The Hot Zone

Very few books are fascinating as this book by Richard Preston. The Hot Zone provides a vivid account of what happened in the 19^th century after an outbreak of an Ebola virus in a monkey in Washington D.C. I first read the book with much anticipation in regard to it loaded content. The story brings together other instance of outbreak in Africa and makes it clear that such catastrophes are very detrimental. I do agree with the idea presented in the book that the first instance of Ebola infection was detected in Zaire by which a French expert, Charles Monet, lost his life.  The fact that Preston gets first hand information from the people affected makes the story credible. It is very horrifying to learn that the Ebola virus kills nine out ten of its victims. The effects of this virus are so gruesome that even the experts are equally terrified as the common citizens. Richard presents a true story of how a small can wreck havoc to the entire human race.

The sudden appearance of Ebola virus in Virginia was very fascinating and tale of curbing it became very hard. The virus was able to clear ninety percent of its victims in just a few days. The account from the book shows that truth can very scarier than fiction. It cannot be questioned that Preston has succeeded in commanding as well as capturing the attention of his audiences.  He is able to effectively locate the apprehensions and fear of disease from the faces of his readers. The use of second person point of view has enabled Preston to directly address his readers. This is quite evident in his description of the horrendous effect of Ebola virus on the human organs. However, it should not go without notice that he fails in acknowledging the effort by medical practitioners by exalting the devastating effect of Ebola virus. He also fails to incorporate vital cultural issues which leaves the reader void and thus would seek other sources of information.

Richard Preston uses a lot of death cases which makes this book very terrifying for the reader. From accounts of the book, Richard Preston is not a fictitious author but rather one who brings out reality in its correct form. This is because most of the information that he presents are first hand from the actual victims of Ebola virus. Presto reminds the reader about the lethality of Ebola virus which kills ninety percent of its victims is just a few days. The hope of eradicating this menace is also thwarted by the fear that Preston presents in the faces of expertise.

The flow of the book can be equated to fascinating novel although it a non-fiction. Preston creates more tension and anticipation on the readers by presenting the threats of Ebola virus to United States as opposed to a small village in the heart of Africa. There is a stereotypical thinking that Africans are very vulnerable to viral attacks. Richards addresses this discriminatory thought by presenting a devastating condition in the heart of America. With the arrangement and vivid narration present in the book, The Hot Zone is a must-read for anyone looking for a chilling read. This is because of the accuracy with which the events are presented as well as the point of view that directly addresses the reader.

The Hot Zone by Richard Preston

This story starts on 1^st of January, 1980 by the introduction of a French national known as Charles Monet. This man works in western Kenya. He is a worker in a sugar plantation in the same part of Kenya. He and another decide to visit Mount Elgon for a camping trip. This is a mountain that had active volcanoes. These volcanoes had disappeared leaving behind very attractive scenery for tourism. It took them an overnight drive to reach the mountain side. 

One of the places they visit is known as Kitum Cave. This was a cave which had different kinds of animals. After this trip, it takes some days before Charles Monet falls ill. He starts by complaining of headache, and then fever comes in before he begins to seriously vomit. Things turn to worse as his eyes turn red and the whole body changes appearance.

His colleague decides to drive him to Kisumu for medical attention after his condition turns worse. The type of his illness turns out to be unknown after he has been examined by the doctors. They try to give him antibiotics which give no effect on the patient. His condition grows worse each minute. It is a horrible explanation of his suffering. The doctors decide to refer him to Nairobi hospital for further examination.

Charles Monet is taken to waiting room of Nairobi Hospital where he starts to profusely bleed. This is an indication of how serious things are turning out to be. This also proves of the damage to the internal organs. He is hurriedly wheeled into the intensive care unit in an attempt to save his life. Dr. Shem Musoke, a young doctor who is liked by many in the hospital attends to him. He is not also sure of what kind of disease Charles Monet suffers from.

He tries to fix a breathing device after realizing that the patient cannot breathe properly. During this process, the patient vomits blood onto Dr. Shem Musoke’s face. The doctor also tries to add the patient blood but realizes of the blood not clotting. The more the blood was transfused, the more it was lost. The struggle to save Monet’s life is lost after he dies that evening.

Dr. Shem Musoke also falls ill after some few days. He thinks he is suffering from malaria and typhoid fever. He treats himself for these symptoms but there seems to be no improvement. His doctor known as Antonia Bagshawe decides to do an exploratory surgery on his condition. He tests positive for a virus known as Marburg.

This chapter brings into board Dr. David Silverstein. This is a well known doctor who is highly esteemed in Nairobi. He is visited by the author and they converse more on the Marburg virus. He recalls how he received a call informing him of the news that Dr. Shem Musoke tested positive of this little known Marburg virus.

This is a not so well known virus which was named after a town in Germany. People in this town had contacted this virus from monkeys who had been brought in from Uganda for laboratory tests. The monkeys had initially been transported to Germany by unscrupulous trader whose main mission was to make money. The trader never considered the health implications of transporting such animals without proper care.

The chapter goes ahead to vividly describe how the virus looks like. It has a filovirus shape: it has tendril-like hair that can tangle together and roll in loops. This feature makes it unique unlike the other viruses. Marburg is deadly virus that kills every one in four patients. It remains to be a threat to the international community. It also goes ahead to explain that another of this type of virus is known as Ebola.

Four years later, the story now shifts to a town called Thurmont in Maryland. This is home town to Major Nancy Maax where she and her family live. Major Nancy and her husband, Jerry both work at Fort Detrick in Frederick as Veterinary Corps of the United States Army. She is a hardworking woman who is also committed to her family. She has a family of two children, a python, a parrot, and two dogs.

Major Nancy Maax is committed to advancing in her undertakings despite any opposition that comes her way. In the Army, she has overcome many obstacles that have come her way due to being a woman. She practices martial arts to help her achieve this end. Apart from her career, it is amusing to learn that she practices martial arts to smooth out her hand motion. Her colleagues had a feeling that her hands were too swift and could be dangerous when working in risky places.

All in all, this chapter brings out the resilience that this woman has. She is a veterinary officer whose work is to research on the animal diseases. This is necessary in order to protect the Army against any biological attach from enemies. More about how martial arts helped achieve this is not written.

This chapter starts with Major Nancy Maax waking up early in the morning the following day to study for her pathology board-examinations. She did this before reporting to his work station. She was training as a veterinary pathologist. This is the study of animal diseases. She studied at the United States Army Medical Research Institute of Infectious Diseases, also known as USAMRIID.

The main work of this institution is to research on the different ways of protecting the military soldiers against biological attacks or naturally occurring diseases. The current assignment that Major Nancy Maax has is to research on the Ebola outbreak. They are trying to find the cure from the infected monkeys they have at the institution. They have caged them to find more of the infectious Ebola virus.

This new project is headed by a civilian Army scientist known as Eugene Johnson. This is a scientist who has a reputation for having enthusiasm at working on such deadly viruses. The story continues by elaborating different areas of United States Army Medical Research Institute of Infectious Diseases. They are categorized depending on the biosafety levels ranging from zero to four. Major Nancy Maax was cleared to deal with level four. Procedures of these biosafety levels are also vividly described.

In this chapter, the story continues by Major Nancy Maax and her supervisors, Lieutenant Johnson enter into a room. This is the room where the experiments take place. There are two monkeys on one side of this room who are not infected by the virus. They act as the control to the experiments. The other side has many monkeys injected by the virus derived from a nurse who had treated Ebola patients in Zaire.

They find out that two of the infected donkeys have bled and succumbed to the virus. Major Maax confirms that they are totally before they start to dissect them. They find out the similarity of the monkeys’ illness to that of Charles Monet’s. The monkeys’ eyes have turn red, bloody noses and proof of extensive damage of the underlying tissues of the skin. The two therefore put on the protective suits and gloves to start dissection.

They start working on the first animal as they keep watch of each other to ensure that they are not exposed to the virus through leaks. Johnson discovers a tear on Maax’s right hand glove. She becomes terrified but she has to endure until the end of the process. She also realizes that she had a cut on her hand while preparing food for the family.

This part takes the reader back to 1976. It follows the origin of Ebola Sudan and Ebola Zaire strains of viruses. The Ebola Zaire is the strain that is later injected into the monkeys in USAMRIID for research. The virus starts in Southern Sudan with the death of storekeeper in one the local factories. His case is used as the index case. Two of his colleagues also die a few days later of the same illness.

This virus passes through sixteen generations with at least fifty percent of deaths occurring to the victims. The Ebola Zaire goes ahead to attach the local hospital in Maridi where patients and doctors succumbed to the same virus. After this attack, the infection of the virus seems to disappear. This is due to the fact that the victims succumb to the attack before infecting others.

Trouble again resurfaces as another trait of the same disease re-emerges two years later. This happens five hundred miles away from the previous scene. This brings havoc and terror on the patients. It proves to be twice as deadly as the former trait. This is evident on the pain that it inflicts on the victims. More and more people die of very horrific symptoms of this filovirus.

 This chapter brings into surface another trait of the virus. It takes the reader to September 1987 when blood samples were smuggled to Eugene Johnson. He later learns that the sample is from a Dutch boy known as Peter Cardinal. This ten year-old boy had died in Nairobi Hospital from what Eugene Johnson describes as a new trait of Marburg virus.

Eugene Johnson also discovers that the late boy had visited Kitum Cave that was visited by Charles Monet in the first chapter. It also emerges that the death of this boy resembles that of Charles Monet but for bleeding. While Monet bled out through orifices, the bleeding of this boy was under his own skin. This was a bit serious and different to the former.

The examination of the blood samples by Eugene Johnson brings out the reality of this virus. Whereas one can think that it can vanish, this can never be the truth. This virus hibernates in careers and resurfaces in different forms. It comes up with different symptoms at every time. Monet contacted a different trait of the virus in the same cave where Peter Cardinal also got infected with a different trait of the same virus.

Eugene Johnson and other colleagues decide to travel to Kenya to investigate Peter Cardinal’s death. He asks permission from the Government of Kenya to be allowed to do an exploration of Kitum Cave. They are granted the permission and embark on their work. They treat the cave as a level four hot zone. They apply all the procedures required for such a zone. They conduct their experiments in the cave while wearing space suits. They also take decontamination showers after finishing their experiments from the cave.

During the research, Johnson and his team exposes monkeys and guinea pigs in different parts of the cave. This is done to help the scientists discover where to specifically find the Marburg virus. They go deeper in their research trapping biting insects and dissecting monkeys in an attempt to find the virus.

The work proves to be a tough one as the research continues. Many small animals and monkeys are killed in the process. Biting insects are also trapped to help find where the virus lives.

Chapter two scenes occur in Reston, Virginia between the month of October and November of 1989. Hazleton Research Products is used to host imported monkeys that are to be used as Primate Quarantine Unit.  U.S is records 16,000 monkeys earmarked for importation. The monkeys must be quarantined to kill any disease they may be hosting. In chapter, we encounter a veterinarian who has been called to establish why the monkeys imported from Philippines are dying because of too much heat. Dalgard finds a couple of dead monkeys and he decides to slice up the monkeys that feed on crabs. He finds out that their spleens are hardened and enlarged.  He was not able to recognize that that condition was as a result of clotted blood which engorged the spleens. Worried about infection, he orders that new monkeys be placed in a different room.

In this chapter, Dalgrad decides to take samples of the monkey’s spleen and blood to USAMRIID to be tested by a civilian virologist by the name Peter Jahrling. The virologist puts on his medical attire and takes the monkey’s spleen to Laboratory 3 for tests. He makes a joke that what affected the monkey’s spleen might not be a Marburg virus. Together with his assistants, Peter Jarling decides to grow a virus in the test tube which is full of monkey cells. He seems to be relieved after learning that the monkeys in Reston were quite okay. However, the relief is cut short as many monkeys dies in the night and hence recording a fifty percent lose of monkeys in room F. as days unfold, many monkeys started to die in other rooms too. According to his diagnosis, the monkeys were suffering from hemorrhagic fever which is harmless to humans though fatal to animals.  Dalgrad resorts to euthanize all the remaining monkeys in room F

In November 17 USAMRIID hires an intern, Thomas Geisbert, who decides to check on the test tubes. Thomas Geisbert is known not only for his dedication in his job but also as a man who loves outdoor activities such as fishing and hunting. He notices that the cells in the test tubes have black specks, are puffy and dying. They thought the samples must have polluted by some bacteria.  On taking a closer view, Geisbert prepares a liquid for the microscope to help them in viewing the cells. As the chapter concludes, it is clear the filovirus incubates in the human system for 3 to 14 days before one begins to feel headache.

This chapter begins with Jaxx family having an atrocious gratitude. Nancy’s father is very sick in the farm and family chooses to travel to Kansas to take dinner with Jerry’s family. The family is still in great turmoil following the death of Jerry’s brother. They decide to take Nancy’s father to the hospital for check up and cancer treatment and the two families longer for couple of days. Dal Dagard is eagerly waiting for the test results from Jarling who have presumed that the monkeys were suffering from hemorrhagic fever. He is yet to ascertain this presumption. Dalgrad is disappointed at the mortality rate. He seems concerned that the condition is also evident in monkeys that are far away in room F.

When Tom Geisbert returns to work on 27^th November, he commences the work on his prepared specimen by slicing it up and then suspending the slices on a drop of water and then takes it for viewing through electron microscope. There are thousands of cells in each slices and this implies that a view on the microscope brings out a landscape from an airplane. He notices that the cells have been driven apart and it appears like they are making slow progress with microscopic worms. He notices a great similarity with the cells drawn from Peter Cardinal who died of Marburg. Tom believes that this must have been caused by improper handling of the specimen which must have caused the infection.

In this chapter, Tom comes up with a picture that is similar with Marburg virus and hands over to Jarling.  Jarling remembers his comments about the monkey tissues “Good thing this ain't Marburg."  However, he decides that this must be a different type of filovirus and not Marburg as Tom claims. He therefore interrupts his meeting with James Peters but flashes the photos to hide them from everyone. Jarling decides to undertake another test to determine the type of filovirus since he is convinced that the virus isn’t Marburg. He assumes that they must have not been cautious and therefore sniffed the virus into the test tube.

After all night research, Tom concludes that the monkeys in Reston are affected by filovirus. Jarling reveals to Dalgrad that there is potential danger but he doesn’t reveal greviance nature of the danger. They decide to suspend all the necropsies so as to avoid human exposure to infected blood.  On the other hand, Jarling continues with test to determine the type of virus that exists in these monkeys. He does this by introducing the virus in the blood sample with a known kind of agents. If the sample glows, then the virus might have found one of its kind. Jarling introduces the virus in a blood sample of a nurse with Ebola virus and to his amazement the sample glows.

In this chapter, Jarling repeats the tests and finds out that the virus is Ebola which kills ninety percent of its victims. He calls out an abrupt meeting with all stakeholders including Major General Phillip K. Russell and Lieutenant Colonel Nancy Jaax. Since Ebola can be transmitted by air, these experts are troubled on how to curb the menace before it starts sweeping the human population. Since they lack vaccines or cure for Ebola, they resort to use bio-containment in the monkey room. They decide to restrict the disease from taking its course and so the animals are euthanized to reduce the intensity of their suffering. As the chapter ends, the operation gains a political aspect which makes it more detrimental.

Dalgard receives a call from the panel of the eminent professionals. He is asked to provide some monkeys. However, he ignores the desire by Colonel Peters to view the monkey rooms. he is met with great shock when he learns that one of the caretakers in the monkey rooms had gone to the hospital due to heart attack. Dalgard is worried that this must have been caused by Ebola virus which leads to blood clot. He refuses to disclose that the person have been exposed to Ebola virus. Colonel Peters together with Nancy Jaxx travels to Reston and Nancy gets the chance to view the monkey’s house using a microscope. She is amazed to observe that some sections of the cells are liquefied due to explosion. The two request to be given samples of monkeys and they are directed to go to the gas station.

In this chapter, Nancy Jaxx and Colonel choose to transports the monkey bodies to USAMRIID for further test. They travel through level 4 which is a hot zone. After performing necropsies, the first monkey dies before the test is concluded.

Colonel Peters decides to call a meeting with all stakeholders who are conversant with Ebola virus. They included Joe McCormick who had witnessed many people die of the virus in Zaire. Joe McCormick offers to help with the outbreak but his attempts are perceived as CDC trying to overtake the entire operation. Everyone knows that his experience in working closely with people affected by Ebola virus make him convinced that it hard to contract the virus and that the army is just over-cautious.

Jerry Jaxx is chosen to take the lead in the house of monkeys. Their plan is euthanize all the monkeys and observe whether the virus can be contained or it can still spread. The troop decides to treat the entire building as a level 4 hot zone.

Dalgrad invites the entire army to euthanize all the monkeys in room F and H. Gene Johnson travels to Reston and finds the workers reluctant and have not taken any precaution to avoid infection.

At this point, the outbreak of the virus has already occurred at the monkey quarantine centre. Jerry Jaax and Jene Johnson are called upon to help save the situation. They park all the tools and equipment they had used during their mission in Kenya’s Kitum Cave. As they travel to Reston, the news is already leaked of an outbreak Ebola outbreak at the monkey house. This is something that Colonel C. J Peters downplays to avoid a possible panic by the people.

Jerry Jaax and the team travels to the centre secretly to avoid being seen by the reporters. They park their car behind the monkey house. They come up with a way of moving the personnel in the building without getting noticed. They had a duty to make things appear as normal as possible. They also have to wear their suits inside the building to avoid any suspicion by anyone.

Jerry is the first man to get in. he puts on the suit and then walks downwards to the level four area. The suit help form a buffer between the contaminated area and the natural world. He and his partner then examine the monkeys before going ahead with a mop handle.

In this chapter, things turn to a worse condition as Dan Darlgard helps an employee into the building and makes him lie down. By this time, already two people have been infected. Jarvis Purdy had a heart attack and was recuperating in the hospital. Now it is Milton Frantig who has fever. Darlgard cannot help out anymore and he decides to surrender the whole institution to the USAMRIID.

The Center for Disease Control staff try had to save Frantig in the hospital. He is later picked up by an ambulance. Unfortunately, the news crew arrives at this time to cover this scene. Things change in this centre as all monkey house workers leave their jobs. Troubles for the 450 monkeys continue as there is no one to feed them. They therefore die of hunger and high temperatures in the house.

It is evident that Darlgard had downplayed the seriousness of these infections. He thought it as a containable and harmless virus to human. This tends to change when Milton Frantig is infected by the virus. The journalists have also arrived to expose the extent of the infection at the centre. This infection is dangerous due to the proximity of this town to Washington DC.

The monkey house already been handed over to the Army. Jerry has a duty of bringing a good number of the crew to help in euthanizing the animals. This crew of animal technicians is known as 91-T, this is why the chapter title is 91- Tangos. It is comprised of young members with a good number of them untested. They agree to don the suits to help save the situation. They do this to ensure that thing do not go out of hand.

Meanwhile, Eugene Jackson does not sleep overnight trying to device a plan for the following day. He understands that a solution must be urgently be crafted. Jerry leads an initiative to feed the monkeys who had not eaten for sometime since the departure of the workers. During this process, he finds out that a number of the monkeys are sick in the building. A thought comes into him that Ebola virus may be travelling by air.

This idea leads them into collecting blood samples from the monkeys by injecting them to knock them down. They test this blood to find out what type of virus it is. The samples they take give out a different type virus known as Reston Virus. A virus that is not harmful to the humans.

The same day in the evening, an emergency arises when the fan in one of the member’s suits starts to die. As she is being evacuated from the building, she realizes a hole in her suit. This hole is enough to cause her trouble. She fears to be contaminated but is told by Eugene Johnson that the pressure in the suit may have kept the virus away. She and her partner are taken to a vehicle to hide away from the press.

The news crew sits near the building to record any incidence from the building. They however are unable to see what happens. This make them bored and later leave without seeing anything. This chapter describes how dangerous working in this place is. Any slightest mistake leads to a very deadly infection. It also brings into surface the dangers that the workers at this place are exposed to.

Everything in this house in handled with care. Any problem with the suit means an exposure to the virus. Contaminating others is also easy after the infection. The whole chapter generally describes the working condition in the monkey house. The news crew also comes around to cover this operation but they are unable due to its nature. Johnson also makes sure that nothing catches their attention.

This second day of operation is rather an eventful one. Thomas Ksiazek, a scientist at the USAMRIID discovers an easy way of discovering if one if infected or not. He finds out that none of the employees at the monkey house has really been infected with an Ebola virus. He gets amazed at this fact.

As people work, one of the monkeys escapes and runs out. This makes the team afraid as the monkey could easily infect other living things. The monkey looks like a fighter. It jumps up and down making it difficult for the crew to capture it. This also makes other monkeys jealous and angry. They decide to continue with other commitments planning to deal with the escapee later.

Rhonda Williams, the lady who had a problem with her suit takes a blood sample from an unconscious monkey. The monkey opens his eyes and tries to bite her. Another runs very fast and sedates the monkey thereby saving her from the infection arising from the bite. The day turns to be with a lot of issues that are very dangerous. This is true especially for Rhonda who was just about to be infected yesterday. Today, she also escapes an infection.

Major Nancy Jaax receives a call early in the morning on Thursday. The call is from her brother who tells her that their father is just about to die. She weighs the options of either travelling to see the father or staying behind to help save the situation. She declines to travel home and decides to stay and report for work. The father later dies while she is at work. She travels at the weekend for his burial.

On Friday, December 7, they finally manage to put down the last monkey who had escaped. The crew feels relieved that their work is over. Just before they call for the celebration, they come across the remains of some of the first monkeys to die two months ago. These are contained in a chest freezer. This exposes them once more and they call the help of the decon team, under the leadership of Merhl Gibson. They had to scrap the walls of the freezer with putty knives to remove the caked matter.

This scenario brings about another turn on the case that the crew thought they had won. Care has to be taken here to make sure that no damage is caused.

In January 1990, the importation of monkeys from resumes by Hazleton Research Products. This activity leads to an outbreak of Ebola again among the monkeys in the house. Interestingly, the company, the Army and the CDC decides not to take any action on the outbreak. They leave everything to take its course in what seems like an experiment. This leads to a big infection in all the rooms.

They find out that once one monkey is infected by this virus in a room, 80% of the monkeys end up getting the infected and dyeing. This time round, it proves to be a more serous case than the former ones. Its seems that the virus has mutated into a flu-like disease. This makes it spread very fast.

This virus is named Ebola Reston. It goes ahead to kill all the monkeys living in the house. All four of the monkey caretakers also test positive of the virus. They however are not affected by the infection as the virus lives in them for a period before vacating without harming them. The author then visits Major Nancy Jaax and gets a chance to see Ebola on a microscope. He sees the difference in the shapes of different traits of the viruses.

This chapter is written three years later at the time when Richard Preston made a trip on his own to Africa so as to investigate the origin of the Marburg and many other viruses including Ebola virus.  He entitles this chapter as highway since him together with his friends travelled through Kinshasa Highway which bisects Africa. This chapter shifts focus to HIV virus in which Preston explores AIDs as a disease and the theme of the chapter. In the chapter, Preston accounts that HIV virus, like Ebola and Marburg viruses, have been able to survive many years in the jungle without ever being noticed. He further explains that the virus gets into the human after being carried by some unknown creatures. At the end of the chapter, Richard accounts that as people travel, they continue to spread viruses to other new places.

The chapter begins by Preston’s visit to the Mt. Elgon and Kitum cave in the company of his friends including Robin McDonald. In the camp, they are given a set of instructions to follow should they become ill. This is mainly because the caves are troubled with infections that anyone can be a victim. The crew chose to pitch their tent at the very place where Charles Monte had camped centuries ago. Preston accounts that everyplace he would look, he could locate potential host of virus. The possible hosts that he enumerates include the flying moths and even the nettles of a tree. Richard had carried with him level 4 spacesuit which wears before going into the cave so as to avoiding catching any illness. Kitum cave is very dusty and dry which provides a good brooding place for various viruses.