The Hot Zone is a best-selling 1994
non-fictionNon-fiction is the form of any narrative, account, or other communicative work whose assertions and descriptions are understood to be fact...
bio-thriller by
Richard PrestonRichard Preston, born August 5, 1954 in Cambridge, Massachusetts, U.S., is a New Yorker writer and bestselling author perhaps best-known for his books about infectious disease epidemics and bioterrorism, although he has written other non-fiction works...
about the origins and incidents involving
viral hemorrhagic feverThe viral hemorrhagic fevers are a diverse group of animal and human illnesses that are caused by four distinct families of RNA viruses: the families Arenaviridae, Filoviridae, Bunyaviridae, and Flaviviridae. All types of VHF are characterized by fever and bleeding disorders and all can progress...
s, particularly
ebolavirusesThe genus Ebolavirus is a virological taxon included in the family Filoviridae, order Mononegavirales.This genus was introduced in 1998 as the "Ebola-like viruses". In 2002 the name was changed to Ebolavirus and in 2010 the genus was emended....
and
marburgvirusesThe genus Marburgvirus is the taxonomic home of one species whose members are two related viruses that form filamentous virions, Marburg virus and Ravn virus...
. The basis of the book was Preston's 1992
New YorkerThe New Yorker is an American magazine of reportage, commentary, criticism, essays, fiction, satire, cartoons and poetry published by Condé Nast...
article "
Crisis in the Hot ZoneCrisis in the Hot Zone was the title of a 1992 non-fiction article by Richard Preston in The New Yorker. It chronicles the story of how the U.S...
".
The
filovirusesThe family Filoviridae is the taxonomic home of several related viruses that form filamentous virions. Two members of the family that are commonly known are Ebola virus and Marburg virus. Both viruses, and some of their lesser known relatives, cause severe disease in humans and nonhuman primates in...
Ebola virusEbola virus causes severe disease in humans and in nonhuman primates in the form of viral hemorrhagic fever. EBOV is a Select Agent, World Health Organization Risk Group 4 Pathogen , National Institutes of Health/National Institute of Allergy and Infectious Diseases Category A Priority Pathogen,...
(EBOV),
Sudan virusSudan virus is a close relative of the much more commonly known Ebola virus . SUDV causes severe disease in humans and in nonhuman primates in the form of viral hemorrhagic fevers...
(SUDV),
Marburg virusMarburg virus disease is the name for the human disease caused by any of the two marburgviruses Marburg virus and Ravn virus...
(MARV), and
Ravn virusRavn virus is a close relative of the much more commonly known Marburg virus . RAVV causes severe disease in humans and in nonhuman primates in the form of viral hemorrhagic fever...
(RAVV) are Biosafety Level 4 agents. Biosafety Level 4 agents are extremely dangerous to humans because they are very infectious, have a high case-fatality rate, and there are no known prophylactics, treatments, or cures. Along with describing the history of the diseases caused by these two
Central AfricaCentral Africa is a core region of the African continent which includes Burundi, the Central African Republic, Chad, the Democratic Republic of the Congo, and Rwanda....
n diseases, Ebola virus disease (EVD) and Marburg virus disease (MVD), Preston describes an incident in which a relative of Ebola virus named
Reston virus- Introduction and Use of Term :Reston virus was first described in 1990 as a new "strain" of Ebola virus, a result of mutation from Ebola virus. It is the single member of the species Reston ebolavirus, which is included into the genus Ebolavirus, family Filoviridae, order Mononegavirales...
(RESTV), which was the result of a mutation in the Ebola virus. Its name is derived from
Reston, VirginiaReston is a census-designated place in Fairfax County, Virginia, United States, within the Washington, D.C. metropolitan area. The population was 58,404, at the 2010 Census and 56,407 at the 2000 census...
, nonhuman primate quarantine facility less than fifteen miles (24 km) away from Washington, DC, because it was where they found it.
The original Reston, VA, facility located at 1946 Isaac Newton Square was torn down sometime between 1995 and 1998.
Synopsis
The book is in four sections:
- "The Shadow of Mount Elgon" delves into the history of filoviruses, as well as speculation about the origins of AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...
. Preston accounts the story of "Charles Monet" (a pseudonymA pseudonym is a name that a person assumes for a particular purpose and that differs from his or her original orthonym...
), who might have caught MARV from visiting Kitum CaveKitum Cave is a non-solutional cave developed in pyroclastic rocks in Mount Elgon National Park, Kenya. The cave extends about into the side of the mountain. The walls are rich in salt, and animals such as elephants have gone deep into the cave for centuries in search of salt...
on Mount ElgonMount Elgon is an extinct shield volcano on the border of Uganda and Kenya, north of Kisumu and west of Kitale.- Physical features :It is the oldest and largest solitary volcano in East Africa, covering an area of around 3500 km²....
in KenyaKenya , officially known as the Republic of Kenya, is a country in East Africa that lies on the equator, with the Indian Ocean to its south-east...
. The author describes in great detail the progression of the disease, from the initial headache and backache, to the final stage in which Monet's internal organs fail and he "bleeds out" (i.e., hemorrhages extensively) in a waiting room in a Nairobi hospital. This part also introduces a young promising physician who becomes infected with MARV while treating Monet. Nancy Jaax's story is told. Viruses, and biosafety levels and procedures are described. The EVD outbreaks caused by EBOV and its cousin, Sudan virusSudan virus is a close relative of the much more commonly known Ebola virus . SUDV causes severe disease in humans and in nonhuman primates in the form of viral hemorrhagic fevers...
(SUDV) are mentioned. Preston talks to the man who named Ebola virus.
- "The Monkey House" The discovery of Reston virus
- Introduction and Use of Term :Reston virus was first described in 1990 as a new "strain" of Ebola virus, a result of mutation from Ebola virus. It is the single member of the species Reston ebolavirus, which is included into the genus Ebolavirus, family Filoviridae, order Mononegavirales...
virus among imported monkeys in Reston, VirginiaReston is a census-designated place in Fairfax County, Virginia, United States, within the Washington, D.C. metropolitan area. The population was 58,404, at the 2010 Census and 56,407 at the 2000 census...
, and the following actions taken by the U.S. Army and Center for Disease Control.
- "Smashdown" is more on the Reston epizootic, which involved a strain of the virus that does not affect humans but which easily spreads by air, and is very similar to its cousin the Ebola virus
Ebola virus causes severe disease in humans and in nonhuman primates in the form of viral hemorrhagic fever. EBOV is a Select Agent, World Health Organization Risk Group 4 Pathogen , National Institutes of Health/National Institute of Allergy and Infectious Diseases Category A Priority Pathogen,...
.
- "Kitum Cave" The author visits the cave that is the suspected home of the natural host
In biology, a host is an organism that harbors a parasite, or a mutual or commensal symbiont, typically providing nourishment and shelter. In botany, a host plant is one that supplies food resources and substrate for certain insects or other fauna...
animal that Ebola lives inside of.
The book starts with "Charles Monet" visiting
Kitum CaveKitum Cave is a non-solutional cave developed in pyroclastic rocks in Mount Elgon National Park, Kenya. The cave extends about into the side of the mountain. The walls are rich in salt, and animals such as elephants have gone deep into the cave for centuries in search of salt...
during a camping trip to Mount Elgon in Central Africa. Not long after, he begins to suffer from a number of symptoms, including vomiting, diarrhea and red eye. He is soon taken to Nairobi Hospital for treatment, but his condition deteriorates further and he goes into a coma while in the waiting room. He dies, but not before a Doctor named Shem Musoke, attempting to insert a laryngoscope, is infected by exposure to Charles' blood and vomit. Musoke is one of the few to become symptomatic from a filovirus and survive. This particular filovirus is called
Marburg virusMarburg virus disease is the name for the human disease caused by any of the two marburgviruses Marburg virus and Ravn virus...
.
Dr. Nancy Jaax had been promoted to work in the Level 4 Biosafety containment area at USAMRIID, and is assigned to research
Ebola virusEbola virus causes severe disease in humans and in nonhuman primates in the form of viral hemorrhagic fever. EBOV is a Select Agent, World Health Organization Risk Group 4 Pathogen , National Institutes of Health/National Institute of Allergy and Infectious Diseases Category A Priority Pathogen,...
. While preparing food for her family at home, she cuts her right hand. Later, while working on a dead, EBOV-infected monkey, one of the gloves on the hand with the open wound tears, and she is almost exposed to contaminated blood, but does not get infected. Meanwhile, Peter Cardinal, a ten-year-old, visits Kitum Cave, gets infected with a MARV relative,
Ravn virusRavn virus is a close relative of the much more commonly known Marburg virus . RAVV causes severe disease in humans and in nonhuman primates in the form of viral hemorrhagic fever...
(RAVV), and does not survive this infection. Nurse Mayinga is also infected by a nun and elects to visit Nairobi Hospital for treatment, where she succumbs to the disease. A
CDCThe Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...
team arrives to collect samples of the virus for study.
In Reston, Virginia, less than fifteen miles (24 km) away from Washington, DC, a company called Hazelton Research once operated a
quarantineQuarantine is compulsory isolation, typically to contain the spread of something considered dangerous, often but not always disease. The word comes from the Italian quarantena, meaning forty-day period....
center for monkeys that were destined for laboratories. In October of 1989, when an unusually high number of their monkeys began to die, their veterinarian decided to send some samples to Fort Detrick (USAMRIID) for study. At the time, it was believed that the virus was
Simian hemorrhagic fever virusSimian hemorrhagic fever virus or simian haemorrhagic fever virus or SHFV is a highly pathogenic virus in monkeys. It is a positive-stranded RNA virus classified in the family Arteriviridae.- Hosts :...
, a
viral hemorrhagic feverThe viral hemorrhagic fevers are a diverse group of animal and human illnesses that are caused by four distinct families of RNA viruses: the families Arenaviridae, Filoviridae, Bunyaviridae, and Flaviviridae. All types of VHF are characterized by fever and bleeding disorders and all can progress...
harmless to humans but almost always fatal to other primates (see
zoonosisA zoonosis or zoonoseis any infectious disease that can be transmitted from non-human animals to humans or from humans to non-human animals . In a study of 1415 pathogens known to affect humans, 61% were zoonotic...
). Early during the testing process in biosafety level 3, when one of the flasks appeared to be contaminated with harmless
pseudomonasPseudomonas is a genus of gammaproteobacteria, belonging to the family Pseudomonadaceae containing 191 validly described species.Recently, 16S rRNA sequence analysis has redefined the taxonomy of many bacterial species. As a result, the genus Pseudomonas includes strains formerly classified in the...
bacterium, two USAMRIID scientists exposed themselves to the virus by
waftWaft is a term meaning to carry along gently as through the air. The term is commonly used to describe scents that have diffused in to other parts of a room, or to describe smoke as being seen moving through the air...
ing the flask. When they eventually tested the samples with known Level 4 agents, only EBOV reacted with the unknown samples. They decided not to tell anyone about their exposure, but they did secretly test their blood every day. After one of the monkey house staff members becomes ill with nausea and violent vomiting, USAMRIID is given permission to send in a team to euthanize all the monkeys at the facility and collect tissue samples. They later determine that, while the virus is terrifyingly lethal to monkeys, humans can be infected with it without any health effects at all. This virus is now known as
Reston virus- Introduction and Use of Term :Reston virus was first described in 1990 as a new "strain" of Ebola virus, a result of mutation from Ebola virus. It is the single member of the species Reston ebolavirus, which is included into the genus Ebolavirus, family Filoviridae, order Mononegavirales...
(RESTV).
Finally, the author himself goes into Africa to explore Kitum Cave. On the way, he discusses the role of
AIDSAcquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...
in the present, as the highway they were on, sometimes called the
"AIDS Highway,"The Kinshasa Highway is an informal name for route across the Democratic Republic of the Congo into Uganda and beyond, consisting of paved highways in some places and seasonally impassable tracks in others. The name has gained currency for the role which long-distance truck drivers played in the...
or the "Kinshasa Highway" was where it first appeared. Equipped with a
Hazmat suitA hazmat suit is a garment worn as protection from hazardous materials or substances. A hazmat suit is generally combined with breathing apparatus for protection and may be used by firefighters, emergency personnel responding to toxic spills, researchers, specialists cleaning up contaminated...
, he enters the cave and finds a large number of animals, one of which might be the virus carrier. At the conclusion of the book, he travels to the quarantine facility in Reston. The building there was abandoned and deteriorating. He concludes the book by saying EBOV will be back.
Reception
Due to the detailed and graphic descriptions of the effects of exotic tropical diseases, as well as the revelation that an ebolavirus was found a few miles away from Washington D.C.,
The Hot Zone was hailed by many as a chilling and accurate story of lethal viruses and their encounters with humans. Because Preston's writing style is that of a "science fact" thriller, some critics accused Preston of dramatizing and exaggerating the effects of an Ebola virus infection and embellishing facts with his own imagination. Since its publication over a decade ago, however,
The Hot Zone is generally regarded as a nonfiction work and acknowledged for its masterful dramatization. In his
blurbA blurb is a short summary or some words of praise accompanying a creative work, usually used on books without giving away any details, that is usually referring to the words on the back of the book jacket but also commonly seen on DVD and video cases, web portals, and news websites.- History :The...
, horror writer
Stephen KingStephen Edwin King is an American author of contemporary horror, suspense, science fiction and fantasy fiction. His books have sold more than 350 million copies and have been adapted into a number of feature films, television movies and comic books...
called the book, "one of the most horrifying things I've ever read." When asked whether any book "scared the pants off you", television writer
Suzanne CollinsSuzanne Collins is an American television writer and novelist.-Early life:Suzanne Collins is the daughter of an Air Force officer. She graduated from the Alabama School of Fine Arts and earned her M.F.A. from New York University in Dramatic Writing....
answered, "The Hot Zone, by Richard Preston. I just read it a few weeks ago. Still recovering."
External links