Nemesis by Philip Roth Houghton Mifflin, 280 pp., $26.00

Between 1894 and 1952 the United States suffered a series of epidemic outbreaks of poliomyelitis. The worst of these, in 1916, claimed six thousand lives. For another forty years polio would remain a substantial threat to public health. The development of a vaccine changed all that: by 1994 the disease had been eradicated not only in the United States but in the whole Western Hemisphere.

Polio has been around for millennia as a contagious viral disease. Before the twentieth century it was an endemic infection of early childhood, causing fever, headaches, and nausea, no worse. In only a tiny minority of cases did it assume full-blown form and attack the nervous system, leading to paralysis or even death.

The mutation of polio into a serious disease can be blamed on improved standards of hygiene. The polio virus is passed on via human feces (the virus breeds in the small intestine). A regime of hand-washing, regular baths, and clean underwear cuts down transmission. The catch is that clean habits rob communities of resistance to the virus; and when nonresistant older children and adults contract the disease, it tends to take an extreme form. Thus the very measures that subdued diseases like cholera, typhus, tuberculosis, and diphtheria made poliomyelitis a threat to life.

The paradox that while strict hygiene lessens the risk to individuals, it weakens resistance and turns the disease lethal, was not widely grasped in the heyday of polio. In afflicted communities, eruptions of polio would trigger parallel and no less morbid eruptions of anxiety, despair, and misdirected rage.

The psychopathology of populations under attack by diseases whose transmission is ill understood was explored by Daniel Defoe in his Journal of the Plague Year, which pretends to be the journal of a survivor of the bubonic plague that decimated London in 1665. Defoe records all the moves typical of plague communities: superstitious attention to signs and symptoms; vulnerability to rumor; the stigmatization and isolation (quarantining) of suspect families and groups; the scapegoating of the poor and the homeless; the extermination of whole classes of suddenly abhorred animals (dogs, cats, pigs); the fragmenting of the city into healthy and sick zones, with aggressive policing of boundaries; flight from the diseased center, never mind that contagion might thereby be spread far and wide; and rampant mistrust of all by all, amounting to a general collapse of social bonds.

Albert Camus knew Defoe’s Journal: in his novel The Plague (La Peste), written during the war years, he quotes from it and generally imitates the matter-of-fact tone of Defoe’s narrator toward the catastrophe unfolding around him. Nominally about an outbreak of bubonic plague in an Algerian city, The Plague also invites a reading as being about what the French called “the brown plague” of the German occupation,…