fast-paced and exciting whilst retaining a human element; i.e. deaths are talked of respectfully. It goes fairly deeply (for a layperson) into the science but manages to hold your hand enough that you can keep up and enjoy the ride.Best non-fiction book I've read possibly ever.

So relevant to todays Covid Pandemic, well worth reading..

Only so many chapters in but its a riveter. Delivery was spot on. really sharp.