"Man and Microbes: Disease and Plagues in History and Modern Times," by Arno Karlen. 266 pages. New York: Tarcher/Putnam. $24.95
For 40 years, doctors were stumped. Workers scoured parks and schools. Parents kept their children away from swimming pools and playgrounds. Inspectors checked food, milk and water. Polio still crippled and killed thousands of Americans.
But the mystery wasn't in anything dirty. It was, science writer Arno Karlen explains, in the new way Americans lived.
During earlier, more crowded times - before the first half of this century - children were exposed to the polio virus by the time they were toddlers. But with newfound prosperity, cleanliness and the suburbs, children no longer routinely exchanged germs and developed immunity to polio.
So by the time they went to school at age 5, they were vulnerable to the disease. And thousands suffered permanent damage or died because of it.
In "Man and Microbes," Mr. Karlen, a respected writer whose essays on history, medicine and behavioral science have appeared in scholarly journals and popular magazines, takes on a difficult task. He chronicles the complicated story of infectious disease in a slender 230-page volume.
Throughout, he weaves an important theme, that no matter how many medicines researchers develop, or how much they try to sanitize the world, the public will always be confronted with new germs. Because with every step humans take to explore, travel and change their environment and lifestyles, they are exposed to more microbes - viruses and bacteria.
In a thorough, authoritative account, Mr. Karlen makes a persuasive case that microbes have helped shape history, from individual lives to powerful empires. And in spite of advances, infectious diseases remain the leading cause of death in the world.
And it is because of the rapid pace of change in modern times that Mr. Karlen says society is facing an epidemic of epidemics. He recommends stepped-up surveillance of all diseases, new and old.
While accessible to the average reader, the book is sophisticated enough to be of benefit to scientists, researchers and others, for it does an excellent job of putting this trend into perspective.
"Infectious disease, then, is not nature's tantrum against humanity," Mr. Karlen writes. "Often it is an argument in what becomes a long marriage."
This provides comfort in a comprehensive, if sometimes oppressive, litany of disease throughout history. Given more room to explore his massive amount of research, Mr. Karlen might have enhanced the book's readability.
Still, the author leaves the reader with one invaluable insight: that any change, any advance comes at a price. And in the case of human civilization, that price is disease - and many, many deaths.
Diana K. Sugg is a science reporter at The Sun. She has also worked at the Sacramento Bee where she was a medical reporter and a crime reporter. Before that, she was a reporter for the Spartanburg (S.C.) Herald-Journal and the Associated Press. She is a contributor to "News Reporting and Writing," Sixth Edition, 1994.