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5.0

"When a pathogen leaps from some nonhuman animal into a person, and succeeds there in establishing itself as an infectious presence, sometimes causing illness or death, the result is a zoonosis." The event of such leap is a spillover.

Spillover: Animal Infections and the Next Human Pandemic is a well-researched book. David Quammen is not an armchair researcher. He visits scientists and doctors allover the world, from Africa, Australia to Southeast Asia, and takes part in the actual field work. The writing is rich and dotted with humor.

The diseases covered in the book include Hendra (horse measles), Ebola, SARS, Malaria, Nipah Virus, HIV (mostly HIV-1), Influenza, and many more. Scientific concepts such as "reservoir" and "amplifier" are explained well. He also explains how RNA virus and retrovirus work and why they behave the way they do. A lot of investigation journalism too. The 100 pages chapter about HIV reads like a very engaging detective story.

A few fun facts (yes I think science is fun, even it is about infectious diseases):
1. "Deer tick" is misleading, as deer is a reservoir but not the most popular reservoir of Lyme Disease. The white-footed mouse is, followed by chipmunks and shrews.
2. A Malaria bug was used to treat a type of late stage of syphilis but also gave the usually mild bug a chance to become deadly.
3. Bats are the most popular reservoir
4. It is almost impossible to eradicate a zoonotic disease because they have a natural animal reservoir. Smallpox is not zoonosis (meaning only in humans) therefore it has been eradicated.

What strikes me most is that the NBO (the Next Big One, i.e. the next deadly pandemic disease) is inevitable. It is not a matter of if, but a matter of when. Ecology plays a crucial part in the happening of spillover events. Human population explosion, the destroy of animal habitat and the proximity between wild animals and human all make such events inevitable. "Human-caused ecological pressures and disruptions are bringing animal pathogens ever more into contact with human populations, while human technology and behavior are spreading those pathogens ever more widely and quickly." However, the inevitability does not mean we are helpless. It all depends how we react.

Is the current Covid-19 pandemic the Next Big One? Probably not, because its mortality rate is not as high as the last big one, 1918-1919 influenza, but history will tell.