A Highly Infectious, Deadly Virus From The Central African Rain Forest Suddenly Appears In The Suburbs Of Washington, DC There Is No Cure In A Few Days Percent Of Its Victims Are Dead A Secret Military SWAT Team Of Soldiers And Scientists Is Mobilized To Stop The Outbreak Of This Exotic Hot Virus The Hot Zone Tells This Dramatic Story, Giving A Hair Raising Account Of The Appearance Of Rare And Lethal Viruses And Their Crashes Into The Human Race Shocking, Frightening, And Impossible To Ignore, The Hot Zone Proves That Truth Really Is Scarier Than Fiction Holy fuck This book will make you want to wash your hands a lot Also, you may feel compelled to go out and purchase your own HAZMAT suit Try not to read this book before bed It may cause some unsettling dreams Like dreams about your internal organs liquifying and bleeding out of your eyeballs I don t know, I found that kind of unsettling This book has singlehandedly accomplished my vow to never visit Africa Mostly because Africa is a giant continent filled with monkey pox and malarial insects Does that make me a big namby pamby puddin head That s okay I m comfortable with that I m fine with staying places on the globe where I m less likely to scrape my hand on bat guano and die a horrible, convulsive, putrifying death 36 hours later I m funny that way.Also, in combination with the book The Coming Plague by Laurie Garrett, with reading this I became convinced that our destruction as a species will come not at the tragedy of nuclear annihilation, which I had feared my entire conscious life but instead through tiny, virulent microorganisms which will become eternally mutating flesh eating death machines, ripping through our communities until there s nothing left but rotting jelly I have felt much relaxed about life since then.Pass the echinacea. This is one of those rare situations where I read an entire book in one sitting This book is absolutely captivating and terrifying It has been over 20 years since I read it and parts of it still stick with me This book and any of the others by Preston about viruses, pandemics, etc are well worth your time Fun fact Richard Preston is the brother of Douglas Preston of Preston Child Pendergast fame Read this while you are eating on a plane next to a sick person. The first thing to know about The Hot Zone, the 1995 bestseller by Richard Preston, is that it is not a romance novel While men, women, exotic getaways and showers are involved, they re not the type that would cue Sade on the soundtrack The book is based on an article by Preston published by the New Yorker in 1992 as Crisis in the Hot Zone but by trying to hit two targets journalism and the thriller suspense genre it misses both The rudimentary style of Preston s writing dispels the material as satisfying non fiction, while the lack of a strong central character or narrative limit it as a yarn.The material concerns the discovery of the Ebola virus in western Kenya in 1980 and efforts by the U.S Army to neutralize it when the virus is discovered in a Reston, Virginia animal facility in November 1989 With a 90% fatality rate and no vaccine, meetings between Ebola virus and human beings proceed along the same lines as Jack the Ripper and his victims The first half of the book sets up the infant rampages of Ebola in central Africa, documenting its effect on human beings and an averted outbreak in Kinsasha, while the second half of the book details the Army s hunt when the killer has the audacity to surface in the U.S.If the book has central characters, they d be U.S Army Lieutenant Colonel Nancy Jaax and her husband, Colonel Gerald Jerry Jaax, veterinary pathologists with the U.S Army Medical Research Institute of Infectious Diseases USAMRIID at Fort Derrick, Maryland The Jaaxes treat service dogs and every other animal working for the Army alas, Preston doesn t specify what the Army uses mules or rabbits for The couple have three children, four dogs and a parrot While Jerry has worked with monkeys, which can be dangerous and infectious, his wife has experience handling Ebola, putting her on par with a spearfisherman who has experience diving with great white sharks When you begin working with biological agents, the Army starts you in Biosafety Level 2, and then you move up to Level 3 You don t go into Level 4 until you have a lot of experience, and the Army may never allow you to work there In order to work in the lower levels, you must have a number of vaccinations Nancy had vaccinations for yellow fever, Q fever, Rift Valley fever, the VEE, EEE, and WEE complex brain viruses that live in horses , and tularemia, anthrax, and botulism And, of course, she had had a series of shots for rabies, since she was a veterinarian Her immune system reacted badly to all the shots they made her sick The Army therefore yanked her out of the vaccination program At this point, Nancy Jaax was essentially washed up She couldn t proceed with any kind of work with Level 3 agents, because she couldn t tolerate the vaccinations There was only one way she could continue working with dangerous infectious agents She had to get herself assigned to work in a space suit in Level 4 areas There aren t any vaccines for Level 4 hot agents A Level 4 hot agent is a lethal virus for which there is no vaccine and no cure.Another adversary of Ebola is Eugene Johnson, a civilian virus hunter contracted by the Army In the spring of 1988, when a ten year old Danish boy visiting his parents in Kenya dies of a Level 4 hot agent known as Marburg virus, Johnson tracks the killer to Kitnum Cave in Mount Elgon in western Kenya, but his expedition is unable to isolate the virus, explain its origins or develop a vaccine Peter Jahrling is a civilian virologist also employed by the Army who along with an eighteen year old intern named Tom Geisbert who s an ace with an electron microscope inhales tissue samples later testing positive for Ebola, putting both men on a self imposed death watch.Ebola s predatory attacks on human beings in central Africa are like murder scenes The onset of Ebola virus is a throbbing headache that typically occurs on the seventh day of incubation Fever and nausea come next, with victims expelling a cocktail of tarry granules and red arterial blood known as black vomit Speckles break out all over the body and expand into bruises The liver, kidneys, lungs, hands and feet become jammed with blood clots Victims turn into passive automatons Walking dead They then hemorrhage in violent epileptic fits the Army calls crashing and bleeding out, Ebola s program for transmitting to a fresh host through infected blood.One of the hosts is a twenty year old who Preston calls Nurse Mayinga She s infected at Ngaliema Hospital in Kinshasa in September 1976 caring for a nun stricken with an Ebola like replicating agent As she develops symptoms, Nurse Mayinga fears that her scholarship to study in Europe might be revoked Rather than seek treatment, the nurse wanders the city of two million, setting up a species threatening event As news breaks out, President Mobutu, the notorious ruler of Zaire, dispatches his armed forces to quarantine the hospital and blockade the rural areas where infected have been reported Through no effort by the regime, Ebola mysteriously fails to replicate and disappears.Preston visits with Karl Johnson, a retired C.D.C doctor and one of Ebola s discoverers who was dispatched to Zaire in 1976 They discuss scenarios like the one introduced by Nurse MayingaAre you worried about a species threatening event He stared at me What the hell do you mean by that I mean a virus that wipes us out Well, I think it could happen Certainly it hasn t happened yet I m not worried More likely it would be a virus that reduces us by some percentage By thirty percent By ninety percent Nine out of ten humans killed And you re not bothered A look of mysterious thoughtfulness crossed his face A virus can be useful to a species by thinning us out, he said.On Wednesday, October 4, 1989, a shipment of one hundred wild monkeys from the Philippines arrive at Hazelton Research Products in Reston, Virginia To prevent the spread of infectious disease, federal regulations require imported monkeys be quarantined for one month before being shipped elsewhere Over three weeks, twenty nine quarantined monkeys die in one room at the monkey house Dan Dalgard, the consulting veterinarian, suspects SHF simian hemorrhagic fever which is deadly to monkeys but harmless to humans Dalgard conducts autopsies and ships samples to USAMRIID at Fort Derrick.Armed with electron microscope photographs by intern Tom Geisbert, civilian virologist Peter Jahrling alerts his superior, Colonel Clarence James Peters, that they may have a filovirus outside Washington D.C Fearing that Peters could quarantine both him and Geisbert in a biocontainment hospital known as the Slammer for thirty days over what could be nothing, Jahrling neglects to report that they handled and inhaled the Reston samples They decide to test their own blood and self monitor Using a blood sample collected from Nurse Mayinga, Jahrling s analysis concludes that the Reston monkeys are infected with Ebola.Jahrling s analysis races up the chain of command Among the experts assembled, Col Peters invites Lt Col Nancy Jaax Her work with Ebola leads her to believe that the virus can be infectious by air, enabling it to nuke an entire building should it get into an HVAC system She also believes that even if Ebola is quarantined in the Reston monkey house, it won t stay there long Col Peters chooses Nancy s husband, Col Jerry Jaax to lead a team of soldiers and civilians into the monkey house to euthanize the animals caged in the building The Army had never mobilized a major field operation against a hot virus before Obviously there were legal questions here Lawyers were going to have to be consulted Was this legal Could the Army simply put together a biohazard SWAT team and move in on the monkey house General Russell was afraid the Army s lawyers would tell him that it could not, and should not, be done, so he answered the legal doubts with these words A policy of moving out and doing it, and asking forgiveness afterward, is much better than a policy of asking permission and having it denied You never ask a lawyer for permission to do something We are going to do the needful, and the lawyers are going to tell us why it s legalThe Hot Zone Crisis in the Hot Zone would ve been a superior title for the book has the makings of a compelling nature run amok thriller Like Jaws, Ebola is the hunter and we re the prey Like a shark sighting, an outbreak of Ebola is scary enough to generate a widespread panic Like the great white in Jaws, the virus is a natural born killer, a prehistoric predator whose hunters both respect and admire it It does not discriminate, ripping apart a ten year old boy cavorting in nature, just like Jaws, and despite the microscopic size of the virus, seems to have the same cunning as the great white.What surprised me about the book was how rudimentary the writing was I haven t read the article it was based on, but the book is pitched at a much less demanding audience than the average piece in the New Yorker Preston repeats himself a lot and spares detail, which is rarely an experience I have with the magazine There s solid character work, but the book takes two hundred pages to establish the Army mission and never locks in around a central character or two It s as if trying to please everyone, Preston took the weakest elements of non fiction and genre fiction and muddled them up I recommend the book for those looking for information on killer viruses and the true life crime story of how an outbreak was averted in the U.S While a virus doesn t have the cinematic menace of a great white shark, Preston s magazine article did inspire two competing killer virus projects in Hollywood in 1994 An adaptation of his book set to star Robert Redford and Jodie Foster under the direction of Ridley Scott fell apart, due in part to the grim reality that the story ends with the euthanization of hundreds of monkeys A competing project titled Outbreak with Dustin Hoffman, Rene Russo and Morgan Freeman did make it to the screen in 1995, pumping up and dramatizing the events of Reston with the aid of at least eight different screenwriters. My take away thoughts from reading The Hot Zone A You do not want to get infected with Ebola.B If A above occurs, head immediately and directly to your nearest lawn and garden store, purchase a pack of rat poison, mix with vodka, and drink your last.C Repeat B above until dead.D Again, you do not want to get infected with Ebola. The subtitle for Richard Preston s 1994 bestseller reads The Terrifying True Story of the Origins of the Ebola Virus How much you enjoy The Hot Zone might just hinge on what you know about Ebola going in and, by extension, how seriously you take that subtitle To say that Preston took artistic liberties is akin to saying Ayn Rand held only a little contempt for Marxism or that Memento had a tendency to confuse its viewers There can be no doubt that Preston delivered a vivid and hair raising thrill ride, a marvelously written if unevenly paced house of horrors, but on balance his book is about as accurate as a Stone age slide rule It might have passed for harmless over sensationalizing, except with the Ebola epidemic in progress and tensions wound tighter than ever, the book has become the bane of disease experts and science communicators working to tamp down the mass hysteria In this case, thankfully, the truth isn t scarier than fiction.The book is structured around four events our first contact in the 1960s with Marburg virus MARV a close cousin to Ebola named for the German city in which it was discovered the earliest recorded outbreak of Ebola Zaire EBOZ in Sudan and DRC formerly Zaire in 1976 the 1989 outbreak of Reston virus RESTV in Northern Virginia and the final act sees Preston donning a biocontainment suit for a solo jaunt in a sub Saharan cave in search of the cagey killer.Preston needs only the space of a few pages to subdue the reader into a state of trepidation I was spooked almost immediately, even knowing it was all a bit light on fact The characters, many of whom are given fictitious names, have blood spurting from every orifice, their insides liquefying, and at one point we read of a nurse weeping tears of blood Such descriptions seem to have in common with the active imagination that goes hand in hand with storytelling than with any viral agent identified to date Preston himself concedes as much in a NY Times interview last month That almost certainly didn t happen OK So there s some exaggeration here and some embellishment there and the 3.5 million copies sold is probably responsible for some of the stateside hysteria But let s not point too much of the blame in one direction An invisible pest that moves from person to person and leaves a high mortality rate in its wake is bound to generate a level of fear, with or without The Hot Zone And when you combine the low science literacy rates in America with its media s penchant for doom mongering and narcissistic over commentary, some version of collective psychosis is all but inevitable Of course, the recent outbreak has sparked renewed interest in the book, and its infidelity to fact doesn t help the situation.In an effort to defuse some of this noise, let s get to know the real Ebola virus, at least what we ve gleaned so far First, some perspective Yes, Ebola is deadly, and international aid groups should be throwing everything they ve got at curbing this latest and greatest outbreak As of 14 November 2014, there have been than 14,000 reported cases and over 5,000 confirmed deaths WHO updates this page weekly since it emerged in Guinea one year ago But as a matter of pure numbers, Ebola is a minor player on the pathogen roster Compare those figures with seasonal flu the reason many of your coworkers have been calling in sick recently which infects hundreds of millions and causes 250 500,000 deaths every year including 20,000 in the U.S alone Or norovirus, which infects 267 million people and kills 200,000 annually Hepatitis C is a virus that currently infects 150 million people worldwide, while malaria kills than 600,000 a year, or about 68 people per hour Even rabies accounts for a steady 69,000 deaths per year Any fear you might have of Ebola should be calibrated against the numbers, which tell us that we re far likely to die from lightning, a car accident or a plane crash than we are from Ebola.Much of that has to do with Ebola s method of transmission Contrary to what Preston repeatedly suggests in The Hot Zone, Ebola is not transmitted through the air or by respiratory secretions i.e., coughing or sneezing , unlike influenza or SARS Ebola can only be transmitted by direct physical contact with the blood, vomit or feces of an infected person A cough or a sneeze from an Ebola host doesn t contain high enough concentrations of the virus to infect someone nearby because Ebola doesn t aerosolize in the way its airborne counterparts do This explains why the reports keep flowing in of infected healthcare workers they are at the highest risk of infection because they re the ones working with the patients after the incubation period is over and symptoms have surfaced So unless you find yourself in contact with any of these three fluids of an Ebola victim, you have little to worry about.Many have frowned on science for not having a vaccine ready by the truckloads This may sound brusque, but given the differential threat of the other viruses mentioned above, Ebola isn t a top priority We ve seen a total of 32 outbreaks over the last 40 years, and yet none have secured a lasting foothold in humans In contrast, flu and malaria are perennial killers of titanic proportions Moreover, vaccines and antivirals like the experimental ZMapp, which co opts tobacco plants to clone antibodies derived from mice are painstakingly difficult and costly to produce and must be adapted to the rapid pace of evolution In the triage of epidemiological exigency, Ebola s sporadic presence and short fused temperament simply rank lower next to many other human scourges.Its tendency to play hopscotch with the human race is also why there is much we still don t know about Ebola As Level 4 contagions go, it is deceptively simple Were you to ogle it under a microscope, you d see a single strand of RNA that codes for a mere seven proteins, one of which VP24 has been identified as the key facilitator for disrupting the cell signaling processes involved in immune response With the key communication lines cut, Ebola is allowed free rein and overwhelms the host system before antiviral reinforcements have time to interfere.The biochemistry is less opaque than Ebola s origins, however One of the finer points we ve yet to work out is zoonotic provenance in which species did Ebola first arise, and from which host population did it make the jump to us Was it in the direction of apes to humans like HIV, or did it spill over from some other creature whose environment overlaps with ours The favored culprit is Egyptian fruit bats, which are known to carry not only the sister virus Marburg but antibodies to Ebola Even so, it could lurk elsewhere in the wild, biding its time until local conditions pave the way for its reemergence Learning how pathogens jump from one species to another is vitally important to preventing future outbreaks and is a hot topic among research communities today.Closing ThoughtsMuch like this review, the central character of Preston s fan favorite is the omnipresent virus The human characters in the book are poorly developed and ultimately forgettable backdrops which fade in and out as Preston heightens the drama around his lurid replicator that nonhuman other for which he prowls in Kitum Cave You ll get a few interesting bits about life inside a biosafety facility, but for the most part any factual profile on Ebola is swallowed whole by the embroidery and myriad grotesqueries sprinkled in at the expense of navigating a careful line between fiction and reality Take The Hot Zone for what it is a high speed medical mystery thriller meant to make you tremble at the raw power of nature In a sense, the earth is mounting an immune response against the human species It is beginning to react to the human parasite, the flooding infection of people, the dead spots of concrete all over the planet, the cancerous rot outs in Europe, Japan, and the United States, thick with replicating primates, the colonies enlarging and spreading and threatening to shock the biosphere with mass extinctions Perhaps the biosphere does not like the idea of five billion humans Or it could also be said that the extreme amplification of the human racehas suddenly produced a very large quantity of meat, which is sitting everywhere in the biosphere and may not be able to defend itself against a life form that might want to consume it Nature has interesting ways of balancing itself. pp 310 311 Note This review is republished from my official website Click through for additional footnotes and imagery. This book scared the crap out of me Not only is it terrifying to read about this insane virus, but I ve never read non fiction work with such urgent and visceral power I felt splattered and shattered by the time the whole ghastly mess was all over, but was feverishly excited to read such fantastic writing, too Definitely only for those with strong stomachs. Both species, the human and the monkey, were in the presence of another life form, which was older and powerful than either of them, and was a dweller in blood. I read this book on the same days I was watching the Netflix adaptation of The Haunting of Hill House, which had a curious effect on me Because, well, the TV show might be very creepy, but I have to say it is nothing compared to the horror of this book.That s what The Hot Zone is A true horror story.Preston uses interviews and first hand accounts to tell the story of the Ebola virus and its various strains I d heard of Ebola, of course I knew it was a disease and that it killed people I knew I didn t want it But I didn t really know I didn t know that it liquidates your organs and turns your body into a walking corpse days before you bleed out I didn t know that it is one of the most infectious diseases that have likely ever existed on this planet.It acts like a predator, lying quietly in wait for a host so it can multiply and multiply to destructive effect Reality can be so much scary than fiction.Truly, this is a terrifying book Preston definitely dramatizes the whole thing, but he s working with some pretty powerful material Imagine a virus with the infectiousness of influenza and the mortality rate of the black plague in the Middle Ages that s what we re talking about. This is the third book about diseases and medicine that I ve really enjoyed though, yes, enjoyed seems like a poor choice of word the other two being And the Band Played On and The Emperor of All Maladies I ll happily take recommendations for any others In the hands of a skilled writer, these books are fascinating, educating and deeply unsettling Also, despite the age of this book, it doesn t feel too dated Maybe that is because Ebola remains a threat Ebola outbreaks are ongoing in Africa, right now One mistake, one oversight, one infected person taking a plane flight and we might not be able to stop it.Blog Facebook Twitter Instagram Youtube Ouch seems I am of the faint hearted sort At the point where Monet starts to literally disintegrate on his plane trip, I got a kind of anxiety attack and had to stop reading so it looks like I might literally not be able to read this book UPDATE I did it..and Preston did apparently later admit that he had slightly exaggerated here and there I must admit that I found his visit to Kitum cave, towards the end of the book, to be a spot of melodrama, as was quite a bit of the rest of book, interspersed with unnecessary filler.I did find it very interesting indeed to read about the research and how virologists work.As a whole I found the book pretty readable when it wasn t scaring me out of my wits, so 3 and a half stars it gets Since the book is quite dated by now, it is worthwhile reading Preston s update on the latest developments pointed to in the thread below by Sarah.Friends Sarah and Ted have both mentioned the aforementioned New Yorker article by Preston, and I myself am very impressed with it, so I m going to link to it in the review itself it is here tends to impress me about Preston is that he goes to a lot of trouble with his research, and he then presents it in a form that is easy to understand for the most ignorant of laymen On the other hand, one of the problems I have with him is that he can become a tad melodramatic which can be irritating when overdone, but in general, the way that he builds tension into his reportage does make for quite gripping reading.