Wednesday, October 29, 2014

"Ebola: The Natural and Human History of a Deadly Virus" is a brief supplementary update to David Quammen's earlier book

Author David Quammen has followed up his previous book (“Spillover”, Oct. 23) with a supplement, “Ebola: The Natural and Human History of a Deadly Virus”.  It is published by Norton, with ISBN 978-0-393-35155-2 for paperback, 119 pages, indexed, and is in 21 “sections” with an Introduction and an Epilogue.

The book does repeat some material from “Spillover” but also brings the history of the current Ebola epidemic in West Africa up to date as of early September 2014.  It does not cover the cases that were treated in Texas (including the two nurses at Texas Presbyterian) or New York City, since these occurred after the book went to press.  That’s a problem with non-fiction book publishing.
Quammen would obviously discourage public health policies that would discourage doctors and nurses from going to West Africa to help treat Ebola patients.  But perhaps a 21-day observation or quarantine period would be negotiated into an assignment, and be paid for. 

Quammen discusses the lurid hyperbolic discussions of the clinical course of Ebola in his 1994 book “The Hot Zone”, which also describes Ebola Reston (which affected chimps only).  No, people don’t really turn to slime alive and dissolve in their beds.  Many cases, even fatal ones, don’t even involve bleeding.  However, the virus does so much damage to the blood supply of vital organs that multiple organ failures often occur.
I bought “The Hot Zone” in the cafeteria at a one-day book fair where I worked in 1994 (at USLICO Corporation, soon to become ReliaStar).  After I brought it into the office and shared it, others called me “Ebola Bill”, having no idea how prophetic the book would become. 
He also provides more details on how the virus may persist in animal reservoirs, especially bats, which are much more numerous than we realize, and whose immune systems are sufficiently different from ours that they can host the virus without becoming ill from it.  The virus seems adapted to these ancient hosts, but not to humans. 
Ebola has several subtypes, and another filiovirus, Marburg, is closely related and causes very similar disease.  Quammen says that the tick-born Crimean-Congo Hemorrhagic fever (caused by a different family of virus) is even more gruesome than Ebola or Marburg. 

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