288 • The Great PlaguePerils and Prospects
Perhaps, as we grow almost smug about influenza, that most quotidian of infec-
tions, a new plague is now gathering deadly force. Except this time we stand
armed with a better understanding of the past to better survive the next pan-
demic.
—Gina Kolata,Flu: The Story of the Great Influenza Pandemic of 1918
and the Search for the Virus That Caused ItThe most dreaded disease ever to afflict humankind shares a crowded stage
with infectious diseases that have not yet made their last curtain call. A wide
variety of bacterial and viral pathogens have clung tenaciously to life for
hundreds or thousands of years. In the seventeenth century, 30 percent of all
reported deaths were associated with epidemics. Wave after wave of typhus,
smallpox, dysentery, and influenza struck capital and countryside.^52 The
threats continue. Benign microbes far removed from the Yersiniabacilli may
suddenly pose a threat, propelled by “minor genetic changes that alter [their]
route of transmission or extend [their] host range.”^53 The recent history of
malaria, tuberculosis, and AIDS reveals reasons for maintaining vigilance
against all potential microbial killers.
Malaria, a protozoa-caused disease with a long history, is believed to have
originated in tropical Africa. The parasite probably infected several primates
besides humans. Hundreds of years later it radiated out to Mesopotamia and
subsequently spread up the Nile River to the Mediterranean Sea, making a
debilitating mark on the ancient Greek and Roman world.^54 Drs. Willis and
Sydenham treated it with quinine in the seventeenth century, and today it
carries away three thousand children daily. One in ten of the global popula-
tion suffers its debilitating fevers and chills. A new, highly virulent form of
malaria appeared at the end of the twentieth century, with vector mosquitoes
resistant to chemical extermination. The situation remains critical in sub-Sa-
haran Africa, where close to 90 percent of the fatalities are of children under
the age of two. As of this writing the leading antimalarials have failed in 80
percent of cases. Responding to this crisis, the United Nations Development
Program, in collaboration with the World Health Organization, UNICEF,
and the World Bank, launched a campaign against the disease in 1998.
Among the promising antidotes is a plant extract that has been used in
China for two thousand years against fevers. The active ingredient in this