Book Review The social ecology of infectious diseases

Too often we hear about ‘bad bugs’ and too little do we contemplate the role that society and the environment play in struggles with the vast microbial world. No question that biomedical research remains important for solving problems, but we should be cautious not to rely too heavily on technology – vaccines and pharmaceuticals, for example. Surely amplification resulting from, and adaptation to human activities will underlie infectious disease threats in the future. Enhanced understanding of these risks constitutes the signal contribution of Social Ecology of Infectious Diseases edited by Ken Mayer and his colleague H.F. Pizer. The volume builds on the landmark 1992 US Institute of Medicine report, Emerging Infectious Diseases. The Institute of Medicine panel, led by a group of distinguished scientists, including the late Joshua Lederberg and Robert Shope, introduced the public health community and policy leaders to phenomena seen by infectious diseases specialists – the emergence and re-emergence of diseases. Far beyond simply describing the threats, they teased apart what underpins emergence – the dramatic increases in population, urbanization and behavioral change; technology and industry; economic development and land use; international travel and commerce; microbial adaptation; and the breakdown of public health measures. The Institute of Medicine revisited these issues in 2003 in Microbial Threats to Health, reiterating and expanding, and including climate and weather, poverty, and intent to harm. Mayer and Pizer explore in greater detail how human activities are central to disease emergence. Our activities create niches in which pathogens can thrive and amplify. Understanding these human activities and