A Review of Richard Preston's The Hot Zone

by Amy Jost

Preston, Richard. New York: Anchor Books Doubleday, 1995. 422 pages.

Synopsis:

Richard Preston's The Hot Zone is a non-fictitious and highly sensationalized account of the emergence of Ebola, a deadly infectious disease with no vaccine or treatment. The first half of the book provides chilling and vivid descriptions of individuals involved in the initial Ebola outbreaks, the first of which happened in 1976 in N'zara, a town in southern Sudan. Soon after identifying the fact that the virus responsible for the Sudan outbreak is related to the previously identified "Marburg" virus, another epidemic occurred, this time in the Catholic mission village of Yambuku in north-central Zaire. After describing the gruesome details surrounding these and a few additional isolated cases, the remaining half of the book investigates the events surrounding an epidemic that took place in 1989 just 10 miles outside of Washington D.C. At the start of this epidemic, 100 Philippine monkeys residing in an animal housing facility in Reston, Virginia fell sick with a virus whose structure and symptoms are nearly identical to the Ebola Zaire strain. The subsequent control of this outbreak required the intervention of a secret military SWAT team and officials from the CDC which ultimately resulted in the euthanization and destruction of the entire Reston facility. Although the Reston strain turned out to be harmless to humans, the proximity and deathly potential of the virus raise many frightening implications regarding the powerlessness of mankind when, in the words of Preston, "the earth mounts its immune response against the human species" (406).

Review and Criticism:

Very few books have caused me to turn pages as quickly and with as much anticipation as I did recently while reading The Hot Zone. In this narrative, Ebola comes alive with Preston's vivid descriptions of the ability of a microscopic filovirus to wreck havoc on human and animal flesh and there is no question that the author certainly has a flair for capturing and commanding the attention of his audience. However, a more discriminating investigation of Preston's structure and approach reveals that this particular depiction of the Ebola outbreak perhaps does more to perpetuate existing cultural stereotypes and disease stigma than it does to advance the reader's understanding of scientific and socio-political ramifications of this deadly virus.

The effectiveness of Preston's style lies in the author's ability to pinpoint (and subsequently play upon) his reader's fears and apprehensions of disease. As he describes the horrific effects of the virus on the various organs of the body in the following passage, Preston chooses to directly address his readers through the use of the second person:

...The red spots on the skin grow and spread and merge to become huge, spontaneous bruises, and the skin goes soft and pulpy, and can tear off if it is touched with any kind of pressure. Your mouth bleeds, and you bleed around your teeth, and you may have hemorrhages from the salivary glands -- literally every opening in the body bleeds no matter how small...The surface of the tongue turns brilliant red and then sloughs off, and...maybe be torn off during rushes of the black vomit...Your heart bleeds into itself; the heart muscle softens and has hemorrhages into its chambers, and the blood squeezes out of the heart muscle as the heart beats...(106)

The reader is continually reminded of the lethality of the various Ebola strains, one of which kills ninety percent of its victims in less than a week. Any hope that the virus responsible for this devastating disease would remain sequestered away in a remote corner of the world is soon quelled as the reader is reminded that "A hot virus from the rain forest lives within a twenty-four-hour plane flight from every city on earth" (16).

The effect of this sensationalistic technique is that the dramatic twists and turns of the story read much more like a novel than one would expect from a non-fiction description of a disease outbreak. While caught up in the horror of the possibility that a merciless virus could potentially render human defenses useless and wipe out the entire human race, it is all too easy to overlook some of the more subtle ramifications and cultural oversights of Preston's literary style. Without question, the level of tension and anticipation increases dramatically when the virus threatens the United States as opposed to a remote village in Africa. Because the author's only descriptions of Africa are always associated with the frightening potential of contracting the deadly virus, a non-discriminating reader could easily be left with the impression that one could catch Ebola from almost anything in Africa. The elaborate space suits and protective measures used by the investigators further implicate the need to insulate oneself from any contact with the land responsible for the emergence of the unwanted disease.

In addition, Preston's elaborate dramatization of the Ebola virus is perhaps somewhat overstated considering its actual impact thus far on the human race. Since Ebola was officially identified by the Antwerp Institute of Tropical medicine in 1976, fewer than 800 people have been known to die of this infection. However, in contrast, the World Health Organization reports that rabies (thought of the most deadly virus) has taken 627,000 lives and AIDS has killed 1.25 million people in this same time period(*). In this regard, the breathless speed with which Preston jumps from one traumatic outbreak to the next has the effect of desensitizing the reader to diseases that are even more in need of treatment or a cure.

Given the reasons described above, The Hot Zone is an excellent choice for a reader seeking an entertaining and spine chilling read. As the actual events described are accurate for the most part, it also provides an adequate overview of the events leading up to the Ebola hype in the mid 1990s. However, one should hesitate before assuming that Preston's account provides an all-encompassing portrayal of the Ebola virus. Many important cultural issues remain untouched, and audiences interested in these intriguing aspects of Ebola will likely want to investigate additional or alternative resources.

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*Moeller, Susan D. Compassion Fatigue: How the Media Sell Disease, Famine, War and Death. New York: Routledge, 1999, p. 82.