¶ … Hot Zone, by Richard Preston, improves mainstream audience's understanding of emerging infectious disease, and yet damages the positive impact of this exposure by introducing known inaccuracies and exaggerations. Preston's book is largely well-written, entertaining, and accessible. While much of the book is well-researched and scientifically accurate, inaccuracies include Preston's claim that a single mutation may cause Ebola to mutate into a much more infectious airborne agent, sensationalism about the importance of the Ebola virus, ethical judgments about the emergence of rainforest viruses, and a misleading representation of viruses as predators. Despite these inaccuracies, The Hot Zone is important to public science education as a way to introduce readers to concepts within the field of emerging diseases. From this point, scientists can use The Hot Zone as a springboard to introducing other concepts within the field of emerging diseases. Ultimately, while inaccuracies and sensationalism damage the public's understanding of the topic of emerging diseases, The Hot Zone, provides mainstream audiences with an effective introduction to modern emerging infectious disease. Preston's often-disturbing The Hot Zone tells the story of the heroic struggles of a diverse group of courageous scientists and military personnel undertake in order to contain the spread of a new form of Ebola virus that has emerged in a monkey facility in the United States. The book describes the origin of the current outbreak, and then goes back to explain in often horrifying and graphic detail the history of the Ebola virus itself, as well as explain the differences between the virus subtypes, including Ebola Marburg, Ebola Zaire, and Ebola Reston. At times, Preston's descriptions are sensationalistic and bloody descriptions of infected people whose insides have turned to mush, and disturbing descriptions of how a virus like Ebola could presumably easily mutate into a dangerous airborne form that could simply hop on an airplane, and be anywhere within the world within a mere 24 hours. Preston's book is not limited in scope to discussing the human and scientific particulars of the Ebola virus and other emerging diseases, as he delves into an attempt to understand the origins of such lethal viruses. Ultimately, Preston concludes that these viruses seem to be emerging from the depths of the untouched rainforest in a sort of unthinking retaliation of human's devastating infiltration into the untouched wilderness. In a sense, their emergence is a type of retribution for mankind's thoughtless destruction of the environment.

The Hot Zone presents the topic of emerging infectious disease in an entertaining fashion, thus exposing the reader to many principles of epidemiology. Preston's fast-paced and engaging novel may have attracted and captured a number of readers that otherwise would never have read a book about the emerging diseases. The story begins as a deadly and infectious virus emerges from Africa, and appears in suburban Washington. Preston's narrative emphasizes the swiftness of the spread, as he describes how a military SWAT team and scientists work to stop the outbreak. Often, Preston's descriptions of events are almost lyrical, and manage to capture both the excitement of the events, and the human cost and horror that they entail. In describing the emergence of the first case of the disease in Africa, he writes, "the doctors remember the clinical signs, because no one who has seen the effects of a Biosafety Level 4 hot agent on a human being can for get them, but the effects pile up, one after another, until they obliterate the person beneath them. The case of Charles Monet emerges in a cold geometry of clinical fact mixed with flashes of horror so brilliant and disturbing that we draw back and blink, as if we are staring into a discolored alien sun" (6).

Above all, Preston's prose and style are accessible and never intimidating to the reader, thus likely attracting many readers who would normally avoid scientific topics. Preston's book is presented simply as an interesting tale, rather than an expert source of information on epidemiology. The novel's beginning quickly establishes that the book will be an easy read. The novel begins, "Charles Monet was a loner. He was a Frenchman who lived by himself in a little wooden bungalow on the private lands of the Nzoia Sugar Factory, a plantation in western Kenya that spread along the Nzoia River within sight of Mount Elgon, a huge, solitary, extinct volcano that rises to a height of fourteen thousand feet near the edge of the Rift Valley" (1).

Preston presents scientific information in a way that is easy for almost any reader to grasp. His description of the HIV virus is typical of this simple style. Preston writes, "HIV is a highly lethal but not very infective Biosafety Level 2 agent. It does not travel easily...

You don't need to wear a biohazard space suit while handling blood inflected with HIV" (4-5).
Preston's simple presentation of scientific information, coupled with his accessible and non-intimidating prose style is important in exposing the reader to emerging infectious diseases. Overall, "Preston tells his story in compelling prose" (Shell), making the book entertaining and interesting to read.

The Hot Zone is accurate in many aspects of its descriptions of emerging infectious disease, thus improving the layperson's understanding of the topic. The cover touts the book as a "terrifying true story." In addition, the book is clearly exhaustively researched (Eckardt). The book may also be useful in introducing scientific topics such as RNA and DNA to students (Matthews).

Despite the many ways that Preston's novel helps improve understanding of emerging infectious disease, critics have noted that The Hot Zone is often inaccurate. These substantiated claims of inaccuracies in The Hot Zone are largely detrimental to the book's credibility, and also may give a false understanding of emerging infectious diseases.

Preston portrays viruses as vicious, brutal, shark-like predators that are utterly selfish, reinforcing a perception that the book is often sensationalistic (Maloney). In a refutation of Preston's depiction of viruses, a review by Trachtman notes, "Current research suggests that viruses may be more like wandering messengers than alien predators, their visitations serving to exchange genetic information among individuals and species in an ecology more intricate and a biochemical balance more delicate than we have yet realized."

One of the most important scientific criticisms of the book is its sensationalism of facts. Amy Jost notes that Preston's "elaborate dramatization of the Ebola virus is perhaps somewhat overstated considering its actual impact thus far on the human race," noting that the virus has only killed 800 people since it was first officially identified in 1976. In contrast, rabies has killed 627,000 people in this same period (Jost).

In the Hot Zone, Preston argues that a single mutation may someday cause a blood-borne virus like Ebola to mutate into a much more infectious airborne agent. Beth Levine, M.D., director of virology research in the infectious diseases division at Columbia University's College of Physicians and Surgeons notes that this is highly unlikely, and that there are no precedents for the claim. Further, Levine argues that it is "irresponsible to raise that concern" (Zimmerman).

In Preston's view, viruses are waiting to "crash into the human species," and that diseases like AIDs are somehow nature's revenge for the human audacity to infiltrate the rain forests. These ethical judgments are one of the downfalls of the book, which sometimes 'preaches' more than it informs.

In addition, Preston never answers some of the more disturbing questions that the book raises. For example, he notes that the Reston virus that emerged in America was infectious but innocuous, and outbreaks of Ebola in Sudan, Germany, and Zaire mysteriously disappeared (Trachtman). In leaving out these answered, Preston leaves the reader with some serious gaps in the knowledge that he imparts.

These inaccuracies mar the book's positive ability to introduce emerging infectious disease to a mainstream audience. A. Bowdoin Van Riper argues that popular culture is often more important than formal science education in shaping the public's understanding of science itself. As such, any inaccuracies in books like The Hot Zone represent potentially serious faults in the public understanding of emerging diseases.

Despite the problems with inaccuracies in the Hot Zone, the book's successful influence in introducing mainstream audiences to emerging infectious diseases cannot be overlooked. The Hot Zone and similar novels should be recognized as an important way to introduce readers to concepts within the field of emerging diseases.

Rather than complaining about problems with scientific accuracy in such movies, A. Bowdoin Van Riper argues, "A better solution is to accept popular culture's treatment of science for what it is -- entertainment -- and use it as a springboard for dialogue with the public."

In conclusion, Richard Preston's novel, The Hot Zone, provides mainstream audiences with an effective introduction to modern emerging infectious disease, but the novel's sometime serious inaccuracies and exaggerations damage a complex public understanding of the topic. The popular media's powerful role in scientific education can hardly be overlooked. For example, the FBI and President Clinton have sought Preston's opinions about emerging diseases and biological warfare (AnnOnline).…