The Hot Zone by Richard Preston

Summary
The Hot Zone, by Richard Preston, is a true story about the filovirus sisters: Marburg, Ebola Zaire, Ebola Sudan, and Ebola Reston. A filovirus is different
from other viruses because instead of being round like other viruses, it is inside loopy, with resemblance to a worm.

Part One
Part one begins with Charles Monet visiting Kitum Cave in Africa. A few days later, Monet comes down with a disease that turns his eyes red, his skin
yellow, and his body into one large hemorrhage. At the hospital, he is treated by one Doctor Shem Musoke, who finds he cannot put an IV into Monet,
or the blood comes pouring out as if he had sliced Monet with a butcher’s knife rather that one prick of a needle. Monet “crashes and bleeds out”, thrashing
wildly while throwing blood everywhere, including into Musoke’s mouth and eyes. At the autopsy, Monet’s organs are found to be swimming in blood.
What the doctors do not realize is that Monet is infected with Marburg, a deadly virus with a kill rate of 25%. Musoke then also becomes ill, but somehow
manages to survive. He sends his blood to USAMRIID, or United States Army Medical Research Institute of Infectious Diseases, for testing. It comes
back positive for Marburg.

The book moves on to four years later, where we are introduced to Nancy Jaax, a researcher at USAMRIID. She is a specialist in animal-related
medical research, and is currently studying a set of monkeys infected with Ebola to look for a possible cure. This is Biosafety Level 4 work, meaning
that it is a very deadly and highly infectious disease. The strain the monkeys have is Ebola Zaire, taken from Nurse Mayinga, who died after treating
a patient with the same illness. Jaax and her supervisor, Tony Johnson, must wear space suits in the Ebola-infested room, or Hot room. Constant
checks on the suits by your partner are necessary, because the slightest bit of blood hot with Ebola in your space suit could get into your body, and
then you’re a goner. While working, Jaax and Johnson perform autopsies on two monkeys who have crashed and bled out. Jaax then sees a hole in
her glove. She had sliced her hand earlier in the morning with a knife, and all that was stopping a million tiny particles of Ebola from entering her blood
stream is a thin latex glove. Fortunatly for her, the glove holds, but the chances of her being sent to the Slammer, a holding cell for those thought to
be infected with “hot” viruses, were overwhelming. People have gone crazy in the Slammer, locked up with no entertainment, no communication, and
the fear that you were going to die very soon.

The Hot Zone rewinds, going to 1976, when Mr. Yu G. was infected with Ebola Sudan. He is known as the “index” case. He and two other coworkers
die of Ebola Sudan, which has a kill rate of 50%, but not before it can infect other people, leading to 16 generations of Ebola Sudan and countless
fatalities. Meanwhile, Ebola Zaire hits Miridi, killing 90% of those infected. Perhaps because of it’s rapid killing, Ebola does not remain for long, but
quickly burns out. The story then jumps in its descriptive passage to the case of Peter Cardinal, a young Dutch boy who came down with a strain
of Marburg after visiting Kitum Cave, the same spot Monet had visited before. Cardinal died, and his blood was sent to Eugene Johnson, a civilian
researcher at USAMRIID.

Eugene Johnson requests permission to visit Kitum Cave. It seems an unlikely coincidence that two people who visited Kitum Cave got the same
disease without getting it from the cave itself, the only place where their paths had met. Johnson and his team treat the cave like a Level 4 hot
zone, taking monkeys and guinea pigs to see if they will contract the disease. They also take tens of thousands of biting bugs, to see if Ebola
and Marburg are contracted through the bugs. Their search proves futile, and Ebola is not found anywhere in Kitum Cave.

Part 2
Part 2 opens with the Hazleton Research Products company’s Primate Quarantine unit in November, 1989, where imported monkeys spend a month
after being imported to make sure they are not diseased. These monkeys will be used for medical research. As we read, Dan Dalgard, a veterinarian at
Hazleton, is called in because a recent shipment of monkeys is dying. It is suspected that the deaths are occurring because the heat will not turn off, a
nd monkeys in Room F begin dying. The autopsies, however, show spleens engorged and hard as rocks, which is not a symptom of overheating. Dalgard
calls USAMRIID and sends samples of the blood and the spleen to Peter Jenning, another civilian virologist. While Jenning and his lab assistants cultivate
the cells, more monkeys begin dying in Room F and Room H, skipping Room G. It is suspected that the monkeys have contracted Simian Hemorrhagic
Fever, which is fatal.


Thomas Geisbert, an intern at USAMRIID, takes a slice of the spleen and takes it to an electron microscope. What he finds is the classic loops representative
of Marburg, which he and many others had handled with only Level 3 protection. One final test is needed, because while it is positively determined that this is
a filovirus killing these monkeys, it is not known whether it is Marbug or something much worse. The test involves injecting the sample into another with a
known agent, such as injecting the monkey blood into blood infected with Marburg. When the sample comes in contact with its own kind, it will glow.
The blood, upon coming in contact with Nurse Mayinga’s blood, glowed brightly. The monkeys were infected with Ebola Zaire.

Geisbert present his findings to his superiors, and it is decided that the monkeys in Hazleton must be exterminated, as there is no vaccine or cure for
Ebola, and it is too dangerous to allow it to simply run its course. Jaxx is sent to perform one more test; perhaps only the first monkey had Ebola,
but the others do have SHF. She takes two dead monkeys from Reston and reviews their blood and tissues under a microscope. The cells are
packed with what look like bricks, meaning that the blood is burning hot with Ebola. There is no doubt left; there has been an outbreak of Ebola in Reston.

Back at USAMRIID, Colonel C.J. Peters is holding a meeting with high-ranking officials from the Center of Disease Control and the Army. The
Army feels that the CDC is trying to undermine their authority in this case, and since the situation at hand poses a danger to the entire nation,
the Army should be in control. It is eventually decided that the CDC will head the extermination.

Part 3
The monkey euthanizing is undertaken by Jerry Jaax, Nancy’s husband, and Eugene Johnson. They treat the Hazleton facility as a Level 4 hot zone,
and create an assembly line using volunteers from the Army. A long needle of anesthetic is stuck into a monkeys thigh, enough to kill it, then the
monkey is carried out onto an operating table, where it is cut open and its internal organs preserved for studying. During the operation, a quick way
to discover if someone has Ebola is created, and a monkey escapes from his cell. This monkey is finally caught, and the last to go down. The entire
facility is then washed down with bleach and disinfectants, even though all the scientists confirm that this strain of Ebola is not lethal to humans, for
one reason or another.

A month later, Hazleton begins importing monkeys once again, bringing in another bout of Ebola, which is named Ebola Reston. The CDC and USAMRIID
decide to allow the virus to run its course, finding that this Ebola jumps from room to room easily and kills 80% of infected monkeys. Humans that come
in contact with Ebola Reston test positive, but the virus simply incubates then fades over time.

A large concern about this strain of Ebola is how easily it can jump. If this strain mutates to become compatible to humans, we would not be able to stop
it from traveling through the air. Also, if a scientist sees Ebola in the patient’s blood work, he may just say, “Oh, it’s okay, this is only Ebola Reston”
and not be concerned, when in reality it could be Ebola Zaire or Sudan.


Part 4
Three years after the outbreak in Reston, Richard Preston, the author of this book, travels to Kitum Cave to inspect it for himself. He does not break
out with Ebola, nor does he find anything that would transfer Ebola. The reader is left with the question of whether Kitum Cave is dormant, and if one day,
Ebola will revive, and a massive outbreak previously unknown will occur.


Ebola Information
Ebola is a virus, from the family Filoviridae, which is the same family as Marburg. It is named after the Ebola River, where
the first case was discovered.
Ebola consists of 7 proteins, and is thin and thread-like. There are 4 subtypes of Ebola:
Zaire, Sudan, Reston, and Tai. Ebola Zaire is the most fatal to humans, whereas Ebola Reston does not have any impact
on the human at all. Vaccines have been made for all 4 types.
The symptoms are usually dangerous separate, but all
manage to lump together into one human-killing machine. High fevers, severe headaches, back pain, exhaustion,
nausea, and dizziness are some of the first signs. As it progresses, the patient’s eyes may become red as a result of
arteries in the eyes popping. The patient may also have diarrhea, vomito negro, and excessive bleeding from every orifice.
The internal organs are destroyed as blood clots begin forming throughout the body, causing heart attacks and blockage.
As the victim dies, seizures occur due to blood clots in the brain, causing the victim to thrash around, splashing blood everywhere.
This is Ebola’s way of looking for a new host.
There is no successful treatment for Ebola once you contract it. You’re only chance
for survival is to go to a hospital. Once there, any surgeries or form of skin puncture should be avoided. In order to prevent
dehydration, almost excessive hydration should be pursued. A catalyst for coagulation of the blood should also be introduced to
the body.
Ebola is a common topic of bioterrorism discussions. Only two vials are supposed to exist in the world, one here and
one in Russia.

external image 135px-Ebola_virus_em.pngexternal image 200px-7042_lores-Ebola-Zaire-CDC_Photo.jpg

Links to a video and animation about ebola.Animation: YouTube - ebola Video: YouTube - Ebola Virus