Note: Last week the World Health Organization declared the deadly Ebola outbreak in Congo an international health emergency. More than 1,600 people have died in the second-deadliest Ebola outbreak in history.
In the summer of 2004, I moved to West Africa to study the Ebola virus. I was a fearless medical student at the time, and I wanted to find out where one of the world’s most dangerous and elusive pathogens went between outbreaks. Every few years, Ebola would appear at random, killing nearly everyone in its path, and then it would vanish. Where did it go? And why did some people survive? My team never solved the mystery, and those questions have gnawed at researchers for years.
In Richard Preston’s extraordinary new book, “Crisis in the Red Zone” (Random House, 369 pp., ★★★★ out of 4 stars), we finally get answers.
The story begins in 2013 in the village of Meliandou, in the Guéckédou region of Guinea. We follow a 2-year-old boy named Emile Ouamouno, who has wandered off from his mother to play by a decaying tree. Preston gives us an idea of what happens next: Emile “might have played with a groggy bat, or he might have gotten some bat blood or bat urine in his eyes or in a cut in his skin.” The boy, along with his sister, mother, and grandmother, would soon be dead.
Piecing the case together, doctors make a startling discovery: after a decades-long hiatus, Ebola was back and Emile was the index case, the first victim of a disease for which there is no cure. The child’s infection set off a chain reaction that quickly spread around the world, and we tag along with the brave scientists who scramble to contain the outbreak. “Patients die in the red zone,” Preston tells us, referring to the area where Ebola patients are hastily quarantined. “They are not permitted to die anywhere else.” But occasionally, they do.
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This story is familiar terrain for Preston, whose groundbreaking 1994 book “The Hot Zone,” about the origins of the Ebola virus, was recently made into a miniseries for National Geographic. His new work is something of a sequel, and he peppers it with gripping first-person accounts and medical oddities. (You probably didn’t know that Ebola causes hiccups). He also digs into the ethical questions facing doctors on the front lines. An experimental medication called ZMapp is in development, but it has never been tested in humans. Who should get it? And who gets to decide? We’re in the room as caregivers survey the red zone and make these agonizing life-and-death decisions.
Preston brings nuance and humanity to this story in a way few can, explaining that the volatile virus is often transmitted during rituals, celebrations and burial ceremonies. (At least 365 cases can be traced back to a single funeral). “Ebola virus,” he writes, “moves from one person to the next by following the deepest and most personal ties of love, care, and duty that join people to one another and most clearly define us as human.” That heartbreaking reality explains why, despite our best efforts, the disease is still spreading.
There have been more than 30,000 cases of Ebola, but it still seems like a disease of a far-away land, something that ravages small villages on the other side of the world. Preston’s reporting challenges that perception, explaining how the virus – and other emerging pathogens like it – touches us all. By the end of this exhilarating book, you’ll agree with his ominous conclusion: There is no such thing as one case of Ebola.
Matt McCarthy is an internist and author of “Superbugs: The Race to Stop an Epidemic.”