Nemesis by Philip Roth (2010)
The Bookclub meeting was held as part of the British Science Association conference on Science Communication, hosted by Manchester Metropolitan University (June 2015). In this case, a more brief meeting than usual was held during lunchtime to demonstrate a typical bookclub meeting. Nemesis was selected for a number of reasons: It is perhaps not the most well known novel about an infectious disease – it is better known for its author. It is relatively brief and easy to read, and addresses the epidemiology of a significant disease of the 20th century, polio.
The nature of the discussion was similar to that of our previous meeting. The book is easy to read, which enabled plenty of discussion. Bookclub members were relatively unaware of the symptoms and epidemiology of polio, and we discussed who had been vaccinated, how (oral, injection, singly/combination), and when. The success of control of this disease is somewhat overlooked – the story might even support the push for increased uptake of MMR. The WHO is co-ordinating a global eradication scheme, but there are parts of the world where comprehensive vaccination is very difficult, for a variety of reasons (the Afghanistan-Pakistan border, and northern Nigeria). Its transmission route means that the disease cannot be eradicated as long as one child remains infected.
The disease is highly infectious: one in 200 infections lead to irreversible paralysis, but the majority of cases are sub-clinical (asymptomatic) or mild: this means that it was difficult for the community in the novel to identify how individuals were infected. The impact of polio on young adults in the UK in the 1950s was similarly devastating. We were able to discuss a range of issues around disease epidemiology, and how it could be used to determine the transmission route, and thence prevention and control.
Some members of the bookclub did not particularly like the book, feeling that the perceived opportunities for spreading infection were too obvious. However, others felt that this was reflecting Bucky’s perception of his own role – whether real or not - in the spread of the outbreak.
The book provided an excellent opportunity to discuss the content of a good novel alongside the epidemiology of a significant global disease, with impact on the general public, and public health. The book would also give ample opportunity for students to explore the epidemiology of polio and the success of immunisation campaigns in the eradication of endemic disease.
Joanna Verran