The End of Plagues: The Global Battle Against Infectious Disease by John Rhodes

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The End of Plagues: The Global Battle Against Infectious Disease by John Rhodes

Category: Popular Science
Rating: 4.5/5
Reviewer: Gloria Nneoma Onwuneme
Reviewed by Gloria Nneoma Onwuneme
Summary: World-leading immunologist John Rhodes chronicles the past, outlines the present, and makes suppositions about the future of vaccination in the mission of ending plagues.
Buy? Maybe Borrow? Yes
Pages: 256 Date: October 2013
Publisher: Palgrave Macmillan
ISBN: 9781137278524

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In The End of Plagues, the remarkably clear voice of immunologist John Rhodes takes one through significant moments in man’s battle against infectious diseases. The artillery on which Rhodes focuses is that of the vaccine, which has taken us further away from the extreme grip infections once had on the course of history. The book starts with the example of smallpox, for which Edward Jenner first made a vaccine, having been in a world where variolation was on the rise. Between Jenner’s first serum transfer – from an immune milkmaid to a servant’s son – and the present day, several vaccines have been developed against ailments such as measles, various influenzas, and polio.

The biographies and the outlines of immunology history are equally excellent and captivating in the book. They show that the passage of time has not eroded the level of complexity of issues which were faced during the birth of the vaccine – rather, it has only slightly altered the nature of the complexities. As a result, the case of smallpox is a solid motif to which Rhodes continually refers, as he weaves the tales of many other diseases. Edward Jenner was busy pioneering the practice of vaccination, succeeding the clever, but problematic, tradition of variolation. But when Jenner suggested using attenuated cowpox to eradicate smallpox, scepticism was great in, and greatly displayed by, the public and fellow English natural scientists alike. Though celebrated today, he was held at arm’s length from the medical establishment in London for the duration of his career and life.

Forces more potent than these served to propagate vaccination, though. The undeniable capability of the cowpox extracts led to figures such as Louis Pasteur lauding Jenner for his genius. His connections in the States were instrumental to mobilising Jenner’s vaccine within that newfangled nation. The incumbent president - Thomas Jefferson – was even designing tools for optimal transportation of the vaccine!

In truth, no vaccination has been wholeheartedly accepted without having passed through a baptism of fire; even beyond this point, not everyone is convinced. Within the world of medical science, issues pertaining to the function of vaccines were seriously disputed. How do they work? Two camps of scientists gave opposing answers, stating that either antibodies or white blood cells conferred individuals with immunity. That was until the clonal selection theory managed to unify the two – when the immune system is challenged, certain white blood cells produce appropriate antibodies. Once that was sorted, there was still a need to figure out whether weakened or dead specimens of viruses and bacteria were best suited for inclusion in the vaccines targeting them. The latter type of debate was salient in the history of the polio vaccine, and today, both types are used in different settings.

Even the outcomes, or consequences, of clinical trials can have a deleterious effect on how accepted the vaccination would become in areas needing it, a fact which painfully postpones the expected date of eradication of a disease.

The relatively small, but insanely persistent, remnant of smallpox cases was just as frustrating as the presently tiny, but dogged, number of reported cases of polio. However, the number didn’t remain without reason in the case of smallpox – the practice of arm-to-arm vaccination, which spread conditions like tetanus, didn’t exactly convince people to put forth their veins. The outrageous suspicion that polio campaigns are in fact surreptitious sterilisation crusades is not the only thing on which parts of Nigeria base their resistance to polio vaccination. For one, a traumatising Pfizer trial of trovafloxacin, a candidate for treating meningitis, killed a number of children, and a certain degree of trust in Western medical researchers and practitioners. In more recent times, the well-circulated misconception of MMR vaccine’s link with autism saw sudden measles outbreaks in areas where the viral infection hadn’t been seen in years.

Jenner, who involved himself very much in getting the smallpox vaccine around in his native county of Gloucestershire, did not live to see his (somewhat modified) brainchild facilitate the eradication of smallpox from the face of the earth. The end of this plague is one which today inspires hope in the campaigners who travel to the ends of the earth with various vaccines. Vaccination is given in combination with surveillance containment of the target disease itself, at the behest of bigger and bigger bodies that are doing everything they can to recruit as many vaccinators and resources as possible. In the last pages of the book, Rhodes leaves behind the looming, dark clouds of continued refusal and avoidance of vaccination, and the creation of potential bio-weapons (consisting of the existing reservoirs of smallpox in a handful of countries). Instead, he expresses a wish to be able to tell Jenner the following concerning a plague poised to become the second one to be vanquished: the name of the last person in history to be naturally infected with polio.

For more detail on the history of poliomyelitis, have a look at Paralysed with Fear by Gareth Williams.

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