Just when you thought it was safe to ease out of your movie-theater seat and head home from a close encounter of the viral kind in Outbreak — wait. It turns out that Dustin Hoffman and Morgan Freeman haven't even begun to tell the real story. For that you'll have to go to Richard Preston's riveting The Hot Zone, the book that started it all. Lurking beyond the bounds of Preston's brilliant reportage are sobering, and compelling, questions about the nature of viruses and the research that is beginning to elucidate their mysteries.
When the U.S. Army, in a morning rush-hour maneuver, moved from Fort Detrick, Maryland, to a small suburban mall in Reston, Virginia, to wipe out a colony of sick African monkeys housed there, people in the greater Washington, D.C. area had no idea they were being saved from the threat of a plague far worse than the Black Death of the Middle Ages. The monkeys, imported for research, arrived infected with a mysterious rain-forest virus thought to be the deadliest ever known — a virus, Richard Preston writes, that 'does in ten days what it takes AIDS ten years to accomplish.' The Army's secret assault on the virus in December 1989, and the history of several earlier outbreaks of such viruses in Africa and Germany, are narrated with chilling, graphic detail in The Hot Zone, a book not meant for readers with faint hearts or weak stomachs. There are paragraphs here that could of themselves produce cold sweats and shortness of breath.
Once you are infected with these viruses, Preston reports, vital organs such as your liver 'begin to liquify,' your skin 'bubbles up' into a rash 'likened to tapioca pudding,' and 'you may weep blood.' I will leave aside other details. His description of one emerging virus, however, will illustrate Preston's way with words. Noting its ability to jump from one primate species to another, he writes, 'It did not know boundaries. It did not know what humans are; or perhaps you could say that it knew only too well what humans are: it knew that humans are meat.'
The viruses Preston writes about belong to a small family of 'thread viruses' named Marburg and Ebola, seemingly primitive particles of RNA (genetic copying instructions) and proteins. Of Ebola's seven proteins, three are vaguely understood and four are 'completely unknown — their structure and their function is a mystery.'
Marburg first showed up in 1967 in a vaccine factory in Marburg, Germany, and was traced to cells from African green monkeys. Seven people died, a quarter of those infected. The first known Ebola outbreak was in Sudan in 1976. The virus spread rapidly from village to village, killing half of its victims. Two months later, an even deadlier strain of Ebola hit Zaire, erupting simultaneously in some 50 villages, killing nine out of ten people it infected. Zaire's president, Mobutu Sese Seko, called out his army to seal off the Kinshasa hospital and the entire zone of infected villages, with orders to shoot anyone trying to come out.
Preston's account makes these events unforgettable, tracing them back to individuals with names and faces and stories, not only the victims but the doctors and scientists willing to risk their own lives to treat and investigate these mysterious outbreaks. The book then focuses on the 1989 emergence of Ebola in the Reston, Virginia, monkey colony, and the Army's attempts to identify and fight this most feared of 'hot agents.'
Preston takes us inside the Army's Medical Research Institute of Infectious Diseases at Fort Detrick, the labs that once developed biological warfare weapons and now search for new vaccines and seek to unravel the mysteries of lethal viruses like Ebola. To work with anything like Ebola, researchers must wear bulky biological space suits and go through elaborate safety and security precautions.
Yet the story Preston tells is full of accidents and misjudgments, and enough scientists and monkeyhandlers were exposed so that, had the virus really been the deadly strain of Ebola, a major plague might very well have been unleashed. In the end, the Reston Ebola proved fatal to monkeys but seemed to infect humans without any harm, although it is so nearly identical to the deadly Zaire virus that scientists still cannot see the difference. By the slenderest thread of some unknown molecular detail, this book reads like a prophecy instead of a postmortem.
Preston casts this story as a scientific thriller, which it is. And he writes in the manner of such popular novelists as Michael Crichton, Robin Cook and Stephen King, who have made the 'strange virus outbreak' into a literary convention of high-tech, neo-Gothic horror. As a result, this book is hard to put down, very scary, crammed with the detail that can make fiction seem real — or reality read like fiction: 'She opened up the space suit and laid it down on the concrete floor and stepped into it, feet first. She pulled it up to her armpits and slid her arms into the sleeves until her fingers entered the gloves. The suit had brown rubber gloves that were attached by gaskets at the cuffs.'
The genre Preston has inherited from the fiction writers draws you in by amassing small, even trivial details, and he is a master at this. But in a science thriller about the realities of AIDS and the threat of future epidemics, one might hope to find the insights of science as well as the ingredients of a thriller. Describing a tense moment when three Army officers arrive at a Virginia gas station to wait for a clandestine hand-off of some dead Reston monkeys for analysis, Preston pauses to tell us, 'Nancy went into the gas station and bought Diet Cokes for everyone and a pack of cheddar-cheese crackers for herself, and she bought C.J. some peanut butter crackers.' This junk-food prose would be fine if Preston gave more attention to the larger questions this story raises.
He reports, for instance, the Army's decision during the crisis to take actions it thought might be illegal. 'You never ask a lawyer for permission to do something,' the general in charge tells his staff. 'We're going to do the needful, and the lawyers are going to tell us why it's legal.' He also notes, as the Army prepared to move on the Reston monkey colony, that 'half of this biocontainment operation was going to be news containment.' Disregarding the law and deceiving the press may have seemed necessary at the time, but these decisions deserve some ex post facto scrutiny and serious contemplation. Here they get no more attention than those officers' snacks.
More important, perhaps, are the questions of science that are never explored. There are clues scattered throughout this story that our relation to viruses is more complex and less understood than our image of them as 'individuals,' as deadly predators, might suggest. Despite repeated dire predictions throughout these pages of epidemics similar to that in Crichton's classic Andromeda Strain, the early outbreaks in Germany, Sudan and Zaire soon mysteriously abated, leaving both the doctors and the scientists puzzled.
Of Sudan, Preston simply says, 'For reasons that are not clear, the outbreak subsided and the virus vanished.' And of fears that Ebola Zaire would devastate Kinshasa, 'But to the strange and wonderful relief of Zaire and the world, the virus never went on a burn . . . and went back to its hiding place in the forest.' And the Reston virus proved infectious but mysteriously innocuous.
Yet these curious facts are left strangely unexamined. It may be as vital to understand why these viruses retreated as to understand why they attacked, but this question isn't asked. 'Viruses,' Preston writes, 'are molecular sharks, a motive without a mind. Compact, hard, logical, totally selfish. . . .' Indulgence in such anthropomorphism and metaphor reinforces a terrifying Darwinian view of 'Nature, red in tooth and claw,' but it blinds us to new views from molecular biology.
Current research suggests that viruses may be more like wandering messengers than alien predators, their visitations serving to exchange genetic information among individuals and species in an ecology more intricate and a biochemical balance more delicate than we have yet realized. One promising experimental drug for AIDS is based on this idea: it blocks a receptor site for the virus' message instead of working through the immune response.
Preston concludes that 'AIDS is the revenge of the rain forest' for human incursions and overpopulation of the Earth. 'It is only the first act of revenge,' he adds. Marburg and Ebola pose the new threat of a virus 'trying, so to speak, to crash into the human species.' These images may owe more to the fictions we know than to the truths we have only begun to recognize. Peering into the edges of the rain forest, Preston shows us a landscape of infectious terror, but he misses a path into the frontiers of science.