The Fever

The Fever: How Malaria Has Ruled Humankind for 500,000 Years


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A “tour-de-force history of malaria…riveting.” –New York Times

“A vivid and compelling history with a  message that’s entirely relevant today.”
–Elizabeth Kolbert, author of Field Notes from a Catastrophe

In recent years, malaria has emerged as a cause celebre for voguish philanthropists. Bill Gates, Bono, and Laura Bush are only a few of the personalities who have lent their names—and opened their pocketbooks—in hopes of stopping the disease. Still, in a time when every emergent disease inspires waves of panic, why aren’t we doing more to tame one of our oldest foes? And how does a pathogen that we’ve known how to prevent for more than a century still infect 500 million people every year, killing nearly one million of them?In The Fever, journalist Sonia Shah sets out to answer those questions, delivering a timely, inquisitive chronicle of the illness and its influence on human lives. Through the centuries, she finds, we’ve invested our hopes in a panoply of drugs and technologies, and invariably those hopes have been dashed. From the settling of the New World to the construction of the Panama Canal, through wartimes and the advances of the Industrial Revolution, Shah tracks malaria’s jagged ascent and the tragedies in its wake, revealing a parasite every bit as persistent as the insects that carry it. With distinguished prose and original reporting from Panama, Malawi, Cameroon, India, and elsewhere, The Fever captures the curiously fascinating, devastating history of this long-standing thorn in the side of humanity.

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“Human history marches to the beat of what? A big brass band? A choir singing hymns? The lub-dub of the human heart? Sonia Shah’s tour-de-force history of malaria will convince you that the real soundtrack to our collective fate is none of these: it is the syncopated whine-slap, whine-slap of man and mosquito duking it out over the eons.”

New York Times, July 27, 2010
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The Fever is an often rollicking read, spanning from modern-day Panama and Malawi to medieval Italy….Shah has put together an engrossing cast….Most fascinating is Plasmodium itself. Like fiction’s best supervillains, it is a complex, brilliant and mysterious foe that has resisted all attempts to tame it. While recent campaigns have had some success, Shah warns that to underestimate the parasite’s resourcefulness is to invite future epidemics. We have 500 millennia of suffering as proof.”

TIME magazine, July 12, 2010

“The lessons of history should give us pause….All these issues, and many more, are brilliant exposed in Ms. Shah’s book.”

-Wall Street Journal, November 19, 2010

“Raw, vivid…Shah presents a fascinating history….The Fever is a mine of information, drawing on diverse accounts from medical experts and field workers. This is an important book on the historical lessons we must not forget and the mistakes we are still making today in the battle against what remains a formidable killer.”

–New Scientist, July 14, 2010
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“The Fever is a call to arms, though it’s written with admirable clear-headedness and not a trace of alarmism. It’s a compelling account of a disease that remains out of sight — and thus out of mind — for most Americans, even as it slowly tightens its grip on other parts of the world. Despite Shah’s engaging prose and obvious enthusiasm, the subject matter means it’s far from an easy read — but it might well be an essential one.

–NPR.org “Books We Like,” July 12, 2010
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“This insightful book explores the human struggle with malaria not just from a scientific angle, which is cogently detailed without being overwhelming, but also from sociological and anthropological perspectives, which turn out to be the real strengths of this work . . . Shah is to be commended for focusing much of this well-written book on exactly these aspects of humankind’s interaction with malaria and how they have contributed to the lack of success in vanquishing it. Focusing on the science of medicine while ignoring its other components is akin to trying to ride a bicycle with only one wheel, and this is true not just with malaria, but also with AIDS, tuberculosis, and other diseases that afflict large numbers of people.”

The Boston Globe, July 7, 2010
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“Engrossing and terrifying….Shah brings a balance of poetry and hard science to her reporting.”

Barnes & Noble Reviews, August 24, 2010

“Shah weaves a compelling tone throughout her book, using her descriptive-writing spell to bring the reader through failed malarial eradication programs even as smallpox and polio vaccinations succeeded.”

–Elizabeth Howell, “Forget Vampires. These bloood-suckers are deadly,” The Globe and Mail (Canada)

A “compelling expose…Shah tells a heart-breaking story.”

Canberra Times (Australia), July 31, 2010

“Science writer Sonia Shah tells all….A good, bleak read.”

The Weekend Australian, September 18, 2010

“Good science writing is worth its weight in diamonds and Shah’s book is no exception.”

The Sunday Age (Australia), August 1, 2010

“A fascinating book that examines a complicated landscape of anthropology, medicine, history, biology and politics.”

Townsville Bulletin (Australia), August 7, 2010

“Fascinating, eye-opening and thoughtful. Part science, part history and part cultural study, it reminds us of the dangers in the hubristic belief that technology can solve all our problems.”

Adelaide Advertiser (Australia), August 7, 2010

“Science journalist Sonia Shah traces the origins of malaria and the history of our attempts to control it….Shah generally does well with her complex subject but she really shines in her critique of the anti-malarial efforts ot governments and aid agencies.”

The West Australian, September 18, 2010

“Impressive…Shah unpacks the complexity of malaria, showing how its impact is dictated by a dizzying array of variables.”

Maclean’s (Canada), September 20, 2010

“A fascinating history of the attempts to eradicate…this troublesome scourge….insightful, even revelatory, on the problems of bed nets.”

–Wendy Orent, “The Monster Mosquito,” The New Republic, August 12, 2010

“Meticulously researched and passionately written….one of this year’s most significant science books for the general reader.”

Cleveland Plain Dealer, July 26, 2010

“Shah is skeptical of a surge of private charity that emphasizes the use of mosquito nets following the decline of government-led anti-malaria programs in the 1990s. Acknowledging the contributions of Bill Gates and former Presidents George W. Bush and Bill Clinton, she lists Veto the ‘Squito, a youth-led charity; Nothing but Nets, an anti-malarial basketball charity; and World Swim Against Malaria. She quotes The New York Times as decrying “hip ways to show you care.” Her own comment: “Just because something is simple doesn’t necessarily mean that people will do it.”

–Associated Press, July 5, 2010
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“In The Fever, journalist Sonia Shah makes sense of the multifaceted history of this harrowing disease and our response to it….By describing malaria’s role in the rise and fall of peoples, cities and civilizations, the book reveals the massive imprint of this disease on health and life expectancy, politics, commerce and war….The Fever clearly traces the growing understanding of the causes, transmission and prevention of malaria….Shah astutely points out that many of the challenges that stalled past efforts have yet to be overcome….Shah’s ultimate message is spot on: that the fight against malaria is complex. Ending it, as she says, is tough and unlikely to happen in our lifetimes. Key actors from different sectors at national, regional and global levels need to harmonize their efforts. Today’s malaria movement has brought both an unparalleled diversity of experience, knowledge, skills and resources to its cause, and far more coordination through an inclusive global consultative process. Hopefully, The Fever will bring new partners to the table.”

Nature, July 8, 2010

“Sonia Shah has written a very interesting book about malaria and its impact on humanity.  More than just a scientific (and medical) overview of the disease, the book also very skillfully examines many of the social, cultural and anthropological reasons behind the lack of success in achieving its eradication.  Reading “The Fever”, one is reminded that science is only one of many components of the art of medicine, and that those who would focus solely upon it at the exclusion of the others do so at their own (and their patient’s) peril.”

Psychology Today

“Fascinating, mordant…Shah’s is an absorbing account of human ingenuity and progress, and of their heartbreaking limitations.”

Publishers Weekly, May 10, 2010
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“[A] sobering account with important lessons for medical historians, anthropologists, biologists and, most of all, policymakers.”

Kirkus Reviews, June 1, 2010
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“Investigative journalist Shah maintains her signature pattern here, exposing both the seemly and not-so-seemly aspects of the subject under review….Malaria may rule humankind, but Shah rules the in-depth investigative report.”

-Booklist, June 1, 2010
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“A vivid and compelling history with a message that’s entirely relevant today.”

–Elizabeth Kolbert, author of Field Notes from a Catastrophe

“A fascinating book, elegantly written and superbly well-researched—a poignant and important reminder of malaria’s relentless human toll.”

–Nina Munk, contributing editor, Vanity Fair

“A thrilling detective story spanning centuries, about our erratic pursuit of a villain still at large and still a threat to mankind…Rich in colorful detail and engagingly told…An astonishing array of characters have joined the fray, and you can only be amazed at the deviousness and skill of the arch-enemy.”

–Professor Malcolm Molyneux, Liverpool School of Tropical Medicine, WHO expert panel on malaria

“Extremely well-researched, The Fever provides a highly gripping account of one of mankind’s worst diseases….Highly recommended.”

–Bart Knols, Managing Director, MalariaWorld

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Excerpt: Malaria at Our Doorstep
From Chapter One, The Fever: How Malaria Has Ruled Humankind for 500,000 Years

The view through the mosquito net is blurry, but I can see the thick skin of grime on the leading edge of each blade of the ceiling fan as it slowly whirs around, keening alarmingly. This is how it was every summer when I visited my grandmother’s house in southern India. While my cousins snore on the bed mats laid across the floor beside me, glistening bodies bathed in the warm night breeze, my sleeping mat is ensconced in a hot, gauzy cage. The mosquitoes descend from the darkened corners of the whitewashed room and perch menacingly on the taut netting, ready to exploit any flicker of movement from their prey within. It is hard to fall asleep knowing they are there, watching me, but eventually I drop off and my tensed body uncurls. They sneak into the gaps my protruding limbs create, and feast.

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Article: “The Tenacious Buzz of Malaria,” Wall Street Journal, July 10, 2010
The Romans called malaria the “rage of the Dog Star,” since its fever and chills so often arrived during the caniculares dies, the dog days of summer, when Sirius disappeared in the glow of the sun. To avoid it, ancient Romans built their grand villas high in the hills, fled the mosquito-ridden wetlands that encircled Rome, and prayed for relief at temples dedicated to the fever goddess, Febris.
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Article: “In Africa, anti-malaria mosquito nets go unused by recipients,Los Angeles Times, May 2, 2010
The premise behind the idea of treated nets is simple. The netting prevents malarial mosquitoes from biting people while they’re asleep, and the insecticide kills and repels the insects. World health experts say that using the nets can reduce child mortality in malarial regions by 20%. But even as donations roll in and millions of bed nets pile up in warehouses across Africa, aid agencies and non-governmental organizations are quietly grappling with a problem: Data suggest that, at least in some places, nearly half of Africans who have access to the nets refuse to sleep under them.

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Article: “Turning to Greener Weapons in the Battles Against Malaria,” Yale e360, May 2, 2010
For over half a century, the battle against malaria has been waged with powerful anti-malarial drugs and potent mosquito-killing insecticides, weapons born from the wonders of synthetic chemistry. In recent years, however, fed up with the financial and ecological drawbacks of chemical warfare, malarious communities from China to Tanzania to Mexico have been forging a new way to fight the scourge, one that draws inspiration from the lessons of ecology more than chemistry. Rather than attempt to destroy mosquitoes and parasites outright, these new methods call for subtle manipulations of human habitats and the draining of local water bodies — from puddles to irrigation canals — where malarial mosquitoes hatch.
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Article: “Malarious World: Square Nets for Round Huts,” Ms Magazine blog, April 26, 2010
This past week, in honor of World Malaria Day, I attended a meeting in Washington, D.C., of a small group of aid workers, social scientists, and others involved in the business of distributing insecticide-treated bednets to women and children in rural Africa, to protect them from malaria.

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Article: “The perfect predator: malaria makes a comeback,” Orion magazine, November/December 2006
MY FATHER PROBABLY WASN’T THE ONLY PARENT in our southern New England town to entertain his children by chasing them around the house pretending to be a scary monster. But he probably was the only one who pretended to be an insect. Crouched down, hands curled in front of his nose, he’d slowly unfurl two fingers. When they started to flutter, that was the signal for my sister and me to start running. Dad had turned into the Giant Mosquito, prime predator of his native India, and he was out to get us. My sister and I would pound through the house, howling in terrified delight.

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Article: How a Tiny Parasite Helped Shape History, Alternet, April 27, 2009
Last weekend, the mosquitoes emerged from the narrow stream that trickles by our house outside Baltimore, flitting around the ankles of my 9-year-old son, skipping stones with his pants rolled up to his knees.

These days, it’s just a benign sign of warmer months to come, but it wasn’t always so. Not too long ago, the local Anopheles mosquitoes — like dozens of mosquito species around the world today — were just as likely to slip in a few Plasmodium parasites with their itchy bites, roiling their victims with the chills and fever named after the Italian for bad air, mal’aria. The stories of how malaria and yellow fever impeded European colonization of Africa and the building of the Panama Canal (surveyed by the Spanish in 1534, unsuccessfully attempted by the Scots in the seventeenth century and the French in the late nineteenth) are familiar. Less known is how malaria’s tide sculpted our own landscape, too.

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Interview: Phillip Adams interviews Sonia Shah about malaria, March 10, 2010

Malaria has been around for five hundred thousand years, but shockingly, the global death toll from malaria has continued to rise since the 1980s. The parasite has developed ever more lethal versions of itself and it now kills a million people a year. Sonia Shah is a self-confessed mosquito-hater. She’s travelled the world tracking down the malaria disease, and has written a book about it.

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The Fever is available from Sarah Crichton Books/Farrar, Straus & Giroux (July 2010).

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