Deadly Feasts by Richard Rhodes
Deadly Feasts: Tracking the Secrets of a Terrifying New Plague
by Richard Rhodes
Simon & Schuster. 259 pp. $24.00
When I was a medical student in the early 1960′s, Creutzfeldt-Jakob disease was another obscure dementia, and kuru was a new and curious neurological illness afflicting tribesmen in New Guinea. Only one researcher, William Hadlow, had made the connection between kuru and an infectious sheep disease known as scrapie or the “scraping” disease. Other scientists explored different leads and troops of geneticists, epidemiologists, toxicologists, and entomologists foraged New Guinea in search of kuru’s cause.
Richard Rhodes is thus quite justified to begin his saga in the lush vegetation of that island off Australia, and he includes exotic descriptions and dramatic photographs of both the geographic terrain and the human disease. Moving forward and backward in time, he proceeds to introduce the reader to an assortment of fascinating characters in one of the hottest mysteries of medical science—and to the possibility of a global epidemic that has already infiltrated or will soon infiltrate not only humans, primates, and cows but birds, fish, and, if you follow the argument logically, maybe even vegetables. The tale is told with the craft of a first-class mystery, and the criminal is exposed—that criminal being none other than the human race. Guilty of being carnivorous, we are justly punished when, as Rhodes puts it, “meat bites back.”
History, when presented by those who make it, is never free of bias. Rhodes’s main source and central protagonist is the mischievous and intellectually omnivorous Carleton Gajdusek of the National Institutes of Health (NIH). Something of a dramatic storyteller, Gajdusek is also described (by the Nobel prizewinner Macfarlane Burnet) as having “an intelligence quotient in the 180′s and the emotional immaturity of a fifteen-year-old” and as a “maniacally energetic” scientist who inspires fierce enthusiasm in his staff. The charismatic Gajdusek charged his team at NIH and other collaborators to test Hadlow’s prescient suggestion that the same type of infectious agent causes scrapie and kuru. At first a disbelieving, almost unwilling, participant, Gajdusek would be awarded the Nobel Prize in 1976 for the discovery that both kuru and Creutzfeldt-Jakob disease were transmissible to primates.
There is in all this a rich tale of scientific rivalry and even theft, not to mention early leads that went unrecognized. Rhodes tells it in part through the journals he unearthed of the anthropologists Robert and Shirley Glasse (the latter now Shirley Lindenbaum) who were the first to draw a formal link between kuru and the cannibalism practiced by the New Guinea tribesmen. (Some of the locals seemed to be aware of the link through common sense.) Also briefly touched upon is the story of D. R. Wilson, who first serially transmitted scrapie in sheep and showed that the infectious agent was filterable (like a virus) yet not sterilizable by treatments that inactivate most viruses. For his original and unpublished experiments Wilson was ridiculed and died an outcast and broken man.
What, then, is the mysterious nature of the infectious agent? Rhodes concentrates on the theory of Stanley Prusiner that the culprit is not a virus, even an unconventional one, but a host protein—a “prion.” The hitch is that this protein (PrP), when purified, is not demonstrably infectious. Moreover, several experiments that claim to show these agents’ almost magical properties—including the fact that their complex structure survives heating to 700 degrees Fahrenheit—have been irreproducible or questionable. In the meantime, a multitude of slow and persistent viruses have been uncovered which employ devious strategies to avoid recognition by immune cells and can repair their own genetic material after damage. It is disappointing that Rhodes does not explore these different views in more detail.
While the argument over the nature of these agents remains unresolved, conveniently forgotten or ignored by most scientists is their ability, like that of other microorganisms, to cause epidemic disease. Experiments conducted by me and my colleagues at Yale in the 1970′s on the transmissibility of Creutzfeldt-Jakob had shown that distant species could indeed be infected, and that the agents involved could acquire an altered range of hosts. Thus, in September 1989, after new agents were found in British cows that could potentially have an enhanced virulence for humans, I privately recommended the slaughter of all cattle on infected British farms (with full compensation for the farmers). Met by an opposing chorus of certainty, to the effect that the infection could not spread to humans (“it’s just like sheep scrapie, and that’s not a problem”), I asked if the British were prepared to watch as their population possibly dwindled away from an incurable and devastating disease. At least in terms of public health, would it not be best to take the most conservative approach—especially since, no matter what the agent was named, it invaded its hosts and behaved like a virus?
But the decision went the other way. The British, hoping the cow problem would politely disappear, spent millions building labs for containing recombinant but uninfectious PrP and little for culling cattle. (They did, however, limit the recycling of contaminated tissues.) I personally stopped eating British beef, recommended to my nephews in London they do the same, and, although sworn to secrecy by Britain’s Medical Research Council, considered it imperative to get in touch with our Department of Agriculture (USDA) just in case we had been importing beef-derived food supplements. We had. Two cats had already been infected, but fortunately there were no known “mad cows” here. The USDA quickly instituted a ban on the suspect food supplements, and I kept my promise of no public disclosure until 1992, when two youthful farmers and two teenagers in England began to show symptoms of Creutzfeldt-Jakob disease. These cases are well-described by Rhodes.
Since the first sick cow was diagnosed in 1985, an estimated one million cows in the British Isles have become infected. It is on account of numbers like these that Rhodes closes his book with premonitions of widespread disaster. But there are others, on the opposite side of the spectrum, who declare with passionate intensity that there is no danger at all. The truth is that no one, not even the few of us who work with these infections, has any idea whether or not a new plague is upon us. Rhodes argues that “downer” cows in the U.S., i.e., cows unable to stand up because of illness, harbor the same infection as the British cattle, but I have not seen any firm evidence of this. If the new and extremely virulent British strain is here, it is not very prevalent. At the very least, this gives us a window of time to reevaluate our own practices and policies.
Rhodes concludes Deadly Feasts by focusing on the governmental response to the epidemic and by recounting how human beings find ways to make use of every last remnant of their domesticated prey. His descriptions of this tend to be unappetizing, though they also show how marvelously inventive we are. Capitalizing on the dire predictions of some scientists, Rhodes leaves us with a picture of PrP converting and overtaking us like the “ice nine” in Kurt Vonnegut’s Cat’s Cradle, a single drop of which turns the oceans into immobile crystal and brings human life to an end. But this scenario is infinitely less fascinating than the cunning strategies of nature itself, which biologists continuously discover. Moreover, anyone who has seen the scourge of protein deprivation in children as a consequence of poverty or neglect—or of rigid systems of belief—will find it hard to embrace Rhodes’s implicit suggestion that we now all act to avert disaster by becoming fanatic vegetarians, rummaging for plants unreplenished by the return of protein. More useful, at least as far as medicine is concerned, would be to try to understand how to prevent and undermine these subversive infections—which have been with us for centuries.