http://www.gao.gov/new.items/d041098t.pdf
Hickman, D.C. A Chemical and Biological warfare threat: USAF Water Systems at Risk: The Counterproliferation Papers. Future of Warfare Series No. 3. USAF Counterproliferation Center.
ACKNOWLEDGMENTS
Like a river finally reaching the sea, the contents of this book come from many streams. Among those sources, four in particular made this book possible. I am profoundly grateful both to my agent, Nat Sobel, for taking on the first book of an academic and providing advice and encouragement during its conception; and to my first editors, Dan Conaway and Jill Schwartzman, for their belief in me, their patience during the creation of the book, and their wise editorial input. As the book moved into its final reaches, Jeanette Perez joined the project, picked up what had become a double orphan, and carried it to the finish with skill, intelligence, and enthusiasm.
Many friends, colleagues, and mentors helped lay the foundation for this book. During my training and the early stages of my research on water, Tom Chalmers and Fred Mosteller (now both deceased), Bill Hendee, Al Rimm, and Kwang Lee provided support, advice, and wisdom. Research is a team effort, and my research could not have happened without the help of a host of graduate students and research colleagues, including Rajika Munasinghe, Chao Zhang, Ria Chubin, Italo Angelillo, and Melanie Miller. I am also deeply grateful to those in the fields of drinking water and epidemiology who believed in me and stood behind me when others did not; these include Devra Davis, David Ozonoff, Doug Dockery, Ronnie Levin, David Hoel, Tony Miller, and Tony Robbins.
Special thanks must go to Anne Marie Audet, for her work on the meta-analysis described in the book, and to Bruce Kupelnick, a most remarkable man, who not only helped with my work on meta-analysis but also provided input on the early stages of this book. Elena Naumova, a fine statistician and a generous spirit, played a key role in my subsequent work on drinking water and human health. Others who read the manuscript at various stages and provided valuable input include Kris Morehouse, Charlie Booth, and in particular my sisters Virginia Morris and Tina Raymond. I must also thank the students at Harvard School of Public Health, whose feedback on a series of lectures on drinking water and public health helped shape and inspire this book.
I drew on many libraries and sources to complete this book, but I am particularly grateful to the staff at the National Library of Medicine, Harvard’s Countway Medical Library, the Libraries of Gonzaga University, and the University of Washington and the town of Boonton. David Zuck, the John Snow Society, Margaret Pelling, and James Symons also provided key resources and assistance. I am also indebted to Scott Davis and the Department of Epidemiology at the University of Washington for appointing me as a visiting scholar during my work on this book. This book was written in hundreds of places, but I must acknowledge my friends at the Spike Coffeehouse, the Rocket Bakery, and the Verite Coffeehouse for their many fine lattes and friendly conversations (not to mention the Spike’s killer ginger peach smoothies).
I also want to thank the people who took the time to provide interviews concerning recent events. Les Roberts, Ron Waldman, and John Morris shared their experiences in Goma and with cholera. The story of Milwaukee relied on the patient input from those who were there, including Tom Taft, Paul Nannis, Steve Gradus, Tom Schlenker, Paul Biedrzycki, Liz Zelazek, Jeff Davis, Sandy Schroederus, Kathy Blair, Don Behm, Eugene Marks, Kate Foss Mullan, Doug Nelson, Steve Hargarten, and Cathy Miller (whose detailed notes taken during the outbreak provided a critical accurate record of events). Kelly Mullholland and Sara Bott provided essential help on my trip to New Orleans.
Tim Ford, Joan Rose, Erik Olson, and Jeff Foran not only provided essential input in the form of interviews, clippings, and feedback, but have also been wise and wonderful professional colleagues. Colleagues other than those mentioned above whose thoughts, comments, and witticisms have contributed to this book include Dennis Juranek, Joel Schwartz, Ephraim King, Cynthia Dougherty, Kim Fox, Rosemary Menard, and Steve Estes-Smargiassi.
My family has weathered many storms during the course of this book, and I must thank the host of people who helped us through. The fine doctors and nurses of the children’s hospitals in Spokane and Seattle saw us through the worst of those storms while many fine women helped our children (Beverly, Lisa, Amy, and Kat deserve special thanks). Family and friends also stepped in to help, particularly Klara, Mimi, Christiane, Marjorie, Charlie, Lindley, and Corrie.
Above all, I must thank my family for their unwavering support. Darwin, Hana, Skyler, and Sage maintained a remarkable spirit through difficult times and were patient all those times I was too busy to play. Astrid, my wonderful wife and challenging first reader, made all of this possible. Without her, this book would not be.
PRECAUTIONS AGAINST CHOLERA.
Apply for medicine immediately to stop looseness of the bowels, or it may bring on cholera.
Do not take any strong opening medicine without medical advice.
Beware of drink, for excess in beer, wine, or spirits is likely to be followed by cholera.
Drink no water that has not been boiled; and avoid that which is not quite clear and well tasted.
Avoid eating meat that is tainted, decayed or unripe fruit, and stale fish or raw vegetables. Cooked vegetables, or ripe and cooked fruit, in moderation, are a necessary part of diet at all times.
Avoid fasting too long; be moderate at meals.
Avoid great fatigue, and getting heated and then chilled.
Avoid getting wet, or remaining in wet clothes.
Keep yourself clean, and your body and feet as dry and as warm as your means and occupation will permit.
Keep your rooms well cleaned and lime-washed; remove all dirt and impurities immediatately.
Keep your windows open as much as possible to admit fresh air; and, if necessary, use chloride of lime or zinc to remove any offensive smells.
If there are any dust or dirt heaps, foul drains, bad smells, or other nuisances in the house or neighborhood, make complaint without delay to the local authorities having legal power to remove them, or if there be no such authorities, or if you do not know who they are, complain to the Board of Guardians.
About the Author
DR. ROBERT D. MORRIS is an environmental epidemiologist and a leading researcher in the field of drinking water and health. He has taught at Tufts University School of Medicine, Harvard University School of Public Health, and the Medical College of Wisconsin, and has served as an adviser to the EPA, CDC, NIH, and the President’s Cancer Panel. His work has been featured in the New York Times and the Times of London, and on Dateline NBC and the BBC. He lives in Seattle, Washington.
www.TheBlueDeath.com
Visit www.AuthorTracker.com for exclusive information on your favorite HarperCollins author.
Credits
Jacket design © 2007 by Sean Lien
Jacket Illustrations:
Cholera © Dr. Dennis Kunkel/Getty Images
Water © Digital Vision/Veer
Copyright
THE BLUE DEATH. Copyright © 2007 by Dr. Robert D. Morris. All rights reserved under International and Pan-American Copyright Conventions. By payment of the required fees, you have been granted the non-exclusive, non-transferable right to access and read the text of this e-book on-screen. No part of this text may be reproduced, transmitted, down-loaded, decompiled, reverse engineered, or stored in or introduced into any information storage and retrieval system, in any form or by any means, whether electronic or mechanical, now known or hereinafter invented, without the express written permission of HarperCollins e-books.
EPub Edition © JUNE 2007 ISBN: 9780061850257
10 9 8 7 6 5 4 3 2 1
About the Publisher
Australia
HarperCollins Publishers (Australia) Pty. Ltd.
25 Ryde Road (PO Box 321)
Pymble, NSW 2073, Australia
http://www.harpercollinsebooks.com.au
Canada
HarperCollins Publishers Ltd.
55 Avenue Road, Suite 2900
Toronto, ON, M5R, 3L2, Canada
http://www.harpercollinsebooks.ca
New Zealand
HarperCollinsPublishers (New Zealand) Limited
P.O. Box 1
Auckland, New Zealand
http://www.harpercollinsebooks.co.nz
United Kingdom
HarperCollins Publishers Ltd.
77-85 Fulham Palace Road
London, W6 8JB, UK
http://www.harpercollinsebooks.co.uk
United States
HarperCollins Publishers Inc.
10 East 53rd Street
New York, NY 10022
http://www.harpercollinsebooks.com
* For the remainder of the book, the term cholera will refer to the modern definition of the disease unless otherwise specified.
* Some of the towns mentioned were relocated and exist today at new locations.
* Lines of dialogue are drawn either from reports of government hearings or from Colin Perkel, Well of Lies (Toronto: McClelland and Stewart, 2002).
* Since this is likely to be the most controversial of my suggestions, allow me to explain my thinking on POU filters. Properly installed and maintained home filters provide an extra measure of protection, yield water that is superior to tap water, and are often safer than bottled water at one tenth the cost, with far less environmental impact. They can eliminate pathogens that our treatment plants fail to remove and can remove chemical contaminants including the by-products of chlorination that most water supplies leave in the water. They can also protect us against contaminants that enter through flaws in our aging distribution systems. Finally, if terrorists choose to attack our water supplies, home filters add an extra measure of protection.
Although they lack the economies of scale offered by large treatment plants, they allow us to focus the highest level of treatment where it is needed most, the water we drink. Less than one percent of the water that flows into our homes is actually ingested. Treating our public water supplies to the highest level possible just so we can water our lawns, wash our cars, and flush our toilets with pure drinking water is, quite literally, pouring money down the drain. In some small communities it might make sense to have a separate communitywide system for delivering drinking water, but this is not practical for most cities. The universal use of properly chosen POU filters based on either ultrafiltration or reverse osmosis coupled with carbon filtration for a home’s drinking water could all but eliminate the risk of waterborne disease.
Can we justify the cost of putting a water filter into every home? Can we count on people to maintain those systems? In fact, many homes now have water filters, but they are installed in a haphazard way as a function of the household’s income and level of concern about the quality of their municipal drinking water. Furthermore, this has been done independent from the drinking-water utilities. As a consequence, POU filters have never been seen as part of the overall system for providing safe water.
The involvement of utilities in the selection and installation of POU water filters would have several advantages. First, it could ensure a level of uniformity in the quality and efficacy of the systems used by consumers. The utilities could also ensure that water filters are properly maintained. Second, it could be viewed as an integral part of the overall treatment system. Utilities could have confidence that occasional occurrences of accidental, incidental, or intentional contamination would have little if any consequence. Furthermore, chlorination by-products could be more easily controlled without concern that reduced chlorine would cause an outbreak. Third, the involvement of utilities could ensure that high water quality is not limited to those who can afford to install and maintain a system. By leasing or renting the filters to consumers, just as some utilities rent water heaters, utilities could spread out the cost of pure water for the consumer. Utilities have tended to look askance at home water filters as the unnecessary product of public health paranoia. We should remember that every waterborne outbreak described in this book could have been prevented by the universal use of POU water filters.
The Blue Death Page 32
