The Hot Zone by Richard Preston. Recommended.

Imagine a virus that may spread through the air and that causes death at the same rate as the Black Plague during the Middle Ages — within a matter of days. You don’t have to imagine it; it’s emerged from the rain forest of Africa. In The Hot Zone, Richard Preston covers the filoviruses, Marburg and Ebola, from their effects on victims, how they are spread, and various outbreaks to the horrifying discovery of an Ebola strain right outside the U.S. capital, in Reston, Virginia.

To shatter our complacency, Preston begins The Hot Zone by detailing how a French expatriate, “Charles Monet,” undergoes the transformation from healthy human being to a Marburg virus host undergoing extreme amplification within days. His fate is to “crash and bleed out” — to throw up the “black vomit,” go into shock, slough intestinal lining, and lose copious amounts of blood from every orifice. This is a true horror story that Poe could not have imagined — yet it is what happens in 50–90 percent of similar cases. There is not only no cure for the filoviruses Marburg and Ebola, there is no treatment.

When the Army and the Centers for Disease Control (inexplicably abbreviated C.D.C.) discover there is an outbreak of an Ebola-like agent in a research monkey holding facility in Reston, Virginia, outside Washington, D.C., a team of virologists, veterinarians, physicians, and technicians go into action to identify and isolate the agent, to euthanize the monkeys, and to kill all life within the building.

Preston follows the daily life of Jerry and Nancy Jaax, both Army veterinarians; Dan Dalgard, consulting veterinarian to the company that imported the monkeys from the Philippines; researchers Gene Johnson and Peter Jahrling; intern Tom Geisbert; Colonel C. J. Peters; and others as they develop and execute a strategy for containing the virus (named by co-discoverers Jahrling and Geisbert Ebola Reston) within the monkey facility population and to protect humans from exposure.

Preston plays up the melodrama inherent in the story. He shows the ordinary home life of the Jaaxes, feeding their children, picking them up from school events, and taking care of their pets. In contrast, Nancy dons a “space suit” to work in relatively safety around Level 4 biohazard agents like Marburg and Ebola. Geisbert is a young father who has sacrificed his marriage to his work. Gene Johnson is unable to write about his research and has recurring nightmares about a breech in his gloves. While Army teams are “nuking” the monkey facility, killing and carving up monkeys that host what was believed to be a virulent, deadly hot agent, children play happily at the day-care center down the hill. These juxtapositions of normal life with scenes of people in space suits in fear for their lives from Ebola are intended to add to the horror. While life goes on, a particularly grisly kind of death is only steps away.

I found the attitude of the veterinarians difficult to understand. Dan Dalgard euthanizes monkeys to see if they have simian hemorrhagic fever (SHF). They prove to be healthy. Preston writes, “Sacrificing the monkeys had been a difficult, disgusting, disheartening task” — a sentiment the other veterinarians echo throughout the book. Dalgard notes, “. . . the animals were unusually well fleshed (butterballs), young (less than 5 years), and in prime condition.” Yet even as he feels the “disgust” of sacrificing the monkeys, he doesn’t question the ethics of working for a company that takes these young, healthy, “butterball” non-human primates away from their natural habitat and family groups and sells them to researchers at a profit — researchers who will most likely inflict pain and suffering on them in the course of research.

Later, to ease the distress of what they are about to do, one of the Army officers tells the young privates sent to assist in killing the monkeys and collecting samples, “These animals gave their lives to science.” This may be comforting to humans, but misses the mark. Animals don’t give their lives to science; their lives are taken from them involuntarily. Five hundred monkeys need not have been euthanized had they not been artificially housed together, amplifying the filovirus’s ability to spread.

At points, Preston sacrifices science for drama. When he writes, “moths and insects” and “a monkey or perhaps a baboon,” one assumes he knows that moths are insects and that baboons are monkeys. He refers to monkey canines as “canine fangs” or simply “fangs” to heighten the sense of danger — but zoologists typically would not use “fangs” in this sense. There are occasionally contradictory statements. In the middle, Ebola is shown to travel through air. By the end, this has become, “You have to wonder if Ebola virus can do that or not,” Peters notes.

The Hot Zone left me with unanswered questions. Why didn’t the virus appear during the 30-day quarantine after the monkeys were imported? Why did Hazleton Research Products import more monkeys from the same source, given the likelihood they would be infected? Why was the second outbreak in the monkey house allowed to burn through the population, causing a cruel death to the monkeys? Why did the company, the Army, and the CDC treat the second outbreak so casually (once they realised Ebola Reston did not affect humans), although today the same filovirus strain requires Level 4 biohazard handling, the same as for the deadly Ebola Zaire strain?

The Hot Zone is a horrifying, compelling story adequately told. In the wake of 9/11/01, it is also a timely one; today, filoviruses are considered bioterrorism threats (although who would want to handle them?). When you’re falling asleep in at night, imagine what else lurks among the life of the rain forest — and consider that the forest may yet have the final word.

15 November 2004
Copyright © Diane L. Schirf