The Hot Zone: The Terrifying True Story of the Origins of the Ebola Virus

Dalgard reaches out to Peter Jahrling, a civilian virologist working at USAMRIID, for help identifying the virus plaguing the Reston Primate Quarantine Unit. A courier delivers a sample to USAMRIID the next day, and Jahrling is annoyed to find the spleen samples “wrapped in aluminum foil, like pieces of leftover hot dog” (159). Jahrling takes the sample to a Level 3 lab, and, wearing surgical scrubs, rubber gloves, and a paper surgical mask, he and a pathologist extract the meat for examination and culture.

In the coming days, more monkeys in Room F sicken. Worse, monkeys in rooms down the hallway begin to get sick. Dalgard receives a call from Jahrling with a tentative diagnosis of SHF based on an examination of the spleen tissue. Hoping to contain the outbreak, Dalgard euthanizes the remaining monkeys in Room F on November 16. He is disheartened to find that they appear healthy upon autopsy, suggesting he may have made the wrong decision.

On November 17, virologists at USAMRIID attempt to examine the flasks of cells with the unknown virus in them, but the cells are in such poor shape that they believe the samples may have been contaminated with bacteria. Jahrling opens a vial and sniffs it, looking for the tell-tale grape juice scent of bacterial fermentation, and offers it to his intern, Tom Geisbert, to do the same. There is no odor, so they prepare the sample for the electron microscope.

Dalgard returns from the holiday to find five monkeys dead in Room H, two doors down from Room F, the site of the previous monkey deaths.

Geisbert returns to work and on November 27 and puts the prepared cell sample into the electron microscope. He finds destroyed cells packed with ropelike filovirus. He tentatively identifies the virus as Marburg and recalls with horror that he and Jahrling smelled the sample 10 days earlier. He thinks of Peter Cardinal, whose gruesome death made international news.

Geisbert prints the images from the electron microscope and brings them to Jahrling. Jahrling notifies the military chain of command in the person of Colonel CJ Peters. Peters wants visual proof of a filovirus inside the monkey tissue sample from the Reston monkey house before he will be willing to rule out cross-contamination and sound the alarm. Neither Jahrling nor Geisbert tells him about having sniffed the flask. They are not eager to be isolated in the Slammer, and Jahrling believes their risk of contracting Marburg from this indirect contact is low. They nonetheless have their own blood drawn, and Jahrling takes it into a Level 4 lab to examine it.

Geisbert finds filovirus particles in the monkey tissue on November 28, and he and Jahrling bring the photographs to Colonel Peters, who is convinced. Jahrling is still running tests for Marburg, but he phones Dalgard at the monkey house to warn him and the staff to take precautions. Dalgard, who had euthanized the 50 monkeys in Room F 11 days before, is alarmed. Jahrling returns to the Level 4 lab and uses the blood serum from human victims, including Dr. Musoke and Nurse Mayinga, to test for Marburg, Ebola Sudan, and Ebola Zaire. Nurse Mayinga’s blood serum reacts strongly to the monkey house agent. This confirms that the virus is either Ebola Zaire or an organism more closely related to it than any other known virus.

Unwilling to believe he may have been exposed to Ebola Zaire, which kills 90% of its victims, Jahrling performs the test a second time with the same result. He phones Colonel Peters, and the two take the result to Colonel David Huxsoll, commander of USAMRIID. He loops in Major General Philip K. Russell, the commander of the United States Army Medical Research and Development Command. They also call in Nancy Jaax, now a lieutenant colonel and the chief of pathology at the Institute. Major General Russell looks at the evidence and says, “We have a national emergency on our hands. This is an infections threat of major consequences” (197). He asks if the virus could travel by air, and Jaax describes the experiment in which her control monkeys died of the virus.

The team then discusses possible strategies for protecting the human population from a potentially deadly pathogen only 10 miles from Washington DC. To achieve biocontainment in the monkey house, the monkeys must either be destroyed or isolated from the world while they die of Ebola. They also discuss the political problem of whether the army should step in against the threat of Ebola. Handling emerging diseases usually falls to the Centers for Disease Control (CDC), but the team doubts the capabilities of the CDC to handle the threat. Major General Russell declares that the army will take on the mission and Colonel Peters will lead it. He phones Fred Murphy, the electron microscoper and co-discoverer of the Ebola virus, who is now the director of the National Center for Infectious Diseases at the CDC. Peters also calls Dalgard at the monkey house and breaks the news to him that the monkeys have Ebola, an even more lethal pathogen than Marburg. He tells him he is notifying state and national public health authorities and asks him to allow a team to come see his dead monkeys.

On November 29, a worker in the monkey house is hospitalized for a heart attack. CJ Peters and Nancy Jaax, along with Eugene Johnson, meet Dalgard at the Hazleton corporation offices, where he takes them to a lab and allows Jaax to examine some samples. The samples show telltale bricks of Ebola virus particles bursting from cells. Later, the monkey house manager Bill Volt meets the Army researchers at a gas station and gives them seven monkey carcasses in black trash bags. They still do not have access to the monkey house.

Jaax begins to dissect the monkeys in Level 4 that afternoon. The first monkey appears almost “normal.”

Peters attends a meeting with General Russell and Fred Murphy and another CDC official, Dr. Joe McCormick. Tensions run high as the Army feels that the CDC is trying to take control of the outbreak management and the virus samples. McCormick believes that Ebola is far less transmissible than the Army officials at USAMRIID claim. His opinion is based on his own experience breathing the air in a hut full of Ebola victims for several days. In the end, General Russell proposes a compromise that the others quickly agree upon: The Army will handle the monkeys and the CDC will handle the humans.

Peters taps Nancy Jaax’s husband, Colonel Jerry Jaax, chief of the veterinary division at the Institute, to lead the extermination of the monkeys. That night, Nancy Jaax announces the results of her necropsies: The monkeys may have died of either simian hemorrhagic fever or Ebola.

Eugene Johnson visits the monkey house and makes a plan for inserting teams in biocontainment suits through a back door. Nancy Jaax also arrives and sees the sick monkeys. As the monkey house staff did not wear masks, neither does Jaax’s team. TV news reporters congregate in front of the monkey house, waiting for something to happen. Nancy Jaax arrives home after processing monkey samples until 1:00 am, and she and Jerry discuss her worry that the virus is spreading to other rooms through the air.