Crisis in the Red Zone

Pub Date:   |   Archive Date: 23 Sep 2019

Member Reviews

“[The Ebola outbreak] was really just a series of small accidents and unnoticed events, which, moment by moment, grew into a crescendo of horror. This was the shockwave produced by an emerging virus as it came out of the ecosystem. The virus magnified itself in people, swept away lives, met opposition from the human species, and finally died out. What will the next shockwave be like?”

This is an informative book that didn’t quite mesh with my own personal interests. It traces the spread of Ebola through several outbreaks beginning in Zaire in 1976. I found the book somewhat repetitive and there was way more discussion of symptoms of Ebola than I wanted to read. I would have preferred more analysis of the socioeconomic underpinnings of disease spread. I’m also interested in epidemiology, and I don’t recall a single mention of whether anyone is looking into the people who don’t catch this highly contagious and lethal disease, or those who recover.  That just wasn’t the focus of this book.

 I did find the book interesting.  My favorite part was near the end when an Ebola doctor was denied treatment with an untested drug, for reasons that seemed like total garbage to me. It would make a good case study in an ethics course. At least they’ve saved a dose of the treatment for our President. 3.5 stars

I received a free copy of this book from the publisher.
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I've always enjoyed every other piece of written work from the author. I was even looking forward the the "fact based" concept I just couldn't lose myself in it. Most likely just me, I'd recommend trying it for yourself.
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This book read like a scary thriller, but it’s unfortunately all too real.  Richard Preston does a great job of humanizing all the people involved in the outbreak, telling everyone’s history, so the reader really roots for them and is saddened if they don’t make it.  While this book often details complex medical and scientific information, it does so in a way that the average layperson can easily understand.  This is an excellent nonfiction book.
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The Ebola outbreak of 2013-2014 in Africa should serve as a wake up call for all global citizens, and the threat of further outbreaks in the future. Richard Preston offers us a compelling fact-driven book that details the bravery of doctors and medical personnel in confronting this deadly threat to us all.
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This was a great follow-up to the Hot Zone. Looking at the way in which we still stumble to confront epidemics is scary but reading about the brave medical staff working to fight these diseases head on is comforting. A Great read!
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I clearly remember the day in 1994 that I picked up the Hot Zone by Richard Preston. I was browsing a long since bankrupt bookstore in a long since abandoned strip mall waiting for a pizza to finish cooking at a, you guessed it, long since out of business pizza parlor. I was really into horror and Michael Crichton at the time, so a book about a hemorrhagic virus and the scientists trying to tack its source seemed like a great way to scratch both itches at the same time. Twenty-five years later, I've long forgotten the pizza, but the book is still fresh in my memory. It's a wonderful book, paced like an action film, filled with interesting facts about viruses, and a chilling reminder that we live in a world where the entire human race could be wiped out by something that we can't even see. 

Crisis in the Red Zone tells the story of the 1976 and 2014 outbreaks of Zaire Ebola. Mr. Preston chooses these two particular outbreaks because while they are the same strain of virus, the 2014 virus mutated in a way that made it much more virulent than 1976 strain. This is the crux of the problem for scientists and the danger to humanity. These Biohazard Level 4 viruses come in contact with humans, mutate as they use human cells to replicate, and sometimes those mutations make it easier to infect even more people. While the 1976 Zaire Ebola only killed 218 people, the 2014 Zaire, even with improvements in medicine and Ebola fighting techniques, infected 28,000 and killed over 11,000 people. In other words, as the virus mutates it becomes harder to contain. Virologists fear that at some point, Ebola and viruses like it, will eventually break containment and travel around the world; mutating, becoming more dangerous, and potentially impossible to contain. 

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Well, this was scary! Timely but scary... Not the kind of book you think would keep you up at night but it did.
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Crisis in the Red Zone is a layman accessible and terrifying real-life narrative about the 2014 Ebola outbreak in Africa and internationally, its development, and eventual (partial) containment. Part detective thriller, part popular science and epidemiology, it captured me from the first page. The author has managed to humanize the headlines we all read at the time and make them more personal and more real.

Released 23rd July 2019 by Random House, it's 400 pages and available in hardcover, ebook, and audiobook formats.

He writes well and authoritatively on the science behind the scenes, and about the healthcare professionals and support staff who sacrificed themselves to contain the epidemic. The heroic, almost superhuman efforts of the doctors and nurses made my heart ache for the horrifying loss of life to the merciless enemy that is Ebola.

The book follows a rough timeline with interconnections in the form of the individuals (where known) who were infected by people they came into contact with and infected others in turn. The background research is impressive and seems quite meticulous. There is a glossary, and map info in the final release version of the book.

It's unclear from the publishing info available online, but the eARC I received also has a handy interactive table of contents as well as interactive links and references. I hope the ebook release version does also. I've really become enamored of ebooks with interactive formats lately.

This book would make a superlative book club selection for non-fiction readers, as well as fans of layman science. It's a terrifying read, even more so because it's non-fiction. It is extremely graphic in places and readers will want to be clear on the fact that the progression of the disease is horrific, resulting in death in approximately 50% of the cases.

Five stars.

Disclosure: I received an ARC at no cost from the author/publisher for review purposes.
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Not my normal read, but I read The Hot Zone, and wanted to see what was new.  The book follows how an Ebola outbreak happened and how it might spread.  Things that could have been avoided and made a difference, and how mother nature will have her way.  It is a intense book, and the author says it like it is. (blood granulated like coffee grounds, will stick in my mine for quite a while).  Then you get to the end and realize the world as a whole is not equip to handle any major outbreaks of any virus's .  I am very glad I read this book, it took longer to read then most books for me, but I wanted and needed time to digest the information.  Not a fun book but very interesting, a must read.
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Richard Preston has written another comprehensible and terrifying account of the Ebola disease that could turn into a global disaster if we aren't careful.  Crises in the Red Zone chronicles the outbreak of 2013-14 and the fact that it jumped continents for the first time infecting people in America.  This book is horrifying and graphic and the doctors and nurses who cared for these patients without thinking of their own safety and knowing they would most likely die is truly amazing and are the heroes of this book. An important book that should be read.
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Crisis in the Red Zone really hit me in a weird, profound way. During the Ebola crisis, around 2015, I just happened to be working on a job that support groups who were diligently supporting the crisis in their capacity. There is a very deja vu sense reading about something and remembering sitting in meetings talking about similar problems and issues.  
I have previously read Preston’s other book Ebola, Hot Zone, and completely devoured it. Crisis in the Red Zone was no different. It was filled with facts and insights I was unaware of at the time, and drew back on past crises to further explain the full scope of what was really going on. Ebola is a deadly, bloody, and scary disease. Without proper care, containment practices, and knowledge (both at a patient and doctor level), it can spread, wreaking havoc on families, communities, villages, and cities. Reading about encounters with those who had caught Ebola, the doctors and nurses tirelessly tending patients, and decisions that were basically “lesser of two evils” being made, Crisis in the Red Zone reads like a horror book. Except that it is all true. Preston is able to capture that horror and the dedication of those who worked on the front lines simultaneously. 
My only complaint is about some of the writing style. A few of the passages were repetitive, both from early in the book and some of his other writings. While I understand presenting information from another work like it is new for new readers, it personally made those passages a bit slow and boring. However, it was easy enough to skim through what I remembered and move on to new facts and stories.
Medical non-fiction is my bookish wheelhouse, and I am glad Crisis in the Red Zone did not disappoint. Now, to just wait for news of any more future work from Preston!
Thanks to Netgalley for a copy of this ARC in exchange for an unbiased review.
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Truly a very well written book. The subject matter, the Ebola Virus is a scarry enough but to read the accounts of those that have lived and dealt with this is truly a horror made worse as this story is real and not fiction. A true eye opener. Very tastefully done not for the faint of heart to read.
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This book is a fascinating look at the Ebola outbreak in 1976 and the reoccurrence in 2013. It's scary to think that it's happening again in the Congo. It's also scary to think that if this were to become a global pandemic we are not even close to ready to combat something like that.

The book is divided into four parts. The first part starts in 1976 with the first documented case of Ebola in a young woman who is brought to the hospital in what use to be Zaire and is now the Democratic Republic of the Congo. She is in labor and had a high fever, the whites of her eyes were bright red and she was bleeding from the gums. This actually wasn't unusual. it looked like a case of cerebral malaria. the midwives and nursing aids were not wearing gloves or eye coverings. The baby was stillborn and the mother died shortly after. Five days later the attending nurse fell ill and died 10 days later. The people caring for her didn't have any idea that what she had was contagious. Medical workers, priests, families stared dying horribly. 

The second and third parts go back and forth between 1976 and 2013 when the reoccurrence happened. The first part felt like it was written in a very simple way, where as the rest of the book was written very intelligently. I like the 2nd, 3rd and 4th parts much better. I would highly recommend this book. it's written almost like a good thriller and not like non-fiction. I am actually giving this a 4.5.

Thank you to Netgalley for the book in exchange for an honest review.
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I received an uncorrected proof of this book thanks to NetGalley. 

Crisis in the Red Zone focuses on the deadliest Ebola epidemic (2013-2014) as well as the Ebola outbreak in 1976. The reader is given some history of the Ebola Virus and the ongoing fight to find a cure or vaccine. But, this is so much more than just a book about a virus. Richard Preston really focuses on human nature and the compassion of the people who were fighting this virus and the many who died. This is about the physical, emotional and ethical conflicts that were taking place across continents.

Due to there being two timelines of Ebola outbreaks, I naturally found myself more interested in one than the other. I worked for a medical company during this epidemic in 2014, so that was the one I found myself far more invested in. I'm more familiar with it and it's one of the biggest reasons I picked this book up. So the numerous sections about the 1976 outbreak I found myself losing interest slightly. They needed to be there and they were written about very well, but it's a lot of information and characters to keep track of and I definitely didn't pay as close attention to those parts. 

I wish there had been more about the mass panic the media was able to stir up surrounding this crisis. Overall, though, I thought Preston did a great job portraying the difficult decisions that needed to be made in the midst of this devastating and chaotic epidemic where people have very little information. Those human moments are what make this book so well done!

Emerging diseases are only going to become more prevalent. With the current Ebola outbreak in Democratic Republic of Congo and WHO announcing this as an international concern, I can’t think of a book more important right now.
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I read “The Hot Zone” by Richard Preston years ago. I am a big fan of medical thrillers. So a nonfiction medical thriller was no-brainer. Plus, seeing the blurb on the back of the book by Stephen King I had to buy it. The quote started out like this:

“The first chapter is one of the most horrifying things I’ve ever read in my whole life...and then it gets worse...” Stephen King

The story told in “The Hot Zone” happened minutes from my house in the same town that my son went to school. Preston described in his book how the government attempted to cover up this event. He was dead-on. The only thing I ever heard was a DJ say, “There’s something going on at the monkey house.”

“Crisis in the Red Zone” (successor to “The Hot Zone”) is about the 2013-2014 Ebola outbreak, the deadliest Ebola outbreak in history, and the outbreak in 1976.

There were six known species of Ebola, now there are seven.

Richard Preston does a great job detailing where the breakout started and how it expanded.

I must admit, after reading about this strain, to wondering if some of these diseases are government engineered and released in Africa.

Kudos to Preston for reporting on this story.

I will not be stepping foot in Africa after reading his books. They have too many nasty diseases going on over there.

Reviews posted at:
I also posted a review on Barnes & Noble. It finally showed up on the Nook app only, but not when I look on the PC.  It seems to be run together, but it's there. LOL B&N can be quite challenging at times. I don't see a link from the app.
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Richard Preston is at the top of the tower of telling the chilling reality of infectious disease. A true master in investigative journalism. For those that have read The Hot Zone and think they've read this book by Richard Preston before will be very surprised at how he goes to tell the story of the most recent Ebola crisis in Sierra Leon, Guinea, and Liberia. He truly delves into the character of those nurses and doctors that have chose to stay in their native countries to be on the front lines of infectious disease their whole lives, and the politics of international organizations that bring aid during outbreaks. 

Richard Preston starts with the telling of the first outbreak of Ebola in the Congo and parallels that tale with the most recent outbreak. It shows that we have not come a long way in managing the spread of infectious diseases and things may be worse before they get better. 

He also shows that what may appear to be unique causes in the spread of disease in Africa may not in fact be unique. Many of the pathways for Ebola to spread would cause it to spread in the USA Europe, etc. Would you not caress and comfort a dying loved one? Would you not select to try to recover from an illness at home?

This story is gripping and compelling. Everyone should read it.
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I read The Hot Zone over a decade ago, and I instantly fell in love with Richard Preston’s writing. As someone who has always loved science, especially virology, Ebola was always the virus that I found to be the most fascinating and also most terrifying. It’s one of the simplest viruses (as contagious as the common cold), it has the capacity to cross-species jump and evolve, and it completely decimates the human immune system in just 7-10 days (something that takes YEARS for HIV to do). That being said, I have always dreamt of becoming an epidemiologist for the CDC and working in the Hazmat suits on Biosafety Level 4. When I found out that he was doing a follow up to my beloved The Hot Zone, I couldn’t request the book fast enough!

Richard Preston does an incredible job of immersing you into the gruesome reality of Ebola outbreaks. He doesn’t spare you the gorey details. When The Hot Zone was first released in 1994, the seriousness of the Ebola virus did not really register for many Americans since it was a virus that was mostly confined to Africa, and there wasn’t widespread media coverage in the 1970s to really highlight the grim reality. The recent outbreak in 2014, brought Ebola into international spotlight, and The Crisis in the Red Zone provides the details that the media outlets did not have access to.

Preston is able to humanize Ebola. He is able to take the medical and scientific jargon surrounding viruses as a whole and make them digestible to all audiences. He recounts stories of medical workers who attempted to save patients and their horrifying experiences in the Ebola wards. (If medical procedures and bodily fluids that are described in painstaking detail make you queasy, this will most definitely not be for you.) The story alternates between the original 1976 outbreak to the 2014 outbreak to answer what has been learned about Ebola and its evolution during that time period.

Overall, this was another fantastic piece by Richard Preston that gives even more insight into this virus as well as provides hope for a future where we are ultimately able to eradicate this virus once and for all.

Thank you to Random House and NetGalley for providing an eARC. This did not influence my review. All opinions are my own.

4.5/5 stars, rounded up!

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"Viruses are the undead of the living world, the zombies of deep time. Nobody knows the origin of viruses--how they came into existence or when they appeared in the history of life on earth. Viruses may be examples or relics of life forms that operated at the dawn of life. Viruses may have come into existence with the first stirrings of life on the planet, roughly four billion years ago."

Richard Preston, author of several bestselling narrative nonfiction titles about infectious diseases, returns to the territory he's best known for. In 1994, he published The Hot Zone, a page-turning, nail-biting account of the Ebola virus told through the Marburg strain's appearance in patient zero, alongside the story of a strain reaching the US. It's gotten an intense, important sequel two decades after its initial publication.

Crisis in the Red Zone puts faces to the staggering numbers of the West African Ebola epidemic that began raging in 2014, of victims and the doctors and health workers who risked - and sometimes lost - their lives trying to care for patients and curb the epidemic. The deadliest outbreak to date, the Makona strain responsible left 7% of the doctors in Sierra Leone dead. Providing background, Preston depicts events from the 1976 outbreak in Zaire, believed to be the first jump of the virus into humans.

The red zone is the section of tents with strict biocontainment measures, cloistered in the center of a typical Ebola treatment unit within Doctors Without Borders and sectioned off behind fences. Red zones are for known infection cases: "Patients die in the red zone; they are not permitted to die anywhere else."

On the ground in Sierra Leone, employing his trademark rich detail and smooth story structure, Preston creates portraits of several African doctors and healthcare workers as well as some sent from various international aid and research agencies. Primary among these are Dr. Sheik Umar Khan and epidemiologists Lina Moses and Lisa Hensley from the NIH working in diagnostic and research capacities. As he did in The Hot Zone, Preston shapes their experience into highly readable and telling story arcs, letting events play out in harrowing real time, allowing readers to follow developments as they progress.

This includes the fear and the learning that characterized their work, as they watched the epidemic explode despite their best efforts, grappled with superstition and misunderstanding, and endured the pain of having to diagnose colleagues or be diagnosed themselves.

"The African medical professionals gave their lives trying to rescue one another, and, at the same time, they served as a thin, dissolving line of sacrifice in which they stood between the virus and you and me."

It's laden with the psychological burden staff were saddled with -- if they treated patients who were bleeding out, they risked infecting themselves. One distressing scene depicts nurses assisting in a procedure on an infected, pregnant colleague. After delivering her baby, they realize the gravity of the situation, covered as they are in fluid and thus, Ebola particles. Preston emphasizes that the virus has been able to thrive thanks to exactly this human capacity for care, including the cultural rituals in the affected West African countries of washing and mourning the dead.

"The Ebola parasite got into a human network of affection and care, the ties of humanity that join each person ultimately to every other person on earth."

It didn't help that science is still learning about the virus, and people in affected communities know much less. It's hard to help them understand the magnitude of what it's capable of, and what it is in its makeup, when what they see is loved ones going to medical centers where they're supposed to heal and instead come out dead, attended by spacesuit-wearing, faceless personnel.

And what are viruses, actually? With his remarkable skill for breaking down complex scientific subjects, making them almost poetic, Preston tackles that, capturing something of their strange existence: "Viruses carry on their existence in a misty borderland that lies between life and death, a gray zone where the things we encounter are neither provably alive nor certainly dead."

He has an incredible gift for scientific and biological writing, not only making it engrossing but accessible to readers like me with limited background and understanding of fields like epidemiology and virology. Yet it never feels like he's talking down to better-versed readers. 

He seems more cautious thanks to some of the criticisms of broad generalizations made in The Hot Zone. Although he traces the genesis of the Makona strain in a story about a boy and a bat, he's careful in identifying what's guesswork and speculation.

"History turns on unnoticed things. Small, hidden events can have ripple effects, and the ripples can grow. A child touches a bat...a woman riding on a bus bumps against someone who isn't feeling email gets buried...a patient isn't found...and suddenly the future arrives."

I'd hoped it would go more in-depth on where this is headed in future -- so, if a Level 4 virus does cross the virosphere into humans, but I guess the apocalyptic-sounding picture he describes of a woefully unprepared, economically imbalanced US says all it needs to. Ethical issues play a big role in this narrative, with serious future implications. When the heroic Dr. Khan contracts the virus himself, the thorny debate arises of whether he should be given an experimental treatment drug not available to all patients. These stories are gut-wrenching, morally complex, sensitively told, and exquisitely written, leaving the reader with deeper understanding and appreciation of the complications. 4.5/5

"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."
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The Hot Zone stuck in my mind for years.  Preston has returned to the subject of Ebola to further inform us - and this one has joined the first in the canon of books one should read to understand the public health challenges we will face in the future.  By placing this story in the voices of the individuals most affected, Preston brings the issue home.  There are a lot of characters this time around (perhaps too any) but then again, this covers a larger outbreak.  There are heroes here in the everyday people and that's what makes this special. Thanks to Netgalley for the ARC.  An excellent informative read that might make you shudder.
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Just as terrifying as The Hot Zone was in the 90s, but Crisis in the Red Zone is also more emotional. Very sad stories about so much loss that could have been prevented. Not in the least that of Dr. Khan, I nearly broke down crying while reading even though I knew the outcome.

This book reads like great fiction but sadly is non-fiction. Please don't forget that while reading. This is real. It is happening right now.

Just this week it was reported that a priest was traveling from a small village to Goma with known symptoms of ebola. When he arrived in Goma he was turned away saying his village of origin was better equipped to deal with ebola. So he was turned away and sent back... and died in transit. This was public transit. So even today people eschew the rules and recommendations given for what to do if you have ebola symptoms and now this priest has gone from a small village to a city with over 1 million inhabitants that has an international airport. Great. 

This book made me absolutely disgusted wtih MSF/Doctors Without Borders. Terrible what they did to Dr. Khan. Their setups seem to be doing more harm than good, squalid conditions etc. The WHO tried to knock some sense into them and just got bureaucratic nonsense in return. Absolutely ridiculous.

If you are reading this prepare to be disgusted, terrified, amazed, and ultimately so angry with the MSF/Doctors Without Borders crew. Why didn't they send more help to Kenema? The doctors and nurses could have been saved. Dr. Khan was a hero that went down with his flock but it could have been prevented. My heart goes out to his family.
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