Pain is often associated with disease. Hand in hand, they sometimes serve to anticipate our ultimate fate - Death. All too often, this pain is utterly devastating and unforgivingly prolonged. In some cases, death is welcomed as the most potent pain-killer of all. However, pain can also serve a more positive purpose. It gives a warning - it gives us time to say goodbye to loved ones and immediate physical reality… Yet, what if an infection evolved, an infection so mighty that it could steal this time away while still punishing its carrier with the most daunting pain? The Ebola virus can cause such disease. It is an organism which can lead to liquefaction of organs in the matter of hours.

‘The Hot Zone’ is a work of non-fiction that tells the disquieting tale of how Ebola infiltrated and threatened to destroy the world population between 1980 and 1993. All characters are real and the text is constructed from the recollections of all the storys’ participants. The book is written by Richard Preston.

Plot, Content and Language

Charles Monet lives in Kenya and leads a quotidian life as a worker in a pumping factory. While walking through the Elgon rain forest in his vicinity, he stumbles across Kitum cave, the depths of which he discovers to be blanketed with a “velvety mass of bats”. Although somewhat fearful of such a sight, Monet tarries to further investigate the cave. Seven days later, signs begin to appear that he has been exposed to an infectious agent – he develops a vicious headache, crippling backache and he begins to vomit ceaselessly.

Here, Preston employs vivid imagery to charge the pages with a overwhelming immediacy, such that the reader involuntarily cringes. He artfully details the most iniquitous of the diseases’ symptoms;-“his lips are smeared with something slippery and red, mixed with black specks, as if he has been chewing coffee grounds…The red spots (on his face), which a few days before had started out as starlike speckles, have expanded and merged into huge, spontaneous purple shadows…his face appears to hang visibly from the underlying bone, as if the face is detaching itself from the skull”.

Monet is rushed to Nairobi hospital, aboard a commuter aeroplane. On arrival, blood is being discharged from every orifice, teeming with virus particles, eager to infect a further host. Preston aims to stupefy the reader with disgust – his images are relentless and horribly violent – “the sound of a bedsheet being torn in half, which is the sound of his bowels opening at the sphincter and venting blood. The blood is mixed with intestinal lining. He has sloughed his gut.”

Monet is swarmed by doctors and nurses, desperately trying to clear his airway of blood with their bare fingers – otherwise, he will asphyxiate – he is now only a carcass with a heartbeat, however – and the infection is spreading…

This is the opening chapter and grips the reader with such force that the book begins to imitate an extension of the upper limbs. Just as the reader is pacifying after Monet’s death, Preston skips to nine days later – one of the doctors (Dr. Musoke) is developing backache. Yet again, the sequence to death is repeated – this time with no less tension than the first. I believe this chapter was exploited by Preston to convey just how powerful this virus really is – even a doctor with every medication at his disposal was powerless to act to oppose the deadly virus.

The story then turns from Africa to America. Major Nancy Jaax is a qualified veterinarian and employee of USAMRIID (United States Army Medical Research Institute of Infectious Diseases) at Fort Detrick. She is currently employed to find a solution to the Ebola mini-outbreaks on the African continent. The premise of her work is quite simple – she infects monkeys, then attempts to cure them with various combinations of drugs. Her experiments are confined to a Level 4 biohazard unit, in which one must wear a spacesuit as protection. The Level 4 agents are extremely infectious and a tear in the suit will almost certainly cause infection resulting in death. Meanwhile, Africa is succumbing to Ebola. Doctors from the CDC (Centre for Disease Control) in Atlanta are called in. Clues emerge that some of the sufferers have been to see Kitum cave and it is decided that the cave will be quarantined and checked out. Live monkeys are placed inside the cave – however, they do not become sick despite growing evidence that the Ebola virus originated there.

At the Reston Primate Quarantine Unit (a facility for quarantining monkeys for one month before they are imported into America) in Virginia, there is a series of unexplained deaths among the monkeys from the Philippines. Dr. Peter Jahrling of USAMRIID discovers that the monkeys are infected with Ebola…The disease is spreading still further.

I will refrain from discussing the story any further as this will certainly spoil the book for a potential reader. Let me just say that the rest of the book discusses the political fire that such a disaster can evoke and also, the desperate attempts initiated to contain the virus. I will say that we would all be dead now were it not eventually contained!

Preston cleverly includes hints of what is to come in his use of language. For instance, just before Monet dies he says “The road was volcanic dust, as red as dried blood”. This creates a subtle tension and suspense that is truly exhilarating in the buildup to a climax. Preston includes illustrations of what Ebola (and its sister virus, Marburg) look like under the microscope. This creates a repulsive intimacy between the reader and the disease – it is another smart ploy by Preston to make the story immediately impactful.

The dialogue in this book is reconstructed from the recollections of the participants. I do believe Preston’s ‘factual’ narrative must be approached with a note of caution, however. He often attempts to impart a character’s most personal thoughts and emotions, perhaps only for dramatic effect. Most likely, he exaggerates for the sake of the reader. The story is often interrupted with the depiction of the single death. Although the language used in such a description is always new and undoubtedly impressive, the sequence of illness becomes a little predictable and monotonous.

The reader is ominously brought back to Kitum cave at the conclusion of the book – it is a grim reminder that viruses lie lurking, ready to awaken in a mutated form and attempt a foray on humanity.


Concluding personal note

Theoretically, the Ebola virus could reemerge as a mutated airborne form, which would easily circle the globe in six weeks. The recent SARS outbreak in the Eastern World has once again highlighted the weak links in international defense against a dangerous pathogen. The growing popularity of air travel makes this ever more alarming. Regretfully, however, the conflict between microorganisms and humans will continue until our species perishes – all we can do is prepare for the next battle...


Recommended: Yes