The following version of this book was used to create this study guide: Osterholm, Michael and Olskhaker, Mark. Deadliest Enemy: Our War Against Killer Germs. Little, Brown, 2017.

Some in the media call Michael Osterholm "Bad News Mike," because when you want to know just how bad an outbreak or epidemic can get, you call him. In Deadliest Enemy: Our War Against Killer Germs, Osterholm and co-author Olshaker use examples from Osterholm's career and from history to build a case for their crisis agenda, their plan to save the world from a truly global pandemic.

Deadliest Enemy does not follow a traditional narrative formula. Instead, various anecdotes from different points in time are used to support concepts and arguments in order of Osterholm's and Olshaker's top priorities. Some anecdotes are used once, while others are repeatedly referred to.

In the introduction, Osterholm introduces himself. He gives a very brief explanation of his career and his worldview. He then introduces the field of infectious disease, explaining that includes any illness that can be passed from person to person, animal to person or food to person, but does not include anything chronic. He believes that infectious disease is the issue that deserves the greatest attention right now because of its ability to totally disrupt society.

In Chapter 1, "Black Swans and Red Alerts," Osterholm recounts the dawn of the AIDS crisis. He talks about how, when he was just 27 years old, he was called into to a CDC round table to help figure out two new, seemingly related outbreaks of rare disease that would turn out to be the results of an emergent, sexually-transmitted autoimmune disorder, and how much fear that would cause as promises to develop a vaccine were not met, until finally a series of medications were discovered that would make this a manageable, though still not curable, disease.

In Chapter 2, "Annals of Public Health," Osterholm tells the reader more about himself, and about the field of public health. He talks about his childhood in Iowa, and his early career in the Minnesota Health Department. He tells the reader about the history of epidemiology and the three men he thinks had the greatest impact on it: Dr. Edward Jenner, who discovered small pox inoculation, Dr. John Snow, who discovered that Cholera was caused by drinking unsanitary water, and could be prevented even without fully understanding the underlying agent, and Nikola Telsa, whose work on bringing electricity into homes and hospitals paved the way for modern sanitation.

In Chapter 3, "White Coats and Worn Shoes," Osterholm builds on the idea of epidemiologists as detectives with two cases from his early career. When young women began dying of toxic shock syndrome, Osterholm was part of a team that identified the culprit as being a new component of ultra-absorbent tampons, but only after a few missteps. When a number of people were seriously sickened with severe diarrhea and dehydration in rural Michigan, Osterholm and his team tracked the culprit down to raw milk, and were able to stop the outbreak without ever identifying the exact cause, effectively "pulling the pump handle," like Dr. Snow.

In Chapter 4, "The Threat Matrix," Osterholm explains why what most scares people, and what should actually most scare them are not always the same things. He says that people get used to a certain amount of death and danger occurring in everyday life, but are shocked and spurred to action by anything novel or shocking, even if it turns out to actually do far less damage.

In Chapter 5, "The Natural History of Germs," Osterholm explains that microscopic life has been on Earth billions of years longer than humans, and developed into so many different types it will likely always be here. While some microbes are beneficial to humans, and most are benign, some can be extremely harmful, causing death and disease. Because microbes evolve so much faster than humans do, only a strong combination of policy and science will be able to best them.

In Chapter 6, "The New World Order," Osterholm says that the modern explosion in the human population and in means of transportation leads to diseases being able to travel like never before. He says people cannot rely on natural immunity to combat these new threats. Comprehensive action must be taken.

In Chapter 7, "Means of Transmission: Bats, Bugs, Lungs, and Penises," Osterholm says that diseases have to come from a reservoir, be spread to humans by a vector, and then be spread between humans. The two most difficult-to-deal-with diseases are those that are spread simply by breathing the same air, and those that are spread by sexual means which social taboos often stop meaningful conversations about.

In Chapter 8, "Vaccines: The Sharpest Arrow in Our Quiver," Osterholm says that vaccines are probably the most effective public health tool in existence, but that we need new methods of funding them if we are going to continue to have enough. Neither a purely charitable nor a purely business model will work - governments need to get involved.

In Chapter 9, "Malaria, AIDS and TB: Lest We Forget," Osterholm addresses the diseases that kill the greatest number of people each year, but are not seen as crises, rather as ongoing poor living conditions related to poverty and a lack of sanitation. The biggest and most effective player in this game is the Bill and Melinda Gates Foundation.

In Chapter 10, "Gain of Function and Dual Use: The Frankenstein Scenario," Osterholm talks about the potential dangers posed by laboratory research conducted on viruses and diseases. When scientists intentionally mutate microbes to be more dangerous, they are able to better prepare for worst-case scenarios, but they also run the risk of causing those scenarios, either if they let their work accidentally escape, or if they let it fall into the wrong hands. To prevent this, ethic and legal considerations need to be serious considered regarding both sharing information about these projects and regarding conducting them in the first place.

In Chapter 11, "Bioterror: Opening Pandora's Box," Osterholm and Olshaker discuss the possibility that terrorist organizations, rogue governments or lone wolves may intentionally spread disease to cause havoc. This has been a concern since the earliest days of war, but the methods of doing so are more sophisticated and more accessible than ever. This was made evident by the 2001 anthrax attacks, and in Osterholm's opinion, the U.S. still has not prepared to deal with anything on a larger scale.

In Chapter 12, "Ebola: Out of Africa," Osterholm describes the most recent Ebola outbreak in West Africa. While Ebola has generally been confined to a few cases in jungle villages, when it hit urban areas in 2014, it exploded like wildfire. The international community was not fully prepared - the response eventually got the virus under control, but only after it had hit epidemic proportions, and Osterholm says that if just a few people had acted differently, it could have become a pandemic.

In Chapter 13, "SARS and MERS: Harbinger of Things to Come," Osterholm recounts two deadly outbreaks of coronavirus that wiped out critical regions and were not properly identified until they started traveling around the world. Osterholm says these examples prove the need for better international communication and coordination in prevention methods, or else the next global pandemic could come at any time.

In Chapter 14, "Mosquitoes: Public Health Enemy Number One," Osterholm talks about vector control methods, and the rise and fall of mosquito reduction programs. He says that serious consideration need to be given to dropping mosquito numbers or genetically altering them to stop the spread of both crises like Zika and ongoing disease like Malaria.

In Chapter 15, "Zika: Expecting the Unexpected," Osterholm described how a disease that had once been considered a low-level problem exploded onto the global stage. The disease mutated - the power of hyperevolution - the disease mutated to be able to cause more extreme symptoms, including birth defects like shrunken heads that caused physicians to advise women delay getting pregnant for the duration of the outbreak. Then, the disease mutated again, so that it can now be spread by sexual contact as well as by mosquitoes, greatly increasing the number of potential vectors.

In Chapter 16, "Antimicrobial: The Tragedy of the Comons," Osterholm explains the history of antibiotic use, and over-use, and how this has lead to a large number of "superbugs," diseases that have evolved immunity to some or all antibiotics.

In Chapter 17, "Fighting the Resistance," Osterholm and Olshaker lay out four necessary steps to keep from getting to a point at which antibiotics will no longer be effective. Antibiotic usage need to be reduced in both humans and animals, in both the developed and developing worlds.

In Chapter 18, "Influenza: The King of Infectious Disease," Osterholm talks about the 1918 flu pandemic, and how the modern world is not fully prepared for something like that to happen again. Flu viruses come from birds and pigs, but are fairly easily able to mutate to infect humans as well, so keeping people healthy means also keeping life stock healthy.

In Chapter 19, "Pandemic: From Unspeakable to Inevitable," Osterholm plays out a scenario that he thinks would happen if a global pandemic hit today, then describes what he thinks governments need to do to make sure things actually go better. It is based on the spread of pandemic Influenza, and draws heavily on the example of the 1918 flu.

In Chapter 20, "Taking Influenza off the Table," Osterholm talks about how different strains of flu appear every year, how flu shots are developed based on the last previous flu pandemic, and what it would take to create a truly universal flu vaccine. There are two main proteins, HA and NA, through which flu strains are identified, and scientists are working to determine which effect humans, and which can only effect animals.

In Chapter 21, "Battle Plan for Survival," Osterholm and Olshaker lay out their nine-point crisis plan and four areas of top priority. They would like to see immediate government action to combat pandemics, epidemics, bioterrorism and endemic global diseases on the scale of the Manhattan project.