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‘The Hot Zone’ helps fan myths — and fears — about Ebola, epidemiologist says

Epidemiologist Tara Smith writes, “ ‘The Hot Zone’ is infuriating to so many of us in epidemiology and infectious diseases.”

New Jersey Gov. Chris Christie speaking during a news conference about New York's first case of Ebola, in New York on Friday.
REUTERS/Carlo Allegri

If you’re basing even part of your understanding about the current Ebola epidemic on the 1994 bestselling book “The Hot Zone” by Richard Preston, then you’re seriously misinformed about the disease, according to Tara Smith, an epidemiologist at Kent State University who specializes in zoonotic infectious diseases (ones that transfer between animals and humans).

“ ‘The Hot Zone’ is one of the banes of my existence” and “infuriating to so many of us in epidemiology and infectious diseases,” Smith writes in a commentary originally published on her blog and then re-printed last week in io9, an online publication that covers “science, science fiction, and the world of tomorrow.”

It’s “one of those books that you read as a young person and think is amazing, only to revisit years later and see it as much more shallow and contrived, the characters one-dimensional and the plot predictable,” she adds. “The problem is that [“The Hot Zone”] is still presented and defended as an absolutely true story, especially by huge Preston fans who seem to populate comment threads everywhere.”

In the commentary, Smith cites several reasons for why she believes the “The Hot Zone” has created “some of the worst myths about Ebola”  — and thus, why it’s helping to fan much of the misplaced fears here in the U.S. about the disease. Here are a couple of those reasons:

  • The book grossly exaggerates the symptoms of Ebola (something Preston himself has acknowledged). Writes Smith:

Over and over, he uses words like “dissolving,” “liquefy,” “bleeding out” to describe patient pathology. … Preston presents these types of symptoms as typical of Ebola. Not “in worst case, this is what Ebola could do,” but simply, “here’s what happens to you when you get Ebola.” It’s even beyond a worst case scenario, as he notes in part: “In the original Hot Zone,’ I have a description of a nurse weeping tears of blood. That almost certainly didn’t happen.”

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Compare that to just about any blog post by actual workers with Médecins Sans Frontières, healthcare workers on the front lines of this and many previous Ebola outbreaks. Stories are scary enough when the reality of the virus is exposed, and with it the dual affliction of poverty and the terrible health system conditions of affected countries. I interviewed MSF’s Armand Sprecher a few years back during a different Ebola outbreak, and he noted this about symptoms — quite different from the picture Preston paints: “The patients mostly look sick and weak. If there is blood, it is not a lot, usually in the vomit or diarrhea, occasionally from the gums or nose.”

  • The book downplays Ebola’s low infection rate. Explains Smith:

Preston describes many “near misses” — people who were exposed to huge amounts of “lethally hot” Ebola-laden body fluids, but never get sick — but doesn’t really bother to expose them as such. All 35 or so people on the little commuter plane that [the Ebola patient pseudonymously named] Charles Monet flies on between his plantation in western Kenya and Nairobi, deathly ill, vomiting his coffee grounds and dripping nasal blood into the airsickness bag he handed to a flight attendant — none of them come down with the disease.

The same is true, Smith points out, for another Ebola victim featured in “The Hot Zone,” the nurse Mayinga N.

Preston again devotes several paragraphs to Mayinga’s gruesome illness and death, and notes that 37 people were identified as contacts of hers during her time wandering Kinshasha. He tells us they were quarantined “for a couple of weeks.”

That fact that exactly zero people were infected because of Mayinga’s time in Kinshasha merits half a paragraph, and not dramatic or memorable.

Smith also takes Preston to task for suggesting that the Ebola virus can be spread through the air and for his gender stereotyping of the one major female character in the book, a military scientist named Nancy Jaax.

“While Preston may have been trying to portray Jaax as the having-it-all, tough-as-nails woman scientist,” she writes, “the fact that she’s the only one [in the book] with any kind of home life is telling — mostly because he devotes more paragraphs to how she neglects both her children and her dying father than any success she has in her life outside of work.”

You can read Smith’s commentary on the io9 website. “The Hot Zone,” by the way, is back on the New York Times’ best-seller list, and has recently been optioned for a FOX-TV miniseries.