Red Madness

February 17, 2014
Jarrow (The Amazing Harry Kellar: Great American Magician) takes readers on a medical detective journey full of dead ends, twists, politics, and culture as she details the story of pellagra, a deadly disease caused by niacin deficiency. Prevalent in the U.S. at the turn of the 20th century, it primarily struck the impoverished in the South (where cotton had displaced nutritious food crops). The disease causes a patterned red rash, intestinal distress, dementia, and eventually death. The author’s extensive research turns up personal stories within the story; interspersed throughout are brief vignettes of “pellagrins” like Mrs. A. Sallie Graham, a 55-year-old Virginia woman whose “health had been good until she developed a skin irritation that wouldn’t go away.... After six months, she began to forget things and wondered if she might be going insane.” These individual accounts create an urgent backdrop of suffering and death for the story of the epidemiological quest to find a cause and cure. Archival photos of sufferers of all ages are poignant and graphic. A FAQ, timeline and glossary conclude the captivating tale, which pinpoints the reason bread is enriched today. Ages 10–up.

Starred review from April 1, 2014

Gr 6 Up-This haunting insight into a little known epidemic from the early 20th century provides statistics, firsthand accounts, pictures, and an easy-to-follow narrative of the pellagra outbreak in the United States. The book details the baffling uprise of pellagra, a life-threatening disease characterized by weakness, rash, and insanity; the medical investigation that ensued; and the eventual changes that were made in America's diet to combat both this sickness and other maladies caused by nutritional deficiencies. This title is descriptive and well researched, with a striking bold-red color scheme. Though the images are graphic and potentially disturbing, they are not sensationalized, and enhance the narrative. This is an excellent addition to nonfiction collections in school and public libraries. [Ed note: See author Q&A, p. 16.]-Tammy Turner, Centennial High School, Frisco, TX

Copyright 2014 School Library Journal, LLC Used with permission.

Starred review from March 15, 2014
In the early years of the 20th century, doctors and researchers were stymied by a mysterious, often fatal illness that seemed to strike primarily Southern agricultural workers. Patients presented with a severe rash, intestinal issues and dementia, and in addition to farm workers, many afflicted were found in institutions like mental hospitals and orphanages. After reviewing cases from Europe, doctors diagnosed pellagra and associated it with poverty and a poor diet featuring moldy corn. As the disease spread, the country's medical leadership searched for causes and cures, and the sense of urgency led to the assignment of epidemiologist Dr. Joseph Goldberger to the case. Eventually, Goldberger and those who continued the work after his death identified the culprit as a vitamin deficiency, determined an inexpensive cure and led the way to nutritionally enhanced foods as part of the American diet. This is a highly detailed look at the difficulties of disease control before modern medicine. Jarrow makes clear how societal attitudes hampered efforts to end the scourge as well as the vulnerability of the poor and marginalized. The many photographs also reveal the devastating nature of the disease. The large number of cases described demonstrates the magnitude of the problem, but they can also be hard to follow and require patient readers. The attractive, red-highlighted design, lively narrative and compelling subject matter will resonate with readers. (Nonfiction. 10 & up)

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April 1, 2014
Grades 5-8 Jarrow delves into the debilitating and oft-forgotten disease that became a public health crisis in the U.S. early in the twentieth century. Pellagra, an illness that causes a menacing red rash, gastrointestinal issues, and eventual delirium and death, was unheard of in America when cases began to surface in the South, especially in orphanages and sanitariums, in 1902. Scientists and physicians raced to find an explanation for its accelerated virulence, in the process exploring new ideas about germ theory, food safety, and cleanliness. It was not until a young epidemiologist named Joseph Goldberger began to analyze data regarding nutrition did people begin to understand the cause as being a simple vitamin deficiency. While the book's main subject is epidemiological, it is also a case study on innumerable social issues of the day, such as the industrialization of the American food supply, the rise of sensational journalism, and the treatment of the poor, the ill, and the elderly. A visually dramatic medical mystery, this is cross-curricular and of high interest.(Reprinted with permission of Booklist, copyright 2014, American Library Association.)