THE VIRGINIAN-PILOT
Copyright (c) 1994, Landmark Communications, Inc.
DATE: Sunday, December 11, 1994 TAG: 9412080658
SECTION: COMMENTARY PAGE: J2 EDITION: FINAL
TYPE: Book Review
SOURCE: BY THAD ZAJDOWICZ
LENGTH: Medium: 84 lines
THE HOT ZONE
RICHARD PRESTON
Random House. 300 pp. $23.
THE COMING PLAGUE
Newly Emerging Diseases in a World Out of Balance
LAURIE GARRETT
Farrar, Straus and Giroux. 750 pp. $25.
EPIDEMIC DISEASE has always been a frightening problem. In The Hot Zone and The Coming Plague, Richard Preston and Laurie Garrett, respectively, write compelling tales of its continuing horror.
The Hot Zone has been on the best-seller list for more than a month, while The Coming Plague has not. The style of the authors has much to do with that unfortunate disparity, as both are worthwhile.
Preston, a frequent contributor to The New Yorker, chronicles the story of a monkey house in Reston, Va., where an Ebola virus epidemic occurred in 1989. Few will recognize the name Ebola fever; Ebola epidemics in Africa - in Sudan and Zaire - in the 1970s were notable for killing more than 90 percent of those infected. Preston graphically describes the rapid, painful death Ebola causes, as he recounts the story of the people who searched for its origins in vain during the original epidemics.
He also raises goose bumps explaining how the Ebola virus was recognized as the cause of a die-off of monkeys in Reston, and how Army personnel from Fort Detrick, where defenses against infectious-disease threats to the military are researched, act to contain the problem: People entering the ``hot zone'' - an area containing lethal, highly infectious organisms - wear spacesuits to protect them from possible Ebola infection. The terror they face is more psychological than physical, and Preston details their thoughts as the monkeys are euthanized and the building is sterilized.
The Hot Zone is a quick, easy, terrifying read, and despite Preston's hyperbolic style, the reader emerges with a clearer idea of mankind's vulnerability to the microbial world. But Preston fails to clarify fully why humans remain ``meat,'' as he terms us, for the microbial predators. (Only monkeys were at risk in the Reston outbreak.)
This is why medical journalist Laurie Garrett's The Coming Plague is much the better book overall. While Preston's style is somewhere between Stephen King and Berton Roueche, Garrett, who researched her book while she was a fellow at the Harvard School of Public Health, writes an illuminating and exceedingly readable tale that is far more informative.
The Coming Plague examines the ecology of epidemic diseases and places them in sharp perspective, from the Black Death to AIDS, and yes, Ebola, with more real information in a single chapter than The Hot Zone contains in toto. As Garrett puts it, mankind bears great responsibility for the emergence of epidemic disease, as it disturbs all sorts of delicate ecological balances. Too often, our species ignores the obvious fact that we live in an enclosed system: Too often, the result of that ignorance is epidemic disease.
This premise isn't new, but Garrett presents it in clear terms. There is even a chapter about toxic-shock syndrome and tampons that better explains the problem than much else written before; the history of the evolution of feminine hygiene products alone is fascinating.
Garrett's only lapse is her chapter on antibiotic-resistant bacteria. She misidentifies a number of microorganisms and the diseases they cause, which will disappoint the purist.
Both of these books deserve reading, Preston's because it tells the tale well (though a little too theatrically for some tastes) and Garrett's because it is well-done and thought-provoking. The global pandemic of AIDS will kill millions of humans before this century ends; as with other microbes, HIV finds us to be ``meat.''
Both The Hot Zone and The Coming Plague force us to re-examine our places in the world: The microbes are always there, and erupt when conditions allow them to. As The Coming Plague best illustrates, the conditions that allow the microbes to erupt into epidemics are even more operative in an overcrowded, polluted world, full of strife. Witness bubonic plague in India, cholera in South America and Rwanda, and HIV on every continent except Antarctica. The hoofbeats of the Four Horsemen, including Pestilence, continue to echo for all of us. MEMO: Thad Zajdowicz is an infectious-disease physician who lives in Norfolk. by CNB