This is a frisson inducing tale of devastation - past and possible - that some of the deadliest, and yet simplest, viruses can wreak. Written like a sophisticated bio-sci-fi horror-thriller, except it is based on true events. Terrifying and fast-paced beginning, and then settles into a more measured and slower pace.
While the author states that the "book describes events between 1967 and 1993", the two main events of interest described, take place in Kenya in 1980 and in the weeks following Thanksgiving Weekend in the US in 1989.
The book starts out by describing the case of Charles Monet in western Kenya who was infected with the Marburg virus, and the horrifying and hard-to-believe effects of the virus on Monet.
Some pages later, the book moves to the US, where the "decon" mission - to decontaminate the facility of the virus took place, "... the first major bio-hazard mission the world ever knew... ", is described as it happened over the course of several days. From the identification of the virus, the coordination and the political tensions between the US Army and the CDC, to the mobilization of the troops and materials, to the actual operation - are all described in detail.
"For a short while, the Reston Primate Quarantine Unit was the only building in the world where nothing lived, nothing at all." [page 271]
Sometimes, however, the description reads a bit like a screenplay. Which in itself is not bad, except that it does tend to distract your attention, away from the plot.
The end is almost reassuringly calm, and almost makes you feel that the world is safe again. But it is not, as the author points out. The fact that the Ebola Reston strain has infected people and yet not made them sick is only the result of a possibly beneficial mutation of the virus. If it were to mutate in some other malevolent way, the consequences could be devastating for the world human population. Given the speed with which diseases can be spread from one corner to the world to the other, one has to assume it is only a matter of time before some as-yet unknown mass-killer pathogen makes it appearance.
The author does speculate that humans may, unsurprisingly, be to partly blame for the emergence of these mass-killers.
"The emergence of AIDS, Ebola, and any number of other rainforest agents appears to be a natural consequence of the ruin of the tropical biosphere. ... The tropical rain forests are the deep reservoirs of life on the planet, containing most of the world's plant and animal species. The rain forests are also its largest reservoirs of viruses, since all living things carry viruses. ...
In a sense, the earth is mounting an immune response against the human species. It is beginning to react to the human parasite, the flooding infection of people, the dead spots of concrete all over the planet... Or it could be said that the extreme amplification of the human race, which has occurred only in the past hundred years or so, has suddenly produced a very large quantity of meat, which is sitting everywhere in the biosphere and may not be able to defend itself against a life form that might want to consume it." [pages 310, 311]
We are given a good indication of not only the horrifying effects of these viruses, but also their lethality:
"The kill rate of Marburg turned out to be one in four, which makes Marburg an extremely lethal agent. ... By contrast, yellow fever, which is considered a highly lethal virus, kills only about one in twenty patients once they reach a hospital." [page 27, 28]
"... the virus killed nine out of ten people it infected. ... 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. ... Ebola does in ten days what it takes AIDS ten years to accomplish." [pages 49, 50]
"To mess around with Ebola is an easy way to die. Better to work with something safer, such as anthrax." [page 47]
The first part is by far the scariest, and written with a cold and terrifying eye for the gruesome detail.
Read this paragraph below from the book only with a strong PG warning:
"During this process, the body is partly transformed into virus particles. In other words, the host is possessed by a life form that is attempting to convert the host into itself. The transformation is not entirely successful, however, and the end result is a great deal of liquefying flesh mixed with virus... His blood is clotting up - his bloodstream is throwing clots, and the clots are lodging everywhere. His liver, kidneys, lungs, hands, feet and head are becoming jammed with blood clots. Clots are accumulating in his intestinal muscles, cutting off the blood supply to his intestines. The intestinal muscles are beginning to to die, and the intestines are to go slack. He doesn't seem to be fully aware of pain any longer because the blood clots lodged in his brain are cutting off blood flow. His personality is being wiped away by brain damage. ... Tiny spots in his brain are liquefying. ... He leans over, head on his knees, and brings up an incredible quantity of blood from his stomach and spills it onto the floor with a gasping groan. ... The only sound is a choking in his throat as he continues to vomit blood and black matter while unconscious. Then comes a sound like a bedsheet being torn in half, which is the sound of his bowels opening and venting blood from the anus. The blood is mixed with intestinal lining. He has sloughed his gut." [pages 14-18]