Hot Zone by Richard Preston- November Book Club Online

[JoanP]

The Book Club Online is  the oldest  book club on the Internet, begun in 1996, open to everyone.  We offer cordial discussions of one book a month,  24/7 and  enjoy the company of readers from all over the world.  Everyone is welcome.

November Book Club Online  Will you join us?

The Hot Zone: A Terrifying True Story
by Richard Preston

It reads like a detective thriller, but it's a true story--how the Ebola virus was discovered, and what happened when it turned up in a research lab just a few miles from Washington, DC. "When Richard Preston's novel "The Hot Zone" was published in 1995, it was, for many, their first introduction to the deadly Ebola and Marburg viruses.  Nearly two decades later, Ebola has infected hundreds of people in three countries across West Africa, in what is considered the worst outbreak in history. As fear over the deadly virus grows, we need a reminder of what we learned so long ago from Preston." British Broadcasting Corporation BBC

DISCUSSION SCHEDULE:

PART ONE: The Shadow of Mount Elgon
Nov. 1 - 5~  First three chapters--Something in the Forest, Jumper, Diagnosis (Africa, 1980)
Nov. 6-9~  Next three chapters--A Woman and a Soldier, Project Ebola, Total Immersion (Maryland, 1983)

For Your Consideration
Nov. 1-5

1. Do the vivid descriptions of the amazing African scenery add to the feeling of horror?  Do they make you want to visit Africa?
2. What was Charles Monet like as a person?
3. Do you know of other caves like Kitum elsewhere?  Are they reservoirs of disease?
4. Does the very detailed, dramatic description of the disease add to or subtract from the story for you?
5. What is the relationship of Marburg and Ebola?
6. How could the first outbreak of Marburg, in 1967, have been prevented?
7. Which interests you more--the human story or the scientific one?




RELEVANT LINKS:
Prediscussion
BBC Ebola Primer
Mt. Elgon National Park

  

Discussion Leader: PatH

[PatH]

Welcome, everyone; at last we can start in on the book.  Here’s where it all began, where this cluster of diseases first made its way into the history books.  Preston paints a colorful backdrop for his story.  There’s a link to Mount Elgon National Park in the heading, to give you some pictures.

Let’s settle in and start.

[JoanK]

Wow, a day early. But I'm ready to go.

Preston has a way of making you feel the lives of the characters in the story, doesn't he? And feeling what it must have been like. That's what kept me reading into the night, but being a science nerd, I was also interested in the scientific explanations.

[JoanK]

Being a birdwatcher, I identified with the solitary nature lover, living in the shadow of the mountain.

[PatH]

Only a third of a day on this coast.

Happy Hallowe'en. 

Boo.

[Ella Gibbons]

I've read a few chapters in the book and they are quite appropriate for Halloween.  Drama, thrills, frightening, terrible.   Rather like a monster out to get us all.

The map is helpful isn't it?  And, yes, I would love to go to Africa; however, my traveling days are over, but Cindy, my daughter, went on safari in Kenya.   Beautiful pictures, a couple of the Masai.

And we thought HIV was a horrible disease, but not near as lethal as Ebola, did you get that impression? 

Taking your Christmas vacation camping on a mountain, all strange isn't it?   I was interested in the "old, half-ruined English colonial farms hidden behind lines of blue- gum trees."    Wouldn't you like to know of the history of those farms.   I wonder if the natives remember those days, coffee plantations or sugar?

[ginny]

I'm loving the book, so far in the first three chapters. I love the way it starts, we have passage into a dangerous security level... I love it. He and his brother Douglas Preston can really write.

So much to discuss in these first chapters. I agree with Ella, such interesting depictions.   I loved the descriptions of Africa, all those places we've read about all these years.  And I agree with Joan K that the way Monet (ironic, huh) was portrayed made me very sympathetic to his plight.

I read  the book outside in this fine fall weather which seemed to make the descriptions of Africa really alive,  and so much enjoyed reading about Monet's peregrinations thru the countryside.  I was astounded that he also  kept moving while all inside him was going to pieces, too, right into the ER in the last stages, that was very impressive and somewhat frightening. The symptoms are very useful to know. I found the descriptions of the working of the virus somewhat similar to reading Nulund's How We Die, actually, tho of course a lot more dramatic as it's due to a killer disease.  Even tho it was graphic it seemed somewhat detached.

In answer to question 1, instead of making me want to go to Africa for some reason it makes me want to get out there and start power walking.    I don't know why.

I've been wondering the whole time about the cover. What is that on the cover? Is it explained in the last of the three chapters, Diagnosis, when they begin to talk about Marburg and the Ebola sisters? It can't be the virus Marburg as it doesn't look like spaghetti,  or cheerios, right? So what IS it? Which  Ebola ARE we talking about, Zaire (wasn't that scary? The death rate is unbelievable)...or  Sudan? Or something else? How about the one in 2014, which is it?

So what IS  that thing on the cover? Can that be seen under a microscope? I'm sure everybody except me knows this,  but I'd like to know.

And I wonder about the 10 day survival rate of the Ebola virus without a host, stated in the paperback. I underlined it and now can't find it but I will ...this book is not new, what if anything has been learned/changed  since that time? And monkeys. And AIDS. There is so much here to wonder at and discuss.

Super choice for a book discussion, it really is.

[PatH]

Now I can't find where the book says it, but the thing on the cover is virus particles coming out of a cell.  The stringy things are the virus, and the round green blob is the cell.  I don't know if it's a drawing or a microscope picture, but I bet the colors are arbitrary.

Good point about the book being old.  It was written in 1994, and some of it's events are still older.  So the characters don't always know as much as Preston did when writing, and Preston didn't know as much as is known now.  We'll have to keep that in mind as we read.  It's the developing history of the disease, and the people trying to fight it, so the information is accurate but not complete.

[Ella Gibbons]

After I read about the mass coming from _____________, one of the victims, I thought the cover was meant to be the spaghetti vomit - not pleasant to discuss but Preston does, over and over with his descriptions of the virus in its victims.  

The Monet story is terribly graphic and yet lovely in its descriptions of Africa - - this is not West Africa and the countries that we are concerned with at present.

"The lower slopes of the mountain are washed with gentle rains, and the air remains cool and fresh all year, and the volcanic soil produces rich crops of corn.

Monet was 56 in this story, I wonder how long he had lived a solitary life - Preston suggests he might have been in trouble in France or just  was moved to live there because of the beauty of the place.  I imagine he made decent money as a mechanic also.

Yes, GINNY - (good to see you here) much to discuss and I am loving the book too, telling friends.  Might buy a copy for our library here.

I have a cave story to tell; but not near as big as Kitum case.  It holds 70 elephants, wow!  The only elephant I have ever seen has been in zoos.  I would love to see them out in the open, they seem like big, gentle animals to me.

[Ella Gibbons]

 The update to KITUM cave:

http://en.wikipedia.org/wiki/Kitum_Cave

It is thought that the Marburg virus is caused by inhalation of the bat guano.   Not proven yet?  Let the bats have the caves, STAY AWAY.

[PatH]

I wouldn't care to go into an enclosed space where 70 elephants might follow me, and caves give me claustrophobia, but I couldn't help longing to see the crystalline petrified forest.

Ella, are you going to tell us your cave story?

[JoanK]

This is interesting from the article ELLA posted:

"In September 2007, similar expeditions to active mines in Gabon and Uganda found solid evidence of reservoirs of Marburg in cave-dwelling Egyptian fruit bats. The Ugandan mines both had colonies of the same species of African fruit bats that colonize Kitum Cave, suggesting that the long-sought vector at Kitum was indeed the bats and their guano."

The book by Q that I read puts an emphasis on trying to find what he calls the "reservoir species" (apparently what's called the "vector" above). This is where the virus is living when there is NOT an outbreak of ebola.

Since the disease appears, dies out, and reappears later, there must be somewhere where it is lurking: an animal host that can carry the virus from generation to generation. We humans can contain an outbreak, but unless we find this "reservoir host", we can never prevent another outbreak. It's assumed that it's a small animal: bird, bat, insect, that has some contact with the monkeys that are known to carry it. Lots of experiments have looked for traces of the virus in thousands of species. I don't remember results as positive as the article suggests.

[JoanP]

Just in from birthday party in NC - and on the way out for another one in an hour. But wanted to peek in to say how much I'm enjoying your posts!  So much here to think about!

I agree the map in the front of the book was helpful - except it frightened this mother of her youngest son who is having the time of his life living in Africa for the next two years.  Each weekend he's out in the wild...fishing in the river, filming hippos, elephants in the wild...and oh, the monkeys.  He loves the monkeys.  He has been reassuring me that the Ebola breakout is up in West Africa - far from Zambia where he lives.  But the map!  Do you see Zambia on Preston's map?  The map brings the volcano and the cave so much closer to where he is living - and camping!  Which of you would rest until this adventurer returns home!?

[JoanP]

Pat - thank you for your clear description of the object, the virus on the front cover of Preston's book.  I'm surprised he didn't reference it in his notes on the book, weren't you?

I found this magnified picture of Ebola Zaire - I think that's exactly what it is...

http://books.google.com/books?id=8VzvrNj8W2gC&pg=PA368&source=gbs_selected_pages&cad=3#v=onepage&q&f=false

[PatH]

JoanP, thanks for posting those pictures.  Your son is very good-looking, and sure looks like Africa agrees with him.  Here's something to ease your worries a bit.  In the heading on this page there is a link labeled BBC Ebola Primer.  This is a link, kindly supplied by Pedln, to a site that's a goldmine of information.  There is a link "Mapping the Outbreak".  If you go there and scroll down, you see a map of all deaths up to the time of the link.  The closest it gets to Zambia is Nigeria, which on the map in your picture is the purple country  just above the angle where the coastline turns from east-west to north-south.  That's where it is now, and it's pretty far away, but even the places Preston is talking about aren't that close to Zambia.

The link has all sorts of good stuff in it, if you follow its many pathways.

[PatH]

Pat - thank you for your clear description of the object, the virus on the front cover of Preston's book.  I'm surprised he didn't reference it in his notes on the book, weren't you?

It's mentioned somewhere in the book; that's how I know what it is, but I sure can't find it now.

[bellamarie]

Hello November, oh how I can see this month flying by with Thanksgiving, my hubby's birthday, Christmas shopping for six grandchildren, and discussing Ebola. 

What I found very interesting in the first chapters is when Charles Monet contracted the virus, not knowing of course he had it, how many different people could have been infected by his travels to his final death.  I am reading this on my ipad and I was trying to highlight each place he went, possibly infecting hundreds of people, since his symptoms were present with body fluids being released all over the places he went, from the plane to the ER, and in the room he was treated in.

They had no idea what was wrong with him, so there was no need to protect themselves while treating him, as we now know it is imperative, and without protocol and quarantine, it can be deadly.

I am still annoyed with this nurse refusing to quarantine herself.  Watching her out bike riding and then speaking with the media, smiling, it's as though she is liking all the publicity she is getting.

http://www.liveebolamap.com/quarantined-ebola-nurse-kaci-hickox-defies-orders-stay-home-goes-bike-ride/

[JoanP]

Thanks, Pat.  I did go to the link in the heading to track the latest Ebola breakouts.  I see there that the first report of Ebola in Sierra Leone was in March, 2014.  I have to tell you that my Will was visiting in Sierra Leone in November, 2013.  His father had been in the Peace Corps there many years ago - Will visited the school where Bruce taught.  Can you believe that he and his Annelies were considering working there for two years...but Annelies was passed over for the position - and that's how they ended up in Zambia!
OK, so  they are not near the current breakouts right now.  I do feel better about that now.

BUT just now I read your post, JoanK!

"Since the disease appears, dies out, and reappears later, there must be somewhere where it is lurking: an animal host that can carry the virus from generation to generation. We humans can contain an outbreak, but unless we find this "reservoir host", we can never prevent another outbreak."

Does Preston leave the impression that the source is Mt. Elgon - or Lake Victoria?  Kitum Cave?

Thanks for the cave site, Ella  Sounds like just the thing that would attract my Will!

[JoanP]

OK, I promise not to dwell on my son's proximity to danger - real or imagined.  It won't bring him home.

Charles Monet - the expatriate loner Frenchman who knows nothing of the danger lurking - everywhere.  Will try to concentrate on him.  Ginny, I got the impression that Monet died from the Marburg virus, not Ebola - wasn't that the Diagnosis Dr. Silverstein came up with?  I might be wrong. To me it sounded like Marburg because after Monet vomited into the doctor's mouth - he survived!  Sounds like Marburg with a kill rate of 1/4, while the Ebola is 1/9 for something like that - don't you think?

 Maybe he'll move into the Ebola virus  (what's the plural?  Viruses?) in later chapters...

Pat, will you let us know as soon as you find the identity of the virus on the cover?

I read Preston's very recent New Yorker article on the Ebola virus.  It is said that he will follow this with another book.  I also read that before he wrote The Hot Zone, he had written an article for the New Yorker about The Hot Zone in 1992 too.  I'll see if I can find it...you might have to subscribe to the New Yorker.

[PatH]

You're right, JoanP, Monet died of Marburg.  It's part of the same family of viruses as Ebola, filoviruses, and is closely related.  We'll get more explanation as the book goes on.

Charles Monet is a pseudonym, as Preston explains in the introduction. (There are a couple of others, and they are explained when the characters appear.)  For me, it's an unfortunate choice; I keep thinking of him as Claude.

[pedln]

JoanP, I'm with you about our intrepid travellers.  Let's keep them on this side of the pond.  That being said, when are you and Bruce going to visit Zambia?

I've read these first chapters twice - kept turning my head away during the second reading.  Stephen King thought it pretty scary too.

"In regard to just the first chapter of “The Hot Zone,” Stephen King called it “one of the most horrifying things I’ve read in my whole life – and then it gets worse."

I keep going back to the book, our discussion and all over the web.  That raises so many questions, but also so many interesting things.  And all the while, I trying to connect the book itself with things that are happening today.  Right now it seems like there was a big knowledge gap between 1970 and now.  Will Preston show us what transpired between 1970 and 1994 when his book was published?  I want to read that New YOrker article if I can get hold of it.

I've been trying to find out more about Dr. Sheth Musoke who treated Monet.  From the little I"ve found he's still at the Nairobi Hospital (2011).

I hate the blame game that is so frequently played about everything.  How do you feel about "Mr. Jones,"  who wonders if some of those Marburg deaths are on his back?

What is the difference between Marburg and Ebola?  Are they equally dangerous?  Do we treat them the say way?

[PatH]

Preston will eventually take us through pretty much all of what transpired up to the 1994, by which time a lot more was known than in these opening chapters, much closer to our present knowledge.  We can then fill in, via articles and other books.

Marburg and Ebola are very similar viruses, part of the same small family, and they produce similar diseases.  Marburg is a little milder than the most dangerous of the several strains of Ebola.  The treatment for both is mostly symptomatic--prompt replacement of the fluids and electrolytes lost, and maintaining nutrition by some means.  Some of the current patients have been given an experimental drug (we've now run out of it) or serum from people who have recovered from the virus, but it's uncertain how much this helps.  It is becoming clear, though that state-of-the-art treatment in a well-equipped hospital reduces the mortality considerably.

I found it interesting and encouraging that the patients who recover do so completely.  Dr. Musoke wasn't impaired, and continued his practice.

[PatH]

Preston hops back and forth in telling his story.  We've seen some Marburg patients in 1980, with a flashback to its first appearance in 1967.  Next we'll have a brief interlude in this country in 1983, then back to Africa for the discovery of Ebola in 1976, and another outbreak of Marburg in 1987.

That takes us up to the episode that will be heart of the book.

[Ella Gibbons]

I agree with Stephen King - I was horrified to read some of these stories.  The last sentence in the Monet chapter:

"Having destroyed its host, the agent is now coming out of every orifice, and is 'trying ' to find a new host."

It's out to get us!

Already, " it" has found its way to America and found a few hosts. 

__________________________________________________________________________

My cave story - as members of a national organization called American Yousth Hostel, 6 to 60, we did a lot of canoeing and kaying - YEARS AND YEARS AGO.

One of the fellows knew a guide to a cave in Kentucky called Carter Cave and off we went for an adventure exploring the cave, which had a lot of rooms, a lot of bats clinging to the walls and some flying around, and we spent a night and ate breakfast in it the next morning.

I would never do it again, it was very frightening to be in a cave where no daylight, twilight, sky or stars can be seen - total darkness.   You had to feel the floor to be sure there was something under your feet.   Of course, the guide had a lantern - all of us were required to have 3 different lights on us, such as flashlights, matches, etc. but at night - OH!!

"When elephants walk through the cave at night, they navigate by thei sense of touch, probing the floor ahead of them with the tips of their trunks."

Exactly!

[PatH]

Yikes, Ella, that cave story is as scary as the book, and you with no trunk.  At least you didn't have the crevice with the dead baby elephants. 

[JoanP]

A scarey story, Ella!  I can understand why you never went caving again!  The only caving I ever did was in Luray Caverns in VA.  Sissy stuff - they had electricity underground!  Miles of caverns - all lit up!  

When my sons were Boy Scouts, they went a number of times...well-outfitted - I remember little lamps attached to their headgear.  They were with experienced leaders and I didn't worry about their safety, although I shivered at their descriptions of the bats hanging from the formations on the ceiling, and how close they came to them as they lowered themselves into the dark (unlit) caves.  It was after the Boy Scouting days - when they felt they knew enough, that they went off on their own to unexplored caves...How easily they could have gotten lost underground in the dark!  Of course I never knew about these little expeditions until after the fact.  I guess these were my scarey cave stories.

So Mt. Elgon - now a National Park?  I went to the site in the heading to look up CAVING -

Caves
"Mount Elgon’s slopes are riddled with caves left by moving lava and erosion of soft volcanic deposits. The most accessible are Kapkwai Cave, near the Forest Exploration Centre, and Khauka Cave on Wanale Ridge. Historically, such features acted as shelters for locals and their livestock; later on they provided manure in the form of bat droppings. More recently, they were used by climbers and their porters, and even today, campsites are still located at Hunters Cave, Siyo Cave (near the hot springs), Mude Cave and Tutum Cave – ideal for overnight expeditions" -

Wasn't this where Charles (Claude) Monet spent the night before coming down with Marburg?  Possibly where the virus lurked - (lurks?)  Am I missing something?  Why isn't this discouraged?

An interesting question, Pat..."How could the first outbreak of Marburg, in 1967, have been prevented?"

[PatH]

He was in Kitum Cave, and you notice they don't mention it, even though it's probably reasonably accessible, since Monet got to it easily enough.  That website is stingy with its pictures, but there are enough to give you the feel of the weird, fascinating African landscape.

JoanP, it's probably just as well you didn't know about those caving expeditions ahead of time.  Since the boys survived, it was probably good for them, but I would have been very nervous indeed.  Caving brings out my inner claustrophobia.

[Ella Gibbons]

I was delighted when Beryl Markham was mentioned in the chapter DIAGNOSIS.  She is the author of WEST WITH THE NIGHT - a wonderful memoir.  If you can find it, do read it.   I have a copy of it and every once inawhile I pick it up again.  What a woman!

I never thought of viruses being named for the place where they are first discovered and I can't think of any virus, at the moment, that has a name - what???  Bult isn't it interesting that Marburg is named for an old city in central Germany and the virus first erupted there in 1967.   

They imported monkeys for research purposes and  this is where the "agent jumped species and suddenly emerged in the human population of the city.   This is an example of virus amplification.

Now where and when can I use that phrase, I would feel so learned.

[Ella Gibbons]

JOANP, your boys had the same experience and probably enjoyed it very much.  Some do.......... And I hope you get that good looking son of yours home shortly.   Do you "skype?"   Am I using that word correctly; I've never done anything like that just know of it.

[JoanP]

Ah, Ella!  Beryl Markham - WHAT A GAL!  WHAT A LIFE!  Makes you wonder what you are doing with yours when there is so much to explore!

Beryl Markham -  "There is her beautifully imagined memoir, ''West With the Night,'' published by Houghton Mifflin in 1942 when she was 40 years old, a triumph of adventure writing, set largely in Africa, which Hemingway called ''bloody wonderful,'' conceding, ''this girl . . . can write rings around all of us.''

But he was right about her ability to capture the feel of Africa and write about it in voluptuous detail in a way he never could. After all, Markham had grown up wild and motherless in Africa, living close to the land and animals, spending most of her childhood in the constant company of local tribes. She was the only white female permitted to hunt with the male warriors, and could handle a spear as well as a rifle. "
 Read more....
http://www.nytimes.com/1987/08/23/books/a-high-life-and-a-wild-one.html

[JoanP]

ps  Yes we SKYPe, Ella - several times a week.  Video, audio communication...clear as a bell - and it's FREE!  Never ceases to amaze.  Then we have an APP called Whatsapp - an international texting service - that's free too.  And there is something called FACETIME - we can communicate face to face on our phones.  That's FREE too!  Should that be enough for the mother?  For one thing - it doesn't work when he's out in the wild...has to be in wifi range or a tower or something...

[JoanP]

"He was in Kitum Cave, and you notice they don't mention it, even though it's probably reasonably accessible." Pat

That's the thing, Pat.  The cave might still be open...other cavers like my son could explore at any time, right?  Also those other caves in the vicinity...might they not harbor the same virus?  To me, that's the really frightening aspect of the virus.

So Monet had the Marburg virus...not quite as contagious, or lethal as the Ebola...although it did kill him, his doctor managed to come through.  Does Preston mention what sort of treatment Dr. Musoke received?

We read how Monet's brain was consumed by the virus...we read how the first sign of the virus was (is) the dreadful headaches.  Doesn't that mean that the virus has infected the brain?  Dr. Musoke began with these headaches.  How  was Dr. Silverstein able to stop the virus from consuming his brain?

[Ella Gibbons]

As I understand it, there are three "filovirus"  - sisters.   One is named Ebola Zaire, the most dangerous of the three; Ebola Sudan and Marburg, which is the mildest.

Has anyone heard about these before?   For example which strain did the man from Africa that came to the US (was his name Duncan?) have and did the two nurses have the same?

And how about that village of Kasenseto, near Lake Victoria,  where the first cases of AIDS appeared?   We were all rather frightened of that when it came out - am I correct that the first case in the media was from a movie star in Paris who was a  homosexulal and it did become, more or less, a  homosexual disease.  A distant relative's brother had it, we met him once.   Sad.  

JOANP, did Dr. Silverstein have Marburg?   I must go back and read a bit.

[Ella Gibbons]

JOANP - I hope your young son is not a fisherman; regardless tell him to stay away from Lake Victoria, seems a deadly place when I read a few articles about it.   I must ask Cindy if she saw the lake  on her trip - she was mainly in Kenya and she has wonderful pictures of the environs.   Knowing she would never go back (it's expensive) she spent a lot of time there and took loads of pictures.

https://www.google.com/search?q=lake+victoria&biw=1110&bih=715&tbm=isch&imgil=ZEgpDkMlTkVBJM%253A%253B3UU5Q7s49QmrNM%253Bhttp%25253A%25252F%25252Fwww.kampalasun.com%25252Fconservation%25252Flake-victorias-top-predator.html&source=iu&pf=m&fir=ZEgpDkMlTkVBJM%253A%252C3UU5Q7s49QmrNM%252C_&usg=__GKi9zcSjDtmiPJ2NvG0fTNtdnho%3D&ved=0CDgQyjc&ei=siBZVKrlOIz-yQT64YGADw#facrc=_&imgdii=_&imgrc=ZEgpDkMlTkVBJM%253A%3B3UU5Q7s49QmrNM%3Bhttp%253A%252F%252Fwww.kampalasun.com%252Fwp-content%252Fuploads%252F2014%252F01%252FLake-Victoria.jpg%3Bhttp%253A%252F%252Fwww.kampalasun.com%252Fconservation%252Flake-victorias-top-predator.html%3B500%3B334

[PatH]

Dr. Musoke began with these headaches.  How  was Dr. Silverstein able to stop the virus from consuming his brain?

My impression is, that although the disease often starts with a headache, the actual brain damage occurs quite late in the disease.  Everyone Preston describes as recovering seems to have no residual damage.

As I understand it, there are three "filovirus"  - sisters.   One is named Ebola Zaire, the most dangerous of the three; Ebola Sudan and Marburg, which is the mildest.

That's about right, although now more than three strains have been discovered.  Everyone in the current outbreak is infected with Ebola Zaire.  I had certainly heard of Ebola before, in the previous outbreaks, and a lot about the Maryland incident that is the heart of the book, but hadn't bothered to learn enough to know about the different strains.

[JoanK]

ELLA: lovely pictures. I've always heard of Lake Victoria as a tourist location, and I see it is.

[Ella Gibbons]

JOANK - and all.  Beautiful pictures of Lake Victoria at sunset - keep scrolling down.  Can't believe these colors, wow!

http://www.africa-expert.com/about-kenya/the-great-lakes/lake-victoria/

[hysteria2]

Way before the current ebola scare, we had universal precautions in place in the hospital. Basically we treated every patient as potentially contagious. We wore gloves for any procedure that would potentially place caregivers in contact with body fluids. Handwashing was a must before and after every contact with a patient. I realize that in Africa when Charles Monet was there, there were no precautions taken. All I could think of when I read the very graphic descriptions of his illness and symptoms was how many people he could have infected. It is no mystery that ebola is not controlled in certain parts of Africa. They just don't have the resources and supplies to effectively prevent it from spreading. I hope the hysteria that is developing here in the US doesn't get so out of control that caregivers are prevented from going there to help.

[PatH]

Here is a recent New York Times article which describes the difference having adequate resources for treatment makes to the outcome:

http://www.nytimes.com/2014/11/01/us/better-staffing-seen-as-crucial-to-ebola-treatment-in-africa.html?module=Search&mabReward=relbias%3Ar%2C%7B%221%22%3A%22RI%3A7%22%7D

[PatH]

And here is one saying that the epidemic is slowing in Liberia, but we aren't sure yet what that means:

http://www.nytimes.com/2014/10/30/world/africa/ebola-liberia-who.html?module=Search&mabReward=relbias%3Ar%2C%7B%221%22%3A%22RI%3A7%22%7D&_r=0