The beginning of the book would get five stars--it is outstanding: exciting, well-written, informative, a page turner. When an author can do this to history, you know they have talent.
The middle of the book was still pretty good. I'd give it four stars. It was a bit repetitive, which made it slow-moving. Before revealing each new detail, the whole plot/history up to that point is revisited/summarized. It could have been edited, regrouped, and trimmed and it would have been much better. He didn't need to say the same thing in 10 different ways. Instead of building the story and excitement, it detracted from it.
The ending, meaning the conclusion and epilogue, were terrible. One star. Some of it was interesting and relevant to the history and applying that history to today's world, but for the most part I wish I'd skipped it. The ending is also very dated. It was at this point that I realized that the book was published in 2006, and it sorely shows.
Also, I honestly don't think this was London's most terrifying epidemic. So that's a little misleading.. Still overall a good book.