The Hot Zone
|Country||South Africa, United States|
|Media type||Print (paperback and hardback) eBook and audiobook|
|LC Class||RC140.5 .P74 1995b|
The Hot Zone: A Terrifying True Story is a best-selling 1995 nonfiction thriller by Richard Preston about the origins and incidents involving viral hemorrhagic fevers, particularly ebolaviruses and marburgviruses. The basis of the book was Preston's 1992 New Yorker article "Crisis in the Hot Zone".
The filoviruses, Ebola virus, Sudan virus, Marburg virus, and Ravn virus 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 have no known prophylactics, treatments, or cures.
Along with describing the history of the diseases caused by these two Central African diseases, Ebola virus disease and Marburg virus disease, Preston described a 1989 incident in which a relative of Ebola virus, named Reston virus, was discovered at a primate quarantine facility in Reston, Virginia, less than 15 miles (24 km) away from Washington, D.C. The virus found at the facility was a mutated form of the original Ebola virus and was initially mistaken for Simian hemorrhagic fever. The original Reston facility involved in the incident, located at 1946 Isaac Newton Square, was subsequently demolished on 30 May 1995, and a new building was constructed in its place.
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. Preston recounts the story of "Charles Monet" (a pseudonym), who might have caught Marburg virus from visiting Kitum Cave on Mount Elgon in Kenya. 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 became infected with Marburg virus while treating Monet. Nancy Jaax's story is told. Viruses, biosafety levels and procedures were described. The Ebola virus disease outbreaks caused by Ebola virus and its cousin, Sudan virus, are mentioned. Preston talks to the man who named the Ebola virus.
- "The Monkey House" chronicles the discovery of Reston virus among imported monkeys in Reston, Virginia, and the following actions taken by the U.S. Army and Centers for Disease Control. It starts with the monkey house receiving a shipment of 100 wild monkeys. After four weeks, 29 of these monkeys have died. This is followed by the veterinarian for the facility, Dan Dalgard, examining the dead monkeys and sending the samples to Peter Jahrling, a virologist at United States Army Medical Research Institute of Infectious Diseases. After seeing a rope-like virus under the microscope, it is suspected that the monkeys were infected with a hot agent similar to the Marburg virus. Jahrling then conducts a blood test to find out that the hot agent is the Ebola Zaire virus. This conclusion leads to the Army Medical Research Institute deciding to euthanize all the monkeys in the same room as the infected monkeys.
- "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.
- "Kitum Cave" tells of the author's visit of the cave that is the suspected home of the natural host animal that Ebola lives inside of.
The book starts with "Charles Monet" visiting Kitum Cave 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. This particular filovirus is called Marburg virus.
Dr. Nancy Jaax had been promoted to work in the Level 4 Biosafety containment area at the United States Army Medical Research Institute of Infectious Diseases, and is assigned to research Ebola virus. While preparing food for her family at home, she cuts her right hand. Later, while working on a dead monkey infected with Ebola virus, 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. Nurse Mayinga is also infected by a nun and elects to visit Nairobi Hospital for treatment, where she succumbs to the disease.
In Reston, Virginia, less than fifteen miles (24 km) away from Washington, D.C., a company called Hazelton Research once operated a quarantine center for monkeys that were destined for laboratories. In October 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. Early during the testing process in biosafety level 3, when one of the flasks appeared to be contaminated with harmless pseudomonas bacterium, two USAMRIID scientists exposed themselves to the virus by wafting the flask. 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.
Finally, the author himself goes into Africa to explore Kitum Cave. On the way, he discusses the role of AIDS in the present, as the highway they were on, sometimes called the "AIDS Highway", or the "Kinshasa Highway", was where it first appeared. Equipped with a hazmat suit, 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. He finds the building abandoned and deteriorating. He concludes the book by claiming that Ebola will be back.
Reston Virus Outbreak
The discovery of the Reston virus was made in November 1989 by Thomas W. Geisbert, an intern at United States Army Medical Research Institute of Infectious Diseases. Dr. Peter B. Jahrling isolated the filovirus further. The Center for Disease Control and Prevention conducted blood tests of the 178 animal handlers. While 6 tested positive, they did not exhibit any symptoms. The Reston virus was found to have low pathogenicity in humans. This was further supported later when a handler infected himself during a necroscopy of an infected monkey. However, the handler did not show symptoms of the virus after the incubation period.
The Hot Zone was listed as one of around 100 books that shaped a century of science by American Scientist. Listed as an “Exploration,” the criteria dictate that the book typically “seeks to engage with the context” elucidating the general topic rather than a specific nuance.
Many reviews of The Hot Zone exemplify the impact the book had on the public’s view of emerging viruses. A review in the British Medical Journal captures the paranoia and public panic described in this book. The reviewer was left “wondering when and where this enigmatic agent will appear next and what other disasters may await human primates.” This can also be seen in a review in the Public Health Reports which highlights the “seriousness of our current situation” and “our ability to respond to a major health threat.”
The Hot Zone has been criticized for exaggerating the threat of Ebola and causing viral panic. In an interview about his book about Ebola, David Quammen claimed that The Hot Zone had “vivid, gruesome details” that gave an “exaggerated idea of Ebola over the years” causing “people to view this disease as though it was some sort of preternatural phenomenon.”
The Hot Zone is described as a “romantic account of environmental transgression.” Reactions to this book could be seen not only in the public’s view of emerging viruses, but in the changes in the Centers for Disease Control and Prevention. In addition to the funding of public health infrastructure during the early 1970s, there were many public discussions of biodefense. This book continued to fuel the emerging diseases campaign. By connecting international health to national security, this campaign used The Hot Zone as a method of justifying increased intervention in the global phenomena of disease.
The Hot Zone elicited a major response by the WHO by shedding light on the Ebola Zaire outbreak. The release of teams of experts was immediate and massive. Many countries tightened their borders, issued warnings to custom officials, quarantined travelers, and issued travel advisories.
In his blurb, horror writer Stephen King called the first chapter, "one of the most horrifying things I've read in my whole life." When asked whether any book "scared the pants off you" writer Suzanne Collins answered, "The Hot Zone, by Richard Preston. I just read it a few weeks ago. Still recovering."
The Hot Zone has received criticism for sensationalizing the effects of Ebola virus. In their memoir Level 4: Virus Hunters of the CDC, former CDC scientists Joseph B. McCormick and Susan Fisher-Hoch lambasted Preston for claiming that Ebola dissolves organs, stating that although it causes great blood loss in tissues the organs remain structurally intact. McCormick and Fisher-Hoch also dispute Preston's version of the CDC's actions in the Reston virus incident.
Failed film adaptation
In January 1993, 20th Century Fox and producer Lynda Obst won a bidding war for the film rights to Preston's 1992 New Yorker article, which was being transitioned into the book. In response to being outbid, Warner Bros. producer Arnold Kopelson immediately began working on the similarly themed Outbreak, a competing film which would ultimately be a factor leading to the collapse of Crisis in The Hot Zone.
Directors considered for the film adaptation included Wolfgang Petersen (who would later direct Outbreak), Michael Mann, and Ridley Scott. Scott eventually signed on to direct the film in February 1994. Screenwriter James V. Hart was also signed to adapt the book. In late-April 1994, Fox announced they had signed Robert Redford and Jodie Foster to star in the film.
However, this version would ultimately not be made. Foster dropped out of the film just before filming was to begin and production was delayed with Meryl Streep, Sharon Stone, and Robin Wright touted as possible replacements. In August 1994, Redford also dropped out of the film. A few days following Redford's departure, it was announced that pre-production had been shut down.
On October 16, 2014, The Hollywood Reporter announced that Ridley Scott again plans to adapt the book, this time as a television miniseries for NatGeo. Kelly Souders, Brian Peterson, and Jeff Vintar wrote the pilot. Julianna Margulies is starring as Nancy Jaax. Filming begins in September 2018.  Lynda Obst will again produce the series.
- C.J. Peters
- Hot zone (environment)
- The Demon in the Freezer
- United States Army Medical Research Institute of Infectious Diseases
- "Best Sellers". The New York Times Book Review. June 4, 1995. Retrieved 2008-09-29.
- Preston, Richard (October 26, 1992). "Crisis in the Hot Zone". The New Yorker. Retrieved July 31, 2014.
- E.G. Bradshaw, Monkey House in Reston, Va
- McCormick, Joseph (1996). Level 4: Virus Hunters of the CDC. pp. 298–299. ISBN 978-0-7607-1208-5.
- Morrison, P. 100 or so Books that shaped a Century of Science. Retrieved February 17, 2016, from http://www.americanscientist.org/bookshelf/pub/100-or-so-books-that-shaped-a-century-of-science
- Galbraith, N. S.. (1994). [Review of The Hot Zone]. BMJ: British Medical Journal, 309(6962), 1168–1169. Retrieved from https://www.jstor.org/stable/29725319
- Morse, S. A.. (1995). The Year 2000: Only a Plane Flight Away from Disaster? [Review of The Hot Zone; The Coming Plague: Newly Emerging Diseases in a World out of Balance]. Public Health Reports (1974-), 110(2), 223–225. Retrieved from https://www.jstor.org/stable/4597805
- Doucleff, M. (2014, November 11). How 'The Hot Zone' Got It Wrong And Other Tales Of Ebola's History. Retrieved March 28, 2016, from https://www.npr.org/sections/goatsandsoda/2014/11/11/362379449/how-the-hot-zone-got-it-wrong-and-other-tales-of-ebolas-history
- King, N. B.. (2004). The Scale Politics of Emerging Diseases. Osiris, 19, 62–76. Retrieved from https://www.jstor.org/stable/3655232
- Ungar, S.. (1998). Hot Crises and Media Reassurance: A Comparison of Emerging Diseases and Ebola Zaire. The British Journal of Sociology, 49(1), 36–56. http://doi.org/10.2307/591262
- "About The Hot Zone". Random House. Retrieved 30 July 2014.
- Jordan, Tina (Aug 12, 2010). "Suzanne Collins on the books she loves". Entertainment Weekly. Retrieved 30 July 2014.
- Level 4: Virus Hunters of the CDC. ISBN 978-0760712085.
- Eller, Claudia (January 24, 1993). "Fox, Obst contract virus pic". Variety. Retrieved March 1, 2015.
- O'Steen, Kathleen (February 13, 1994). "Virus pic fever infects Fox, WB". Variety. Retrieved March 1, 2015.
- "Ridley Scott has signed on to direct "Crisis in the Hot Zone"". varietyultimate.com: Variety. February 14, 1994. Retrieved March 1, 2015.
- "Fox set the deals on "Crisis in the Hot Zone" for Robert Redford and Jodie Foster". varietyultimate.com: Variety. May 2, 1994. Retrieved March 1, 2015.
- "Robert Redford has departed 20th Century Fox's "Crisis in the Hot Zone."". varietyultimate.com: Variety. August 15, 1994. Retrieved March 1, 2015.
- ""Crisis" in the Not Zone". varietyultimate.com: Variety. August 19, 1994. Retrieved March 1, 2015.
- Siegel, Tatiana (Oct 16, 2014). "Ebola TV Series in the Works From Lynda Obst, Ridley Scott (Exclusive)". The Hollywood Reporter. Retrieved 20 October 2014.
- Trendacosta, Katharine (Oct 16, 2014). "20 Years Too Late, Ridley Scott's Finally Adapting The Hot Zone". IO 9. Retrieved 20 October 2014.