Deadliest Enemy

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Deadliest Enemy: Our War Against Killer Germs
Deadliest Enemy, Our War Against Killer Germs.jpeg
AuthorMichael Osterholm, Mark Olshaker
PublisherLittle, Brown and Company

Deadliest Enemy: Our War Against Killer Germs is a non-fiction book by epidemiologist Michael Osterholm and writer Mark Olshaker that explores public health emergencies such as antimicrobial resistance, emerging infectious disease and the threat of an influenza pandemic, and in response also suggesting a solution. It was published by Little, Brown and Company in 2017. It also focuses on the epidemiology of HIV/AIDS, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), toxic shock syndrome, Zika, Ebola, bioterrorism, gain-of-function influenza research, and the antivaccine movement.

It proposes a nine-point "Battle Plan for Survival" for dealing with these threats, including solutions to antimicrobial drug resistance.


The book has 21 chapters:

  1. Black swans and red alerts
  2. Annals of public health
  3. White coats and worn shoes
  4. The threat matrix
  5. The natural history of germs
  6. The new world order
  7. Means of transmission: bats, bugs, lungs, and penises
  8. Vaccines: the sharpest arrow in our quiver
  9. Malaria, AIDS, and TB: lest we forget
  10. Gain of function and dual use: the Frankenstein scenario
  11. Bioterror: opening Pandora's box
  12. Ebola: out of Africa
  13. SARS and MERS: harbingers of things to come
  14. Mosquitoes: public health enemy number one
  15. Zika: expecting the unexpected
  16. Antimicrobials: the tragedy of the commons
  17. Fighting the resistance
  18. Influenza: the king of infectious diseases
  19. Pandemic: from unspeakable to inevitable
  20. Taking influenza off the table
  21. Battle plan for survival[1][2]

Osterholm describes his book as "part history, part current affairs, and part blueprint for the future". Top of his concerns are influenza pandemics, antibiotic resistance and bioterrorism, combined with "no clear international governance structure for how we are going to deal with these issues".[3] Focusing on major infectious diseases, he highlights the world's vulnerability to their emerging threats.[4][5]

Content includes HIV/AIDS, SARS, MERS, toxic shock syndrome, the 2015–16 Zika virus epidemic, and Ebola outbreaks, covering all the main outbreaks over the previous 30 years,[4] including influenza bioterrorism,[3] gain-of-function influenza research, the antivaccine movement, and antimicrobial resistance.[4] The concept of "game-changing influenza vaccines" is introduced in the chapter "Taking influenza off the table". This provides reasoning and mechanisms for developing vaccines.[4] Solutions to antimicrobial drug resistance are suggested in the chapter titled "Fighting the resistance".[4]

The authors divide infectious diseases into four classes: pathogens that have the potential to cause pandemics; pathogens important to particular regions; endemic diseases; and bioterrorism, dual-use research of concern, and concerns over gain-of-function research, where modifying pathogens in the laboratory might potentially be misused.[4][6]

The book contains personal experiences, including Osterholm's La Crosse encephalitis,[4] and it uses medical history to assess the threat of pandemics and anti-microbial resistance, while also discussing political responses.[7]

It proposes a nine-point "Battle Plan for Survival" to fight emerging threats, with the aim of informing and inspiring people into public health work.[3]


The book was described by Richard Preston as a "powerful and necessary book" that "offers us not just fear but plans".[4] John M. Barry described the book as Osterholm's way of getting results.[8] Frank Weimann described the book's "dismal introduction on the threat of epidemics" and the main content as "a disturbing description of what humans are doing to keep" epidemiologists in business. Weimann is convinced by Osterholm's call for planning, research, and funding.[9]

Excerpts from the book appeared in Wired[10] and on MPR News.[11] It was listed in the Johns Hopkins Bloomberg School of Public Health's best books of 2017.[12]


  1. ^ "Deadliest enemy : our war against killer germs". Washington County Library. Retrieved 25 April 2019.
  2. ^ Osterholm, Michael T.; Olshaker, Mark (2017). Deadliest Enemy: Our War Against Killer Germs. Little, Brown. ISBN 9780316343695.
  3. ^ a b c Howard, Sarah (13 March 2017). "Detecting Infectious Diseases". School of Public Health, University of Minnesota. Retrieved 7 April 2019.
  4. ^ a b c d e f g h Adalja, A. A. (1 January 2018). "Deadliest Enemy: Our War against Killer Germs". Emerging Infectious Diseases. 24 (1): 185. doi:10.3201/eid2401.171081. PMC 5749459.
  5. ^ Perry, Susan (10 April 2017). "Why we can't be complacent about the threat of infectious disease: a Q&A with Michael Osterholm". MinnPost. Retrieved 24 April 2019.
  6. ^ National Institute of Health. "Gain of Function Research". Office of Science Policy. Retrieved 25 April 2019.
  7. ^ Kiser, Barbara (22 March 2017). "Books in brief". Nature. 543 (7646): 489. doi:10.1038/543489a. ISSN 1476-4687.
  8. ^ "Deadliest Enemy: Our War Against Killer Germs". CIDRAP. Retrieved 7 April 2019.
  9. ^ Weimann, Frank (13 January 2017). "Deadliest Enemy: Our War Against Killer Germs". Publishers Weekly. Retrieved 8 April 2019.
  10. ^ Osterholm, Michael T.; Olshaker, Mark (18 March 2017). "Peer Into the Post-Apocalyptic Future of Antimicrobial Resistance". Wired. ISSN 1059-1028. Retrieved 8 April 2019.
  11. ^ Weber, Tom (29 March 2017). "How the Mall of America could become 'as toxic and uninhabitable as Chernobyl'". MPR News. Retrieved 7 April 2019.
  12. ^ "Best Global Health Books of 2017". Global Health NOW. 12 December 2017. Retrieved 8 April 2019.

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