Crisis in the Red Zone: The Story of the Deadliest Ebola Outbreak in History, and of the Outbreaks to Come

by Richard Preston

Viruses are subtle, logical, tricky, reactive, devious, opportunistic. They are constantly evolving, their forms steadily changing as time passes.

It is to say that history turns on unnoticed things. Small, hidden events can have ripple effects, and the ripples can grow.

The virus was out there, it was spreading, and the local people would become violent if the team tried to find it. It was very clear to him—after nearly being killed in a village—that his nation was heading for a disaster. All he could do, personally, was just keep working and try to keep his family safe.

Because, as everyone knew, Americans did not typically know what they were doing. She had begun to imagine that the Americans could do something idiotic with the virus and Jean-François could end up getting infected.

“This is how all outbreaks end,” Armand Sprecher, the Doctors’ official in Brussels, said. “It’s always a change in behavior. Ebola outbreaks end when people decide they’re going to end.”

In the case of the hot Ebola, the Makona strain, one amino acid was different in the protein of the soft knob. In the wild Ebola, the Meliandou Ebola, the amino acid was alanine. It got changed to a different amino acid, valine, in the Makona strain.

The mutant Ebola sticks to a receptor knob on the outside of a human cell that pulls cholesterol into the cell, called the Niemann-Pick receptor. Ebola uses the Niemann-Pick receptor to invade human cells. (Niemann-Pick disease is an inherited, fatal disease in which a person’s cells can’t absorb cholesterol properly.

If viruses can change, we can change, too.