Why prions?

A Cure for Madness - Jodi McIsaac

I received a free copy of this book from NetGalley in exchange for an honest review.


Why prions? Throughout the entire book that thought kept circulating through my head. To put it simply, prions are proteins that are improperly folded. Due to the nature of their configuration, the proteins mass together and cause damage to the brain. Furthermore, they “attack” other proteins and refold them improperly as well. Prions are suspected to be the cause of a number of neurological diseases, the most well-known being Mad Cow Disease and Kuru. There are no known cures for prion caused diseases; both antivirals and antibiotics are useless in treating them. This much the author got correct, however, she got a few more important facts wrong. The incubation period for prions is a lot longer than 72 hours, we’re talking years here. Kuru has been known to incubate for as long as 20 years. Prions are transmitted in one of several ways: eating infected meat, coming in to contact with infected medical equipment, or coming in to contact with infected spinal fluid, brain matter, or lymphatic fluid. There is also strong evidence that a prion disease can be inherited. There are no known cases, outside of a laboratory setting, of prions being transmitted by aerosol, which means sneezing on somebody, while possibly infecting them with a number of other diseases, isn’t going to infect them with this one. Prion diseases are always fatal. Those two facts, punch huge holes in the premise of the story.


Don’t get me wrong, it’s an interesting premise, I just feel the author went about it the wrong way. There are plenty of ways to infect a large population of people, using the aerosol method feels like a cop out. Furthermore, I believe the author could have used the long incubation period to write a far more interesting story. Due to the fact that prions can be hard to test for, and can be passed on through some organ donations and contaminated medical equipment, the author missed a chance to spread this disease farther. The longer incubation period could also have led to a delay in the CDC figuring out what they were dealing with, which would have allowed the author to ramp up the panic in the population. Of course, the author would be telling a different story if these changes had been made. Which brings me back to my initial question, why prions? A bacterial or viral infection would have been far better suited to this type of story. Both are more easily spread throughout the population and can have significantly shorter incubation periods. If she was worried that the disease would be too easily cured, no worries, antivirals have come a long way, but they’re not miracle drugs. As for antibiotics, there has been a rise in the number of antibiotic resistant bacteria. Using either of those two options, the bulk of the story could have remained the same, even the cure could have been kept as is.


I realize, this makes it sound like I didn’t enjoy the book, but I did; I just had some issues with parts of it. Overall, the writing was engaging and the author did a good job of keeping the story moving, even if I didn’t particularly like the direction that it moved. It was interesting, but perhaps not really aimed at me as an audience. I gave this book 3 stars.