Sunday, January 4, 2015

Book Review: the Hot Zone by Richard Preston

Hot (Military Slang.): Lethally Infective in a biological sense.” (Preston 418)
"Hot agent: Extremely lethal virus. Potentially airborne.” (Preston 418)

These two definitions taken from Richard Preston’s the Hot Zone convey the urgent and serious tone which Preston uses to describe his topic: Ebolaviruses and Marburg virus of the Filoviridae family. In his non fiction book, he uses a combination of anecdotes of patients’ experiences and facts about the viruses to recount the history of Ebola viruses and depict a general overview of the Filovirus family. Richard Preston starts the book with an account of Charles Monet’s Marburg infection and subsequent outbreak in 1980. He takes us on the journey that Monet went on to and from Kitum Cave in Mount Elgon, he makes the reader apprehensive about the possibility of transmission to those he is around on the plane, the medical staff at the hospital. He describes the progression of his illness with vivid imagery: “He is becoming an automaton. Tiny spots in the brain are liquefying. The higher functions of consciousness are winking out first, leaving the deeper parts of the brain stem still alive and functioning. It could be said that the who of Charles Monet has already died while the what continues to live.” Furthermore he appeals to the readers’ emotions and stomachs when he describes how Monet’s internal organs fail and he bleeds out from all body parts. 

By starting out with an account of the Marburg illness and not giving the reader the facts about Filoviruses, he builds up the suspense and piques the interest in finding out the details about Filoviruses: their route of transmission, their origins, their level of infectiousness. If the reader had no prior knowledge about Marburg when he started reading the book, he would become a detective alongside the author trying to figure out what this disease is. 

A very thrilling part of the book describes Nancy Jaax, ’s encounter with Ebola. After grabbing the reader’s attention with the story of Charles Monet’s illness and subsequent death, he transitions to Thurmont Maryland 1983 and follows the experience of Major Nancy Jaax, a veterinarian with Ebola. What makes the book more appealing to the mass audience is partly the fact that Preston throws in some details about personal lives of the characters and doesn’t just state the facts of the viruses. He interweaves details about Ebola with descriptions of how Nancy always cooked in the house, gave her children baths, lived in a Victorian house, and was married to another veterinarian. These details make her personable and make the readers more concerned when they read about the fact that when she is working with a dead monkey with Ebola, her glove tear. She has a cut on her hand from making dinner the day before and is exposed to the virus. Fortunately she doesn’t have the virus, but he spends several pages accentuating her fears and her apprehensions. 

He goes on to describe Ebola: its classification, appearance, symptoms, etc. He repeatedly says that the knowledge of the properties of Ebola in the scientific community needs to be substantially improved. He describes the history of the Filoviridae virus family and contemplates the origins of AIDS. He devotes several pages to describing the several Biosafety levels and the dangerous implications of Ebola’s classification as a Biosafety level 4 virus. He describes the Ebola Sudan and Ebola Zaire strains and writes about the discovery of the Reston strain and the involvement of the US Army and Centers for Disease Control in its containment. He writes about the eruption of the Ebola virus in a monkey house near the CDC. 

The book ends on a forbearing tone. In the last pages he indicates the fast mutation rate of the AIDS virus and the lack of vaccines for it. Furthermore he conveys the point that while the AIDS virus was disregarded as a minor concern for a minority population of homosexuals in California when it first appeared, it soon progressed to play a major part in society alarming the medical community. He thus compares AIDS to Ebola, not only because they serve as the “revenge of the rain forest,” but also because they have underdog features. At the time of the novel’s publication, Ebola was being ignored by a large part of the world due to the fact that it had at the time of the novel only infected people in West Africa. He states that "AIDS might not be Nature’s preeminent display of power implying that the readers should anticipate something stronger and more dangerous. After discussing AIDS, he travels to the abandoned monkey house in Reston and concludes the book here: “Ebola had risen in these rooms, flashed its colors, fed, and subsided into the forest. It will be back. 

His book serves not just as an interesting informant of the history of Filoviruses but rather as a call to action to the medical community and society in general to enhance research, create effective treatments, and design better ways to combat Ebola when it gets out of the Kitum Cave or some other secluded place again. 

By Mariam Kyarunts

(also posted on amazon.com )

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