Spores, Plagues, and History: The Story of Anthrax (review)

Spores, Plagues, and History contains a mix of topics: the medical identification and treatment of anthrax, the history of the recent anthrax bioterror attack in the United States, the history of presumed anthrax use as a weapon of terror, and the influence of anthrax through history. These subjects are coupled with a discussion of past biowarfare programs, primarily of Japan, the United States, and Russia. The book is an enjoyable and overall informative read, although some parts are superficially presented, lacking detail, while others, especially the history sections, provide more questions than answers.

The clear strength of the volume is Chris Holmes's discussion of the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), the Army Dugway testing program, and the account of the anthrax bioterror attack in the United States in 2001. The reader is transported into the events occurring in Florida, post offices, the U.S. Senate, and NBC/CBS news networks. Holmes emphasizes that this investigation is still not complete four years later, and he relates the costs of surveillance and investigating hoaxes. Chapters on biowarfare experiments done by the Japanese in Manchuria and China in the 1930s and 1940s are chilling, as is the author's discussion of the agreements regarding the fate of Japan's biological weapons between Japan and the United States, and Japan and Russia, after World War II—and the effect of these bargains on the Cold War.

Unfortunately, there are a number of weaknesses that lessen the value of this book. For one, there are overt errors. For example, the statement "Anthrax was diagnosed by Polymerase Chain Reaction (PCR) testing, a technique which produces large amounts of bacteria from a single cell" (p. 13) is incorrect: PCR amplifies the DNA of a sample, and does not enhance organisms' growth. Second, there are also a number of omissions. For example, although there is detail as to the clinical diagnosis of anthrax and the treatment of the disease, there is minimal information as to why anthrax is virulent: mention is made of "protective antigens," "lethal factor," and "edema factor"—but what they are, and how they work, is given short shrift. This is unfortunate, given the enormous knowledge on the structure and function of these toxins that has accumulated over the last several years. Similarly, there is no information on either how the antibiotics work against anthrax, or how the vaccine works. Other omissions that lessened the value of the book to this reader were the lack of discussion on host susceptibility, or why certain people got sick and others did not, and what separates sickness from death. Later in the book (p. 133), Table 2 lists the advantages of various biological weapons in terms of influencing a population of 500,000 to become predictably ill or to die. Its source is listed as only WHO: there is no bulletin, volume, page, or year listed, in either the text or the references, to allow the interested reader to further explore this issue. Similarly, the outbreak of anthrax in Sverdlovsk, Russia, in the 1970s is presented in a way that the reader is unable to satisfactorily evaluate because the total number of those exposed is not given—just the numbers of those who died, entered hospital, or were ill.

Lastly, although it is interesting for discussion, there is little evidence to support the author's claim that anthrax was probably one (the fifth and sixth) of the ten plagues visited on the pharaoh of Egypt through God's messenger, Moses; or that anthrax killed Alexander the Great; or that it caused the Plague of Athens; or that it was involved in the Great Plague of the thirteenth century. However, the discussion of woolsorter's disease in England and of Pasteur's anthrax vaccine study in Pouilly-le-Fort, and the association of anthrax as a bioterror weapon with the Iraqis in the Gulf War and the period leading up to the...