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Author | Richard Preston |
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Language | English |
Subjects | Virology, Ebola Virus, Medical, Epidemiology |
Genre | Nonfiction |
Publisher | 1st Anchor Books Edition Knopf Doubleday Publishing Group |
Publication date | September 20, 1994 |
Publication place | South Africa, United States |
Media type | Print (paperback and hardback) eBook and audiobook |
Pages | 368 |
ISBN | 0-385-47956-5 |
OCLC | 32052009 |
614.5/7 20 | |
LC Class | RC140.5 .P74 1994 |
Website | https://richard-preston.net/book/the-hot-zone/ |
The Hot Zone: A Terrifying True Story is a best-selling 1994 nonfiction thriller by Richard Preston about the origins and incidents involving viral hemorrhagic fevers, particularly ebolaviruses and marburgviruses. [1] [2] The basis of the book was Preston's 1992 New Yorker article "Crisis in the Hot Zone". [3]
The filoviruses—including Ebola virus, Sudan virus, Marburg virus, and Ravn virus—are Biosafety Level 4 agents, extremely dangerous to humans because they are very infectious, have a high fatality rate, and most have no known prophylactic measures, treatments, or cures. Along with describing the history of the devastation caused by two of these Central African diseases, Ebola virus disease and Marburg virus disease, Preston described a 1989 incident in which a relative of Ebola virus, Reston virus, was discovered at a primate quarantine facility in Reston, Virginia, less than 15 miles (24 km) away from Washington, D.C.
The book is in four sections:
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 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 goes to Ngaleima Hospital in Kinshasa 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. The virus found at the facility was a mutated form of the original Ebola virus and was initially mistaken for simian hemorrhagic fever virus. They later determine that, while the virus is 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 goes to Africa to explore Kitum Cave. On the way, he discusses the role of AIDS in the present, as the Kinshasa Highway that he travels on was sometimes called the "AIDS Highway" after its early appearance in the region. 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.
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 six 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 necropsy of an infected monkey, as the handler did not show symptoms of the virus after the incubation period. [4]
The Hot Zone was listed as one of around 100 books that shaped a century of science by American Scientist . [5] 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". [6] 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". [7]
The Hot Zone was described in an academic journal covering research in the history of science 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 to justify increased intervention in the global phenomena of disease. [8]
The Hot Zone elicited a major response by the World Health Organization (WHO) by shedding light on the Zaire ebolavirus.[ clarification needed ] Teams of experts were immediately released.[ clarification needed ] Many countries tightened their borders, issued warnings to customs officials, quarantined travellers, and issued travel advisories. [9]
In his blurb, horror writer Stephen King called the first chapter "one of the most horrifying things I've read in my whole life". [10] 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." [11]
The Hot Zone has received criticism for sensationalizing the effects of Ebola virus. [12] In their memoir Level 4: Virus Hunters of the CDC (1996), [13] 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.[ citation needed ] In an interview about his book Ebola: The Natural and Human History of a Deadly Virus (2014), 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". [14]
In January 1993, 20th Century Fox producer Lynda Obst won a bidding war for the film rights to Preston's 1992 New Yorker article, which was still being transitioned into book form. [15] In response to being outbid, Warner Bros. producer Arnold Kopelson immediately began working on a similarly themed production. This competing film, Outbreak , would ultimately be a factor in the collapse of Fox's planned production, Crisis in The Hot Zone. [16]
Directors considered for Crisis in The Hot Zone included Wolfgang Petersen (who would later direct Outbreak), Michael Mann, and Ridley Scott. Scott eventually signed on to direct the film in February 1994. [17] 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. [18]
Crisis in The Hot Zone, however, was never 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; [19] a few days after Redford left it was announced that pre-production had been shut down. [20]
On October 16, 2014, The Hollywood Reporter announced that Ridley Scott again planned to adapt the book, this time as a television miniseries for NatGeo. Kelly Souders, Brian Peterson, and Jeff Vintar wrote the pilot. Julianna Margulies starred as Nancy Jaax. Filming began in September 2018. [21] Lynda Obst again produced the series. [22] The series first aired from May 27 to May 29, 2019, [23] and was later renewed for a second season.
Marburg virus disease (MVD), formerly Marburg hemorrhagic fever (MHF) is a viral hemorrhagic fever in human and non-human primates caused by either of the two Marburgviruses: Marburg virus (MARV) and Ravn virus (RAVV). Its clinical symptoms are very similar to those of Ebola virus disease (EVD).
A biological hazard, or biohazard, is a biological substance that poses a threat to the health of living organisms, primarily humans. This could include a sample of a microorganism, virus or toxin that can adversely affect human health. A biohazard could also be a substance harmful to other living beings.
Filoviridae is a family of single-stranded negative-sense RNA viruses in the order Mononegavirales. 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 the form of viral hemorrhagic fevers.
Outbreak is a 1995 American medical disaster film directed by Wolfgang Petersen and written by Laurence Dworet and Robert Roy Pool. The film stars Dustin Hoffman, Rene Russo, Morgan Freeman and Donald Sutherland, and co-stars Cuba Gooding Jr., Kevin Spacey and Patrick Dempsey.
The genus Marburgvirus is the taxonomic home of Marburg marburgvirus, whose members are the two known marburgviruses, Marburg virus (MARV) and Ravn virus (RAVV). Both viruses cause Marburg virus disease in humans and nonhuman primates, a form of viral hemorrhagic fever. Both are select agents, World Health Organization Risk Group 4 Pathogens, National Institutes of Health/National Institute of Allergy and Infectious Diseases Category A Priority Pathogens, Centers for Disease Control and Prevention Category A Bioterrorism Agents, and are listed as Biological Agents for Export Control by the Australia Group.
The genus Ebolavirus is a virological taxon included in the family Filoviridae, order Mononegavirales. The members of this genus are called ebolaviruses, and encode their genome in the form of single-stranded negative-sense RNA. The six known virus species are named for the region where each was originally identified: Bundibugyo ebolavirus, Reston ebolavirus, Sudan ebolavirus, Taï Forest ebolavirus, Zaire ebolavirus, and Bombali ebolavirus. The last is the most recent species to be named and was isolated from Angolan free-tailed bats in Sierra Leone. Each species of the genus Ebolavirus has one member virus, and four of these cause Ebola virus disease (EVD) in humans, a type of hemorrhagic fever having a very high case fatality rate. The Reston virus has caused EVD in other primates. Zaire ebolavirus has the highest mortality rate of the ebolaviruses and is responsible for the largest number of outbreaks of the six known species of the genus, including the 1976 Zaire outbreak and the outbreak with the most deaths (2014).
The Demon in the Freezer is a 2002 nonfiction book on the biological weapon agents smallpox and anthrax and how the American government develops defensive measures against them. It was written by journalist Richard Preston, also author of the best-selling book The Hot Zone (1994), about ebolavirus outbreaks in Africa and Reston, Virginia and the U.S. government's response to them. Preston decided to write the book following the 2001 anthrax attacks, discussing the two diseases together because both could be potential biological weapons.
Clarence James Peters, Jr is a physician, field virologist and former U.S. Army colonel. He is noted for his efforts in trying to stem epidemics of exotic infectious diseases such as the Ebola virus, Hanta virus and Rift Valley fever (RVF). He is an eminent authority on the virology, pathogenesis and epidemiology of hemorrhagic fever viruses.
Lisa Ellen Hensley is the associate director of science at the Office of the Chief Scientist, National Institute of Allergy and Infectious Disease Integrated Research Facility in Frederick, Maryland. She was previously a civilian microbiologist in the virology division of the United States Army Medical Research Institute of Infectious Diseases (USAMRIID). Hensley is one of the premier researchers of some of the world's most dangerous infections, including Ebola hemorrhagic fever, Lassa fever, the coronavirus diseases Severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), and smallpox. She has been involved in research uncovering critical mechanisms in the pathogenesis of hemorrhagic fever viruses, and has used those discoveries to develop candidate therapeutic drugs for their treatment.
Kitum Cave is located in Mount Elgon National Park, Kenya. In the 1980s, two European visitors contracted Marburg virus disease there. It is one of five named "elephant caves" of Mount Elgon where animals, including elephants, "mine" the rock for its sodium-rich salts.
Dr. Eugene "Gene" Johnson was an American virologist who specialized in filoviruses like Ebola, and Marburg. Formerly of USAMRIID, the United States Army Medical Research Institute for Infectious Disease, he was on staff at the Armed Forces Medical Intelligence Center, until his death in 2019. While at USAMRIID, Johnson coordinated the first efforts to identify the vector for Marburg virus in Kitum cave, Kenya. He also participated in the joint Centers for Disease Control and Prevention/USAMRIID containment of the 1989 Reston Ebola outbreak near Washington DC.
The species Bundibugyo ebolavirus is the taxonomic home of one virus, Bundibugyo virus (BDBV), that forms filamentous virions and is closely related to the infamous Ebola virus (EBOV). The virus causes severe disease in humans in the form of viral hemorrhagic fever and 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, Centers for Disease Control and Prevention Category A Bioterrorism Agent, and is listed as a Biological Agent for Export Control by the Australia Group.
Reston virus (RESTV) is one of six known viruses within the genus Ebolavirus. Reston virus causes Ebola virus disease in non-human primates; out of all 6 ebolaviruses, it is one of the only two not known to cause disease in humans, but has caused asymptomatic infections. Reston virus was first described in 1990 as a new "strain" of Ebola virus (EBOV). It is the single member of the species Reston ebolavirus, which is included into the genus Ebolavirus, family Filoviridae, order Mononegavirales. Reston virus is named after Reston, Virginia, US, where the virus was first discovered.
Marburg virus (MARV) is a hemorrhagic fever virus of the Filoviridae family of viruses and a member of the species Marburg marburgvirus, genus Marburgvirus. It causes Marburg virus disease in primates, a form of viral hemorrhagic fever. The World Health Organization (WHO) rates it as a Risk Group 4 Pathogen. In the United States, the National Institute of Allergy and Infectious Diseases ranks it as a Category A Priority Pathogen and the Centers for Disease Control and Prevention lists it as a Category A Bioterrorism Agent. It is also listed as a biological agent for export control by the Australia Group.
Ravn virus is a close relative of Marburg virus (MARV). RAVV causes Marburg virus disease in humans and nonhuman primates, a form of viral hemorrhagic fever. RAVV 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, Centers for Disease Control and Prevention Category A Bioterrorism Agent, and listed as a Biological Agent for Export Control by the Australia Group.
Ebola, also known as Ebola virus disease (EVD) and Ebola hemorrhagic fever (EHF), is a viral hemorrhagic fever in humans and other primates, caused by ebolaviruses. Symptoms typically start anywhere between two days and three weeks after infection. The first symptoms are usually fever, sore throat, muscle pain, and headaches. These are usually followed by vomiting, diarrhoea, rash and decreased liver and kidney function, at which point some people begin to bleed both internally and externally. It kills between 25% and 90% of those infected – about 50% on average. Death is often due to shock from fluid loss, and typically occurs between six and 16 days after the first symptoms appear. Early treatment of symptoms increases the survival rate considerably compared to late start. An Ebola vaccine was approved by the US FDA in December 2019.
The Hot Zone is an American anthology medical drama television series, based on the 1994 non-fiction book of the same name by Richard Preston and airing on National Geographic.
The 1967 Marburg virus disease outbreak was the first recorded outbreak of Marburg virus disease. It started in early August 1967 when 30 people became ill in the West German towns of Marburg and Frankfurt and later two in Belgrade, Yugoslavia. The infections were traced back to three laboratories in the separate locations which received a shared shipment of infected African green monkeys. The outbreak involved 25 primary Marburg virus infections and seven deaths, and six non-lethal secondary cases.