Karl Taro Greenfeld (KTG) in his book follows the SARS virus from its early beginnings in Guangdong Province (China) in late 2002 right to its end during 2003. He starts off with the rumours flying around Guangdong in late 2002 and then follows the virus around to wherever it goes. He also covers the science effort to identify it and the efforts to contain it.

KTG calls SARS the first pandemic of the 21st century. Perhaps it should be called the first pandemic which didn't happen. The figures of infected people and casualties he quotes at the beginning of each chapter are an approximation only as KTG admits at the end of the book and I can well believe that because when you read about the virus's impact on China you would think that the casualty figures should be higher.

China comes out badly in all this. As official policy dictates that the virus does not exist, it does not exist and therefore it spreads virtually unhindered until official policy changes, which eventually it did. But guess how many lives could have been saved if official policy had changed faster or if it hadn't been formulated in the first place. When you read KTG's bit on how China works you can see that it will happen again. That's the terrifying bit I took home from reading this book. Imagine a virus that outpaces the speed at which bureaucracy moves. We could be all dead by the time they make up their minds.

This nonfiction account of tracking and treating SARS in China is a gripping read. I have read quite a few of these "new virus" books and found this to be one of the best. Not only does it provide a provocative explanation of the conditions under which a virus moves from an animal host into humans, the book also offers a fascinating picture of life in China today.

Given the large population and the impact of industrialization on Chinese culture and living conditions, it's easy to see how a new disease could arise and get out of control very quickly. The immediate response of China's government to the outbreak of SARS was to keep the disease secret and that led to complications that may not have occurred if the government had allowed more information sharing among the world's epidemiologists.

But the most intriguing thing that Karl Taro Greenfeld points out in The China Syndrome is that the strategies that kept SARS from becoming a worldwide pandemic were developed in the 19th Century to control TB and other infectious diseases. In short, before antibiotics there was cleanliness. Hospitals took great care to control the spread of germs and to isolate individuals who had communicable diseases until they were either recovered or dead. Harsh perhaps, but effective. Then came antibiotics and the ability to just kill the germs instead of controlling them. Trouble is, some of those germs have developed resistance to antibiotics over the years and this may have been the case with the SARS virus.

Now that some microbes are resistant to our medicines and vaccines, we find that hospitals can actually amplify disease. Think of it -- A bunch of sick people are collected in one place and that place becomes highly infectious. Who are those most likely now to become infected? Healthcare workers and the friends and relatives who come to visit sick people in the hospital. Thus, the hospital becomes a giant petri dish and the first folks to get sick are the health workers upon whom the ill depend to care for them. It's a bad situation all around.

Using techniques such as quarantine and cleanliness, doctors in China and Hong Kong managed to get the SARS virus back in its box, but no one knows for how long. Where SARS came from and where it might be headed are questions whose answers are yet to be fully nailed down. I highly recommend Greenfeld's book for anyone interested in this and similar topics.

Other excellent books in this subject area are Laurie Garret's The Coming Plague and Survival of the Sickest by Sharon Moalem.

My wife read this book first and urged me to do so. I'm glad I did. As a non scientist, I found Greenfeld's writing and analysis very understandable and riveting. From patient zero, a chop shop employee in one of Hong Kong's teeming "Wild Flavor" eateries, to the pursuit of patients in the steppe of China's rural areas, he has put together a concise and chilling treatise on how fragile life in this world can be, and make you wonder when another killer virus will emerge. I recommend this book to every infectious disease specialist out there and any lay person who wants a great summary on the killers that are waiting for their genetic lottery tickets to get punched.

A fiesta for infomaniacs. Fascinating microbiology, world history, and an especially nice introduction to China today.

Favorite vignette: Q: Is it possible SARS can be transferred from humans to livestock?

A: You will be held accountable for your words!

My wife read this book first and urged me to do so. I'm glad I did. As a non scientist, I found Greenfeld's writing and analysis very understandable and riveting. From patient zero, a chop shop employee in one of Hong Kong's teeming "Wild Flavor" eateries, to the pursuit of patients in the steppe of China's rural areas, he has put together a concise and chilling treatise on how fragile life in this world can be, and make you wonder when another killer virus will emerge. I recommend this book to every infectious disease specialist out there and any lay person who wants a great summary on the killers that are waiting for their genetic lottery tickets to get punched.

I admit approaching Karl Greenfeld's CHINA SYNDROME with a certain degree of skepticism, not about the course of SARS or the research to discover its cause and source, but about the atmosphere created in China by the first great epidemic of the 21st Century. Writing from his Time Magazine base in Hong Kong, I wondered whether Mr. Greenfeld could really capture the various levels of uncertainty, disbelief, helplessness, fatalism, paranoia, and outright fear I experienced living and teaching in Suzhou (about 50 miles west of Shanghai) throughout the winter of 2002 and the spring and early summer of 2003.

Having now finished CHINA SYNDROME, I give the author a perfect 10 for his presentation of the scientific research associated with the hunt for the nature of SARS and its causative virus, a 9 for his detailed rendition of the SARS story at its epicenter in Guangdong Province and nearby Hong Kong, and an 8 for his discussion of SARS in Beijing and Shanxi Province. In each of these areas, Mr. Greenfeld does an outstanding job tracing the arc of the disease from Fang Lin, a meat cutter in one of Shenzhen's exotic animal markets and one of the disease's first suspected cases, to the final suspected case a year later, a thirty-two year old television reporter in Guangdong, with 884 dead and nearly 8,500 infected as the epidemic ran its course. Along the way, we meet a wide-ranging cast of characters, including China's most famous physician, Zhong Nanshan, WHO researcher Dr. Carlo Urbani in Vietnam, the family of Anna Kong in Hong Kong's Amoy Gardens residential complex, one of the outbreak's most virulent sites, Dr. Jiang Yanyong, who blew the whistle on Beijing's false reporting of SARS in the nation's capital, and Hong Kong microbiologists Malik Peiris and Guan Yi, who isolated the SARS coronavirus and identified its host source.

Mr. Greenfeld presents the story of SARS as a series of short vignettes, each centered around one of the players in the SARS story: victim, carrier, doctor, nurse, politician, epidemiologist, microbiologist, WHO member, or his own family. These short, newspaper length snapshots create a sense of immediacy and intimacy; following one on another, they trace out very effectively the multiple simultaneous threads of the SARS story line. The author has clearly done an immense amount of research and interviewing, delivering each person's slice of the story with telling personal details that make these individuals come alive. Rather than being an academic historical accounting of a nearly tragic pandemic, CHINA SYNDROME reads as a story of medical fear and confusion, of scientific drive and frustration, of political calculation and obfuscation, and of selfless (and sometimes tragic) heroism in the face of an unknown danger. And there most certainly were heroes in the SARS battle. Guan Yi literally risked his life to smuggle infection samples out of mainland China; Dr. Jiang Yanyong risked his career to expose Beijing's lies about the seriousness of SARS within the mainland and has since suffered house arrest; Carlo Urbani sent early samples of the infection to the WHO before he, too, died of SARS, effectively giving the entire planet a head start on isolating the virus. The actions of these three men alone certainly saved the lives of countless thousands and helped gain understanding of the disease and how to combat it.

Mr. Greenfeld's story makes all too clear just how fragile and precarious is the line separating civilized society from debilitating viral pandemic. Those front lines are manned by a small cadre of dedicated epidemiologists, microbiologists, and health professionals, including those at the U.N. World Health Organization. It is only by their collective knowledge and vigilance that future pandemics will be minimized or prevented. One cannot read CHINA SYNDROME without experiencing a sense of dread over how close we came in 2003, how lucky we were, and how likely it is that another, perhaps even more virulent virus, can attack us at any time. Equally scary is the realization that China's government appears not to have learned its lesson from the SARS experience, that a handful of self-serving technocrats were, and still are, willing to put the entire planet at risk for the sake of their own political self-preservation.

As for the author's ability to convey the degree to which SARS shut down life in China, I give him only a 4. The dread atmosphere created by SARS receives rather short shrift in the book. Even in cities like Suzhou, where no cases of SARS were reported, life and commerce came to a near halt. Every stranger was suspect, every cough was an alarm, every public surface a risk of infection. I hope I never again experience something that so closely duplicated the atmosphere of Camus's THE PLAGUE, and I was not even living in a city where SARS was present. The fear of its arrival was enough by itself, and Mr. Greenfeld falls a bit short in conveying just how powerful this fear was. I was also mildly disappointed to not see tables or charts showing the number of infections and deaths by country and by province within China at different time intervals; these would have added greatly to the story by illustrating more precisely how, and how widely, the disease actually spread.

On balance, however, I credit Mr. Greenfeld with a meticulously researched, highly readable, and well-told story that will make you realize how much of a bullet we dodged and how easy it would be for the next epidemic to be far worse. I highly recommend CHINA SYNDROME to anyone interested in epidemiology and the prospects for a future global pandemic.

A periodically terrifying, very accessible story of the rise of SARS, its probable origins in the wildlife markets of Southern China, its march through Asia and then around the world, and the Chinese government's attempts to censor and hide the true severity of the disease. I have both personal and professional interests in the ecological impacts of the wildlife trade, and it was edifying to hear Greenfeld's account of how the rise of China's economy in the 1990s led to an "era of wild flavor," in which exotic animals from around the world were thrown together in horrifying wildlife markets, slaughterhouses, and "wild flavor" restaurants. This proves to be an unbeatable environment in which viruses can mutate from one animal host to another, through the relentless pace of viral evolution, and eventually make the zoönautic leap to infect humans.

Greenfeld, who was a journalist and editor for TIME Asia in Hong Kong at the time, makes heroes out of the epidemiologists and virologists who raced to understand the SARS virus and the brave doctors and nurses who treated patients, risking their own lives, while the Chinese government mercilessly censored the story. He intersperses his own story, as he and his family and the journalists he worked with were fearful of their own safety while trying to understand and cover the story. As Greenfeld observes, SARS has by no means been beaten -- it's not clear why the disease roared through China and Southeast Asia in 2003-2004 and has receded since then, since it's still basically uncurable by the medical technologies there. So there is abundant reason to fear another outbreak.

There are some periodic laugh-out-loud moments in the story, surprisingly. For various reasons of political correctness and increased delicacy in the international medical community, for example, it's no longer considered kosher to name a disease after its place of origin. Thus, we'll have no more new diseases like "Spanish flu" or "Ebola virus." But through sheer carelessness or inattention to detail, the coalition of scientists and medical people who named the disease Severe Acute Respiratory Syndrome inadvertently gave it the common nickname SARS - as if they were naming it after the Special Administrative Region (SAR) that the Chinese government now calls Hong Kong and the New Territories, where the disease was first detected. Huh.

Mr. Greenfeld has written an immensely readable, honest, and intelligent history of epidemics past and possible future. If you are concerned about avian influenza and the future threat of a pandemic, read this book. Even if you aren't, read it anyway.