NCIS this week focused on an anthrax attack that took down two of the agents. Marburg deaths have been slowly increasing in Angola over the past half-year. AIDS statistics continue to amplify. Whether news or fiction, virulent infections capture our attention.
The fear of plague is deeply rooted in us. The thought of a disease that wipes out one in five, one in three, or nine of ten panics us, even when the infection is happening in a remote part of the world and is nominally under control. So how much more terrifying is the realization that there is no part of the world remote enough to contain contagion, and that these agents enter our borders daily, taking up residence in our population centers, smoldering unrecognized?
The chilling tale in Richard Preston's The Hot Zone is a true story. It opens with the description of a death in western Kenya, a horrifying account of how the Marburg virus kills. We meet Charles Monet, who dies in a gruesome fashion in a hospital in Nairobi. We meet the physicians and nurses who contract the disease from him. And, more horrifying, we find that Marburg is the least lethal filovirus of three related agents. Ebola Sudan, which surfaced in the war zone of southern Sudan, kills half of those infected. Ebola Zaire kills eight to nine of ten infected. In this context, Marburg is relatively safe, killing "only" an average of one in two infected. (Unfortunately, the current strain in Angola is much more virulent; as of May 11, 2005, the WHO reports that 276 of 316 reported cases have been fatal.)
I first read Hot Zone in 1999, when bioterror was a collegium topic rather than a keyword in current events. The tale of the discovery of a fourth filovirus—Ebola Reston—in a monkey house on the outskirts of Washington, D.C. was an eye-opener for all. Preston's dry, matter-of-fact style gives the already-chilling tale a liquid-helium twist. See, he says on more than one page, we dodged the bullet this time. Next time, we might not be so lucky. The tale of the discovery, containment and disinfection of the building is interspersed with equally factual tales of the devastation wrought by Ebola and Marburg in Africa.
Article comments
1 - Dawn
No, I don't want to keep playing. I sweat with fear of this type of thing. I can barely take having the flu, let alone some horrifying disease like ebola.
If you ask me, people need to stay the hell away from animals. That's where all these killer viruses come from. Rural, backwards parts of the world with strange and bizarre animal husbandry, that's the fricken problem. SARS, EBOLA, MARBURG,AIDS, all of them from animals.
2 - DrPat
Preston (and others) make a pretty good point that many of these emergent "hot agents" are tropical and rainforest in origin. It makes me wonder if exploring the rainforest looking for cancer cures isn't going to land us in a much-worse health position.
Flu (including SARS), now, that's a relatively benign infection.
3 - Victor Plenty
Diseases, like money, are another form of information. In a globally interdependent world, no border can remain permanently closed to them.
If there is a way to obtain safety from these plagues, it lies in obtaining the same basic safety for every human being on this planet. A worldwide public health system might achieve this, but not if any regions remain mired in the chaos and social collapse that follow in the wake of war.
War was not so dangerous in previous ages, when significant human communities lived in isolation from each other. This is no longer the case. Now every war, now matter how small, no matter how remote it seems, might trigger events that could wipe us out for good.
It doesn't really matter whether the deadly consequence is an unstoppable plague, or the spread of nuclear weapons into the hands of countless terrorist groups, or something even worse we haven't yet invented.
Until we abandon war, as a species we will simply be spinning the chamber, pointing the gun at our head, and pulling the trigger. Over and over again.
4 - DrPat
The outbreak of Ebola Reston at the center of Preston's account had nothing to do with war or conflict. The monkeys were from the Phillipines, imported for the purpose of testing vaccines for known agents.
I'm not sure any world-wide health organization could have prevented this outbreak - certainly the excellent hospitals in Germany were not capable of curing or containing the original Marburg outbreak.
5 - Nancy
Preston also points out that a goodly part of the problem, according to various of his medical informants and sources, is not only widespread illegal poaching as well as nil hygiene practices, but intensification of human populations, and that basically Nature is, like an infected body fighting back, trying to fight off the 'virus' of overpopulated humanity. One of his sources, C.J. Peters, in a book of his own titled "Virus Hunter" postulates a scenario set in Bangkok (Chapter 11) almost identical to the historical outbreaks of bird flu in S.E. Asia as well as SARS in China. Like it or not, people are still just as much animals as any colony of 4-legged critters, and science has proven over and over again that when populations of animals expand beyond viable population limits, then disease sets in along with aberrant, violent, and agressive behaviors (i.e. crime and war) and starvation. What does it take to convince people that we are not some species of angel, and that if we continue to breed at current rates, we are only cutting our own throats? 'There are none so blind as those who will not see', etc. In any event, HIV & AIDS are already doing a burn in places where the governments are in a state of near total denial. They're less dramatic than the filoviri and other hemorrhagic nasties, but quite effective at culling a species in their own slow but steady way.
6 - DrPat
I took from Preston's account (and others, some listed in the Amazon click-set for my post) that it is not absolute numbers of people in the world, but patterns of living and concentrations of peoples that constitute "playing Russian Roulette" in this case.
It is not a good idea to extrapolate human behavior from that of caged rodents. (...when populations of animals expand beyond viable population limits, then disease sets in along with aberrant, violent, and agressive behaviors.) Especially since the cage we are in is cultural rather than physical - we can choose not to play.
But will we?
7 - HIV/AIDS Network
AIDS is raising fast, over 1 million documented cases in USA alone now! Maybe another half mil that do not even know they are infected yet!
http://www.HIVAIDSsearch.com/menu.htm
8 - Bart
Hello. I read the hot zone recently in my 9th grade english class last year and I was wondering if anyone knows Charles monets or Peter Cardinals real name or know if there are still records on them, I would just like to know because things like Ebola fascinate me and I just want to see if theres more information on them, thanks.
9 - Laurel Buckheart
Congrats, Bart! I read it in my 9th grade Biology class back in 1999. Most likely, following standard doctor/patient relationships, Charles Monet and Peter Cardinal are *not* theoir real name, and it would be difficult to find more information on the actual person.
Look up "filovirus" or read Laurie Garrett's "The Coming Plague" if you want more information on diseases like Ebola, Lassa, and Marburg.
10 - DrPat
Other great sources of information can be found from the Wikipedia References list for Ebola and William McNeill's excellent book, Plagues and Peoples (see Amazon link above). Since I wrote this review, I have read Level 4: Virus Hunters of the CDC by McCormick and Fisher-Hoch, husband-and-wife team formerly highly-placed in the Centers for Disease Control in Atlanta (at the time of the Reston scare). I can recommend it, as well.
11 - Kasey
Does anyone happen to know what the hidden connection between Marburg, which is a form of Ebola, and HIV is? I need help with this for class, and I was wondering if anyone knew. Thanks!
12 - MeBabyMe
^--- Actually, it's very easy to find "Cardinal's" real name. Its first letter is "R". It takes more effort to find the real "Monet", but it too is possible without getting up from before the keyboard.