Cultures, Carriers, and the Outbreak Narrative


a John Hope Franklin Center Book

More about this series

Book Pages: 392 Illustrations: 11 illustrations Published: January 2008

Author: Priscilla Wald

American Studies, Cultural Studies, Medicine and Health

How should we understand the fear and fascination elicited by the accounts of communicable disease outbreaks that proliferated, following the emergence of HIV, in scientific publications and the mainstream media? The repetition of particular characters, images, and story lines—of Patients Zero and superspreaders, hot zones and tenacious microbes—produced a formulaic narrative as they circulated through the media and were amplified in popular fiction and film. The “outbreak narrative” begins with the identification of an emerging infection, follows it through the global networks of contact and contagion, and ends with the epidemiological work that contains it. Priscilla Wald argues that we need to understand the appeal and persistence of the outbreak narrative because the stories we tell about disease emergence have consequences. As they disseminate information, they affect survival rates and contagion routes. They upset economies. They promote or mitigate the stigmatizing of individuals, groups, locales, behaviors, and lifestyles.

Wald traces how changing ideas about disease emergence and social interaction coalesced in the outbreak narrative. She returns to the early years of microbiology—to the identification of microbes and “Typhoid Mary,” the first known healthy human carrier of typhoid in the United States—to highlight the intertwined production of sociological theories of group formation (“social contagion”) and medical theories of bacteriological infection at the turn of the twentieth century. Following the evolution of these ideas, Wald shows how they were affected by—or reflected in—the advent of virology, Cold War ideas about “alien” infiltration, science-fiction stories of brainwashing and body snatchers, and the HIV/AIDS pandemic. Contagious is a cautionary tale about how the stories we tell circumscribe our thinking about global health and human interactions as the world imagines—or refuses to imagine—the next Great Plague.


Contagious is an informative, enjoyable, and well-researched interdisciplinary work that bridges literary analysis with medical history and goes a long way in explaining our fascination with outbreak narratives. The numerous popular narratives in television and film act as more than examples; they are important ways in which the outbreak narrative establishes a cultural foothold in popular imagination.”
— Shayne Pepper, Journal of Popular Culture

“[Contagious] is brimming with intriguing and thoughtful analysis. . . . It has profoundly influenced how I interpret the disease process in both my own patients and our society.” — Danielle Ofri, Journal of Public Health

“[S]uperb. . . . A model of impressive broadbased interdisciplinary research that draws on popular culture (the novel, film, science journalism, and hygiene manuals), sociology and information theory, bacteriology and virology, and the history of public health, Wald’s book traces with great clarity the complex cultural logic of what she calls the “outbreak narrative” across the long twentieth century.” — Kathleen Woodward, MLQ

“[T]he thesis involving the outbreak narrative is interesting, and readers intrigued by the influence of epidemiology on emerging infections as well as its broader implications to society and the world will find this book worthwhile.” — Stephen B. Thacker, Emerging Infectious Diseases

“It is unlikely that Wald’s cultural critique with its plethora of examples from novels and films offers the kind of data that can alter America’s medical landscape, but thoughtful physicians, nurses, and public health workers who do encounter her book will never battle an ‘outbreak’ without pondering how it might give rise to yet new cultural expressions, symbols, and social relationships.” — Alan M. Kraut, American Studies

“Priscilla Wald's book affirms how the critic's attention to narrative and rhetorical patterns yields far-ranging social insights, as it articulates the ways cultural representations of epidemics have shaped notions of American national community from the late nineteenth century to the present. . . . By pushing the social possibilities of cultural criticism, Contagious is an object lesson in thinking about our own critical practices and theoretical concepts, and how we might reorient and revitalize them.” — Arnold Pan, Modern Fiction Studies

“The book is extremely well written. . . . It is a good book that has given me a new perspective on the outbreak narrative.” — Sanjaya N. Sennayake, Medical Journal of Australia

“The outbreak narrative is powerful but malleable, and Wald’s significant scholarship traces cultural histories of contagion heretofore underexplored, demonstrating their centrality to more familiar American studies and cultural studies concerns. In doing so, she creates a framework in which we can think about, and beyond, the stories of illness that shape living and dying on this earth.” — Bill Albertini, Contemporary Literature

“This book captures the fascinating, complicated, and powerful conventions of the mythico-medical story of disease, global networks, and social transformation through which disease emergence are generally understood.” — Rosemary Cook, Metapsychology Online Reviews

“Wald demonstrates how our narrative tradition has been pervaded by our understandings of disease, and its potential. What emerges is a thorough revision of disease itself that can take into account the variety of social, cultural, economic, political, racial, and geographical factors that shape its transmission, development, and management. . . . Highly recommended to readers of cultural studies and science studies.” — Adam Dodd, M/C Reviews

“Wald does a remarkable job in this book of integrating science, culture, elements of myth and story—all while carefully keeping everything in historical context.” — Cullen Clark, Journal of the History of Medicine and Allied Sciences

“Wald has made a substantial contribution in terms of uniting theoretical insights from such fields as mythology, literature, and film studies, and applying them to the history of infectious disease epidemiology. In doing so, she makes a strong case for the importance of both the cultural critic and of interdisciplinary thinking in the preparation for future outbreaks of global disease.” — Richard McKay, Medical History

“Wald is at her best when probing the literary and historical roots of today’s conventions, homing in on particular moments in the past. She is superb, for instance, in recalling how an immigrant Irish cook named Mary Mallon was deemed a typhoid carrier, recast as the notorious Typhoid Mary, and banished to an island off the Bronx.” — Amanda Schaffer, Bookforum

“Wald powerfully shows not only that narrative is, in effect, the essence of epidemiology, but also that all people in every aspect of their lives make sense of the world through unarticulated structures of narrative. Articulating them, as she has done, shines a bright light outward on a scary world of shadowy threats and inward on ourselves.”
— David S. Barnes, Journal of American History

“Wald shows how the spread of information about disease can affect economies and behaviors, triggering market crashes and creating stigmas. She warns against our tendency to conveniently correlate disease with factors other than poverty and neglect, thus absolving ourselves of social responsibility. Understanding the outbreak narrative, she hopes, will teach us to evaluate the stories we tell ourselves with a critical eye, and perhaps wage a better, more humane war on contagion." — Kacie Glenn, Chronicle of Higher Education

“Wald’s study . . . provides a compelling understanding of the subconscious emotional responses to an outbreak, and should provide an enlightening read for any care provider.” — Erika Larson, Registered Nurse

"Wald describes how the circulation of ideas and attitudes about contagious diseases led people to form social groups and eventually social cultures. Her book is filled with an exceptionally thorough review of varied pieces of information from journalism and films, as well as from real-life scientific events, that will help readers glean perspectives of how disease and outbreak narratives can shape the way people think about their societies and how they relate to others in the face of danger and infection risks. . . . In our interconnected and borderless world, outbreak narratives can endanger or save us." — Suok Kai Chew, New England Journal of Medicine

Contagious is a magnificent book, notable for its prose, its expansiveness, its courage, and its creativity.” — Rita Charon, founder of the Program in Narrative Medicine, Columbia University Medical Center

“Priscilla Wald stunningly demonstrates how epidemics are forms of cultural autobiography, telescoping stories of outbreak and contagion that are reflected in our myths, symbols, archetypes, and social networks. Beautifully written and passionately argued, Contagious is required reading for those interested in learning how our diseases shape the ways we think about ourselves and our relationships and how our desires to be close to other people overlap with our anxieties about being infected by them.” — Jonathan Michel Metzl, author of Prozac on the Couch: Prescribing Gender in the Era of Wonder Drugs

“Rippling across the span of the twentieth century, Priscilla Wald’s book traces the trajectories of ‘outbreak narratives,’ stories about the spread and conquest of contagious diseases. With beautifully crafted prose, Wald shows how the scientific and fictional, social and microbial intermingle as outbreak narratives confront an essential paradox, that human connectedness both imperils and saves us. Contagious is essential reading for science studies, for the field of literature and medicine, and indeed for anyone interested in the social, discursive, and cultural implications of epidemiology.” — N. Katherine Hayles, University of California, Los Angeles


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Open Access

Author/Editor Bios Back to Top

Priscilla Wald is Professor of English at Duke University. She is the author of Constituting Americans: Cultural Anxiety and Narrative Form and the editor of the journal American Literature, both also published by Duke University Press.

Table of Contents Back to Top
Acknowledgments ix
Introduction 1
1. Imagined Immunities: The Epidemiology of Belonging 29
2. The Healthy Carrier: "Typhoid Mary" and Social Being 68
3. Communicable Americanism: Social Contagion and Urban Spaces 114
4. Viral Cultures: Microbes and Politics in the Cold War 157
5. "The Columbus of AIDS": The Invention of "Patient Zero" 213
Epilogue 264
Notes 271
Works Cited 323
Index 353
Sales/Territorial Rights: World

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Additional InformationBack to Top
Paper ISBN: 978-0-8223-4153-6 / Cloth ISBN: 978-0-8223-4128-4
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