50 pages • 1 hour read
Richard PrestonThe Hot Zone: The Terrifying True Story of the Origins of the Ebola Virus
Nonfiction | Book | Adult | Published in 1994A modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.
Part 3, Chapters 22-28Chapter Summaries & Analyses
Part 3: “Smashdown”
Part 3, Chapter 22 Summary: “Insertion”
On Friday, December 1, Eugene Johnson loads his stockpile of protective gear from the failed Kitum Cave expedition and sets off for the Reston monkey house. The Washington Post breaks the story of the outbreak. CJ Peters is quoted in the article, where he strives to understate the level of cause for alarm. Wearing civilian clothes and driving unmarked vehicles, a small team converges on the monkey house and begins the task of destroying the 500 monkeys inside. Working in pairs, the team visits each cage, where one member holds each monkey in place with a pole while the other sedates the monkey with a pole-mounted syringe. The sedated monkeys are subjected to blood-draws and lethal injection and are then opened for tissue sampling before being bagged up for disposal. Monkeys necropsied by Nancy Jaax on this day show obvious signs of Ebola, some “essentially a heap of mush and bones in a skin bag, mixed with huge amounts of amplified virus” (373).
The following Monday, Dalgard arrives to find a monkey worker on the lawn outside the monkey house in a white Tyvek jump-suit. He is at first annoyed because all workers are under orders not to allow their protective gear to be seen in public, and then he is alarmed because the man is outside vomiting.
Part 3, Chapter 23 Summary: “A Man Down”
Despairing over his employee, Dalgard calls CJ Peters and turns the facility and the monkeys over to USAMRIID. The CDC meanwhile decides to send the sick monkey worker to Fairfax Hospital, a nearby public hospital where he will be isolated as a possible Ebola patient. Peters feels he should have been sent to the Slammer, but Joe McCormick is insistent that Ebola is not infectious enough to require that level of containment. The Channel 4 news van follows the ambulance to the hospital.
Part 3, Chapter 24 Summary: “91-Tangos”
Jerry recruits members of the 91-Tangos—the Army’s animal-care technicians, who are classified 91-T—to do the dangerous work of destroying the monkeys. Many of these soldiers are as young as 18, and none have ever worked in a space suit. Eugene Johnson and Jerry Jaax both feel protective of these “kids” and afraid there will be casualties (267). On December 5, the full team arrives at the monkey house and begins the serial euthanasia of the remaining 450 monkeys.
Part 3, Chapter 25 Summary: “Inside”
The operation inside the monkey house continues. Soldiers begin using up the batteries for the air supply on their space suits, and two must be extracted from the building just as a news van pulls up. They hide in a vehicle until the van is gone, and then dress and go to the woods to relieve themselves, where they find used hypodermic needles scattered on the ground.
Part 3, Chapter 26 Summary: “A Bad Day”
On December 6, a monkey escapes from its cage in Room C. Witnesses disagree about whether it also escaped from the room and ran down the hall. Jerry Jaax chases the monkey around the room with a net, to no avail. They leave it loose in the room overnight. Meanwhile, in the euthanasia room, a monkey awakens and grabs a technician’s hand while she is trying to draw its blood. The monkey pulls her hand toward its mouth to bite it. Coworkers wrestle the monkey to the table. Back at the lab, Peter Jahrling and Tom Geisbert check in with each other about their Ebola exposure. They are coming to the end of the incubation period, and neither of them has symptoms, but they are more nervous after the monkey caretaker vomited on the lawn. If that man has contracted Ebola without cutting or poking himself on the job, he must have caught it through the air (290).
Part 3, Chapter 27 Summary: “Decon”
On Thursday, December 7, Jerry Jaax recaptures the escaped monkey, and the last monkey is killed and bagged. The team makes a last inspection of the building, finding a freezer full of dead monkeys. The euthanasia team exits the building. None have sustained any bites or cuts, and their leaders begin to feel relieved. The decontamination team next enters the building and begins the process of cleaning the blood and feces from the walls and floor by scraping it with spatulas and scrubbing it with bleach. The sick monkey worker is sent home from the hospital after feeling better and testing negative for Ebola (298). Scientists, including Jahrling and Geisbert, regard the lack of transmission to humans as an interesting mystery. CDC efforts to trace the virus to its source eventually find that monkeys had been dying in large numbers in the Ferlite Farms monkey house near Manilla before the infected monkeys were shipped to Reston, but no monkey workers there had fallen ill, either. The CDC does not reach a conclusion on how Reston reached the Philippines, since the virus’s similarity to Ebola Zaire suggests an African, rather than Asian, origin. On Monday, after a weekend of manual cleaning, the Decon team seals the building and uses electric frying pans to fill it with formaldehyde gas for three days.
Part 3, Chapter 28 Summary: “The Most Dangerous Strain”
The monkey house returns to operations only to see the virus resurface less than a month later. It arrives in a new shipment of monkeys from the same monkey house near Manila, owned by Ferlite Farms. Given the lack of human casualties during the last outbreak, the Army, CDC, and the Hazleton company decide this time to let the virus run its course. The virus runs from room to room through the air ducts. Each time a monkey with a runny nose appears in a new room, 80% of the monkeys in the room die within a few days. Then, in mid-February, a Hazleton employee performing a necropsy cuts himself with a scalpel. USAMRIID tests the piece of liver he had been cutting and finds it extremely full of virus particles. His exposure is certain. The Army scientists expect the man to die of Ebola, but the CDC declines to quarantine him. He circulates in public, drinking with his friends in bars, to the horror of the USAMRIID scientists. But the man never sickens (303). Eventually, all the monkeys in the monkey house are wiped out by the virus and Hazleton has its monkey import license suspended for a few months, triggering a loss of millions of dollars (307).
All four monkey caretakers from the Reston facility eventually test positive for the Ebola Reston virus, though only one of them had cut himself. None ever show signs of illness. Clearly, this virus differs from Ebola Zaire. It looks just like Ebola Zaire under a microscope and reacts with the blood serum of Ebola Zaire victims, but it does not sicken humans. This conclusion is not particularly comforting, however. Given its potential for rapid transmission, General Philip Russell observes, “with certain kinds of small changes, this virus could become one that travels in rapid respiratory transmission through humans. I’m talking about the Black Death. Imagine a virus with the infectiousness of influenza and the mortality rate of the black plague in the Middle Ages” (304-05).
Near the end of the chapter, Preston visits Nancy Jaax, and she shows him slides from her experiment with airborne transmission of Ebola Zaire. She has visual evidence of lung cells bursting virus particles directly into the airspace of the lungs. CJ Peters, too, is convinced that Ebola spread through the air during the Reston event, but he explains to Preston that he has chosen not to run experiments on airborne transmission of Ebola for fear that the Army would be accused of developing “a doomsday germ” for bioweapons purposes (309).
Part 3, Chapters 22-28 Analysis
As the Army and the CDC work to eradicate the outbreak at the Reston monkey house, Preston continues to emphasize how difficult it is to fully contain the virus. Despite the best efforts of the team, there are ripped space suits, a loose monkey, a near-biting incident, scattered needles outside the facility, and stray monkey bodies nearly overlooked in a freezer.
These failures of control comprise another aspect of The Dehumanizing Nature of Viruses: Not only do viruses challenge belief in human exceptionalism, but they also threaten the human sense of mastery over the natural world. Jerry Jaax’s thought process while chasing the loose monkey is emblematic of the message here: “We don’t have the tools to handle this situation. We are not in control here – we are along for the ride” (286). The variables of human, animal, and virus behavior stack the deck against human efforts to create perfect containment. Even after bathing the building in formaldehyde gas for three days, Preston concludes “Decon” with the observation that “Total, unequivocal sterilization is extremely difficult to achieve in practice and is almost impossible to verify afterward” (300). Risk of infection can never be entirely eliminated.
Eugene Johnson tells the 91-Tangos, “This is the real thing. A biological Level 4 outbreak is not a training session,” but, ironically, the Reston outbreak proved to be more training session than real (269). While the Army proceeded with Level 4 containment on the assumption that the population of the greater Washington, DC, area was at risk, they were protecting people against a virus that only harms monkeys. By choosing to let the exposed monkey workers be treated in public hospitals and circulate freely, the CDC actually endangered no one, though they could not have known this at the time. The results could have been quite different had the virus been Ebola Zaire and not Reston. Successful containment of the monkey house outbreak owed much to the nature of the virus and little, in the end, to the monumental efforts of the Army and CDC. The takeaway message remains one of the vulnerability of human populations almost anywhere in the world to a major outbreak.
As it probes the subtle differences between Ebola Zaire and Reston, this section emphasizes the arbitrary nature of viral destructiveness:
A tiny difference in the virus’s genetic code, probably resulting in a small structural change in one of the seven mysterious proteins in the virus particle, had apparently changed its effects tremendously in humans, rendering it mild or harmless even though it had destroyed the monkeys (305).
The subtleness of this difference implies the terrifying possibility that an equally small mutation could result in the opposite effect on humans. In the debate over whether Ebola can be spread through the air, Preston appears to be tipping the scales toward acknowledging airborne spread, as he concludes the chapter with Nancy Jaax’s visual evidence of the lung tissue of a monkey (who was also infected through the lungs) hatching virus particles into the air. The overall impact is a somber warning not to underestimate the contagiousness of Ebola or dismiss it as merely “Africa’s problem.”
Tracing the virus’s path to Virginia, Preston further explores The Murky Ethics of Virus Research. The Reston outbreak enters the United States via a monkey farm in the Philippines. The route the virus took from Africa to Asia is uncertain but almost certainly involves an airplane and the human movement of animals for the scientific research industry or for the pet trade. Reston is a monkey-trade problem. Preston also clearly implicates the monkey trade in the first Marburg outbreak and speculates convincingly that the monkey trade, with its concentration of large numbers of monkeys of various, naturally isolated species and their close contact with humans, may be behind the first jump of Ebola and HIV into human populations. It is reasonable to ask the question of whether the use of laboratory monkeys—even for vaccine research, in which they have been crucial—is worth these enormous negative consequences and the risk of still more to come.
CJ Peters’s concluding remarks upon his hesitation to infect research monkeys with Ebola through the air are also a sobering note on The Murky Ethics of Virus Research. Peters says he is reluctant to create the appearance that the Army is creating “a doomsday germ” for biological warfare (309). Of course, airborne Ebola could do more than look like a bioweapon: it could be a bioweapon, and research into how Ebola is spread could be used either to further public health during an epidemic or to go down the path of weaponizing the pathogen. These comments, coming as they do at the end of “Smashdown,” reframe the Army’s eagerness to risk personnel’s lives to secure blood and tissue samples from the Reston monkeys.
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