Ebola: The Natural and Human History of a Deadly Virus

Ebola: The Natural and Human History of a Deadly Virus by David Quammen was a short read about the notorious microscopic killer bug from Africa. I am currently reading a succession of short books in anticipation of a library interloan that could arrive any day from the University of Manitoba. Ebola is the third book I have read about the disease, yet the first since I started writing book reviews in 2010. It was a speedy read, and I learned more from its 111 pages than from either prior title. Quammen accompanied researchers throughout central Africa and interviewed survivors of the disease. It was indeed a page-turner, but without the Hot Zone dramatics (now disproved) of patients' bodies liquefying and bleeding out. The greatest mystery is finding the host where the Ebola virus incubates. Ebola kills primates and has a high mortality rate in humans. But a virus needs a host to survive, and throughout the book Quammen in his explorations and interviews tries to determine what this host is. There is leading evidence that the host may be various species of fruit bat.

While the most famous strain of the virus was named after the Ebola River in the Democratic Republic of the Congo, there are in fact five known species of the virus. The author cites a scientific paper written by a team headed by Jonathan S. Towner from the Centers for Disease Control and Prevention about the five strains of Ebola that have been discovered:

"Viruses of each species have genomes that are at least 30-40% divergent from one another, a level of diversity that presumably reflects differences in the ecologic niche they occupy and in their evolutionary history."

Ebola outbreaks have occurred in Africa as far east as Uganda and as far west (and most recently) as the cluster of western nations of Sierra Leone, Guinea and Liberia. Each location experienced a different strain of the virus, and some strains are more deadly than others. One of the risks of working with Ebola either in hot zones where outbreaks occur, on in Ebola research, is that one might unfortunately contract the disease. Doctors and nurses are exposed to infected patients in field hospitals and scientists have contracted the disease via laboratory accidents like needle pricks. Viral researcher Kelly L. Warfield accidentally pricked herself in 2004 and during her quarantine she received the news that she had tested positive. This was suspenseful reading, and Quammen wrote of her deathly anguish. You can almost see her bloodshot eyes darting back and forth as she says:

"'If I die, I want you to learn everything you can about me'--everything they could about Ebola virus disease, she meant. 'Store every sample. Analyze everything you can. Please please take something away from this if I die. I want you to learn.'"

Fortunately Warfield received a false positive, which was not unusual in certain Ebola tests.

For a brief and balanced analysis of Ebola from its first outbreak in the mid-seventies up till its latest outbreak in western Africa, I recommend David Quammen's Ebola. In it he debunked Richard Preston's The Hot Zone, but at the same time was grateful for it. That earlier book scared so many people that scientists received a sizable bump in grants to research the disease.

Interesting insights about origins of Ebola virus.

2014: the year that Ebola became an issue for the world. For decades most people in denial, upon hearing this terrifying word, could point to some random place in Africa on a world map and say "that's their problem." No more. Ebola is now a potential issue for everyone. The sheer horror it inspires derives not only from its incurability and high mortality rate, but from its aggravating evasiveness. It appears, wipes people out, disappears, then reappears somewhere else, wipes more people out, and disappears again. No one can pin it down. Only one thing remains certain: it will strike again and it will destroy many lives. The 2014 outbreak, which some prefer to call an epidemic, has demonstrated Ebola's true virulence. Where did this disease come from and why has it suddenly appeared on the world's doorstep?

The small book, "Ebola: The Natural and Human History of a Deadly Virus," actually an excerpt from a larger book, tells the entire story in an accessible and highly readable manner. Though it appeared just before Ebola came to the United States and so does not cover the events in Texas, it nonetheless contains a trove of valuable information that will illuminate this lurking and frightening mystery for any general reader. Will it keep readers up at night and fill them with never-ending anxiety? Possibly, though knowledge and understanding often provide the best route to tranquility. The book also accuses the 1989 best seller "The Hot Zone," which described an outbreak of Reston virus in the USA, of excessive sensationalism about the disease's effects on the human body. Though doubtlessly horrible enough, Ebola victims do not dissolve into nondescript piles of goo and gore. In this way the book actually dispels some myths and may help some relax - at least a little.

Though the recent spread of Ebola, sensationalized afresh by the media, Ebola and related viruses had appeared earlier outside of Africa. The book tells the story of exposures in England in 1976 and Russia in 1996. A Swiss woman also carried Tai Forest virus with her back home in 1992. In 2004, another close call happened to USAMRIID virologist Kelly Warfield in the US after a lab mouse kicked a needle into her thumb and drew blood. She was injecting her final Ebola infected mice of the evening with antibodies. Her ensuing isolation in "the slammer" didn't deter her from further research. Such stories highlight the often neglected unsung heroes who dedicate their lives to disease eradication.

One of the book's major themes involves tracking down Ebola's elusory reservoir host. Since the disease appears, disappears and reappears after a time it must reside in some animal between outbreaks. Just which animal remains a mystery, though many suspect bats. A small breakthrough occurred in 2008 after a Dutch tourist died tragically from Marburg virus following a visit to a Ugandan cave. Subsequent studies found live Marburg virus living in the cave's numerous bat population. But no one has yet to document live Ebola virus in bats.

The book's epilogue ends in September 2014 with the most recent outbreak's death toll at 2,112. Things of course accelerated and the total number dead now exceeds 5,000, though more than one of the affected countries have declared themselves Ebola free. Thankfully, at this moment, and despite some missteps, the world seems to have avoided a truly global outbreak on a wide scale. The book does not mention any potential vaccines, though this research apparently continues. It does mention some of the interesting collaboration amongst scientists in varying fields who have contributed to Ebola and filovirus research, including the fascinating story that led to the journal article "Bats: Important Reservoir Hosts of Emerging Viruses." It also mentions the five known strains of Ebola and briefly discusses the unthinkable nightmare subject of the virus evolving and becoming even more deadly. Let's hope that doesn't happen and that Ebola researchers, those listed and not listed in this book, locate the disease's reservoir host and find a cure or a solution before another 2014 reoccurs.