The Hot Zone

by Richard Preston

The headache begins, typically, on the seventh day after exposure to the agent. On the seventh day after his New Year’s visit to Kitum Cave—January 8, 1980—Monet felt a throbbing pain behind his eyeballs.

A hot virus from the rain forest lives within a twenty-four-hour plane flight from every city on earth. All of the earth’s cities are connected by a web of airline routes. The web is a network. Once a virus hits the net, it can shoot anywhere in a day—Paris, Tokyo, New York, Los Angeles, wherever planes fly. Charles Monet and the life form inside him had entered the net.

The airsickness bag fills up to the brim with a substance known as the vomito negro, or the black vomit. The black vomit is not really black; it is a speckled liquid of two colors, black and red, a stew of tarry granules mixed with fresh red arterial blood.

It is hemorrhage, and it smells like a slaughterhouse. The black vomit is loaded with virus.

By the time an extreme amplification peaks out, an eyedropper of the victim’s blood may contain a hundred million particles of virus.

It could be said that the who of Charles Monet has already died while the what of Charles Monet continues to live.

The kill rate of Marburg turned out to be about one in four, which makes Marburg an extremely lethal agent: even in the best modern hospitals, where the patients are hooked up to life-support machines, Marburg kills a quarter of the patients who are infected with it.

By contrast, yellow fever, which is considered a highly lethal virus, kills only about one in twenty patients once they reach a hospital.

Marburg is one of a family of viruses known as ...

The word filovirus is Latin and means “thread virus.” The filoviruses look alike, as if they are sisters, and they ...

While most viruses are ball-shaped particles that look like peppercorns, the thread viruses have been compared to strands of tangle...

Marburg particles sometimes roll up into loops. The loops resemble Cheerios. Marburg is the only ring-shaped virus known.

it was established that the family of filoviruses comprised Marburg along with two types of a virus called Ebola.

The Ebolas were named Ebola Zaire and Ebola Sudan. Marburg was the mildest of the three filovirus sisters. The worst of them was Ebola Zaire. The kill rate in humans infected with Ebola Zaire is nine out of ten.

Marburg virus (the gentle sister) affects humans somewhat like nuclear radiation, damaging virtually all of the tissues in their bodies. It attacks with particular ferocity the internal organs, connective tissue, intestines, and skin.

Marburg lived in some other kind of host—an insect? a rat? a spider? a reptile?

Did HIV crash into the human race as a result of the monkey trade? Did AIDS come from an island in Lake Victoria? A hot island? Who knows.

Today this particular strain of Marburg virus is known as the Musoke strain.

All the containment levels at the Institute, from Level 2 to Level 4, are kept under negative air pressure, so that if a leak develops, air will flow into the zones rather than outward to the normal world.

Nancy had vaccinations for yellow fever, Q fever, Rift Valley fever, the VEE, EEE, and WEE complex (brain viruses that live in horses), and tularemia, anthrax, and botulism. And, of course, she had had a series of shots for rabies, since she was a veterinarian.

Level 4 hot agents. A Level 4 hot agent is a lethal virus for which there is no vaccine and no cure.

Ebola virus is named for the Ebola River, which is the headstream of the Mongala River, a tributary of the Congo, or Zaire, River. The Ebola River empties tracts of rain forest, winding past scattered villages. The first known emergence of Ebola Zaire—the hottest type of Ebola virus—occurred in September 1976, when it erupted simultaneously in fifty-five villages near the headwaters of the Ebola River.

An airborne strain of Ebola could emerge and circle around the world in about six weeks, like the flu, killing large numbers of people, or it might forever remain a secret feeder at the margins, taking down humans a few at a time.

Ebola is distantly related to measles, mumps, and rabies.

Ebola does in ten days what it takes AIDS ten years to accomplish.

Viruses fall apart under ultraviolet light, which smashes their genetic material and makes them unable to replicate.

It could be said that without sticky tape there would be no such thing as biocontainment.

There was another possible reason why the Ebola Sudan virus vanished. It was exceedingly hot. It killed people so fast that they didn’t have much time to infect other people before they died.

They were using five needles a day to give injections to hundreds of people in the hospital’s outpatient and maternity clinics.

Ebola Zaire attacks every organ and tissue in the human body except skeletal muscle and bone.

There is a branch of the C.D.C. that deals with unknown emerging viruses. It’s called the Special Pathogens Branch.

Murphy stood up abruptly, feeling strange. That lab where he had prepared these samples—that lab was hot. That lab was as hot as hell.

“I’ve seen young physicians run from these hemorrhagic viruses, literally. They’re unable to work in the middle of an outbreak. They refuse to get off the plane.”

which was to cut their villages off from the world, to protect their people from a raging plague. It was reverse quarantine, an ancient practice in Africa, where a village bars itself from strangers during a time of disease, and drives away outsiders who appear.

This was not like AIDS,” she later recalled to me. “AIDS is child’s play compared with this.”)

A virus does not generally kill its natural host.

So the first time we went into the cave, it was a bunch of Kenyans and me wearing these military gas masks and these flowered pillowcases on our heads, and the Kenyans are just cracking up.”

The best way to find a virus in the wild, at the present time, is to place a sentinel animal at the suspected location of the virus and hope the animal gets sick.

They collected somewhere between thirty thousand and seventy thousand biting insects inside the cave—the

Each year, about sixteen thousand wild monkeys are imported into the United States from the tropical regions of the earth.

Imported monkeys must be held in quarantine for a month before they are shipped anywhere else in the United States.

Crab eaters are used as laboratory animals because they are common, cheap, and easily obtained.

The monkeys prefer to sleep in a dead tree so that they can see in all directions, keeping watch for humans and other evil predators.

He will want to kill the human who stared at him:

(You can’t cut up a dead monkey in front of other monkeys—it will cause a riot.)

When a filovirus begins to amplify itself in a human being, the incubation period is from three to eighteen days, while the number of virus particles climbs steadily in the bloodstream. Then comes the headache.

The incredible thing about living systems is that no matter how small the view, it is just as complicated as ever.

The Killer Angels, a novel by Michael Shaara about the Battle of Gettysburg:

She averted her eyes and behaved respectfully around the monkeys, because she did not want a monkey to get a notion in its head to spit at her. They have good aim when they spit, and they aim for your face.

When a single animal with a nosebleed showed up in a room, generally 80 percent of the animals died in that room shortly afterward.