The Outbreak Atlas

Book Title: The Outbreak Atlas

Authors: Rebecca Katz, Mackenzie S. Moore

Publication Details: Vanderbilt University Press, 2024, 330 pp., $24.95 paperback

Public interest in infectious disease reached new heights during the 2020 COVID-19 pandemic as terms such as incubation period and surge capacity merged into everyday vernacular, and debates about vaccine efficacy dominated social media forums. However, while family physicians retooled for inpatient roles and school administrators served as local epidemiologists, public understanding of the evolving worldwide health emergency was plagued with both honest misunderstanding and nefarious misinformation.

In The Outbreak Atlas, authors Rebecca Katz and Mackenzie S. Moore argue that public engagement is essential for a successful outbreak response, and that is predicated on an educated public. Thus, in their 330-page layperson’s textbook, Katz, a professor and the director of the Center for Global Health Science and Security at Georgetown University, and Moore, a doctoral candidate and Wellcome Trust scholar at the University of Edinburgh in Scotland, aim to combat misinformation with a self-described “armchair epidemiologist’s guide to outbreaks” (p. xv).

The book is a descendant of the Georgetown Outbreak Activity Library, an interactive online resource that provides indexed material to respond to all phases of an outbreak. ¹ While the website is designed for the health professional, the book is geared to the interested, nonmedical reader. Given the critical role of family physicians in pandemic response and recovery,² both are useful physician resources.

The authors’ overarching goal is to improve public health literacy by way of an educated public. Beginning with an overview of epidemiology, the book is divided into 15 chapters intended to cover, in order, each phase of an outbreak and recovery. The chapters do not necessarily need to be read in order but rather can be used on an as-needed basis. Chapters include both medical topics such as lab analysis, data collection, prevention, and treatment, as well as logistical considerations such as security, governance, and public communication. Throughout the book, icons in the margin alert the reader to related information in other chapters.

As the book reminds us, COVID-19 was not the first outbreak complicated by misinformation. Regarding the 2001 anthrax attacks, the book cites the ineffective communication between public health officials and providers concerning anthrax diagnosis and treatment, and the inconsistent public messaging regarding the risk and spread of the pathogen. Regarding the 2015 Zika outbreak, the authors examine how the public’s increased information seeking and sharing led to the propagation of conspiracy theories to try to make sense of the outbreak. To help combat such misinformation, the authors lay out steps to help the public identify misinformation, fact check, and spread accurate information.

This book is well-timed because the number of infectious disease outbreaks has more than tripled in the last few decades. In addition to COVID-19, between 2005 and 2022 were six additional public health emergencies of international concern: H1N1 (2009), polio (2014), Ebola West Africa (2014), Zika (2016), Ebola Congo (2019), and Mpox (2022), each of which are examined in the book.

Most compelling are the clinical vignettes and case studies. Using examples such as the 1925 diphtheria outbreak in Alaska, the 2014 cholera outbreak in Ghana, and the 2022 salmonella outbreak (due to contaminated chocolate Easter eggs), Katz and Moore demonstrate key points of an infectious outbreak. The authors also share some interesting trivia: One anecdote reminds us that the widely used t test originated from late 19th century efforts at the Guinness Brewery to increase beer production while maintaining the same quality.

While the book is written for the nonmedical reader—and perhaps used as a freshman undergraduate text—it does serve as a refresher on key terms and general concepts using a shared language physicians may employ when communicating with their patients and their community. Given the importance of a family physician’s effective risk communication during an outbreak, ³ the book’s straightforward language and clear organization make it a useful read for the physician and an excellent resource to recommend to the curious patient.

With the persistence of COVID-19, the annual spread of influenza, and the next unknown pathogen lurking among worldwide travelers, a shared understanding and public engagement are our best allies as we work to educate and protect the communities in which we serve.