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tv   Book TV  CSPAN  January 30, 2011 1:00pm-2:00pm EST

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nixon, i was one of the four of the lucky 3%. >> host: wise move. we're up with the hour, so we have spent the hour talking about the neoconservatism persuasion selected essays 1942-2009 of irvnig kristol. thank you, bill. >> guest: thank you. >> visit booktv.org to watch any of the programs you see here online. type l title or author in the search bar and click search. you can click share on the upper left side of the page and select the format. booktv streams live online for 48 hours every weekend with top nonfiction books and authors.
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booktv.org. .. [applause] >> thank you. thank you for coming. i'm going to try to talk for maybe 40, 45 minutes and then have some time for questions. and i wanted to explain a little bit about "inside the outbreaks." i'm going to show you a little film i took which lasts three minutes, and then we'll have some illustrated slides, hinges
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like that. but -- things like that. but i thought i would go over, very quickly, my other books. my first book was called for god, country and coca-cola. it's a history of coca-cola, which a lot of my friends said can you really write a book all about a soft drink? but it turns out it was a fairly thick book. interesting. second book is called victims of memory. it was about the very widespread practice of repressed memory therapy in the early 1990s and the disastrous effect it had. my third book was "uncommon ground," this was a history of coffee, probably my best selling book although a lot of them are in different foreign editions and what not. this one has the biggest legs, i think. a lot of people are really interested in coffee, for good reason. next book was "mirror mirror: a history of mirrors."
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this was very wide ranging. it goes from people recognizing themselves in mirrors if you think about it, to know that you're looking in a mirror, it's something humans and possibly dolphins and elephants can do. it goes all the way up to the hubble space telescope, so it covers art and magic and science. interesting. oh, and i wanted to mention "jack and the bean soup." this is my breakout book. it's a children's book, basically an elaborate fart joke book so if you know any children or adults that would appreciate that sort of thing, that's that. okay. "inside the outbreaks," i did take over five and a half years to write this as my wife reminded me repeatedly. it's about an organization called the epidemic intelligence service. and a friend of mine went through this and told me about
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it. and when he -- well, first he sent me an e-mail, and he said, you ought to write a history of the eis. i wrote back and said, thanks, andy. what is the eis? i've never -- i don't know what it is. when he told me it was the epidemic intelligence service, i thought, wow, this is nonfiction? there really is such a thing as the epidemic intelligence service? and there is. it's part of the cdc, it began in 1951 in the middle, and i'll show crow the guy who start -- show you the guy who started it. alexander langmur was the head epidemiologist at the centers for disease control, at the time it was called communicable disease center. it's always been the cdc. he had this idea that he wanted to get young doctors out into the field immediately, within 24 hours of being notified that there was an 'em demick. they would have their -- epidemic. they would have their bags packed and be ready to go.
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it sounds exciting but, guess what? nobody wanted to go into the field of public health. nobody realized this was an interesting area because at that time it appeared that the new antibiotics were going to wipe out all the bacterial diseases and that we were getting more and more vaccines that were going to deal with the viruses. people said, alex, you're going into a dying field. forget it. and he said, no, i think you're wrong, and he was correct. as you know, we haven't advantage wished all of the microbes of the world. but he couldn't get anybody interested in joining this group because it was considered a dead end. fortunately, we were in the middle of the korean war, and there was a doctor draft. so the doctors didn't want to go into the army, and when they joined the eis, it gave them an out. they spent two years in this program rather than two years in the military. by the time the doctor draft ended with the vietnam war, it
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had become a well known organization, and they didn't need the doctor draft to get people into it. anyway, he was a bigger than life character. if you read the book, you'll see that he sort of -- his daughter said when he walked into a room, you could feel the room tip towards him. he was arrogant, he was intimidating, the eis officers were very afraid of him. i call this his silverback pose. and he was also brilliant and visionary, and he led the eis not only into dealing with microbes and infectious decides, in other words, but into many other areas as well which i'll be talking about. and at this point there's a little caricature of him. he even had somewhat of a sense of humor. he played the wizard in one of these skits. every april they have a skit which is quite sophomoric and
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full of things about diarrhea which they have to deal with. it's their way of letting off a little bit of steam after all the very, very serious diseases they've been dealing with for the last two years. now, i wanted to follow them in the middle of a happening epidemic, and i never was able to do that because the state governments or the countries that they were going to were too nervous. what i did get to do was to follow them in assessment surveys of programs that they were doing in africa. so i went to niger which is a fascinating experience, and i went to kenya. and i wanted to show you when i was in niger, i couldn't go into the village -- let me just, let me queue something up for you here. i want you to look at a little movie i took. i had a digital camera with me,
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and it occurred to me, oh, gee, i could actually take little movies. you know how you can with a digital camera? so i was like a magnet for the children who would come up here. and i took this film, and it's very charming, but it has -- i'll warn you, it has a very serious ending. but i turned this in to youtube, and if you wanted to look at this, you can go to my web site which is just my name, markpendergast.com. and if you click on the outbreak subpage, then there's a link to what you're about to see. so anybody -- and also if anybody wants to get hold of me, it's easy. just go to that web site, my name.com, and you can e-mail me directly pa there. -- from there. so let's play this. ♪
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♪ >> you go to school and you learn english, yes? yes. [inaudible conversations] >> your teacher's name is annie? is e yes, okay. i want to hear a song in be german. can you, can you sing? no? [inaudible conversations] [laughter] >> oh, well.
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♪ if you're happy and you know it, clap your hands. ♪ if you're happy and you know it, clap your hands. ♪ if you're happy and you know it, then your face will surely show it. ♪ if you're happy and you know it, clap your hands. ♪ ♪
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♪ ♪ >> all right! that's wonderful! [cheers and applause]
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>> so, you know, what i wrote there is true, and you can see in their eyes how really, you know, kids are universal, people are universal. one of the eis officers i interviewed said, you know, wherever i go whether people have lips that are stretched blue or whether they're sitting in front of computer terminals, they all want the same thing; something good for their family and, you know, they're all trying to do the best they can. some people are born into places where it's very unequal. so i really admire this program. it's one government program which, as i said in the book, it's probably the most important government program that you never will have heard of, but it
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may very well have saved your life. but you wouldn't know it. and that's the nature of public health in general, is that these are really unsung heros. they go about their business without any fanfare, and they don't get the recognition that they deserve most of the time. so i'm very pleased that in this book i think they do. let me just tell you how it's organized. each little section of the book is a subheading, and it's basically a little mystery story. every little subhead. so i tried very hard not to telegraph what the answer was because i wanted the reader to feel the same urgency and the same puzzlement as to what is causing whatever is killing people or causing terrible diseases. and they often didn't know when they were going into it. so i'm going to read you -- this
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is almost an at random sample, but it'll give you an idea of how the book reads. and in a way the eis officers are sort of the generic leading characters although they're very different personalities as you can imagine. now, most of these at the beginning were in their late 20s, and most of them were white male. doctors. over time that changed. now most of them are about 34 on the average, over half of them are women. about 25% of them are minorities of one sort or another, and about 10-15% of them are from other countries. it's really almost a uniteddations down there in atlanta. so i'm going to read you this section about infants. in a little st. louis hospital run by the salvation army, some 30 babies a month were born to unwed mothers.
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the nurses and doctors ran an immaculate operation with complete prenatal care, delivery and nurturing of newborns. on april the 17th, 1967, a week-old baby developed a mild fever. then became slick with sweat, his tiny heartbeating rapidly. transfer to a major hospital nearby, the child was treated with antibiotics but died within 24 hours. immediately of after this death, three more babies began to sweat profusely. they survived following blood transfusions. blood cultures of the babies were negative for any known infection. the hospital closed its nursery for ten days for thorough cleaning. a month later another baby died suddenly with the same symptoms, and three more infants barely survived after transfusions. second year eis officer randy
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ieker in was -- eichner was called in and he found that all the babies had been full-term babies and appeared normal. they had all been delivered by different doctors. he was looking for something unusual, and he wasn't finding it. the maternal vaginal canals had been cleaned with an eye dean compound, all babies had been given the same eye ointment and vitamin injections. finally, eichner found a possible cause. since july 1966 surfaces in the nursery had been cleaned with a disinfectant containing four fee knoll derivatives including hex clear teen which had been shown to send newborns into convulsions. newlinens were purchased, and
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the disinfebruary about the had been discontinued. case closed. two months later on august the 29th, another baby at the st. louis louis hospital began to sweat profusely, and the hospital immediately called the cdc. eichner had graduated from the eis. it's a two-year program. so officer robert armstrong prepared to investigate using eichner's notes. he noticed that chemical analysis had found traces of hydrocarbons. after a quick literature search, he discovered that pent clear fee knoll, used primarily as a wood preservative, had caused exactly the same symptoms in ore outbreaks. other outbreaks. when he arrived at the small hospital in the morning, armstrong began in the attic. i found every box, bag, container, and i took them apart. by the afternoon he had worked
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his way down to the basement laundry room where, in a storeroom, he found a large card board barrel. he turned it around and saw a label for loxine, a whitening agent. among its ingredients was pen that clear fee knoll, and the label warned: not to be used in hospitals. the laundry ladies told me they put it in the washer for the terminal rinse for diapers and other linens, armstrong recalled. he asked them to stop using it, called the health department, took samples and locked up the barrel. the chemical was easily absorbed through the skin. after a previous outbreak of infant illness in a north dakota hospital had cast suspicion on loxine, the company that made it had added the cautionary or label. now the manufacturer denied any
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negligence. the label had said it shouldn't be used in hospitals. armstrong was not persuaded especially after his own blood was found to have a relatively high level of the chemical. the st. louis how tell where he'd stayed during during the investigation also used loxine for its sheets and talls. while the u.s. department of agriculture had regular power over the laundry product -- don't ask me why, it was the usda -- their initials didn't see the necessary -- officials didn't see the necessity to pull the product. armstrong went to cdc directer david fencer. after reviewing the data, sensor called the producer and told him to recall the product and never sell it again in the united states. although the cdc had no
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regulatory power, sensor promised he would make a very public stink about it if executive did not agree. that was the end of loxine. so this book has -- i haven't counted them, i but many, many incidents such as this. and, you know, intellectually it's very stimulating and fascinating, but if you were one of those parents who had a baby who died or almost died, that's, obviously, what you would focus on. and i tried to get that into the book as much as i could. so let me just whip through these slides again, and i may go through some of them quicker than others. but there's some really interesting, interesting parts here. now, let me see. if i click on this -- yeah, okay. and can i go to the slide show and -- no, i'll have to zip p
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through these. down, down, down, down. okay. oh, that was the logo. i love this logo. the shoe with a hole in the bottom of it because they call themselves shoe leather epidemiologists. and, in other words, they get out in the field, they actually go and experience things. and i found be myself really identifying with them because in many ways they're similar to journalists, investigative journalists is what i do. i go out in the field, i interview people, but i just don't do it scientifically. i'm not as smart as these guys. but they do have a sense of humor. this is a picture of camp dietrich which later became fort dietrich. we used to do offensive biological warfare in be 1969 -- in 1969. but the eis people had a very early alliance with them which made me uncomfortable and many
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of them uncomfortable too. but there were some fairly interesting things in the early history which i criticized them for. they did some experiments on prisoners and mentally ill patients. it was not just them, most medical people were doing that at the time. they no longer do that, thank goodness. this is an example of an early shoe leather epidemiologist, this was somebody that was in the first class. his name is ray, and he's there on the left. this is a diphtheria outbreak in ohio, and he told me -- and i quoted in the book -- he said, you know, up until then i had been just working if hospitals -- in hospitals. i'd never been out to see where people were getting things. and it was only when i actually went to people's homes like this that i began to see why they were getting what they did. come on, click. there we go. when the vaccine came out in 1955, it was cause for a huge
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celebration. only -- sol -- some of you may remember the time when you didn't let your children go to swimming pools or to movie theaters. there was this widespread terror of polio, and here was the magic bullet. you had this shot you could get that was going to protect you, and it did. it did work. unfortunately, within two weeks of them beginning to give this to first and second graders, some of them began to get polio, they were paralyzed in the same arm they'd been getting the injection in. eis officers quickly figured out it was one manufacturer's seen, cutter laboratories -- vaccine, cutter laboratories,ing the people who bring you your insect repellant. they had not killed the vaccine. when it get swoos your body, your body reacts to the vaccine as if it's live, but it's dead. in this case they were giving children live vaccine. i discovered, by the way, that
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it wasn't just cutter laboratories, it was also wyeth, and eis officers investigated that, wrote up a full report on that but langmuir suppressed it. he never allowed it to be published. they took the vaccine off the market, but he was afraid if it was publicized, people would be so afraid of the vaccine, they would be afraid of the entire program. anyway, that put him on the map. the cutter innocent, it was call. -- incident, it was called. langmuir saw an opportunity to go overseas to become an international agency. the very first eis information i wrote about -- investigation i wrote about was in south korea during the korean war in 1951. but this was an opportunity to bring a bunch of people over. there was a big smallpox
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epidemic in east pakistan which later became bangladesh. the eis has never had money. it still doesn't have money. they have a pathetic budget which is one of the points of my book. i hope that they get funded better be. but the state department had to pay their way over. they went to the state department, and they weren't the least bit interested. they said, what do we care about all these people in east pakistan until they found out that the russians were sending a team of a epidemiologists and, of course, we had to beat the russians. so langmuir took all these guys over, and smallpox is a major theme in the book which we'll talk about in a minute. i actually found letters that malcolm page had written to his girlfriend at the time, now his wife, and i quoted them in the book, and be it gives a real immediacy to this even though this was in 1958. he was talking about people running away and how he could barely get women to -- this is very unusual that he's actually
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next to a woman at all. they would usually stick their arms out the door because muslim women weren't supposed to be seen. and he had to give himself the vaccine over and over again to make them understand it wasn't going to hurt them. there weren't very many women, as i mentioned. this was a den bay fever outbreak in puerto rico. they began to test the jet gun injector to give smallpox vaccine. again, eis officers did this in brazil, all kinds of adventures. they decides they could get rid of measles after the vaccine came out in '67, and they couldn't. it's finally gone. in 1968 i think this was the biggest medical breakthrough of the 20th century, and it's sort of unheralded. cholera is the horrible disease
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that can kill you within 24 hours from dehydration. it gives you such terrible diarrhea that you lose all of your vital nutrients and electrolytes, and you die. the treatment for it until then was simply to give an iv drip to replenish the minerals that you were losing and the water which works but which is not available in many parts of the world. and you have to have an expert to install it, etc. so in many places, in many rural areas where this is occurring 20, 30, 40% of the people who contracted cholera died. well, the eis officers in this case and a little laboratory in bangladesh, they were testing out something called oral rehydration solution which was to replace the electrolites and the fluids that they were
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losing. this is a cholera cot. that child is evacuating through a hole in the cot directly into the bucket, and you can see that it's measured. and they would make sure that the child was getting exactly as much of the oral rehydration solution as was being evacuated into the bucket, and it saved her life. and it saved many, many lives. this was the hospital that they were doing that work at. a later eis officer named richard levine was assigned there, and they were supposed to be working on a vaccine for cholera which never worked very well. but he realized, you know what? he kept seeing the boats pull up with the cholera patients with the bottom just full of excrement. and he would watch the boats being turned over in the lagoon here and washed out. so he thought, this is not good. he did a study, and he showed that the cholera level near the hospital was much higher than
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the cholera level of places 50 miles away. and he got them to clean their act up. so this is one of the unintended consequences of what they were doing, they were actually spreading the disease they were supposed to be stopping. there's a lot in the book about bangladesh. this is actually right before the revolution that created it. it was a terrible typhoon. of this is one of the first natural disasters that they investigated, and there were quite a few of them in subsequent years. and what i concluded from these was that it's very rare after a hurricane or a flood that you have an infectious disease epidemic, although that's what people are usually worried about. but quite often what you really need is food, shelter and clean water. and that was true i in this case -- in this case. and al sommer, the guy who investigated this as an eis
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officer, he later went on to pioneer giving vitamin a to children to save their eyesight and their lives. and then he went on to become the dean of the school of public health at johns hopkins. that's one point i wanted to make. it's a relatively small program, only 3,000 or so, a little over 3,000 have gone through it, but it's had an enormous impact because of where these people have gone on to. they've gone on to work at the world health organization, at the gates foundation, in state health departments. they're all over the place, and there are now 36 clone eis programs around the world that eis alumni have begun. so they're spreading this methodology of shoe leather epidemiology around the world, and it's really had an impact. anyway, al sommer said, you know, these people gave us the craziest things. this was the first real, you know, public -- this is where george harrison had, you know,
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the concert for bang la kerr. -- bangladesh. people were really galvanized by what had happened to them. but they sent electric blankets, they sent vitamins, they sent outdated track question risers, they sent crazy things. they sent whole field hospitals, and he said, we didn't need field hospitals. either people had drowned or been blown away or this was the worst injury they had, from holding on to a tree to survive during the typhoon, they had abrasions, and that was it. so what they needed was food and shelter. and that's one of the interesting things i found about epidemiologists. many times during the disaster when they came in and they were trying to sort out what was going on like in a refugee camp or wherever, the doctors like, you know, doctors without borders would be there, and they would say why aren't you guys doing? you know, you're trained medically, why aren't you taking
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part in primary health care? but they began to be won over when they realized that by taking a broad view and seeing where the help needed to be applied, they were saving more lives than zooming in. i began the book with a little parable that's sort of like this where -- i won't read it to you, but the parable is -- and several of these guys i interviewed told me this. picture two doctors are by a river, and bodies are floating down the river. you're pulling the bodies out, you don't know what's killing people, but you're missing most of the bodies. one of the doctors suddenly drops the person they're attending, runs upstream. the other doctor says, what are you doing? he says, i'm going to go upstream to find out what's causing this. well, that's what the epidemiologists are doing. this was one of the first environmental impact that the
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eis studied. actually, one of the very first members, bob melon, he was called to examine what they thought was a st. louis encephalitis outbreak. and it turned out it was lead poisoning. and when he realized that, he started the first poison center in the united states. well, many years later in 1972, eis officer was called in to el paso, texas, because they had very high lead levels in the children. and he found that there was huge amounts of lead in the dust around this lead smelter. i included this picture because i like the outfits that they were wearing. [laughter] 1973, barry i -- levy's over there on the left. again, he's become a very
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important figure in public health and has written a very interesting book about war and public health and about bioterrorrism. but when he was an eis officer, and these guys, you know, they're very young, and they get to be on television, sort of exciting, he told me all of the things he did in the first six months he was there. it was just amazing. so i wrote all that up in the book. but one of the things he did really struck me. he did a salmonella outbreak in a bar, and it wasn't very hard to figure out that it was the potato salad that had been the culprit. you know, interview everybody who is there and what they ate, and, you know, all the people that had the potato salad got sick, and nobody who didn't eat potato salad got sick, so you could figure it out. most things were more complicated than that. and he could figure out why it happened. he interviewed the guy and said, oh, yeah, first i had the
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chicken in there in that bowl, and then i cooked it, and i made the potato salad in the bowl. did you wash the bowl out first? no! cross-contamination, classic mistake. but it bothered him. he said, you know, if they had had a restaurant inspection which would have cost $15, this could have been prevented. how much did it cost? it took a lot of his time, it sent 15 people to the hospital, they lost time at work, he figured it cost about $30,000. so he wrote with it up as an article, and it go into time magazine and "the new york times" and, hopefully, it created a few more people running around investigates restaurants. this was one of the skits that i mentioned. i've been to several of them. they're quite funny. and in 1975 they made a pilot movie starring maureen reagan, ronald's daughter, and it's actually robert urich.
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they never made the television series, and my book is an option for a television series. and i think it would make a great series. it would be fantastic. but the odds of it actually becoming one are probably relatively small. but you should all call whatever television exconservative -- executives you know. smallpox is the only disease that we have completely e -- eradicated from the world. we're on the verge of e eradicating any worm, and we're very close to eradicating polio, although it's not clear whether we'll ever succeed. but smallpox, the eis officers were very much involved in west africa and then in the end game in india and bangladesh. and i have a whole chapter on this which i think is quite amazing what they went through
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because they had to travel by elephant, as you can see here, or dugout canoe. many of them found people who didn't want to be vaccinated, and this presents a moral conundrum, what do you do? because you know those people might pass it on to others. nowadays, you couldn't get away with this, but many of them forced vaccination people. there are all kinds of interesting ethical issues involved in this history. nonetheless, they did manage by 1977 the very last case of smallpox was found in somalia. there hasn't been any ever since. they still have kept smallpox in freezers, ultimately in atlanta at the cdc and in moscow. it turns out the russian were making it illegally, and who knows where it is now?
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so this is a big poor that bioterrorrists may get hold of it, but for the time being it's gone. that led to an expanded program, and again, that's had an enormous impact on the world with. this is sort of almost a bit of humor, comic relief. crate canner lake is supposed to be, you know -- crater lake is supposed to be the most pristine water in the united states, and it had a terrible diarrhea epidemic. my wife while she was complaining how long it took me to get this finished she said, it's a great book, it's really interesting, but take out the diarrhea. [laughter] i said, hey, this is what happens. anyway, the concessionary there is to admit there was a problem, and he kept having his very sick restaurant workers continue to work and pass it on to other people. it was an interesting thing. and then the cdc got blame withed for it for not closing the park earlier. they closed the national park,
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first time it had had ever happ. the very next year in 1976 i call this chapter the year of living dangerously. pause at the beginning of the -- because at the beginning of the year there was a huge fear there was going to be a swine flu epidemic. in fact, all during the year there was fear of this. i was surprised that the media -- this just shows how my crop ing our -- my croppic our news media is, and they only look at what's happened in the last two minutes generally. but with this swine flu pandemic we've been having -- and it is a pandemic although thank goodness it's not as dangerous a strain as we thought it might be, but in this case a private, an 18-year-old private at fort dix in new jersey went on a 5-mile forced march in the morning, you know, part of his training. he didn't feel well, he collapsed, and he died. and he had flu, and it turns out what he had was h1n1 which was
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swine flu. so they thought it might be like 1918, the last time we'd had a terrible swine flu, and that it might be somewhat mild in the spring, but it would come back having mutated into becoming this horrible killer in the fall. so they decided to the inoculate everybody in the united states. it never came back, so cdc looked really dumb over this. what did come right when they were looking for it, and they thought at first it was swine flu, was legionnaire's disease in philadelphia. now, this was the bicentennial year, and here we had people falling over and dying of some mysterious ailment. so there was widespread rumor that this was bioterrorrism or communists or somebody doing this. and they could not figure it out. eis officers spread all over pennsylvania trying to figure
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this out. this guy, steve thacker, is now in charge of the person who's in charge of the eis program at the cdc. he told me that he went into this room and that the press had been following, and he turned around, and nobody had come into the room with him. [laughter] they were all scared. one photographer poked her head around to take that picture and then ran back away. it turns out what was causing legionnaire's disease was a hitherto unrecognized bacterium that grew only in cooling towers and air-conditioning systems. so it had probably been around forever, but it hadn't proliferated and affected human beings, and this was one of the unintended consequences of technology. so there are a lot of lessons to be learned from reading this history of what we've gone through in the past of 0 years or so -- 60 years or so.
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this was also the year of the first ebola outbreak. and again, eis officers were summoned. there was a guy named joel bremmen who went to this one, and he told me he was just coming out of an autopsy because with somebody had died of swine flu. they had died of something else, but it was after they'd gotten the swine flu vaccine, and he needed to make sure that it wasn't from the vaccine, and it wasn't. they get the call, and it was from his boss back in atlanta. he said there's this new disease in the middle of nowhere in africa. it seems to have 100% mortality, everybody's dying from it. how would you like to fly over there and try to solve it? and he said, well, let me talk to my wife, you know, i have two little kids. and he did go. and he told me that when they got there -- oh, he went with another eis officer, and they stopped in geneva on the way o
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consult with the world health organization, and the other eis officer freaked out and said, i can't go. and he went back to the united states. joel went ahead, he and a lab guy got there. they were, basically, totally sleep deprived, they hadn't had any sleep in 48 hours. they are rushed immediately to a meeting, and everybody's talking in french which joel under, and they explained that it was in this remote area and that they were going to send a team in. and he thought, oh, good, they're organized, they know what they're doing, thank goodness. and then all eyes turned to them, and there was silence. they were the team. [laughter] so he ended up going. this was an interesting one. there were many and more imported flowers coming from chile, and it turns out they had very heavy pesticide load on them. so they investigated that.
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there's a lot of really weird things you never would have thought about, but this one about the flowers later on more and more, as more and more of our produce came from mexico or from latin america, we began to get more and more diseases as a result. so i think we're going to be going more and more back to local food now, and i think that's a very good idea because we're less likely to seem terrible. this is something that has happened several times, too, because of liquid manure systems. they didn't have proper ventilation and this poor 16-year-old who was working on the farm died because of it. this was a real example of the impact that one person can have. karen starko's son, now, is going to the university of
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vermont medical school. so i've gotten to know her fairly well when she e comes to visit her son. that's her son. in 1978. she was assigned to the state of arizona, and there was a flu epidemic. and in the middle of the flu epidemic, a number of children began to die of rice syndrome. it doesn't happen very much anywhere because of parents in large measure. but it was a disease that usually came in the middle of a flu epidemic or chickenpox. children would be getting better, and then suddenly they began to projectile vomit, they would become combative, they would fall into a coma, and they would die. it was a terrible, terrible death. these were children who up until this point had been totally healthy, nothing the matter with them. eis officers had been working on this for several years.
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they couldn't figure it out. so seven children died, and she did a case control study. it's remarkable to me nobody's done this before. a case-controlled study is where the cases are these seven children, and you want controls who are as similar as possible but who didn't get reyes syndrome. so she chose two children from their elementary school classes who had also gotten flu but had recovered uneventfully. and she asked the parents, what had the children had for medicine, what kind of pets were in their houses, what was the heating system, what vaccinations had they gotten because she was on a fishing expedition. of she doesn't know what had cause it. and when she -- she had a hard time figuring out what was in the medication, so she had to go back to the pharmacies to figure it out. when it all came down, it was aspirin that was the common
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denominator that the cases had. some of the controls also were given aspirin, but not as much. so nobody could believe this. this was like saying, you know, mom and apple pie, that was the girl who died -- this is a 1962 ad for aspirin, very typical of, you know, if you get a cold, give your child aspirin. and so nobody believed her. in fact, she couldn't even get can her article published at first. but when they did other studies, it became clear she was right. it was aspirin. and the aspirin industry fought tooth and be nail against putting labels on med caig for children -- medications for children containing aspirin. and they delayed warning labels for five years. during those five years, at least 300 more children died of reyes syndrome, and that's the ones we know about.
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there were probably well over a thousand. so this is one of the cases where companies put federal pros ahead of people's lives. there were other cases. this is another case. toxic shock syndrome. perfectly healthy 21-year-old women were dying while they were menstruating. and it turns out they were all wearing tampons, they were all wearing a particular type of tampon. a new highly-absorbent tampon. and it was caused by a staph infection that was proliferating in the sort of perfect little -- [inaudible] as the eis officer called it. and, again, they -- just a picture of the ones who were working on it. they asked the company to withdraw rely when was made by procter & gamble. rely was the tampon most implicated, it wasn't the only
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one. and they didn't want to withdraw it, and the ceo of procter & gamble got down on his knees and begged the eis officer, i beg you, take what this means to -- think what this means to our company. we've spent billions of dollars on this, what be you're wrong? and -- what if you're wrong? and the eis officer said what if it were or your daughter? what if you were wrong? so they withdrew it. i'm going to stop here, i think. there's so much more i could talk about, but let me just read you the little end of this, and then we've got time for some questions. i'm sorry, i went on a little bit too long. i want today read you the last -- wanted to read you the last bit in the book here. in 1951 alexander langmuir seized a cold war opportunity to fund a small training program for young epidemiologists who would keep an eye out for
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biological warfare while responding promptly to unintended epidemics. i forgot to mention, that's how he got the fund oring for -- funding for it. he scared people because the communists were supposed to be polluting our water and spreading anthrax until 2001, and that was the eis officers doing that too. today the eis officers are the front line disease detectives. for an obscure government program, the epidemic intelligence service has produced remarkable results. perhaps it has done so in part by remaining relatively small, nimble and flexible. one of the lessons of the eis history is the impact that one person can have. put creative, intelligent, motivated individuals into the right environment, and the outcome can save lives and lead to vital careers. eis officers and alums have had an impact far beyond their original numbers. today with global public health
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bedeviled by substantial threats, the lifesaving work performed around the world by these shoe leather epidemiologists is more essential than ever. the eis program has, in short, influenced and defined how field epidemiology and public health are practiced on our planet. and i will stop there, and i hope you have some questions. [applause] yes. >> what is it about the investigative journalism approach you have to your book that you find so rewarding? if you find it rewarding at all. >> yeah. sort of like the eis officers. you're trying to find the answers to some questions that you pose. how did things come to be the way they are? you know, as i said before, human beings are the same and
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yet different, you know? so we all want kind of the same things, but it's fascinating what we choose to do and in what ways we handle it. one of the exciting things is going into archives, it's not just going and following people in africa, and you come across something that is -- like that suppressed paper about the wyeth polio vaccine. you think, wow, this is great. i'm going to use that. so it's like a little exploration, sort of like a perpetual treasure hunt: any other questions? yes. >> you've written about a variety of topics, and i'm wondering because especially the books go into your topics in depth, when you begin these, you don't have any specialized knowledge of the subject, and do you find you need to play catch up a lot, or do you inform yourself as you're, as you're
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doing -- >> so in other words, how do you become an expert on a topic that you've chosen to write about, and you don't know anything about it? [laughter] you know, an expert is somebody who finds out as much as they can about something. and at some point they get to know more than most people about it. in this case, you know, i read everything that i could find about epidemiology. i interviewed all these people, i read all of their -- they write a report after each of their investigations which they made available to me. it was wonderful, like a treasure-trove. you know, i asked the same questions about e.j.cohn jr. i wasn't so worried about becoming an expert, but it just seemed endless, you know? you just keep going and going and going. you could spend the rest of your life researching this stupid soft drink, you know?
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and i could have. and he said, well, what i've found is that when you start to interview people and they tell you who else you should talk to and you've already talked to them and they tell you stories you've already heard, then you should start writing. and that's very good advice. and that's, basically, what i did. >> [inaudible] before you start interacting with people who are -- [inaudible] do you have to raids your own, you know -- did you have to do a lot of preliminary research to do the research -- >> no. the question was did i have to do preliminary research so i can't look like a complete idiot when i interviewed the experts. no. i don't mind looking like a complete idiot. i'm a smart guy, i have common sense, and i'm not afraid of saying i don't understand that, can you explain that better because i'm not dumb. i can understand it.
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and people respect that. they, you know, be they get all holier than thou and get up on their high horse, that's their problem, not mine. and i do get up to speed. it's not like i just go in there totally blind. i've read a fair amount usually before that. yes. >> i've always wondered back with the rely tampon issue what was the manufacturing defect in that that made that particular one especially lethal? because you never hear of that anymore. they must have designed it differently. i never really understood that. >> part of it was -- i'd have to go back to that slide. part of the problem with the rely tampon was, number one, it was superasob end, and it's an anaerobic factory. the staff -- it was a combination of factors that caused this. it was a particularly bad type
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of staff lo cockal infection that was going around for some reason, and when they did studies on women, about a tenth of them at that time, harbored this in their vagina fairly harmlessly. but when it was introduced into an environment where it would proliferate, that's what caused the harm. so it was nothing intrinsically that mattered with rely tampons, it was a combination of factors that caused it. yes. >> [inaudible] many, many hours and not changing them as frequently as they should, and that's part of what was harboring -- [inaudible] >> very good point. yes. they were wearing them longer, and they discovered that that was a factor. they also had the little string that come down, it was a multifill ament string, so it was kind of like a wick that would bring more microbes up
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into it. any other questions? i didn't get to cover a whole lot of stuff, but i think we're running out of time. one more question? that's it. good. thank you so much for coming. [applause] >> mark pendergast is the author of many books including uncommon grounds, the history of coffee and how it transformed our world. visit his web site, mark pender gras.com. >> cleo paskal, global warring, not global warming. >> yeah. it's a little bit of an extreme title. a lot of the analysis around climate change stops with it's going to get a little warmer. this goes on to say what that actually means in terms of national security, global economic issues. we're starting to see it a little bit in the arctic where
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suddenly there's conflict where there hasn't been before, and new players are coming coming io areas that are completely unexpected. so china has an ice breaker. they know what's going on in the arctic caused by -- [inaudible] so they want a piece of the action. it's rechanging the way global politics and economics are acting out. it's a little disconcerting. >> why would china have an ice breaker, and what's going on in the arctic that we should be concerned aboutsome. >> well, there's major oil and gas fields in the arctic, a lot of them are in russia. the pipelines are built on thawing perm ma frols. a pipeline's only as good as its weakest point. it makes sense in that situation to start to shift. if russia starts to ship the shipping, that means they're not tied into liberty europe, they can deliver to china instead. so they can continue to supply without losing the revenue stream. now with the pipeline if you turn off the tap, you lose the
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revenue stream. so china increasingly wants a piece of of that action. >> what is your background? how did you get involved in this issuesome. >> i was a journalist for a long time, and i was going to places like the pacific, and it's going to disappear because of rising sea levels. i started to wonder what does that actually mean? you know, if it disappears, does it cease to exist as a country? do the waters become international waters? overlaid on to top of that you e china and taiwan fighting for control. it was the u.s. stomping ground, now hillary clinton was just in american saw samoa of all place- saw samoa. of that well balanced port starts to shift in ways we haven't really considered and perhaps should be.

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