Nature is anything but simple. This emerging virus was like a bat crossing the sky at evening. Just when you thought you saw it flicker through your field of view, it was gone.
Richard Preston’s 1994 bestseller about the origins of Ebolavirus and early outbreaks, The Hot Zone, has been criticized for inaccurately depicting Ebola’s symptoms and overemphasizing the gruesome and grotesque. Specifically, this has included claims of blowing symptoms out of proportion for shock value, overuse of the word “liquefy” to describe effects to internal organs, and too much emphasis on hemorrhaging blood. Hmm.
Preston doesn’t specify that only around 20% of sufferers exhibit such extreme symptoms, and in reading the book alone you’d definitely have the impression that the extreme experiences of the pseudonymous Charles Monet and a Belgian nun whose hospital room was so blood-spattered after her death that staff could only close the door and leave it, are the norm. They’re not, but they’re not entirely fiction, either.
And this book did motivate many people to learn something about the virus, or even to pursue work in epidemiology and infectious disease research, as the scientist in the interview linked above notes. Maybe it did stoke fears more intensely than necessary – I still remember being morbidly fascinated by this book when I was a kid and it first came out, but was too terrified to read it (“preternatural phenomenon”, also from that scientist’s interview, is exactly the impression I had).
But with the outbreaks in recent years in West Africa and the Congo and ensuing prevalence in news stories and global health topics, I wanted to know more about its origin and some background about how it operates, replicates – even all the gory details. Plus this book is being adapted into a six-part National Geographic miniseries at the end of this month.
I’m sure the book has its flaws and inaccuracies in describing some symptoms and effects of the virus. But I learned from it exactly what I wanted to – what’s known of the origins of Ebola and related viruses, like Marburg, and the background of some of the early outbreaks in humans that have been identified. And it’s so readable and intense, paced like a thriller and hard to put down. I didn’t expect it to be so engaging and well written.
And actually, if anything, I found some of it reassuring. Ebola isn’t airborne, though there’s still some uncertainty around whether certain strains can become so via water particles (but this holds true for plenty of viruses). You have to come in direct contact with infected fluids. That means flying on a plane with someone who’s ill or most of the other alarmist scenarios that the media becomes hysterical over – as in 2014 when the largest outbreak since 1976 began in West Africa – generally aren’t enough to transmit it.
The book begins with the story of Charles Monet (he being a kind of patient zero) acquiring the Marburg virus at Kitum Cave on Mount Elgon in Kenya (a bat cave!), the stages of his swiftly worsening illness and unusual death, spreading a secondary infection to a doctor in the course of it.
Most of the book’s second half focuses on a play by play of an outbreak of a previously unrecognized strain, Reston virus, named for its discovery in Reston, Virginia in a “monkey house,” a primate research facility. When the virus is first tentatively identified, the Army pathology specialists are unsure what exactly it is, and if it can be transmitted to humans. It’s told mostly through the lens of Nancy Jaax, a veterinary pathologist working at the facility to establish a protocol for dealing with and containing this highly lethal virus, and figuring out what it is in the first place. The tension is heightened by the monkey house’s location just outside Washington DC, and the menacing implications their failure could have.
They did not care to do research on Ebola because they did not want Ebola to do research on them.
Even decades after this book was written, Ebola research remains in its infancy, which makes for an interesting scientific perspective in the narrative told here. There’s a lot of trial and error, figuring things out as they happen, and once the the deadliness of the virus group is understood, it’s pulse-pounding to follow along with the process of handling it. This section around the Reston monkey house and Jaax’s work is the most thriller-like, immersing in the lives of the people who worked on testing and identifying the strain with very little background of what they were dealing with and a harrowing, secretive atmosphere surrounding it.
The whole book is packed with detail but compulsively readable. Although it may verge on the sensational in points, it does present a good picture to gain an understanding of the origins and some significant historical events in Ebola’s relatively young timeline. 4.25/5
The Hot Zone:
The Terrifying True Story of the Origins of the Ebola Virus
by Richard Preston