Bill Bryson - When Things Go Wrong: Diseases

Bill Bryson

Bill Brysons bestselling books include A Walk in the Woods , The Life and Times of the Thunderbolt Kid , and A Short History of Nearly Everything (which won the Aventis Prize in Britain and the Descartes Prize, the European Unions highest literary award). He was chancellor of Durham University, Englands third oldest university, from 2005 to 2011, and is an honorary fellow of Britains Royal Society.

B OOKS BY B ILL B RYSON

The Lost Continent

The Mother Tongue

Neither Here Nor There

Made in America

Notes from a Small Island

A Walk in the Woods

Im a Stranger Here Myself

In a Sunburned Country

Brysons Dictionary of Troublesome Words

Bill Brysons African Diary

A Short History of Nearly Everything

A Short History of Nearly Everything: Special Illustrated Edition

The Life and Times of the Thunderbolt Kid

Shakespeare: The World as Stage

Brysons Dictionary for Writers and Editors

At Home: A Short History of Private Life

At Home: A Short History of Private Life: Illustrated Edition

One Summer

The Road to Little Dribbling: Adventures of an American in Britain

When Things Go Wrong: Diseases

from The Body

by Bill Bryson

A Vintage Short

Vintage Books

A Division of Penguin Random House LLC

New York

Copyright 2019 by Bill Bryson

All rights reserved. Published in the United States by Vintage Books, a division of Penguin Random House LLC, New York, and distributed in Canada by Penguin Random House Canada Limited, Toronto. Portions originally published in hardcover in The Body in the United States by Doubleday, a division of Penguin Random House LLC, in 2019.

Vintage and colophon are registered trademarks of Penguin Random House LLC.

The Cataloging-in-Publication Data for The Body is available from the Library of Congress.

Ebook ISBN9780593312162

Cover image by Phonlamai Photo/Shutterstock

www.vintagebooks.com

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I came to typhoid feverread the symptomsdiscovered that I had typhoid fever, must have had it for months without knowing itwondered what else I had got; turned up St. Vituss Dancefound, as I expected, that I had that too,began to get interested in my case, and determined to sift it to the bottom, and so started alphabeticallyread up ague, and learnt that I was sickening for it, and that the acute stage would commence in about another fortnight. Brights disease, I was relieved to find, I had only in a modified form, and, so far as that was concerned, I might live for years. JEROME K. JEROME ON READING A MEDICAL TEXTBOOK

I

IN THE AUTUMN of 1948, people in the small city of Akureyri, on the north coast of Iceland, began to come down with an illness that was at first taken to be poliomyelitis, but then proved not to be. Between October 1948 and April 1949, almost five hundred people, out of a population of ninety-six hundred, grew ill. The symptoms were wondrously diversemuscle aches, headaches, nervousness, restlessness, depression, constipation, disturbed sleep, loss of memory, and generally being out of sorts but in a pretty serious way. The illness didnt kill anyone, but it did make nearly every victim feel wretched, sometimes for months. The cause of the outbreak was a mystery. All tests for pathogens came back negative. The disease was so peculiarly specific to the vicinity that it became known as the Akureyri disease.

For about a year, nothing more happened. Then outbreaks began to occur in other, curiously distant placesin Louisville, Kentucky; in Seward, Alaska; in Pittsfield and Williamstown, Massachusetts; in a little farming community in the far north of England called Dalston. Altogether through the 1950s ten outbreaks were recorded in the United States and three in Europe. The symptoms everywhere were broadly similar but often with local peculiarities. People in some places said they felt unusually depressed or sleepy or had very specific muscle tenderness. As the disease proliferated, it attracted other names: post-viral syndrome, atypical poliomyelitis, and epidemic neuromyasthenia, by which it is most commonly known now. Why outbreaks didnt radiate outward to neighboring communities but rather leaped across great geographical expanses was just one of many puzzling aspects of the disease.

All the outbreaks attracted little more than local attention, but in 1970, after several years of quiescence, the epidemic reappeared at Lackland Air Force Base in Texas, and now at last medical investigators began to look at it closelythough not, it must be said, much more productively. The Lackland outbreak made 221 people sick, most for about a week but some for up to a year. Sometimes just one person in a department came down with it; sometimes nearly everyone did. Most victims recovered completely, but a few experienced relapses weeks or months later. As usual nothing about the outbreak fit into a logical pattern, and all tests for bacterial or viral agents came back negative. Many of the victims were children too small to be suggestible, ruling out hysteriathe most common explanation for otherwise unexplained mass outbreaks. The epidemic lasted for a little over two months, then ceased (apart from the relapses) and has never returned. A report in The Journal of the American Medical Association concluded that the victims had been suffering from a subtle but nevertheless primarily organic illness whose effects may include exacerbation of underlying psychogenic illness. Which is another way of saying, We have no idea.

Infectious diseases, as you will gather, are curious things. Some flit about like Akureyri disease, popping up seemingly at random, then going quiet for a time before popping up somewhere else. Others advance across landscapes like a conquering army. West Nile virus surfaced in New York in 1999 and within four years had covered the whole of America. Some diseases wreak havoc and then quietly withdraw, sometimes for years, occasionally forever. Between 1485 and 1551, Britain was repeatedly ravaged by a terrifying malady called the sweating sickness, which killed untold thousands. Then it abruptly stopped and was never seen there again. Two hundred years later, a very similar illness appeared in France, where it was called the Picardy sweats. Then it too vanished. We have no idea where and how it incubated, why it disappeared when it did, or where it might be now.

Baffling outbreaks, particularly small ones, are more common than you might think. Every year in the United States about six people, preponderantly in northern Minnesota, grow ill with Powassan virus. Some victims suffer only mild flu-like symptoms, but others are left with permanent neurological damage. About 10 percent die. There is no cure or treatment. In Wisconsin in the winter of 201516, fifty-four people, from twelve different counties, fell ill from a little-known bacterial infection called Elizabethkingia. Fifteen of the victims died. Elizabethkingia is a common soil microbe, but it only rarely infects people. Why it suddenly became rampant across a wide area of the state, and then stopped, is anyones guess. Tularemia, an infectious disease spread by ticks, kills 150 or so people a year in America, but with unaccountable variability. In the eleven years from 2006 to 2016, it killed 232 people in Arkansas, but only one person in neighboring Alabama despite abundant similarities in climate, ground cover, and tick populations. The list goes on and on.

Perhaps no case has been harder to explain than Bourbon virus, named for the county in Kansas where it first appeared in 2014. In the spring of that year, John Seested, a healthy, middle-aged man from Fort Scott, about ninety miles south of Kansas City, was working on his property when he noticed he had been bitten by a tick. After a while he began to grow achy and feverish. When his symptoms didnt improve, he was admitted to a local hospital and given doxycycline, a drug for tick-bite infections, but it had no effect. Over the next day or two, Seesteds condition steadily worsened. Then his organs began to fail. On the eleventh day he died.

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