Q&A with Sonia Shah

Sonia Shah, photo by Johnny Martyr

Sonia Shah is the author of the new book Pandemic: Tracing Contagions, from Cholera to Ebola and Beyond. Her other books include The Fever and The Body Hunters. Her work has appeared in a variety of publications, including The New York Times and The Wall Street Journal.

Q: You write that "for most of the twentieth century, the conventional wisdom...was that developed societies had vanquished infectious diseases for good." What were the key factors leading to the discrediting of this belief?

A: Probably HIV, which first came to national attention in the early 1980s. It came along with a flurry of other novel pathogens that routed our medications: new forms of influenza, coronaviruses like SARS, Ebola and others. 

Q: In the book, you note, "Many experts believe that a cholera-like pandemic looms." Why did you focus much of the book on cholera, and why do many experts believe a similar pandemic will arise?

A: Only a handful of pathogens have been able to cause pandemics in modern times. Among them, cholera stands alone--it has caused no fewer than seven global pandemics, and the latest one is going on right now.

The conditions that allowed cholera to cause pandemics--human invasion of wildlife habitat, urbanization, acceleration of global trade and travel, weakening of public protections--are being re-created today, but on a global scale.

Q: You describe your own family's experience with the MRSA bacterium. What can readers learn from that experience, and how are you doing now?

A: I'm fine, thankfully! I still get MRSA abscesses but over time they've become much less painful and long-lasting. It's a tough infection that is becoming increasingly common, unfortunately.

Q: You write that "we still can't rely on modern medicine to save us from the threat posed by new pathogens." What are the strengths and the limitations of modern medicine when dealing with this threat?

A: Modern medicine is great at figuring out how new diseases are transmitted (for example, the fact that Zika is spread by mosquitoes and through sex was figured out within weeks of the current outbreak). That's important because it gives us the understanding we need to change our behavior to avoid infection.

But it still takes years to devise new drugs and vaccines to tame infectious pathogens. For most of these pathogens, which spread exponentially, that is too slow. That's why for new pathogens, it makes more sense to focus on prevention, rather than treatment.

Q: What are you working on now?

A: I'm currently investigating the migrant crisis in Europe and how that might alter the disease landscape there.

--Interview with Deborah Kalb