Plague Time: How Stealth Infections Cause Cancer, Heart Disease, and Other Deadly Ailments Hardcover – November 14, 2000

About halfway through Plague Time, the author notes the reaction of the evolutionary biologist William D. Hamilton to the theory that AIDS was caused by a contaminated vaccine. He states that Hamilton did not say that a contaminated vaccine definitely introduced AIDS into humans, but instead stated that the idea needed to be evaluated rigorously because it was being dismissed without adequate evidence for dismissal. I think that same statement could apply to the ideas presented in Plague Time.Ewald does a marvelous job of taking the readers through the intricacies of evolutionary biology. He effectively demonstrates how evolutionary biology theories can help explain many of the mysteries surrounding diseases that are currently attributed to a multitude of causes. It should be noted that he never definitively proves that viruses and bacteria are the causes of these diseases. But, he does present enough evidence to justify further exploration of the idea.The book is not perfect. Some of the language gets a little technical at times. Also, Ewald has a tendency to repeat the same examples, thus giving the impression that there is some "filler" in the book. But, these points don't detract from the fact that this is a very persuasive work. The theories inside it may prove to be invalid, but they are certainly worth further exploration by both the scientific community and the reader attempting to educate themselves on their health.

Professor Ewald lays out a very interesting and persuasive case for the potential involvement of infectious agents as the cause of many "non-infectious" diseases. This book offered a fascinating account into the history of disease and makes plausible predictions about future discoveries. I read this book several months ago and have since been keen to periodic news reports concerning recent discoveries linking infection as a possible cause for various chronic aliments. I believe Professor Ewald may be ahead of his time.I'm not a medical professional, just an interested layman. Mr. Ewald's book is an easy read for a non-professional. If you're interested in the topic this book will not disappoint.

This book clearly deserves more than five stars. This is one of the three best books published so far in 2000 that I have read.Plague Time is an important book for the future health of all. It is the most articulate argument I have seen for improving the basic mechanisms of studying and preventing disease in the most effective ways. And it shows important lessons about what is needed to overcome stalled progress in any field. Professor Ewald is a profound stallbuster! We will only get full benefit from his work though, if this thinking is quickly absorbed by the medical community, as a sort of idea virus.The perspective of this book will be new to many readers. Evolutionary biology is something that few have learned in school. Basically, the field looks at a germ's eye view of the world.For example, if a germ kills the host it feeds on too quickly, that's bad for the germ. The germ hasn't yet had time to spread to a new host. On the other hand, if it takes too long to spread to other hosts, that's bad for a germ also. So germs will do best that are able to spread quickly from host to host, and keep the host alive to provide more food. That spells a prescription for the prevalence of many chronic diseases that are associated with long-lived infections from bacteria and viruses.The germ theory of disease is only about 120 years old. So it is fairly recent that we have been using hygiene (washing between patients and clean water to drink), vaccines (to help the body's immune system prepare for a larger invasion), and antibiotics (to kill bacteria) to control disease-producing agents. From this work, we have learned that acute diseases are almost always linked to a bacterial or virus invasion of our bodies. These invasions can come from other people (sneezes, blood, or germs on a surface) or vectors (agents like mosquitos).What many will not realize is that many chronic diseases are turning out to be caused by such invasions as well. For example, most peptic ulcers (once thought to be caused by stress and too much stomach acid) are now easily treated by antibiotics. Cervical cancer is also related to an infection. It is estimated that 15 percent of all cancers are now shown to be caused by such infections. Cancer researchers also can account for only about 50 percent of cancer risk from environmental factors. That remaining 35 percent gap could well turn out to be related to unsuspected infection links, working in combination with environmental factors.Professor Ewald proposes a number of interesting hypotheses that would appear to deserve serious attention. First, the evolutionary biology view would suggest that sexually transmitted infections as a primary source of chronic disease in wealthier countires. These infections live in the host for a long time without immediately killing the host, and are highly contagious. The sites of many diseases also show the presence of these same infections (examples include c. pneumoniae -- related to Chlamydia -- found in the brains of Alzheimer's patients and damaged artery walls experiencing arteriosclerosis). Other sexually-transmitted diseases may also have these effects on other chronic diseases. Further, people are reluctant to talk about having sexually-transmitted diseases so partners are often kept in the dark.The book also takes an interesting look at the dangers of being ravaged by some new biobomb or spread of disease from one part of the underdeveloped world to the developed world. These problems do not seem to be as great as the popular press would suggest. Basically, anything really virulent tends to extinguish itself by killing the hosts too rapidly.The fascinating part of the book to me, though, was the description of why we are so slow to look at these hypotheses. Professor Ewald points out that doctors are used to drawing their hypotheses from close associations in frequency and time in their own practices. Minor infections from sexually-transmitted diseases that cause chronic diseases decades later deny doctors that easy association.His proposal is brilliant: Keep records of everyone who gets better or worse unexpectedly from a chronic disease to find out what other medications or lifestyle factors may be involved. For example, peptic ulcers were being treated with antiobiotics successfully in a few hospitals 40 years before that became common practice. A database that showed that result could have stimulated an NIH study much sooner. If we find that everyone who takes a certain antiobiotic improves in some chronic disease, this may suggest a linkage to a bacterial infection. I hope this idea will get top priority!The author also takes on the medical model of looking for things that "kill" germs in a "war-like" environment. It turns out to be much faster, simplier and cheaper to adopt treatments that encourage germs to evolve into milder versions. By trying to kill them, all we do is create more virulent versions. So the whole approach to antibiotics needs rethinking along the lines of this book.By the way, chances are your doctor is unaware of this line of thinking. I mentioned the potential risk of infection causing arteriosclerosis to my primary care physician, and asked what antibiotic I should take. He laughed, and said that if it was that simple, everyone would already know about it. Apparently, he did not know about the peptic ulcer experience.As the author points out, our tests of medical effectivenesss are too high in some cases. If we find that a certain treatment almost always works, we can begin to use that treatment long before the 14 year study is completed that explains exactly why it works. After all, we are still learning the basics of why aspirin works, but many people use aspirin anyway.After you have read (and shared this book with everyone you know), I suggest you also think about where causes and effects may not too obvious because of long time lags. What research is not being done in those areas?Enjoy better health by having health researchers ask better questions today!

Question: are most diseases caused by infectious elements? Solution: talk about diarrhea, hiv, hpv, chlamydia, more diarrhea, cervical cancer from hpv, more diarrhea, and some evidence.Seriously, there is some good information here but it is so poorly written and surrounded by fluff. The topics chase each other tails over and over. This book could have been written on half the pages it took. The author should have taken a vertical approach and written about each disease and used his chapters as subheadings to better organize the book. It seemed unorganized reading about the same diseases over and over a paragraph at a time and it was so wordy and drawn out, I feel like the author was just rambling in his sleep. Also...diarrhea.

Plague Time is fascinating, but not a page turner. Pretty dry stuff. On the other hand, it is a great review of the history of our acute and chronic infection knowledge - and contains information that anyone interested in disease prevention should know. The author is an evolutionary biologist. What does that mean to us? Well, he will walk you through the reasoning required to understand why most diseases cannot be due to faulty genes (despite all the money & time that goes into that research). That includes cancer...so if chronic diseases mostly can't be attributed to genetic flaws, what is the cause? Take a gander.PS I'm 1/3 of the way through it at this point.

進化医学の第一人者Ewaldによる慢性疾患と感染症についての啓蒙書．まず急性疾患について進化の視点から見た病原体感染の特徴をおさらい．病気の毒性(悪性)の高さは病原体の視点からみるとどの程度までホストを搾取するかとどうすれば伝染効率を高められるかのトレードオフの妥協点であることが力説される．そして本題の慢性疾患について．ここで衝撃的なのは現在の医学界は慢性疾患について病原体感染と認めたがらないという事実，そして胃潰瘍がピロリ菌による感染症だということを認めるのに非常に時間がかかった事実，さらにガンについて10年ごとにウィルス感染が原因とされるものが増加し続けているという事実である．どうもいまやガンのかなりの部分(乳ガン，子宮ガン，肝ガンについてはかなり証拠が蓄積されつつあるらしい)，そして心臓病を含むアテローム性硬化症，さらに一部精神病まで感染症である可能性が高いらしい．そもそも進化的に考えて慢性病が遺伝子不全のために起こるにしては頻度が高すぎるのではないか，自己免疫疾患がこれほど多いのは多くの人々が慢性の感染を抱えているからではないかとし，有害な慢性病のほとんどはいったん感染症を疑うべきだとまで言い切る．そして現代の通説であるリスクファクターで説明しようとする態度を物事の真の理由から目をそむけるものだと痛烈に批判する．そしてこのような感染症と戦うためには敵が容易に進化する以上進化的な視点が欠かせないと力説する．特にワクチン，対病原体薬品の開発，使用についてはその視点が欠かせないとする．かなり衝撃的な内容です．アメリカでは医者になるカリキュラムに進化に対する部分が欠けていると嘆いていますが，それは日本でも同じなのではないでしょうか．進化医学に興味のある人には必読文献と言えましょう．これから医者を目指す人にも是非読んで欲しい一冊です．