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Secret Agents: The Menace of Emerging Infections

Madeline Drexler
Joseph Henry Press, £17.95, pp 316
ISBN 0 309 07638 2
Rating: ****

The relationship between microorganisms and humans is perhaps the most fascinating story relating to humankind. The origins of the relationship date from well before the appearance of the first hominids on Earth, although we began to write the story only about a century ago. It is a tale of love and hate because, while humans need microorganisms, we also fight them.

This excellent book is, to some extent, a story of war, from the intricacies of the initial strategic plans of both armies to the open battles with their deadly consequences. The narrative is revealing, authoritative, and well documented. It looks at many infectious diseases that have thrown up major challenges over the past century and at how we have sought to confront them. Despite the many battles gained by one or other army, this is a war with no winner. It is endless.

At the dawn of the 21st century we cannot forget the too optimistic estimations of scientists who thought that, with the advent of the first antibiotics, infections would be conquered in a few years. They clearly underestimated the nature of the adversary. For the enemy was on the battlefield billions of years before us. Even considering only the bacteria carried on our bodies, this opponent outnumbers our own cells by several times. In the case of viruses, this enemy knows more about our cell biology than we do ourselves. This rival has displayed an outstanding versatility and adaptability, surviving despite the potency of our antibiotics. Finally, this contenders true forces are unknown to us, as we have identified only a tiny fraction of microbial agents.

However, this book also deals with another kind of war—that of humans against themselves. Humans do not hesitate to use microorganisms and their products as bioweapons, as evidenced by the recent anthrax crisis and, especially, by many governments refusal to comply with the agreements on biological weapons.

Also—in what is an undeclared, ignominious, and no less deadly war—while the wealthiest countries fight vigorously against their own infectious diseases, they allow them to devastate the poorest countries of the globe. This indifference is rather surprising considering that infectious agents do not recognise borders, religions, or ethnicity; considering that sooner or later the richest nations will suffer the consequences of their apathy, as exemplified by the AIDS and tuberculosis pandemics; and considering that the world is not just a global village, but a global culture medium.



Julio Collazos, chief of the section of infectious diseases, Hospital de Galdakao, Vizcaya, Spain


studentBMJ 2002;10:259-302 August ISSN 0966-6494



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