I am Richard Preston, a writer who knows Ebola. I’m author of “The Hot Zone,” the book inspired by my 1992 article in The New Yorker. My latest article, published this week in the magazine, describes the current outbreak. I also wrote “Cobra Event” and “Demon in the Freezer” (the Dark Biology Triad). I’m happy to take questions about the Ebola situation now, or any of my books. Ask me anything!

Proof: Me with the skull of a crab-eating monkey, the species that was infected with Ebola, featured in “The Hot Zone” https://www.facebook.com/218144878241860/photos/a.218607071528974.52990.218144878241860/736779056378437/?type=1&theater

https://twitter.com/NewYorker/status/497018870293880832

Update: My time's up, and thank you so much for your great questions, hope I answered a few. Please feel free to message me on my FB page: https://www.facebook.com/pages/Richard-Preston/218144878241860

Comments: 1609 • Responses: 21  • Date: 

mmacpuguy728 karma

How can the doctors and nurses prevent themselves from getting the virus as they help others?

RichardPreston1635 karma

They haven't been able to fully protect themselves, doctors and nurses are dying. They're wearing full protection biohazard suits, but the Ebola wards are just horrifying, 30 Ebola patients with one doctor and one nurse, both in space suits. Conditions are awful in those wards, we need more doctors and nurses - not even a space suit can totally protect you if the ward is really a mess.

Huck95451 karma

Hey Mr. Preston, thanks for doing this AMA!

I'll have several questions for you over the course of this, but I'll start out with one.

To your knowledge, has any genetic processing been done to see how closely related this particular strain of Ebola Zaire is to previous outbreaks? I know we haven't seen EZ in this region before, and I was curious as to whether it was closer to say, the Mayinga strain from '76, or the strain from Kikwit in '95, or is totally different from both of those, but still classified as Ebola Zaire. Thanks!

RichardPreston649 karma

Great question. Yes, scientists have already done the gene sequence of this new Ebola. It's very close genetically to the Ebola Zaire species, which popped up in 1976 in Congo (Zaire). That was 2,000 miles away from West Africa where the strain is now. How did it get there? Maybe in the bodies of migrating bats infected w/ Ebola … nobody quite knows.

Frajer443 karma

is any of the panic surrounding Ebola justified?

RichardPreston969 karma

Not entirely justified. This is a kind of war with a non-human enemy. It is a fairly clever and very aggressive enemy. However, if you are in a jam it is never a good idea to panic. That's how you lose. The doctors in Africa definitely are not panicking, they are just working 20 hours a day in the fight. And we sure don't have to panic in the US, we've got a strong medical care system.

Huck95438 karma

What do you think about this experimental serum that we heard about being used on Thursday? Something that is directly contributing to the two Americans' recovery, or not necessarily the case?

Also, are there any common lasting effects among those that manage to live through Ebola? All I've heard about is some joint problems and whatnot, but I would've expected there to be much more severe aftereffects.

RichardPreston690 karma

good q's - the antibody serum ZMAPP seems to be amazingly effective but we don't know because it's only been tried on the two patients. As for aftereffects, i interviewed Dr. Shem Musoke who nearly died of Marburg (close cousin of Ebola) and he told me it took him about a year to recover fully but now he was fine. It's a crushing disease but if you survive you do recover.

AmericanHigh319 karma

Could you describe what it was like finishing Michael Crichton's last novel, Micro? (Excellent job, by the way! I know you had a lot to live up to.)

RichardPreston537 karma

Micro - I fell in love with Michael Crichton's writings when I was 15 reading The Andromeda Strain. Hot Zone is kind of a salute to Crichton. His widow, Sherri Crichton, contacted me and asked me finish Michael's last (unfinished) novel, Micro. It was a privilege to complete his work, and actually a lot of fun.

TheBossMan24270 karma

Yesterday, my mother and I talked about Ebola patients making their way to the US. I told her there isn't any worry about a large-scale outbreak starting here, because Ebola is only transmitted through bodily fluids and the US is much more equipped medically than West Africa, yet she is worried all the same. How do I convince her that her fear is not entirely justified?

daveirl517 karma

Get her to stop watching television news and other outlets that drive their ratings/sales by stoking fear about all manner of things.

RichardPreston953 karma

Tell your mother that a) our medical care system can definitely handle Ebola patients if any do crop up in the US and b) it's hard to catch Ebola unless you are taking care of a person who is really sick with it, and the hospitals would be doing that anyway. What the heck, if I step out into the street at the wrong time a bus could kill me, but we can't live in a state of fear about everything that could kill us.

cookiecatgirl218 karma

Hey! I went to elementary school with your girls. Always found your work pretty neat! I remember in middle school you came and read from your children's book to us. Have you done any more children's lit since then? I haven't kept up.

RichardPreston338 karma

Yes, I'm working on a YA novel, a fantasy novel about a giant forest….yeah I know, it's different from bloody viruses.

ozlaz202 karma

Although the mortality of this outbreak is around 60%, is it worse because it's spreading so fast? Is there any chance this outbreak could really take over a lot of africa? If so, when would a greater international presence step in to help? Cheers

RichardPreston524 karma

The worry is that Ebola could get into a large city in Africa, like Lagos, capital of Nigeria, pop. 21 million. Pop of Texas is 25 mill. So take most of Texas, cram it into one city, then remove access to good medical for most people, add poor sanitation, and there could be a big problem with Ebola. What's needed is a full-court press of international teams going in and working to stop it. That's happening now.

littlebeef66172 karma

Hi, Mr. Preston. I read a quote from infectious disease specialist William Schaffner suggesting that Ebola can be sexually transmitted. Is this true? If so, how likely is it to be contracted via sex versus other modes of transmission?

RichardPreston766 karma

It can be sexually transmitted. That is probably not the main mode of transmission, given the fact that if have Ebola you probably aren't in a loving mood...

karmanaut149 karma

What would be the plan if there was ever a large-scale outbreak?

RichardPreston287 karma

you mean in the US, right? The major hospitals are equipped to deal with small numbers of Ebola patients. I don't anticipate more than handfuls of Ebola patients here in the US, even if it gets really bad in West Africa. Reason is that we have a solid, structured medical care system, they unfortunately don't.

karmanaut117 karma

The major hospitals are equipped to deal with small numbers of Ebola patients

What would happen if they had to deal with large numbers of Ebola patients?

Let's just assume that for some reason, the procedures in place to prevent the outbreak from ever happening just stopped working, and there were a large number of infected patients.

What would be the plan then?

RichardPreston208 karma

ok interesting q. In the US in the 1800s we had to deal with outbreaks like this, including smallpox and yellow fever. We survived and grew as a nation but diseases were worse for many people. Yes, the doctors could deal with a major OB, but it wouldn't be fun at all.

Huck95141 karma

I know there was research being done in the late '80s looking into whether Ebola could be spread through the airborne route (which showed some promise), and again in 2012 it was shown that there was potential for this, while Dr. Joe McCormick staunchly disagrees with this, citing personal experience. Where do you stand on this issue?

RichardPreston246 karma

Airborne Ebola - unlikely. Dr. Joe McCormick is right about this, and he was face to face with Ebola patients in Sudan. You can trust him on this. However - there is evidence it was spreading through the air among monkeys in the Reston monkey house (The Hot Zone). But those are a different species of primate than Homo sapiens, us.

Dunkh121 karma

Do viruses evolve or are they pretty much set genetically? If they do evolve then given the increase in cases/hosts do you think Ebola could evolve to an airborne form at an accelerated rate?

RichardPreston224 karma

Airborne Ebola? Seems unlikely from what we know about it now. The virus's genes seem to be remarkably stable, in other words it doesn't evolve quickly for reasons nobody understands. A virus, when jumping into the human species, does tend to evolve and change very quicky as it "feels" its way into its new human host. But I think airborne Ebola is less likely.

ElliottGarber104 karma

Where in the world did you get that skull of the crab-eating monkey? Thanks for taking the time to join us all here!

RichardPreston184 karma

Hi Elliot, bought it in a junk shop in SoHo NYC for a few bucks…. I don't think they knew what it was!

machiatto12382 karma

Thank you for doing this AMA, you are my favorite author and it's so great to be able to ask you questions. You're books are ones that I have read multiple times, and your ability to turn a non-fiction topic into an engaging story is truly an art.

I am currently on the last chapter of your book Panic on Level 4, it's my first time reading it. I am really enjoying the shorter essay-style writing and topics that may not (or probably could with more research) be enough to fill an whole book on their own. Do you have plans to write any more of these compilation books?

And another question, again unrelated to ebola, what was you favorite moment researching for your books? And which was your favorite to research for?

RichardPreston180 karma

My fav moment was also my worst moment. Whe nI was inside the Army Ebola lab in a space suit--this is true--my suit exploded on me, it fell apart. It was on old loaner from the Army. Anyway, I was ok, but it gave me insight into Col Nancy Jaax's terror in the chemical shower airlock when her suit failed on her.

Stoooooooo71 karma

Could you describe your writing process?

RichardPreston202 karma

I'm a slow writer. Bugs me. I do a ton of research, interview lots and lots of people, then zero in on a great story (nonfiction, true story). I do focus interviews, for example spending 10 hours with Col. Nancy Jaax interviewing her about the accident when she got Ebola blood inside her space suit. I try to experience my characters' worlds, so I went inside the Army Ebola lab when it was "hot", wearing a space suit. Then I do a ton of fact checking and also use an outside fact checker to check my own writing for factual errors. The result is difficult and drives me crazy but also really satisfying.

adventurousslut67 karma

Okay, so obviously you know your stuff about Ebola. Do you think that this outbreak in western Africa is just the beginning? Or do you think it will kill itself off soon like some other experts are saying?

Love "The Hot Zone" by the way! Reading it for the second time right now!

RichardPreston124 karma

I think it's the beginning of a long difficult fight against Ebola. If it spread s into major cities in Africa it will be a big battle. I'm hopeful in the end the doctors and disease hunters will get it under control, but there will be more casualties among the doctors and medical workers.

adventurousslut21 karma

I totally see that. A lot of people are brushing it off with the excuse that it is "only transmitted through bodily fluids, so don't worry." On the other hand, I feel like this outbreak has really raised awareness of the disease. Do you feel like the raised awareness could cause us to see reliable treatments in the near future?

RichardPreston68 karma

Yes, let's hope for successful treatments. And there is hope. The ZMAPP compound may be effective, and there's also hope for a good vaccine at some point. If you survive Ebola (40 % do in this OB) there is evidence you have strong immunity to it afterward. Not sure about that, but it means that we could have a good vaccine. Raised awareness is good for everybody because it gets the scientists working on the problem.

ElliottGarber65 karma

Are you still in contact with Jerry and Nancy Jaax, the now-retired Army veterinarians who were featured in The Hot Zone?

I'm a vet in the military now and attribute much of my career path to the inspiration you provided through their stories.

RichardPreston100 karma

Yes - Cols Nancy and Jerry Jaax have retired from the Army, they're living on their family farm in Kansas and having a good life. I talk to them once in a while - they're doing fine. My guess is they are consulting right now with the Army doctors who are working in Africa ...

GwydionSuilebhan54 karma

I'm hearing lots of folks say -- as you have done -- not to worry about Ebola here in America, that we have the infrastructure to handle it. Okay, fine. But the extent to which it might affect Africans is certain something about which we ought to be saddened, no? And isn't the simple fact that such a new, deadly disease CAN emerge -- and, in a relatively short span of time, spread so widely -- a thing to be feared in and of itself? Aren't we still just one airborne pathogen away from legitimately needing to be afraid?

RichardPreston179 karma

We need to be very aware and concerned about the potential of new viruses, potentially airborne, getting into the human species from the world of nature. Ebola is by no means the biggest threat, I think. Also, we should not forget the bravery and heroism of the doctors and nurses who are working in the Ebola wards in W. Africa right now. They are seeing their colleagues die and think they may also die, but they are going in anyway, trying to save lives and stop the outbreak. One American doctor told me that he'd spent the week bursting into tears every now and then, he's lost so many friends among his colleagues.

kaloPA-16 karma

I'm sorry but calling yourself a expert in a field and giving a fiction book as your credential is unacceptable. Especially when it comes to viruses. Can you provide a list of scientist that recognize you as a expert ? or medical journal publications that can confirm you are a expert in the field?

I can draw a sword but this doesn't make me a expert weapon smith.

RichardPreston13 karma

The Hot Zone is nonfiction, the characters are real, the quotes and incidents are fact checked. I'm a writer, got D's in high school math (sorry) but am passionately interested in my subjects. What I do is listen carefully to lots of scientists, take careful notes, and then fact check my writing with the scientists afterward. It's research. I kind of love it, getting immersed in a world that's so different from the "normal" world of my own life.