Here’s the blurb from the back:

Working from high-tech labs in Canada or remote villages in Africa, epedemiologists travel the world trying to keep us safe from deadly diseases. Learn how these “disease detectives” are coming up with new wayts to fight disease, and find out if you have what it takes to become an epidemiologist, too!

I’d seen that before. What I hadn’t seen, until the books arrived today, was this very nice cover quote from Jonathan M. Samet, MD, Professor and Flora L. Thornton Chair, Director, Institute for Global Health, University of Southern California, Los Angeles (quite the title!):

“This book captures the excitement and significance of epidemiology and the hard work of being an epidemiologist. It is a great starting point for those who want to benefit world health by becoming an epidemiologist.”

Very nice. And now that I have my author’s copies, I can get the book entered into the Saskatchewan Book Awards before the first deadline of July 31.

In the movie Outbreak, researchers from the U.S. Army Medical Research Institute for Infectious Diseases and the Centers for Disease Control and Prevention (CDC) have to figure out how to stop a kind of super-Ebola virus from ravaging the U.S.

In 1995, the same year Outbreak came out, Marta Guerra, who already had her Doctor of Veterinary Medicine degree and was finishing her master’s degree in public health. “I remember seeing that movie and thinking, ‘Wow, that’s what I want to do!’”

Five years later, Guerra, now with a Ph.D. in epidemiology and a brand-new officer of the Epidemic Intelligence Service (EIS) of the CDC, received orders to head out on her first international mission: to study and combat an outbreak in Uganda of Ebola virus.

She joined a team in Lacor, Uganda, working in a laboratory set up at St. Mary’s Hospital, a private hospital which had much more advanced equipment than the local government-run hospital-equipment that allowed them to diagnose people with Ebola in less than 24 hours.

Accurate, fast diagnosis was important not only to identify Ebola patients but also to allow those who didn’t have the disease to be sent home, minimizing their risk of exposure.

Guerra’s tasks included tracking the spread of the disease, identifying those who had been exposed, and educating the public.

Every day team members would go to the government-run hospital and get the list of people who were newly admitted and/or diagnosed. “Then we would go out to the person’s home and make a list of contacts. Those contacts would have to be visited for 21 days. If there was anyone that appeared to be unhealthy or developing any kind of symptoms, then we would call in to the hospital to bring an ambulance out.” The effort involved 150 trained volunteers.

Over the course of the outbreak, 5,600 people who had been in contact with infected patients were identified and observed.

Although the Ugandan government had done a “wonderful job” educating people about HIV, Guerra says, the lessons learned regarding HIV actually made it harder to deal with Ebola. Whereas people who test positive for HIV remain infected for life, people who recover from Ebola are no longer contagious and are also protected from the disease in the future.

Because of what they’d learned about HIV, people thought that anyone with antibodies to Ebola was contagious and was dangerous to have around. “We’d find [survivors] totally by themselves, without food, because nobody wanted to share their food with them, allow them to use any dishes, anything.”

To counteract that, “I would definitely go up and touch them, or try to show them that I was not scared to be around them. I always ended up giving them some money so they could get food at least for a week to be able to buy some pots and pans and some things to sleep on, because some of them were not being allowed to come back to their families.”

Most people in the area would first be cared for by family members when they became ill, Guerra explains. After that, they would probably turn to traditional healers rather than trying to get to a probably distant clinic. That led to tragedies like the death of all four sisters in one family.

Team members urged the locals to go to a clinic as soon as they felt ill. “If it was malaria, then good, you got your treatment early,” Guerra would tell them, while if it was Ebola, the patient could quickly be isolated and supportive care begun.

The researchers, who knew what precautions to take, weren’t particularly concerned about contracting the disease. They were more worried about the risk of violence.

 ”We were in the territory of the Lord’s Resistance Army in northern Uganda. A lot of people had been displaced up there, a lot of people kidnapped and killed.”

In the end, though, Guerra’s team saw nothing of the rebels. “I think they were also very scared of the Ebola outbreak,” she says, and with good reason: it killed 225 people before being brought under control

Despite the difficulties and dangers, Guerra calls the experience “just wonderful.”

“There are still chances to go out there and help people who are in a very disadvantaged state,” she says. “There are still chances to go out there and do investigations.”

The chapters are much longer than these science columns, but I thought in honour of the book’s release, I’d try over the next little while to boil down some of those chapters into columns.

Call it the Reader’s Digest Condensed Books Version—not just condensed, but extremely condensed!

One chapter focuses on Jonathan Epstein, a veterinarian epidemiologist with the Consortium for Conservation Medicine. In 2005, he led the first of five expeditions into China that eventually determined that bats were the “natural reservoir” of the virus that emerged into humans in 2003 as Sudden Acute Respiratory Syndrome (SARS).

The SARS outbreak began on November 16, 2002, when the first case of an unusual form of pneumonia was reported in Guangdong province in southern China. It soon spread to countries around the world, including Canada. A vigorous containment effort paid off, but by the time SARS burned itself out, 8,098 people had become ill and 774 had died.

Scientists soon realized that SARS was caused by a new strain of coronavirus, the same kind of virus that causes many other upper respiratory infections, including the common cold.

They suspected it had emerged in the live animal markets of Guangdong.

According to Epstein, those marketplaces are “a complete menagerie. There are animals of all species, of all types, alive and dead, being kept together in very unhygienic conditions. As soon as someone picks one out, they butcher it with bare hands right there on site, so there is plenty of opportunity for cross-infection to occur among different animals.”

A WHO team tentatively concluded that the virus had jumped to humans from civets. But had it originated with civets, or did it circulate naturally in some other species?

Epstein became involved when he contacted Hume Field, a veterinarian epidemiologist in Australia, in search of research partners interested in testing bats in China for Nipah virus, which he’d been researching in Malaysia, where it emerged in 1998, killing 100 people.

Field wondered if the SARS virus might also be circulating in bats, and that eventually gave rise to the expedition led by Epstein, and the four that followed.

“There were bat biologists with expertise on a lot of things related to bats, but no one had a lot of experience collecting diagnostic samples from wild animals,” Epstein explains.

The expedition worked in extensive cave systems as much as two kilometers long, with some caverns as large as airplane hangars. To catch bats, they strung “mist nets,” similar to a volleyball net but with a much finer mesh, between two twenty-foot-tall bamboo poles.

Viruses can be transmitted by bats in their feces. To minimize that risk, the researchers wore long clothes, face masks with filters, safety glasses–and, of course gloves, made of a tough material stronger than latex that allows good movement but is puncture-resistant; bats “have pretty sharp teeth,” Epstein notes.

As each bat was untangled, it was put into a small cloth bag in which the bats could hang. That calmed them. Then the scientists began collecting samples of blood, saliva and feces.

The lab results revealed four or five different viruses within the bats, all within the SARS coronavirus family.

Putting all the pieces together, scientists now presume that bats infected with a SARS-like coronavirus were brought into the marketplace, where they came in contact with civets. In the civets, the virus mutated. It then jumped from civets to people.

“What happened with SARS is what everyone fears might happen with avian influenza,” Epstein says. Part of the mandate of Epstein’s employer, the Consortium for Conservation Medicine, is to point out that problems such as the emergence of the SARS virus arise from human behavior, not from anything the animals have done.

“The knee-jerk reaction from the public may be, well, if these bats are carrying a disease that kills people, why not just get rid of the bats. Our job is to say, no, these animals serve a very important function ecologically.

“We need to recognize that human activities are what are causing these diseases to emerge. It’s not the fault of the animals.”