on the fields where people work. Irrigation agriculture and fish farming provide ideal living conditions for the snails carrying schistosomiasis and for flukes that burrow through our skin as we wade through the feces-laden water. Sedentary farmers become surrounded not only by their feces but also by disease transmitting rodents, attracted by the farmers' stored food. The forest clearings made by African farmers also provide ideal breeding habitats for malaria-transmitting mosquitoes. If the rise of farming was thus a bonanza for our microbes, the rise of cities was a greater one, as still more densely packed human populations festered under even worse sanitation conditions. Not until the beginning of the 20th century did Europe's urban populations finally become self-sustaining: before then, constant immigration of healthy peasants from the countryside was necessary to make up for the constant deaths of city dwellers from crowd diseases. Another bonanza was the development of world trade routes, which by Roman times effectively joined the populations of Europe, Asia, and North Africa into one giant breeding ground for microbes. That's when smallpox finally reached Rome, as the Plague of Antoninus, which killed millions of Roman citizens between a.d. 165 and 180. 1O 6 •GUNS,GERMS, AND STEEL Similarly, bubonic plague first appeared in Europe as the Plague of Justinian (a.d. 542-43). But plague didn't begin to hit Europe with full force as the Black Death epidemics until a.d. 1346, when a new route for overland trade with China provided rapid transit, along Etfrasia's east-west axis, for flea-infested furs from plague-ridden areas of Central Asia to Europe. Today, our jet planes have made even the longest intercontinental flights briefer than the duration of any human infectious disease. That's how an Aerolineas Argentinas airplane, stopping in Lima (Peru) in 1991, managed to deliver dozens of cholera-infected people that same day to my city of Los Angeles, over 3,000 miles from Lima. The explosive increase in world travel by Americans, and in immigration to the United States, is turning us into another melting pot—this time, of microbes that we previously dismissed as just causing exotic diseases in far-off countries. Thus,whenthe human population became sufficiently large and concentrated, we reached the stage in our history at which we could at last evolve and sustain crowd diseases confined to our own species. But that conclusion presents a paradox: such diseases could never have existed before then! Instead, they had to evolve as new diseases. Where did those new diseases come from? Evidence has recently been emerging from molecular studies of the disease-causing microbes themselves. For many of the microbes responsible for our unique diseases, molecular biologists can now identify the microbe's closest relatives. These also prove to be agents of crowd infectious diseases—but ones confined to various species of our domestic animals and pets! Among animals, too, epidemic diseases require large, dense populations and don't afflict just any animal: they're confined mainly to social animals providing the necessary large populations. Hence when we domesticated social animals, such as cows and pigs, they were already afflicted by epidemic diseases just waiting to be transferred to us. For example, measles virus is most closely related to the virus causing rinderpest. That nasty epidemic disease affects cattle and many wild cud-chewing mammals, but not humans. Measles in turn doesn't afflict cattle. The close similarity of the measles virus to the rinderpest virus suggests that the latter transferred from cattle to humans and then evolved into the measles virus by changing its properties to adapt to' us. That transfer is not at all surprising, considering that many peasant farmers live and sleep LETHALGIFT OF LIVESTOCK • Z O 7 close to cows and their feces, urine, breath, sores, and blood. Our intimacy with cattle has been going on for the 9,000 years since we domesticated them—ample time for the rinderpest virus to discover us nearby. As Table 11.1 illustrates, others of our familiar infectious diseases can similarly be traced back to diseases of our animal friends. cjiven our proximity to the animals we love, we must be getting constantly bombarded by their microbes. Those invaders get winnowed by natural selection, and only a few of them succeed in establishing themselves as human diseases. A quick survey of current diseases lets us trace out four stages in the evolution of a specialized human disease from an animal precursor. The first stage is illustrated by dozens of diseases that we now and then pick up directly from our pets and domestic animals. They include cat-scratch fever from our cats, leptospirosis from our dogs, psittacosis from our chickens and parrots, and brucellosis from our cattle. We're similarly liable to pick up diseases from wild animals, such as the tularemia that hunters can get from skinning wild rabbits. All those microbes are still at an early stage in their evolution into specialized human pathogens. They still don't get transmitted directly from one person to another, and even their transfer to us from animals remains uncommon. In the second stage a former animal pathogen evolves to the point where it does get transmitted directly between people and causes epidemics. tablen.i Deadly Gifts from Our Animal Frends Animal with Most Closely Human Disease Related Pathogen Measles cattle (rinderpest) Tuberculosis cattle Smallpox cattle (cowpox) or other livestock with related pox viruses Flu pigs and ducks Pertussis pigs, dogs Falciparum malaria birds (chickens and ducks?) X O 8 •GUNS,GERMS, AND STEEL However, the epidemic dies out for any of several reasons, such as being cured by modern medicine, or being stopped when everybody around has already been infected and either becomes immune or dies. For example, a previously unknown fever termed O'nyong-nyong fever appeared in East Africa in 1959 and proceeded to infect several million Africans. It probably arose from a virus of monkeys and was transmitted to humans by mosquitoes. The fact that patients recovered quickly and became immune to further attack helped the new disease die out quickly. Closer to home for Americans, Fort Bragg fever was the name applied to a new leptospiral disease that broke out in the United States in the summer of 1942 and soon disappeared. A fatal disease vanishing for another reason was New Guinea's laughing sickness, transmitted by cannibalism and caused by a slow-acting virus from which no one has ever recovered. Kuru was on its way to exterminating New Guinea's Fore tribe of 20,000 people, until the establishment of Australian government control around 1959 ended cannibalism and thereby the transmission of kuru. The annals of medicine are full of accounts of diseases that sound like no disease known today, but that once caused terrifying epidemics and then disappeared as mysteriously as they had come. The 'English sweating sickness,' which swept and terrified Europe between 1485 and 1552, and the 'Picardy sweats' of 18th– and 19th-century France, are just two of the many epidemic illnesses that vanished long before modern medicine had devised methods for identifying the responsible microbes. A third stage in the evolution of our major diseases is represented by former animal pathogens that did establish themselves in humans, that have not (not yet?) died out, and that may or may not still become major killers of humanity. The future remains very uncertain for Lassa fever, caused by a virus derived probably from rodents. Lassa fever was first observed in 1969 in Nigeria, where it causes a fatal illness so contagious that Nigerian hospitals have been closed down if even a single case appears. Better
