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Preston - Crisis in the red zone: the Story of the Deadliest Ebola Outbreak in History, and of the Outbreaks to Come

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Preston Crisis in the red zone: the Story of the Deadliest Ebola Outbreak in History, and of the Outbreaks to Come
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The 2013-2014 Ebola epidemic was the deadliest ever--but the outbreaks continue. Now comes a gripping account of the doctors and scientists fighting to protect us, an urgent wake-up call about the future of emerging viruses--from the #1 bestselling author of The Hot Zone, soon to be a National Geographic original miniseries. This time, Ebola started with a two-year-old child who likely had contact with a wild creature and whose entire family quickly fell ill and died. The ensuing global drama activated health professionals in North America, Europe, and Africa in a desperate race against time to contain the viral wildfire. By the end--as the virus mutated into its deadliest form, and spread farther and faster than ever before--30,000 people would be infected, and the dead would be spread across eight countries on three continents. In this taut and suspenseful medical drama, Richard Preston deeply chronicles the outbreak, in which we saw for the first time the specter of Ebola jumping continents, crossing the Atlantic, and infecting people in America. Rich in characters and conflict--physical, emotional, and ethical-- Crisis in the Red Zone is an immersion in one of the great public health calamities of our time. Preston writes of doctors and nurses in the field putting their own lives on the line, of government bureaucrats and NGO administrators moving, often fitfully, to try to contain the outbreak, and of pharmaceutical companies racing to develop drugs to combat the virus. He also explores the charged ethical dilemma over who should and did receive the rare doses of an experimental treatment when they became available at the peak of the disaster. Crisis in the Red Zone makes clear that the outbreak of 2013-2014 is a harbinger of further, more severe outbreaks, and of emerging viruses heretofore unimagined--in any country, on any continent. In our ever more interconnected world, with roads and towns cut deep into the jungles of equatorial Africa, viruses both familiar and undiscovered are being unleashed into more densely populated areas than ever before. The more we discover about the virosphere, the more we realize its deadly potential. Crisis in the Red Zone is an exquisitely timely book, a stark warning of viral outbreaks to come.

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Copyright 2019 by Richard Preston Map copyright 2019 by Mapping Specialists - photo 1
Copyright 2019 by Richard Preston Map copyright 2019 by Mapping Specialists - photo 2

Copyright 2019 by Richard Preston

Map copyright 2019 by Mapping Specialists Ltd.

All rights reserved.

Published in the United States by Random House, an imprint and division of Penguin Random House LLC, New York.

R ANDOM H OUSE and the H OUSE colophon are registered trademarks of Penguin Random House LLC.

Portions of this book first appeared in The New Yorker in somewhat different form.

Grateful acknowledgment is made to the following for permission to use previously unpublished material:

Jean-Franois Ruppol: Excerpts from an unpublished journal entitled Ebola 2 by Jean-Franois Ruppol. Reprinted by permission of the author.

Nadia Wauquier: Excerpts from an unpublished journal entitled Ebola Diary by Nadia Wauquier. Reprinted by permission of the author.

LIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA

Names: Preston, Richard, author.

Title: Crisis in the red zone : the story of the deadliest Ebola outbreak in history, and of the outbreaks to come / by Richard Preston.

Description: First edition. | New York : Random House, [2019]

Identifiers: LCCN 2019010492 | ISBN 9780812998832 | ISBN 9780812998849 (ebook)

Subjects: | MESH: Hemorrhagic Fever, Ebolahistory | Hemorrhagic Fever, Ebolaepidemiology | Disease Outbreakshistory | International Cooperationhistory | History, 21st Century

Classification: LCC RA644.E26 | NLM WC 534 | DDC 614.5/7dc23 LC record available at https://lccn.loc.gov/2019010492

Ebook ISBN9780812998849

randomhousebooks.com

Book design by Susan Turner, adapted for ebook

Cover design: Carlos Beltrn

Cover photograph: Matteo Colombo/Getty Images

v5.4_r1

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Contents

And another angel came out of the temple, crying with a loud voiceThrust in your sickle and reap, for the time has come for you to reap, for the harvest of the earth is ripe.

J OHN , Revelation

PREFACE

Crisis in the Red Zone is the successor to my 1994 book, The Hot Zone. Both books are nonfiction. The people in this story are real and the events are actual, and have been reported and told to the best of my ability. The narrative is supported by hundreds of personal interviews and years of research into published and unpublished documents and source material. Quoted speech comes from my interviews with subjects or from their recollections of words spoken by someone whos no longer alive.

The people in this story have been largely unnoticed by the world. Yet, for me at least, their actions and choices, their lives and deaths, seem to loom at the center of the most destructive rapid epidemic in anyones lifetime, one which sent feelers into Dallas and New York City, and may be an example of things to come. Though this story focuses on a few people at certain moments in time, I hope it can be thought of as a window that looks at the future of everyone.

Richard Preston

SELECTED PERSONS The Crisis of 2014 In order of appearance MILE O UAMOUNO - photo 3
SELECTED PERSONS
The Crisis of 2014
(In order of appearance)

MILE O UAMOUNO a two-year-old boy in Meliandou village, Guinea.

M ENINDOR ( F INDA N YUMA) botanist and healer in Kpondu village, Sierra Leone.

D R. H UMARR S . K HAN chief physician of the Lassa Fever Research Program, Kenema Government Hospital, Sierra Leone.

A UNTIE M BALU S . F ONNIE chief nurse of the Lassa ward at Kenema Government Hospital.

L ISA H ENSLEY associate director of the Integrated Research Facility (IRF), Fort Detrick, Maryland.

P ETER B . J AHRLING director of the IRF.

S IMBIRIE J ALLOH coordinator of the Lassa research program, Kenema Government Hospital.

D R. P ARDIS S ABETI genomic scientist at Harvard University and the Broad Institute.

L INA M . M OSES scientist with Tulane School of Public Health and Tropical Medicine, New Orleans.

D R. L ANCE P LYLER chief of emergency medical operations for Samaritans Purse, ELWA Hospital, Monrovia, Liberia.

D R. K ENT B RANTLY chief physician of the Ebola ward, Samaritans Purse, ELWA Hospital, Monrovia, Liberia.

M ICHAEL G BAKIE biosafety officer and epidemiologist, Lassa research program; deputy to Humarr Khan.

A UGUSTINE G OBA director of the Lassa Laboratory (the Hot Lab) of the Lassa research program, Kenema Government Hospital.

N ADIA W AUQUIER epidemiologist with biotechnology firm Metabiota.

S AHR N YOKOR ambulance driver, Kenema Government Hospital.

D R. T OM F LETCHER WHO doctor; scientist at the Liverpool School of Tropical Medicine, U.K.

L UCY M AY nurse, Kenema Government Hospital.

I YE P RINCESS G BORIE nurse, Kenema Government Hospital.

M OHAMED Y ILLAH epidemiologist in the Lassa research program, Kenema Government Hospital. Brother of Auntie Mbalu Fonnie.

A LEX M OIGBOI senior nurse, Ebola ward, Kenema Government Hospital.

L ARRY Z EITLIN cofounder and president, Mapp Biopharmaceutical Inc., San Diego.

G ENE O LINGER scientist at the IRF, Fort Detrick, Maryland.

G ARY K OBINGER chief of pathogens at the National Microbiology Laboratory, Winnipeg, Canada.

D R. T IM OD EMPSEY WHO doctor; professor at the Liverpool School of Tropical Medicine, Liverpool, U.K.

A LICE K OVOMA nurse, Ebola ward, Kenema Government Hospital.

N ANCY Y OKO nurse and later supervisor of the Ebola ward, Kenema Government Hospital.

D R. J OHN S CHIEFFELIN WHO doctor; pediatrician with Tulane University School of Medicine, New Orleans.

N ANCY W RITEBOL medical worker with Samaritans Purse.

The Crisis of 1976
(In order of appearance)

S ISTER B EATA ( J EANNE V ERTOMMEN) midwife at Yambuku Catholic Mission Hospital, Zaire (now Democratic Republic of the Congo).

F ATHER S ANGO G ERMAIN priest at Yambuku Catholic Mission, Zaire (now Democratic Republic of the Congo).

D R. J EAN- J ACQUES J . J . M UYEMB- T AMFUN virologist at the National University of Zaire, Kinshasa, Zaire.

S ISTER M YRIAM ( L OUISE E CRAN) nursing sister at Yambuku Catholic Mission Hospital.

D R. J EAN- F RANOIS R UPPOL head of the Belgian medical mission in Zaire.

D R. K ARL M . J OHNSON head of the Special Pathogens Branch of the Centers for Disease Control, Atlanta, Georgia, U.S.A.

P ATRICIA A . W EBB virologist at the Special Pathogens Branch of the CDC.

ABBREVIATIONS
Occasionally Used

CDC = Centers for Disease Control

ELWA H OSPITAL = Eternal Love Winning Africa Hospital

HEPA FILTER = high-efficiency particulate air filter

IRF = Integrated Research Facility

NIH = National Institutes of Health

PPE = personal protective equipment

USAMRIID (pronounced You-SAM-rid) = United States Army Medical Research Institute of Infectious Diseases

WHO = World Health Organization

PART ONE
NAMELESS SACRAMENT YAMBUKU CATHOLIC MISSION ZAIRE NOW DEMOCRATIC REPUBLIC - photo 4
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