The Hot Zone

by Richard Preston

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 plane

Monet’s coma deepened, and he never regained consciousness. He died in the intensive care unit in the early hours of the morning. Dr. Musoke stayed by his bedside the whole time.

They had no idea what had killed him. It was an unexplained death. They opened him up for an autopsy and found that his kidneys were destroyed and that his liver was destroyed.

It was yellow, and parts of it had liquefied—it looked like the liver of a cadaver. It was as if Monet had be...

The first person known to be infected with the Marburg agent was a man called Klaus F., an employee at the Behring Works vaccine factory who fed the monkeys and washed their cages. He broke with the virus on August 8, 1967, and died two weeks later.

The victims developed headaches at about day seven after their exposure and went downhill from there, with raging fevers, clotting, spurts of blood, and terminal shock.

Marburg is one of a family of viruses known as the filoviruses. Marburg was the first filovirus to be discovered. The word filovirus is Latin and means “thread virus.” The filoviruses look alike, as if they are sisters, and they resemble no other virus on earth. While most viruses are ball-shaped particles that look like peppercorns, the thread viruses have been compared to strands of tangled rope, to hair, to worms, to snakes.

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

Not long after Charles Monet died, 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. Ninety percent of the people who come down with Ebola Zaire die of it. Ebola Zaire is a slate wiper in humans. 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.

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. It

Ebola is a rather simple virus—as simple as a firestorm. It kills humans with swift efficiency and with a devastating range of effects. Ebola is distantly related to measles, mumps, and rabies. It is also related to certain pneumonia viruses: to the parainfluenza virus, which causes colds in children, and to the respiratory syncytial virus, which can cause fatal pneumonia in a person who has AIDS.

Ebola seems to have developed the worst elements of all the above viruses. Like measles, it triggers a rash all over the body. Some of its effects resemble rabies—psychosis, madness. Other of its effects look eerily like a bad cold.

The Ebola virus particle contains only seven different proteins—seven distinct types of large molecules arranged in a long braided structure that is the stringy Ebola particle. Three of these proteins are vaguely understood, and four of the proteins are completely unknown—their structure and their function is a mystery. Whatever these Ebola proteins do, they seem to target the immune system for special attack. In this they are like HIV, which also destroys the immune system, but unlike the creeping onset of HIV, the attack by...

Your body becomes a city under seige, with its gates thrown open and hostile armies pouring in, making camp in the public squares and setting everything on fire; and from the moment Ebola enters your bloodstream, the war is already lost; you are almost certainly doomed. You can’t fight off Ebola the way you fi...

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

It hit the hospital like a bomb. It savaged patients and snaked like chain lightning out from the hospital through patients’ families. Apparently the medical staff had been giving patients injections with dirty needles. The virus jumped quickly through the hospital via the needles, and then it hit the medical staff. A characteristic of a lethal, contagious, and incurable virus is that it quickly gets into the medical people. In some cases, the medical system may intensify the outbreak, like a lens that focuses sunlight on a heap of tinder.

The virus erupted simultaneously in fifty-five villages surrounding the hospital. First it killed people who had received injections, and then it moved through families, killing family members, particularly women, who in Africa prepare the dead for burial. It swept through the Yambuku Hospital’s nursing staff, killing most of the nurses, and then it hit the Belgian nuns. The first nun to break with Ebola was a midwife who had delivered a stillborn child. The mother was dying of Ebola and had given the virus to her unborn baby. The fetus had evidently crashed and bled out inside the mother’s womb. The woman then aborted spontaneously, and the nun who assisted at this grotesque delivery came away from the experience with blood on her hands. The blood of the mother and fetus was radiantly hot, and the nun must have had a small break or cut on the skin of her hands. She developed an explosive infection and was dead in five days.

Ebola Zaire attacks every organ and tissue in the human body except skeletal muscle and bone. It is a perfect parasite because it transforms virtually every part of the body into a digested slime of virus particles. The seven mysterious proteins that, assembled together, make up the Ebola-virus particle, work as a relentless machine, a molecular shark, and they consume the body as the virus makes copies of itself.

Small blood clots begin to appear in the bloodstream, and the blood thickens and slows, and the clots begin to stick to the walls of blood vessels. This is known as pavementing, because the clots fit together in a mosaic. The mosaic thickens and throws more clots, and the clots drift through the bloodstream into the small capillaries, where they get stuck. This shuts off the blood supply to various parts of the body, causing dead spots to appear in the brain, liver, kidneys, lungs, intestines, testicles, breast tissue (of men as well as women), and all through the skin. The skin develops red spots, called petechiae, which are hemorrhages under the skin. Ebola attacks connective tissue with particular ferocity; it multiplies in collagen, the chief constituent protein of the tissue that holds the organs together. (The seven Ebola proteins somehow chew up the body’s structural proteins.) In this way, collagen in the body turns to mush, and the underlayers of the skin die and liquefy.

The skin bubbles up into a sea of tiny white blisters mixed with red spots known as a maculopapular rash. This rash has been likened to tapioca pudding. Spontaneous rips appear in the skin, and hemorrhagic blood pours from the rips. 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 is swallowed or spat out. It is said to be extraordinarily painful to lose the surface of one’s tongue. The tongue’s skin may be torn off during rushes of the black vomit. The back of the throat and the lining of the windpipe may also slough off, and the dead tissue slides down the wi...

The brain becomes clogged with dead blood cells, a condition known as sludging of the brain. Ebola attacks the lining of the eyeball, and the eyeballs may fill up with blood: you may go blind. Droplets of blood stand out on the eyelids: you may weep blood. The blood runs from your eyes down your cheeks and refuses to coagulate. You may have a hemispherical stroke, in which one whole side of the body is paralyzed, which is invariably fatal in a case of Ebola. Even while the body’s internal organs are becoming plugged with coagulated blood, the blood that streams out of the body cannot clot; it resembles whey being squeezed out of curds. The blood has been stripped of its clotting factors. If you put the ru...

Ebola kills a great deal of tissue while the host is still alive. It triggers a creeping, spotty necrosis that spreads through all the internal organs. The liver bulges up and turns yellow, begins to liquefy, and then it cracks apart. The cracks run across the liver and deep inside it, and the liver completely dies and goes putrid. The kidneys become jammed with blood clots and dead cells, and cease functioning. As the kidneys fail, the blood becomes toxic with urine. The spleen turns into a single huge, hard blood clot the size of a baseball. The intestines may fill up completely with blood. The lining of the gut dies and sloughs off into the bowels and is defecated along with large amounts of blood. In men, the testicles bloat up and turn black-and-blue, the semen goes hot with Ebola, and the nipples may bleed. In women, the labia turn blue, livid, an...

Ebola destroys the brain more thoroughly than does Marburg, and Ebola victims often go into epileptic convulsions during the final stage. The convulsions are generalized grand mal seizures—the whole body twitches and shakes, the arms and legs thrash around, and the eyes, sometimes bloody, roll up into the head. The tremors and convulsions of the patient may smear or splatter blood around. Possibly this epileptic splashing of blood is one of Ebola’s strategies for success—it makes the victim go into a flurry of seizures as he dies, spreading blood all over the place, thus giving the virus a chance to jump to a new host—a kind of transmission through smearing. Ebola (and Marburg) multiplies so rapidly and powerfully that the body’s infected cells become crystal-like blocks of packed virus particl...