>> host: thank you, kathy. >> guest: yeah, thank you for that question. ultimately,s it is going to be american citizens who decide whether or not we give a too citizenship to undocking united people, right -- undocumented people. if i was creating policies, what would those policies be, and as an american citizen myself, i believe that people who have been in this country on average ten years is the average number of years that undocumented people have been in this country, who have made this country their home and who are contributing to the country economically and socially and culturally, i as an american citizen do believe they should be be given a path to citizenship. ultimately, it's not them who decide because they don't get to vote. we as american citizens get to vote on those policies and get to vote on who our representatives are who decide those polices julissa arce iss, the author of this book, became a wall street executive, shest became a citizen in august of 2014. pick up the book to find out what that process was like. thank you for being on booktv with us, and outside this gallagher theater where we've been live all day, a lot of activity, a lot of people, a lot of book selling going on. another beautiful day down here in tucson. another author panel is just about to begin. this is on epidemics. live coverage on booktv. >> good afternoon. welcome to the ninth annual tucson festival of books. my name is matt russell, i'm the ceo of russell public communications, and it'll be a privilege for me to moderate this session this afternoon. i'd like to thank cox communications for sponsoring this venue, mr. mcneil is sponsored by research corporation for science advancement and mr. shurkin, the presentation will last an hour. please hold your questions until the final part of the program, and we will manage the questions from the floor. immediately following, mr. mcneil will be autographing his book in the u of a bookstore tent on the mall, booth 141. books are available for this. mr. mcneil will be about 20 minutes late to the signing area due to a live interview with c-span following the program, and i do want to say hello to our c-span television audience who's watching live right now. we hope you're enjoying the festival and invite you to become a friend by texting friend to 520214 book, 5202412665 as shown on the sign at the front of the room or visit the friend of the festival booth, number 110 on the mall. of course, your gift makes a difference this keep -- in keeping festival programming free of charge and supportingdi critical literacy programs in the community.cy program now, out of respect for the authors, i ask you to, please,u turn off your cell phone as i introduce our paneltists this afternoon -- panelists this afternoon. joel shurkin is the author of "the invisible fire: the story of hand kind's triumph over the ancient scourge of smallpox." book came out this 1979. although you might have seen him speak about his latest book, "true genius."the book a lot of people now have heard of it, and they're talking about it today. joel is a freelance writer inr baltimore, he is a former p science writer at the philadelphia inquirer and was part of the team that won aa pulitzer prize for covering three-mile island this 1979. that same year he also won the national association of science teachers best children's science book, award for his book jupiter, the star that failed. he has ten published books, and he taughting journalism at -- taught journalism at stanford, the university of california-santa cruz and the university of alaska-fairbanks. we're also privileged to have don mcneil with us who has written "zika." he's a health reporter for "the new york times"es specializing in plagues and pestilences. [laughter] he covers diseases of the world's poor be including aids,i ebola, malaria, swine and bird new, mad cow disease and sars. he joined the times in 1976 as a copy boy ask has been an environmental reporter, a theater columnist and an editor. i'd like another hour for this session, please. [laughter] he has won awards for stories about cities that have successfully fought aids, about patent 40 monopolies that keep drug prices high in africa and about diseases that cannot be eradicated. this afternoon we're talking about epidemics old and new. a round of applause, please, for our panelists this afternoon. [applause] now, gentlemen, before we really dig into these diseases, i'd like to invite you to offer some introductory remarks about your works that we're talking about here and really what you set out to accomplish with them. joel. >> this is a well hone the phenomenon among journalists -- known phenomenon known as the medical writers syndrome that when you write about a disease, you get all the symptoms of it. [laughter] you must have a hell of a life. i wrote the book about smallpox at the time when they had announced it had been e rad indicated. it turned out they were wrong by a couple months, but what the hell. smallpox is, was -- past tense -- one of the worst epidemics this history. we think as many as half a billion people died from it. and they did not die nicely from it. it was a terrible disease. sometimes it would be this and out in two or three days. you'd be perfectly well walking down the street, and you were dead the next evening. it's carried by a virus. to this very day, there is no cure. fortunately, there is no disease. one of the things i did, one of the reasons i liked the book is because it was an awful lot of fun to write. i'm sorry, but it was. i managed to go to somalia where i interviewed the last human being ever to catch can smallpox. there was an accident in a laboratory in london a couple years later that killed several lab workers k the lab chief committed suicide shortly thereafter. but the ambulance driver in somalia was the last human being to catch smallpox. i had a son who was 47 who has the same scar that i have, i had it, it's here someplace. the smallpox scar that every child in america, every child the western world got. i have a son who was five years younger who has no scar because in the interim, they stopped the vaccination. the virus itself still exists.s. it's in a deep freeze in atlanta at cdc, and the russians have a sample, and nobody knows exactly where. as long as they stay in the deep freeze, we're safe. if it ever gets out, we are in very serious trouble. >> donald, do you have the scars of medical writers' syndrome? >> just a little while ago is went to the doctor, i had been feeling really lousy. i was getting recurring fevers every afternoon. i had come back from colombia where i can was covering zika and thinking, oh, i couldn't have gotten so unlucky, the doctor heard me cough and said, oh, get up on the table. took one listen to my chest, and he said i know what you have, i'm sending you for an x-ray. i had pneumonia, but i had diagnosed it, of course, as zika. and i had a whole list of other diseases i could have diagnosed it as. [laughter] so the book i've written is about zika. i've actually been covering diseases mostly of the world's poor, but all infectious diseases since 1997 when i was a correspondent in africa. i started covering aids there, that's how i shifted over from being a broadway theater correspondent to being a news -- i mean, a science news person when i came back from overseas. about ten years ago, a colleague and i wrote a whole series about diseases on the brink of eradication which is actually more germane to this discussion than zika is because zika is just beginning in this hemisphere. we're going to see it around for quite a while, i think, it'll be a long time before anybody thinks about eradicating it. people don't know about this one pause it's an animal disease. it kills animals. and that may not seem important, but you're in east africa in the 19th century when the disease finally reached africa with mussolini's troops, it wipe out all the, virtually all the hoofed game and all the cattle in west africa and a third of the horn of africa starved to death. and the disease -- it was eradicated a few years ago by the efforts of a lot of hard working veterinarians who finally realized they had to stop tackling the cows because it panicked the animal, and they trained the herders to just gogo through the herds and stick them with the vaccine. you know, celia dugger and i, my partner, wrote about polio, guinea worm, measles, elephant itis and iodine deficiency, and once you have a solution, once you have a good, working vaccine that provides long-lasting protection which many diseases do not have, once you've got a good solution, it's relatively easy to get the first 99% of the disease , and be it takes years, sometimes decades. we have been tighting polio. the -- fighting polio. the effort to fight polio was started by rotary international back in 1988, and it was going to be their millennial gift to the world.ft they raised $200 million and got it down to more than 99%, and we're still fighting polio, and bill gates is putting about a billion dollars into the fight a year. it's like squeezing jell-o to depth.o when you think you've gotten it, it pops up. two years ago, we thought it had been eradicated this africa, and cases popped up in northern nigeria last year. there's war going on, you can't get in to vaccinate, and you can't do the testing to find out whether people have it. there's a pocket of polio in northern nigeria where boko haram and the nigerian government are fight being it out, and we also know it's onn the border of pakistan and afghanistan in sort of the no-go areas along there. it's a combination of war and also just bad luck sometimes. in guinea worm, there are very few pockets left in the world,d, but only recently it made the jump from people into dogs. the dogs picked et up from fish guts, and now they've got more cases this dogs than people, and the dogs reinfect the drinking water where the people pick it up from, so there's going to be a whole new struggle over that. so you can see it's a long, complicated, discouraging effort. every disease is different, and, but it's fascinating to write about them. >> thank you. we're going to get to the heart of the battles with these diseases this just a bit, which i think have all of the makings of a major hollywood thriller x. as you're going to hear, there's even some lying, cheating and stealing that has gone on in the course of that. but let's start before the pen even hit paper. of joel, the first case of smallpox was reported thousands of years ago. ago wit we e eradication and victory declared more than 40 years ago, i'm curious, how did you get your head around researching this disease that literally changed history? >> it was my job. it fascinated me. smallpox is actually an easy disease to eradicate relatively speaking. it has several characteristics that polio, for example, does not have or zika probably does not have. i was watching television, and they made the brief announcement that smallpox had been eradicated, and i said, my heavens, there's a book in there. it turned out there was a book in there. i traveled all around the world to report it. i must say, i had an awfully good time doing it. we pent some time in northern -- spent some time in northern india demonstrating to the people who lived that there that the vaccination was painless, it wasn't a big deal. we'd go like this and stab our arms. i am now about the most immune smallpox be human being finish. [laughter] or pretty darn close to it. it was a challenge, and the people who were involved with it were a challenged as well. the book is somewhat controversial. there are timeses when the virus was not the enemy, the bureaucracy of the world health organization was the enemy, and you've heard of lying, cheating and stealing. the people who were out in the field kept running up against the world health organization repeatedly and learned to get around the bureaucracy. i should add that d.a. henderson who was the man who ran the smallpox be program -- who died just a couple of months ago, by the way -- blames me and my book for their not getting a nobel prize for medicine. i hope he's not right, because they honestly deserve it. >> what about you, donald? zika didn't really hit the global scene until 1947 in uganda, so one might assume you had a bit of an advantage over joel since you only had to pore, what, 70 years of stories? >> and there were very few stories, it was discovered in 1947 in a monkeying with in a cage hosted in a tree in the impenetrable forest in uganda, but then it disappeared x there weren't tests for et for a long time. -- for it for a long time. it somehow left asia and started crossing the south pacific, and there was an outbreak in micronesia that the cdc investigated. that we fought over in world war ii in the japanese. there are some services that the united states still provide to the micro islands. there were no serious side effects. they didn't notice anything. it was a mild disease. then it turned up in polynesia back in 2013 and there it was pretty well investigated. a race of the population 66% 6% of the population were infected in six months and they did notice and uptake in cases of temporary blouses. but terrifying paralysis. they did notice anything about babies. it was only when the disease got to brazil that it the brazilian some month problems going on. then they were relieved. the health administered that this was good news. it turned out to be zika and were not worried, that's a mild disease. it was only in late august, early september in the northeast where they had a tremendous epidemic of zika, nine months before the doctors that worked in the intensive care unit, it began to talk to each other and say there's a mother and daughter team that worked in hospitals and said hey, i normally see one or two sick babies and i have five in my word right now. her daughter said i had seven. they called other doctors and realized that something had happened. they looked at the mothers and said that a lot of them head zika symptoms five months before. in my case, i had heard heard of zika two or three months before because i got a phone call out of the blue from a population person for the university of texas medical branch and he said hey, there's a doctor here would like to talk with you about bengay. i should be writing more but they been around more and i have a lot of things to do. he said there's this other disease called zika. that's a catchy name. what is a? i ended up talking to the doctor and he told me that some of the background of asia in front polynesia and the fact that there's but there's no mention of microsoft list. as i took notes and i signed them, dated dated them put them in my head file of things i'm going to get to when i can get to this file which is a must do it now pile and it was in the week after christmas last year and a slow news week and i was waiting for an item that i'd read 300 word column i read read every week along with every other coverage and saw out of brazil a notice saying the health administration asked women stop having children. that made my antenna stood up meanly. you never hear that kind of thing. yes, china had the one child policy but i never have another country asking the mothers do not have children. the thought policy you want to have. if you keep it up there won't be any more brazilians. i called the only doctor i knew in brazil and asked if this was true. it's terrifying and we don't know what it is but we have a horrible el niño year, last year and lots of lots of mosquito bites and we don't know what disease zika is caused, we don't know what other disease is the mother had we don't know much about diseases. were still trying to figure it out so i wrote a story that day, december 209 and we called our bureau tree and he and i collaborated a day later. that's how we got off the back sounding the alarm and the battle cry. we won the smallpox battle in the late 70s and it's said that the engagement was more like conventional warfare. can you talk about that chris martin one of the weaknesses it goes from person to person. it doesn't hide in birds, it doesn't hide in animals, itt doesn't fly around with mosquitoes. so if you could break the chain between one infection and another, you stop the unnext. the standard way of doing it was to vaccinate everybody around. now, give some thought to the idea of vaccinating everybody in india, everybody in bangladesh or pakistan or nigeria. clearly, it doesn't work. it works in western countries. small ox was unheard of -- smallpox was unheard of in the western hemisphere by the mid old the -- middle of the 20th century. somebody figured out that you didn't really need to do that, it was impossible to do that. what they found out was if you had a case of shawl pox, you would -- smallpox, you would find think person who had any contact with that person, and then you'd draw a circle aroundr them and vaccinate anybody within the circle. town a would be vaccinated and its surroundings. that broke it. that was how it was done. they also had several other advantages, other decides do not -- diseases do not have. the vaccine itself goes back to 1769 and edward jenner whonn discovered that dairy maids would get sores on their hands called cow pox, and why they had cow pox be, they never got smallpox.ou what would happen if you take the material from the sores on their hands and gave it to somebody, would that give them immunity as well? they did it to a 7-year-old boy. he inswrected some cow pox and put it on the kid's arm, and then deliberately put vaccine -- virus from the smallpox into another wound later on to watch what happened, and what happened was nothing. he was immune.te so, a, you had a very good vaccine. second of all, you could freeze-dry this vaccine. it wasn't wet, it did not need refrigeration. you could care carry it for months in the desert without having to worry about electricity.ey they also invented a bifurcatede needle which means you didn't have to actually unjekyll it. you would -- inject it. would they'd put police lean -- glis lean into the fluid. required. emotionally doesn't hurt, i can tell you from that from experience. we learn to smile as we did the. [laughter] those characters do not exist in any other disease. once they got those things organized and wants the people from cdc and the world health organization figured out the way of isolating potential victims that's what they do. >> that's the war that was one. worse still, donald engaged in war with zika. two days ago the cdc updated its travel guidance that recommended that pregnant women not travel anywhere there is zika virus. what is today's bona fide and zika look like chris mark. >> is a little unclear because it's still cold. we been through your one from my.of view we did very badly, were feeling zika. the advice to women to simply wear deeds and long sleeves is not enough. not a single city in the western hemisphere except miami is like blowing flog out of the back. the mosquitoes live in very close proximity with people. you have zika about 200 miles of the south of tucson. sometime in the near future it will be here. it may be a race between the virus in the vaccine. it's mostly a mild disease but it is completely devastating to fetuses. it's extremely dangerous for pregnant women to get it. what upset me is that neither the cdc nor the who would clearly speak out and say, if you can avoid getting pregnant during the high season of zika transmission in your town, please avoid it and we will help you avoid it by getting new contraceptives. the cdc was actually speaking contraceptives and puerto rico in large amounts but it wasn't saying anything about it. it said that they should talk to their own doctors. many women don't have doctors before they get pregnant. it's actually true that it's difficult for women, teenagers to prevent any pregnant. it's never been true that it's been impossible for every buddy. the other thing they should have talked about with abortion. there are countries in the hemisphere where abortion is legal and for the mothers -- you may have seen a story in the new york times today, she spent time with three mothers who had zika babies and these babies cannot make eye contact, they will never have anything like memory or thoughts, they often are cramped up like this, they're actually at a fair risk for death because of aspiration, pneumonia, or constant seizures. had those had those mothers been able to choose, some may have chosen -- and that should have been made clear and available to them. no one should force anyone to have contraceptives or abortion but it should be discussed. those agencies refuse to do that. i think of the real public health failure. i don't know anyone who's been able to back as the case in these battles, were talking about the whole as a disease. how ironically, they find themselves battling with the science itself. we'll get to who in a minute but i want to get back to that but let's talk about the world politics pla >> actually it was one of the shining moments of politics.n this was during the cold war, so we were antagonistic to the russians.. we and yet the group of people that i hung around with at the world health organization comprised from just about ever country in the world, and they were all actually cooperating. the russians were helping the americans, the americans were helping the russians. the guy who was leading me around was czech. this was the time when check czechoslovakia was a communist country. the money was available. smallpox had gotten to the point where -- and this happens with many diseases -- it became a childhood disease. children would get it. they would die or wouldn't die. if they didn't die, they were immune for the rest of their lives. so it became relatively easy to keep them out of the country. the united states spent millions and be millions of dollars to put people at every port of entry to look for someone coming in with smallpox. it was one of the best exampless i know of of international cooperation and could not have been done without it. >> donald, you and i were talking just before the session, i shared with you some to of my own experiences doing a lot ofe nih appropriations work.k. from a funding perspective, you've said fighting some diseases becomes a fad and fighting others doesn't, and that just doesn't seem rational. can you talk about that? >> okay. more people of tuberculosis than almost any other disease in the world, but tb, for some reason, has lost its fetishness. there is a u.n. aids that specializes in fighting aids. the tuberculosis and aids epidemics are linked because it's often people with immune systems depressed from hiv that end up dying from tuberculosis. but that's a disease that is out of fashion, whereas there is a great deal of money spent on aids, breast cancer gets a great deal more money than other kinds of cancer because it's, because it becomes politically popular, it becomes a cause. flu is always pretty well financed. worm diseases around the world are completely ignored. and diarrhea and pneumonia kill most kids under 5 around the world. fighting diarrhea and pneumonia means fighting a whole lot of different things that cause those, but you don't hear the attention paid to it and you don't see the fundraisingef efforts from individuals or countries.tr when a disease like polio catch on, and it's often one group like rote9ly decides this is our disease, we're going to get rid of it.e i'm in favor of fight being all diseases, so i'm not saying we ought to leave this disease alone, but it definitely is true that some diseases get a lot more attention because there's, essentially, a sort of -- they become the hip disease to fight. >> have you seen that weave its way through the public sector as well as the private sector in terms of funding? >> they all go along. i it's a combination of newspaper cover am, advocacy leading to newspaper coverage leading to attention to congress. >> the world health organization. we could do an hour and a half on the w health care o -- >> that's right. i did 300 page offense it. [laughter] >> joel, you've said they were both the hero and the villain in your book. i want you to expound a little bit. sounds like there's a bit of drama in this dichotomy, yes? >> yes, there was drama. the world health organization is a very, very large bureaucracy. it is my pet theory based on no facts whatsoever that the reason they're the way they are is because they're based in geneva, switzerland, on this gorgeous hill with a lawn and beautiful tree, and the people who work there call themselves internationalists. for one thing, they don't pay any taxes to any country, and their country is the world. i always thought if i took a kid with scabies and put them on the front hawn to remind them of what they're supposed to be doing, the world would be a better place. the people who are out in the field spent a great deal of their time trying to get the course resources they needed and the permissions they needed to do what they needed to do. for example, they needed more trucks and be more jeeps in india, and for some reason or another the people in geneva decides they didn't need more jeeps and more trucks. so they stole them. and when when they were done with them, they returned them tn wherever they stole them from after they were done inoculating people. there was a woman who i'll never forget, very, very lovely, stately woman who, like many international travelers, internationalists, had exactly two dresses. she would wear one one day, wash it, wear the second, the second dress the second day. and this is how she went through life, because she was always out in the field. and she told me how she'd learned when necessary, she could learn to cry. she would go up to a bureaucrat, the bureaucrat would say, no, you can can't do this whereupon she would, on cue, weep. [laughter] and she swore to me she always got what she needed to get. k in geneva, was so bad that when the book did come out that anderson try to disown what he told me. i had it on tape and actually do that. the world health organization did not get a nobel prize which they deserved but they were sabotaged. >> if you're talking about the world 80 affirming grin you said that the world health organization despite its importance in stopping economics is essentially powerless. how will it impact the fight? >> let the tweeting begin. the big deadline. >> at the time people have occasionally said let's we want to do something big in the gate foundation. if the 800-pound gorilla of global health. shouldn't we look at into the problem of causing it? yes it has become the 800-pound gorilla but the truth is the 80e it was the 800-pound float called the world health organization. it absolutely needed someone else driving it. at the same time, the world health organization actually has a tiny budget, two-point to billion dollars. i'm writing a piece about the race for the director general of global organization. the first time the electing cause i democratically. they have 8000 employees. they haven't $8.2 billion 2 billion-dollar budget which is a quarter of the cdc's budget and half the new york post at syrian hospital. the employees, many of them are scattered in local offices and regional offices. there's a great deal of time wasted in battling back and forth with local and regional offices in geneva and they often don't do what people want to do. they had terrible leadership problems. three quarters of their budget is not from un dues but from donations. the united states, great britain, melinda gates, norway, japan and other powers give them three quarters of their budget and that comes with strings attached, i've heard a who call it a straitjacket. you can spend it on this but you can't spend it on this. one of the things that the money gets spent on, proportional polio. that's formally the rotary pet project. i'm in favor of eradicating polio but it takes up a lot of time. at the who is essential for doing things like biting ebola. they did a bad time, it took them months to get them cranking, doctors without borders was fighting the disease alone in africa. the who used to have teams, rapid teams, rapid response team that would leave geneva to tackle ebola after. they isolated patients by burying the dead and by decontaminating them with bleach. but the last one in 2014 got away from them and the people who fled from the villages where the epidemic, fled to the capitals. the disease began to spread from the capitals and from that.was out of control for quite a while >> in the field in central africa, you are living in tents, driving a jeep i imagine what the weather was like we have steak, we have alligators, and you are having a pitched battle over postage stamps. >> at the same time, the who is the only organization i can declare a public emergency which you need to do to get it alerted. it gets a lot of countries cranking there own equivalent cdc to fight the disease. also, when you have an epidemic they oversee the coordination of the network of laboratories, national laboratories and sometimes state laboratories around the world, making them share virus samples with each other so that you have a sense of what's happening and what direction it's moving in. in the age of debt travel is very important. the who -- countries don't like to report that they have diseases. bill cover up diseases, they don't like to report it because it means either business travel and, terrorism or you can no longer export food from your country if your reputation is bad. if they wound here national pride to say that yes we have this horrible fatal disease and we can't control it. countries often don't report as members of the united nations and the who have to report. it takes a while for the who to beat it out of them but they managed to get the news out. also, when you fight want to fight an epidemic you need hundreds of doctors flying in, countries in west africa had a cup couple hundreds of doctors and most of them died in the first wave of the epidemic. when the cdc sends a hundred doctors to a to the scene very often those doctors and military uniform, there in in the military or the public health service and when then several hundred troops from another country land in your country, your national pride can be wounded quite a bit if you're sierra leone or libya or guinea. the fact that the who is medical peacekeeping troops rather than doctors is the important psychological effect to being able to fight the academic. >> we talk about the news, and is a public representative, the media is an important group and i respect your nod to the public relations, it was smallpox was eradicated before mobile devices, blogging, blogging, tweeting and in the absence of a digital derivative media what role did the media play in the 60s, 70s, 80s. >> none that i can think of. >> is a good thing or a bad thing? >> good thing. smallpox had disappeared in europe. it had disappeared in north america. pretty much disappeared in south america by the 1970s. certainly not in japan or china but it existed in undeveloped countries and we tend to ignore undeveloped countries. we were very careful in keeping people who might have smallpox by guarding our borders. some of you may be old enough to remember traveling overseas and you had to carry little yellow card that said you been vaccinated with any number of things including smallpox, actually actually. when you got off the plane from london one of the things they wanted to see was your passport in health certificate. it worked. there was an occasional case in new york city and in every single instance it was someone who came from overseas who was carrying the virus with them. by and large, the underdeveloped world had and we weren't paying attention. >> certainly we were paying attention to zika last year. we had surroundsound as a media perspective. olympians deciding whether or not to go to rio. daily headlines on the battle and $1.1 billion to spray south florida and provide health care at torrey in the territories and i can see that you might be biased but did the media change? >> since i kind of started it at yeah, i think we were game changers. i was sort of shocked when i realized, you know, when i saw that -- i mean, i was just casting around for an idea for a column, and i suddenly saw this news item. it was a local cnn affiliate in brazil that finally picked it up and was mentioning the tate of emergency, and i called the cdc and said what about this? and i looked immediately on their web site, and they said, oh, somebody will have to get back to you tom. and i said -- the you tomorrow. and i said why isn't there some sort of travel advisory for pregnant women? basically, we haven't talked about it yet. and i kept -- i mean, as i reported on it, the cdc kept making -- i got to the point where i was getting phone callsw from pregnant women calling me saying, look, i don't know what to do, i'm supposed to go to a family wedding, i'm three months pregnant, and i'm on the phone going, ma'am, i'm a reporter with a b.a. from rhetoric. you should get medical advice. my doctor seems to think it's fine, but there's been no guidance from the cdc. good god, no, don't go, as far as i can -- [laughter] and i do not understand why the cdc is not putting out a warning, and i started screaming. there's a whole chapter about me basically screaming at poor tom skinner saying why are you not issuing a travel alert, and the answer was, we're working on it. i'm getting more calls from pregnant women, i'm calling the cruise companies and the airline companies, and their attitude is cdc says it's perfectly fine to go. women should just be careful about getting bitten byy mosquitoes, we have plenty of deet on our cruise ships, and we don't plan on stopping to land this these ports. i finally demanded an interview with a doctor that i know, and he was very cagey. he said we're discussing it with our partners.sn i said, what does that mean? what he clearly meant was we are calling mexico and all the cities in latin america and all the islands in the caribbean to let them and their bodies know that we are about to drop -- their ambassadors know that we are about to drop a neutron bomb on their tourism trade. a lot of pregnant women are getting on planes and ships, and they're in danger, issue it now. and they finally, it was a giant circus, they kept telling me it's going to come out in an hour, it took them until 7:00 at night after they originally scheduled it at noon. and they finally issued it and, yes, a neutron bomb dropped on the traded of those countries. just a minute but i'm curious with smallpox having been wiped out, what is next on the eradication horizon? are we still in that 1% we've gone to the 99 fairly well checked off. >> if i were to bet it would i would say polio. it may take years. that 1% may be permanent. viruses out there and they're going to stay out there and they won't leave us alone. that will be my guess. >> is going to be polio or ginny worms. they're down to fewer than 100 cases cases a year. but they been down below 300 cases for many years and problems keep popping up. i'm hoping jimmy carter is still alive to see the ginny worms. it's looking more dicey. although he is aware of it and i'm hoping bill gates is money doesn't run out before polio is eradicated. [laughter] >> what lessons can we learn from science and even from golf smallpox story. try to give you some encouragement about these zika outbreaks unless there's a second edition of your book in the works. >> not that i know of. i learned today that i have a sponsor when i introduce me. i didn't know that. [laughter] i get the prize all the time. i think we'll be talking about zika again. right now, what stopped zika, except in miami and it can always come back -- when i was a cop reported the police would say is the best top on the force , jack frost. why ? because people go indoors and stop killing each other. [laughter] deck frost is also the best stopper of mosquito borne diseases. it will be hot and wet again and the disease will be on the move again. we don't know how much herd immunity there is. probably more than a quarter of puerto rico got infected in the first way. once you been infected you can't get infected again you can't spin up the viral storm. puerto rico may be safe. a lot of the islands in the south pacific have zero cases because everyone got infected. in a lot of places, including the united states, there is no cured immunity. >> every expert i talk to will say the word flu within the next first two sentences, influenza. it's not if, it's when. >> people don't take flu enough seriously. every year there's the flu shot and it loses faith and credibility. in 1918 when the event comes back as it could in anytime, people will be crying for a vaccine. >> i would like to offer the opportunity for the audience to ask questions. we have microphones on either side of the center part of the room so will only be able to take your questions if you step up to the microphone. please introduce yourself and direct your question specifically to one or both of our authors. >> thank you. question for both of you. why is there so much misinformation about vaccinations and want to be done to combat that information? oh boy. i have no absolutely idea. it makes no sense to me whatsoever and again, the first vaccine was 1769, edward jenner's. we have proven proven that they worked in 1769. either the earth is flat or the earth's not flat. >> the vitamin industry is a lot under against the vaccination. i thought in south africa and aids, they basically said you don't need to take those antivirals, their poisons. they can be poisonous but if you have a it's with to save you. it was a vitamin salesman and the anti- vaccination is being pushed by people who have alternative cures are alternative treatment. i find that pernicious people. people who believe that the moon walk place on a sound stage in life in us. we no say on the other hand, the vaccination center says this doesn't work. there's no question that vaccines have side effects. new vaccines need to be tested ferociously for safety but most of the routine vaccinations have arty been through that testing and some side effects do come up in some children do die but if you go on the internet and look at old medical films of kids dying from diphtheria or tetanus you'll see how horrible the consequences could be. >> great question. >> hello. my name is jenna and i'm studying to become an epidemiologist in the long run. i was wondering how difficult it is to find that balance in alerting the public about a disease outbreak versus inducing panic. >> you have to write it very well. usually if in the second paragraph. it's not in the first paragraph. i will.out to you as every medical writer will say, people who have the disease if your uncle is dying of cancer and you see a story about a study done on mice in australia you will call the writer, no matter how many caveats people will do the very best they can and won't work. >> i see my job as trying to calm down the irrational panic about diseases and yet occasionally, trying to spread a little panic. if there's not enough attention being paid to it. wally podrazik is an example. trying to spread a little panic about zika. the flu every year. you can see the lines go up and down every year they try to push a panic about this is a really bad flu season and it hasn't been a really bad flu season since 2009. i try to write sensible articles and not ringing the alarm bells. they've cracked the genetic sequences and he successfully predicted, the last pandemics. he was accurate. but the other 13 times, henry i'm going to keep an eye on it. >> do you remember the panic over swine flu? that's nobody's fault, that's just the -- >> the '76 swine flu. the 2009 swine flu be, different bug. >> great question. again, thank you so much. sir. >> truth of disclosure, i had a maternal grandfather who was a veteran of world war i and died of tuberculosis 14 years later. my question for you, joel, is the fact that edward jenner, you know, as you pointed out, had already discovered the vaccine for smallpox.st however, it was very rare, cow pox was very rare at that time. and i don't know why, if it disappeared, but if it did disappear, is that somethingt that we sort of need to keep in mind. the other question i have is fon both of you all, and that is i've been told if you have a disease called spanish flu, you can be assured it isn't from a spain, it's from some orr country. if you got german measles, the last country you can blame is germany. do you have any thoughts with regards to the identification for the source of diseases thatt have a country associated with it? >> there's a reason why it was called spanish flu, but darn if i remember what it was. >> this was no military censorship in spain.n. the flu may have emerged out of fort reilly, kansas. but the flu devastated the armies of germany, england, trance and the united states, but there was military censorship imposed so that nobody wants to talk about the deaths over there.e. only when the flu got to spain was will no military censorship, so it became known as the spanish flu. i don't know about german measles. >> yes, sir. >> my name's trey english. i found out the man i always thought was my grandfather was actually my great uncle because my grandfather died of the spanish flu. and his brother married his brother's wife. but what happened in that case, and i think this other times in the past, is that without our modern medicines, communities do what they can the try to -- to try to stop pandemics. there was a movie about six years ago, i believe, called contagion that i thought was very good in terms of everything that was on screen.th but i was really disturbed by most of the stuff that was off screen because they didn't have any recognition that there might be some social problems of getting food and that sort of thing across borders. and be i'm wondering if you can comment on what past epidemics in previous times have done, what communities have done to try to stem epidemics when they didn't have our modernties havee medicines. >> mostly they used isolation. during the black death, you'd have entire cities and towns that walled themselves out, walled themselves up and wouldn't let anybody in or out. it was actually fairly effective. and keep in mind, most of these diseases -- including smallpox -- come this waves. they come and go. they're not there all the time. but think of the black death in the 4th century -- 14th century. the only thing they could do was to isolate the towns and the villages. i ought to point to out if there is no cure for smallpox, and if you caught it now -- which you won't -- there's almost nothing they can do for you. >> the word quarantine comes from the italian word for 40. and it's because that's how they, when boats came into the harbor, before they could up load or anything they'd come off they'd have to sit in the harbor for 40 days.su nobody could come off. so quarantine was the earliest way. now we race to make a vaccine. it's very hard to pose a quarantine. people get over borders one way or another, certainly you to know that here, and also when you impose a quarantine, you end all business, all trade, you cause chaos, and virtually no disease can be stopped by quarantine. i remember when the swine flu came out of mexico in 2009, people were talking about close the border, shut it off, and i was sitting there in manhattan saying, wait a minute. the first outbreak of swine flu in new york city was caused by a group of catholic school students this a high school in queens who had been to mexico on their spring break. are we going to close the east river and let nobody leaves queens? [laughter] you really can't -- flu youea can't stop with quarantine. >> and vaccines only work against viruses. the bubonic plague was a bacteria. >> so regret my, we are coming to the end of our time here. this is live television. oh, i'm so sorry. this is not fun for me, really. but anyway, we do want to thank our authors here for a very rich discussion about epidemics.o th [applause] and i want to thank you all for attending this session, for yout support of the festival. don't forget to become a friend to insure or that this festival remains free and supports important literary programs in our community. remember, donald mcneil will be about 20-30 minutes late to the signing area due to a live interview. enjoy your evening and thanks s. much for coming. 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