In 2015, mosquito-borne pathogens caused approximately 830,000 deaths worldwide. Malaria alone killed 435,000 people in 2017. Statistical extrapolations suggest that mosquito-borne viruses and parasites have killed roughly half of all humans who have ever lived.1 While yellow fever, dengue, and malaria have long been the most virulent of these diseases, newer zoonotics (diseases transmitted from animals to humans), such as West Nile, chikungunya, and Zika, are dramatically on the rise, with the latter impacting women with particular ferocity. Increasing global temperatures and sea levels bode well for mosquitos but very badly for us, their human prey. Timothy C. Winegard’s The Mosquito: A Human History of Our Deadliest Predator is thus a timely and thoroughly readable survey of how the common Culex, Aedes, and Anopheles mosquitos have shaped our history as a species.
Winegard, a professor of history and political science at Colorado Mesa University, opens by speaking directly to the reader. He asks her to imagine herself as the perfect target for a hungry mosquito — on a camping trip, sitting down to a cold beer after a long day of hiking. He then provides a step-by-step, real-time description of how the mosquito feeds, transmits disease, and reproduces. The first several chapters provide a plethora of facts about the mosquito and her behavior, exploring the diseases she carries — and it is always she, because only females bite. Winegard goes on to explore the most sophisticated biological response that humans have mounted to mosquito-borne threats: the sickle cell trait, so named for the abnormal sickle-shape of red blood cells in carriers, who are predominantly descended from Sub-Saharan Africa. The sickle cell gene protects carriers from malaria, but when passed through both parents it also results in anemia, edema, chronic pain, infections, stroke, and a shortened lifespan.
Beginning in Chapter 3, Winegard jumps back in time to pursue his central premise–the “human history of our deadliest predator.” Starting in ancient Greece, Winegard moves forward at a compelling chronological clip. He organizes each chapter around familiar historical touchstones and elucidates the role of mosquitos in each. It makes for interesting and surprising reading. The malarial Pontine Marshes both protected and eventually devastated ancient Rome, and from these marshes eventually came the word malaria itself, from the Italian mala aria for the “bad air” that was long thought to be the carrier of a wide array of diseases. In the early Middle Ages, Kublai Khan’s invasions of the Levant were repeatedly pushed back by outbreaks of malaria, and massive summertime losses of Mongol troops due to mosquito-borne disease effectively ensured the military and economic supremacy of pre-Renaissance Europe. In Chapter 7, we arrive at the Columbian Exchange, as a result of which the billions of previously harmless mosquitos of the Americas were quickly converted into carriers of old-world disease, to which indigenous populations had neither seasoning nor inherited immunity. Winegard makes his way through the colonization of the Americas, the American Revolution, the Civil War, and then onto the World Wars, demonstrating at every turn that the mosquito (or miasma — the noxious clouds of “bad air” that she always seemed to follow) was a key player in each.
In the second half of the nineteenth century, modern germ theory superseded the miasmatic “infectious air” theory of disease. In 1877, Scottish physician Patrick Manson pinpointed the mosquito as the carrier of filariasis (also known as elephantiasis).2 Two decades later, British doctor Ronald Ross and Italian zoologist Giovanni Grassi identified the mosquito as the carrier of malaria.3 With the mosquito unmasked as a disease vector, governments and researchers worldwide focused intense efforts on understanding the mosquito and pursuing its eradication. In the final third of the book, still moving chronologically, Winegard explores the cost-benefit dance between fighting the mosquito and suffering the consequences for doing so. Many eradication efforts backfired badly, including excessive use of DDT that rendered the pesticide useless on the quickly adapting populations of mosquitos advancing across the globe.4 Winegard especially hits his stride in these chapters. It is no small task to spend virtually the entire book detailing the devastation of mosquito-borne illnesses, only to leave the reader with open questions about the ethics and consequences of CRISPR genetic modification, or the permanent global destruction of all mosquitos.
Described by the publisher as “narrative nonfiction,” The Mosquito is readily accessible to a non-technical, non-medical reader. While the book is light on primary source analysis, Winegard synthesizes a wide variety of sources into a cohesive narrative. Though few readers will have a masterful command of all the conflicts and time periods he covers, I can say from my own areas of expertise that he approaches events that I know well with an accurate and critical eye. Like similar works, including Jennifer Wright’s Get Well Soon, J.N. Hays’ The Burdens of Disease, and J.R. McNeill’s Mosquito Empires, the book covers a lot of historical ground in a single volume — 2,500 years in just under 450 pages. For me, this was a plus, though it is certainly an approach that prioritizes breadth over depth.
Like many readers of Nursing Clio, I am interested in recovering lesser-known stories of the past. I was thus left a bit wanting by Winegard’s sustained emphasis on military conflict as the primary driver of history. Additionally, the book’s ultra-narrow focus on the mosquito tended to be reductive, sometimes flatting complex historical events into a simplified battle of insect versus man. I came across The Mosquito initially in researching how Philadelphians in the 1790s responded to successive, devastating yellow fever epidemics. Winegard touches on these events, but only briefly. However, he is clear that his argument is top-down, not bottom-up; he contends that war and colonization have brought together disparate populations with wildly different immunities, and these conflicts reliably disrupted land, waterways, and ecosystems. Such upheavals made new homes for mosquitos to breed and spread disease. Yet, I wanted to know more about what it was like for everyday people facing epidemics that had fatality rates sometimes as high as 90%. What was it like for the survivors of such devastation? The book doesn’t tackle these questions as well as one might hope. But, in the end, the fact that Winegard provided me with so much information and spurred my curiosity to find out more surely is not a bad thing at all.
As I was finishing this review, I received a news alert that mosquitos within five miles of my house had tested positive for Jamestown Canyon Virus and West Nile. This was no longer just another buzz coming from my phone. The Mosquito situates such alerts in their global and historical context, and also illuminates what the increasing frequency of these diseases mean for all of us now and in the future.
- Timothy C. Winegard, The Mosquito: A Human History of Our Deadliest Predator (New York: Dutton, 2019), 2. Return to text.
- Winegard, 351. Return to text.
- Winegard, 353. Return to text.
- Winegard, 380. Return to text.