Crisis in the Red Zone

June 15, 2019
A sequel of sorts to the landmark bestseller The Hot Zone (1994), this time with a focus on the 2013-2014 Ebola outbreak in the forests of West Africa. "Viruses are the undead of the living world, the zombies of deep time," writes New Yorker contributor Preston (Panic in Level 4: Cannibals, Killer Viruses, and Other Journeys to the Edge of Science, 2008, etc.). In this richly detailed narrative, he plunges readers into the "horrifying chaos" of overcrowded field-hospital wards in Sierra Leone, where "disoriented, infected patients" wander while scientists across the world scurry to identify a contagious disease for which there is no treatment or cure. First detected in 1976 near Zaire's Ebola River, where it jumped across species into humans, the virus returned with deadly force in the 2013 outbreak recounted here, infecting 30,000 villagers and killing 11,000. Moreover, it posed the nightmare threat of spreading into populous cities. Preston tells engrossing human stories of doctors and patients while providing a clear understanding of Ebola, from its genetic code and mutations to its terrible impacts on victims (fever, paralysis, diarrhea, etc.). In scene after scene, the author vividly re-creates the drama: Villagers throw rocks at epidemiologists during a burial, nearly killing them. A teenage herbalist eerily predicts the deaths of Ebola nurses. French and German scientists struggle to identify the virus. A doctor forgets himself and gets infected while trying to save a child. Cambridge scientists stare at mutations in the Ebola code and try to understand what they are seeing. Doctors are in short supply, nurses abandon hospitals, and villagers text message rumors about "white foreigners" in space suits experimenting on people. "Many didn't believe in this thing called Ebola," writes Preston, who also provides sharp portraits of virologists like Lisa Hensley, a longtime Ebola researcher at Maryland's Fort Detrick, and Sheik Umar Khan, declared a "national hero" for leading Sierra Leone's fight against Ebola, who contracted the disease himself, sparking debate over whether he should be given an untested experimental drug. An exhaustive and terrifying story of viral mayhem that will rivet readers.

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Starred review from June 24, 2019
Preston follows up his 1994 book The Hot Zone with another terrifying real-life thriller about the threat of viruses—in this case, Ebola. He leavens the subject’s essential grimness with inspiring portrayals of men and women who risked, and sometimes lost, their lives battling the virus’s resurgence in West Africa in 2013 and 2014. They include Lisa Hensley, an American researcher and single mother who chooses to travel to Africa to offer what help she can, and Humarr Khan, a physician who, even before the Ebola outbreak, had already decided to stay in his native Sierra Leone and fight Lassa, another virus endemic in West Africa, rather than pursue a lucrative American career. Along with character sketches, Preston delves into the moral complexities that can arise in disease research, in this case when an apparent miracle cure—dubbed wow “because everybody was typing Wow in their emails”—yields amazing results in monkeys and the researchers must decide whether to experiment with its efficacy for humans. His concluding sections establish why this story remains relevant, as the Ebola outbreak is a cautionary tale of what could happen if a similar mutated supervirus reached cities. This nonfiction page-turner will both educate and scare readers.

Starred review from June 1, 2019
"Viruses are the undead of the living world, the zombies of deep time." And perhaps none are more gruesome than Ebola, a Biosafety Level 4 virus (or hot agent). Highly contagious and lethal, Ebola is spread by direct contact with bodily fluids. Symptoms include high fever, hemorrhaging, profuse diarrhea, and oddly enough, hiccups. Preston, who first wrote about Ebola in the best-selling The Hot Zone (1994), chronicles the 2014 Ebola outbreak in West Africa. Over 11,000 people died across eight countries, including the U.S. He flashes back to accounts of the first outbreak of Ebola in 1976 in Zaire (reminding readers of the lessons that might have been learned). Preston poignantly details the human drama of a place on the precipice of devastation. The suffering portrayed is staggering. Descriptions of Ebola hospital wards and quarantine tents are often nightmarish. Yet acts of heroism and the high prevalence of altruism (especially among local nurses) are astounding. In addition to devoted health care workers other captivating characters abound, including a teenage prophet and a mysterious herbalist healer. Preston addresses issues of medical ethics and justice throughout, and the clash between superstition and science, duty and self-preservation are constantly in play. Medical thriller, cautionary tale, and a public health call-to-arms are all bundled together in this powerful read.(Reprinted with permission of Booklist, copyright 2019, American Library Association.)