Level 4: Virus Hunters of the CDC, is a memoir by America's most famous virus researchers. "Level 4" is the highest degree of laboratory containment for isolation and experimentation on microbiological organisms. Level-4 organisms produce lethal illnesses in humans and, for the most part, have no treatment and no prevention. Among the most infamous are the hemorrhagic viral diseases Ebola and Lassa Fever.
This is the story of those who hunt the emerging diseases making global headlines. Join husband-and-wife team Dr. Joseph B. McCormick and Dr. Susan Fisher-Hoch in their search for those who may be infected by these lethal viruses. You will travel through equatorial Africa, the ghettos and rainforests of Brazil, and through settlements in northern Pakistan. Both Dr. McCormick and Dr. Fisher-Hoch will offer their scientific knowledge about how and why these viruses are so lethal to humans and what can be done to prevent any kind of devastating epidemic from ever breaking out. The book shows how dedication, intelligence and courage can prevail--and give us hope for the future of global health.
So my criticisms for this book remain. It seems to be a direct response to "The Hot Zone" by Richard Preston by continually saying things like "despite what popular fiction and non-fiction novels say Ebola does not 'melt the organs' they stay intact" which is fine. Maybe Preston exaggerated a bit, but the truth is that his writing is both compelling, exciting, and informative. This book suffers from too many narrative voices, as well as trying to be both clinical and compelling. It made me pretty confused.
On the good side they were exceptionally compassionate towards the victims of the disease and the issue of poorly run third world governments. They also made another good point in that these diseases have probably always been around in rural and farming communities but have come to light due to overpopulation in cities and the subsequent outbreaks in urban hospitals due to the overpopulation and decrease in hygiene.
My main disappointment with this book is although I find the lab techniques interesting, the thing I want to know is exactly how the diseases work. Why I liked "The Hot Zone" and "Yellow Fever, Black Goddess" so much is that they talked about how the diseases worked on a cellular level, not just the symptoms and treatment. So they somehow managed to be extremely clinical while not giving me the details I find the most interesting.
Writing-wise, Susan is far more interesting of a writer than Joe, but near the end of the book they start combining paragraphs so you don't know who's writing what till they refer to each other. That makes it very confusing. There are also several blatant grammatical mistakes which considering that I was reading an "updated" copy really should have no excuse being there, this wasn't the first print.
But despite all my problems with the book, they still told a really solid story about finding and fighting disease in hellaciously poor and war-torn parts of the world.
I may have over-starred this book because I like its subject. It was written by two people who worked separately and then together and later in life married one another. The writing follows their lives separately, so early chapters are experiences of Dr. McCormick, then come chapters written by him alternating with chapters by Dr. Fisher when they worked together which continues to the end of the book. Sometimes they alternated in the same chapter. It was a bit confusing until I learned to pay attention to each author and to identify who was writing.
The most interesting thing is that this book could have been written for the current coronovirus covid-19 pandemic (plandemic?) since we are in the exact same position scientifically. In 1996, when this book was written, hydroxychloroquine (chloroquine, quinine, cinchona bark) was the only thing that ever possibly helped with any of the viruses. It especially helped best if taken in the earliest stages of the fever, and may not have worked after the illness advanced. Now, in 2020, there is no improvement in therapy. They had developed then an antiviral which in 1996 was called ribavirin. They administered ribavirin continually for many years for many illnesses, but could never establish any proof of its efficacy.
Interestingly, the most effective thing against the viruses was barriers, such as distance, screens, gloves, masks and gowns. This was far more effective than anything else. Containment of Ebola was the most dramatic result to show the effectiveness of barriers and keeping distance.
The other interesting thing was that the immune plasma recovered from the blood of infecteds who had survived also was not proven to work when injected into the sick. It seems to me that if the body cannot become immune to a virus, there cannot be a vaccine. It seems that viruses would mutate to defeat any vaccine attempt. Viruses are just crystals of RNA/DNA (sometimes with a lipid coat which is why soap works) and I read a theory that viruses come out from a sick cell who extrudes its own material.
Also quite interesting was how rodents, rats and mice leave their body fluids on grains and people eat these grains and become infected. There was a section on mice peeing on rice spreading massive infections until this was identified and the mice began to be trapped (and not eaten). In another instance, goats, sheep, and camels had ticks which spread viruses. In another instance, dusty musty buildings or caves which had housed rodents or bats seemed to cause infection from only breathing the air. Marberg and other viruses came from monkeys and primates. Many infections were from eating the monkeys, bats, rats and mice and other animals. (Also, cannibalism seems to cause the brain viruses in many species.)
In Pakistan, 60% had hepatitis which was spread by doctors using the same syringes to inject vitamins into healthy people. There were cases of counterfeit medicines manufactured in China which were a completely different substance. There were beautiful counterfeit packages which people trusted but which were worthless inside. They discussed AIDS/HIV which may have been diminished by sexual condom barriers.
There were helpful maps (no photos) which identified the locations where these viruses flourished which was helpful to determine the cause. When an outbreak occurred, they had to put up barriers and then identify what was different in the environment before they could begin to isolate the cause. These doctors worked all around the world on many viruses and the first, and most effective and maybe the only, line of defense was the barrier: distance, gloves, masks, gowns. I enjoyed this book because I am predisposed to like its subject.
I enjoyed learning about the various Level 4 viruses like Lassa fever, Ebola, and other hemorrhagic fever viruses. It was fascinating learning what the vectors for passing the diseases to human could be, such as ticks, mice urine, rats etc, how the diseases are spread in hospitals by the lack of proper barrier nursing procedures and the re-use of needles, and all the symptoms of these diseases and how they are treated in developing countries under crude conditions and how they are treated in first world countries like the United States and England. So those were the parts of the book that I liked and that made the book worth reading. What I didn't like was the switch between narrators and constant Sue and Joe and Joe and Sue and Sue and Joe...after they started working together in 1983. I didn't want to be involved in their personal lives and to start thinking about when their romance started and the reasons for their divorces etc. But the Sue and Joe and Joe and Sue...kept my mind there and without knowing what went on in Joe's marriage, besides his constant absence from home, I started feeling sorry for his first wife. So I think the book would have been much better just written by Joe, or if it was written by both of them, just leave it at colleagues with no discussion of personal lives.
I picked up this book several years ago. I contemplated reading it at the beginning of the pandemic, but decided it would be a bit too much. However, here we are, a year into the pandemic, and nothing has changed, so I decided it might help me to learn more about how BSL-4 viruses are studied.
I've seen some other reviews commenting that the book is slow, or boring. I personally disagree. I was completely fascinated at all points reading this book! I thought the stories were written in an extremely immersive way, and I grew to really admire Dr. McCormick and Dr. Fisher-Hoch. If anyone's curious, they've been active in the discussion of SARS-COV-2, which I find pretty neat.
If you enjoy non-fiction books that take you on a journey, I'd highly recommend this book. All of the epidemiological information was presented in a highly comprehensive way. And the stories were just fascinating! The only frustrating part is that we as humans have not seemed to learn our lesson after so many years dealing with viruses. One day, maybe we will.
It only took about 15 pages for me to remember why I picked this book up in high school only to lose interest and give it back to the library unfinished. Sure, it's about one of my favorite subjects - epidemiology - and it's set in interesting, exotic locations. But somehow, it still manages to be boring.
It took me over 6 months to read it because I was trudging through it four or five pages at a time, sometimes without opening it for weeks because I had zero motivation to do so. As much as I loved the accounts of field work in Africa, Pakistan, etc., I feel like the book spent entirely too much time describing how hard it is to get any science done in third world countries. I understand that it's frustrating, as it frustrated me, too. But really, if you want a fascinating book about filoviruses, read The Hot Zone. Seriously. A big chunk of this book is just review from that anyway.
An excellent, fascinating look at the experiences of two epidemiologists as they travel around the world trying to puzzle out various diseases. This is good stuff - plenty of suspense as they deal with unexpected threats and try to figure out where a disease originated, coupled with interesting stories about the challenges of maneuvering around and trying to practice science in third-world countries. Fairly easy to read, too - definitely written for the layperson. If I had one quibble, it's the transitions between sections written by each author. They uses phrases like "But that's Sue's story. I'll let her tell it" and so forth. That just struck me as a bit awkward, though I'm not sure how I could have more effectively arranged it. Anyway, that's a minor thing. Over all a truly fascinating read.
4.5/5. Absolutely fascinating. I couldn't put it down. It doesn't hold back on the scientific detail, but the reader is not left behind as most things are explained in a very accessible manner. There is also a handy appendix that outlines the basics of many of the viruses/diseases mentioned.
Where it falls short: The transition between McCormick and Fisher-Hoch is sometimes unclear, so I had no idea whose scientific escapades I was reading about. The book could do with some updating, as science has moved along since publication. (For example, in chapter nine the book states that HIV infection is not preventable, this is no longer the case.)
I love books like this – medical mysteries about the quest for the sources of various diseases – as long as they don’t go on for so long that they don’t get boring. This book was not boring.
It is mainly sort of an autobiographical journey of discovery on the trail of several different diseases. Joseph McCormick started his career in Africa teaching at a church-sponsored school. What he saw there inspired him to go to medical school and come back to see if he could help improve medical care in Zaire and similar places.
Susan Fisher-Hoch began her career in London working in a public health agency before joining a virology lab studying potentially deadly viruses. She worked with Legionnaire’s disease (a bacterial disease) before getting involved with various hemorrhagic fevers. Eventually, she too went to Africa to work on these viruses.
Joe and Susan worked separately and together on Lassa Fever, Ebola, and Crimean Congo Hemorrhagic Fever, as well as several other hemorrhagic fevers in Africa, Central America, and other places throughout the world. They were also involved in early studies of AIDS in Africa – trying to find the source of it, how it spread, and why it had suddenly assumed epidemic proportions in the rapidly growing cities. When they were working at the CDC in Atlanta, they had state-of-the-art facilities. In Africa and other parts of the Third World, they had to make do with what they could bring with them or what they could find or make. The story of the poor conditions in some of these places is heartbreaking.
This book was written in the 1990s. At that time nobody had found the ultimate carrier of the Ebola virus, despite looking extensively. Also, I think this was still fairly early in the AIDS epidemic in Africa. As bad as it was when they were there, I think it became much worse later on, spreading back out into the countryside and killing off nearly a whole generation of parents.
They eventually left the CDC as the politics of the place began to get weird and eventually wound-up teaching at the Aga Kahn University in Pakistan, hoping to be able to train more competent doctors for the Third World.
This is a great book that tells each situation like it is: virus hunting, the poverty that drives decision-making by medical practitioners in economically depressed areas, and how it feels to actually be there, dealing with personalities and motivations.
I loved the part about Dr. Fisher-Hoch's trip to Saudi Arabia. As a woman who has been to the Middle East and studied the culture - and who will not accept limitations on women - I was intrigued to read that she had not known what the culture and legal limitations for women are like there. What I loved was her decision never to return, no matter what they might need from her. (I went to a country next door, where this was not a problem.) It was anecdotes like that that made the narrative seem real and comprehensible. They applied virus hunting to everyday life.
The book segues neatly between the two physicians as they share the narrative, taking turns. It was fascinating.
The fascinating stories of two CDC epidemiologists who spent years working in Africa, as well as Asia and South America, chasing highly contagious and dangerous viruses. There were some slow points in the book, but overall, I found it extremely interesting to read about the actions of actual epidemiologists working first hand with these viruses in their host countries. The book deals mostly with Lassa Fever, which I admittedly knew very little about before reading this book. I had picked up this book because of the words "tracking ebola and the world's deadliest viruses" that were written on the front, so I was initially disappointed that Ebola was only briefly mentioned. Overall, however, I found the stories fascinating and thought the Doctors did a wonderful job at explaining the science and the techniques involved without dumbing them down too much.
As a second year medical student with quite a bit of microbiology information under my belt, I found this book absolutely fascinating. Sure at times there were slow bits where they would describe a lab's construction or a biochemical test, but I thought it gave a very frank representation of infectious disease doctors working on the global scene and in public health. It was enlightening to be given a look behind the scenes of some of the mass outbreaks of viruses that terrify the general public, and even more incredible to hear the truth (and not mass hysteria reporting) about many of these viruses. I can't say it's inspired me to work in public health, at the CDC, or abroad chasing infectious diseases, but it's definitely opened my eyes to these fields on a global scale.
I managed to read the preface and three chapters before I could take the errors no longer. On three pages alone (p. 32-34) I found simple statements that were unclear and unexplained, another that was inaccurate scientifically, and a third that contained a logical fallacy. This is written by a major leader in infectious disease? No confidence in him. NOT RECOMMENDED.
A memoir and an exploration of the investigations into Ebola, Lassa, and other nasty viruses. It's actually a very comforting book, since it details how scientist work towards understanding (and halting) the spread, and creating cures or treatments.
A highly interesting book about, among other things, how deforestation puts humans into contact with deadly viruses, reduces the posibility of living off the land, as well as how certain viruses were found and diagnosed, and how viruses spread/don't spread among and between humans and animals based on sanitary conditions.
This book also made me want to shower, but I'll settle for staying in the USA. Not that it helps; one of the last viruses that is discovered made its way to the USA through the import of Monkeys (creatures that are used for testing by cosmetics industries as well as veing used for testing by the pharmeceutical industry). It also shows how Africa in general, being significantly poverty-stricken in the locations these viruses were showing up, could not afford the patented tests, kits, or vaccinations that they need just to survive.
The book leads me to conclude three things:
1. Vaccinate yourself, and if you have any, vaccinate your damn children. Herd immunity IS all it is cracked up to be
2. With the advance in global climate change heating up the ice and releasing any and all pathogens trapped within: it won't be the rising oceans that kill us but the deadly diseases none of us are equipped to handle resurging, and that combined with airplane transport means that there is nowhere that is safe.
3. The biggest obstacle in getting people worldwide the vaccinations that they need relies (at least in big part) on funding. Give your money wisely, but give. Or, stop patenting life-saving machinery and then selling it at a rate you know poverty-stricken countries cannot afford even on an individual basis.
This was excruciatingly boring. They clearly were pissed about the exaggerations in The Hot Zone, but can’t match the excitement that The Hot Zone had. Like how do you make hemorrhagic fevers boring? Apparently these two can.
I also docked off mental points for the fact that this was in first person but you had no idea who’s POV it was, after it switched to Susan’s ‘section’. Halfway through the chapter I realized it was Joe talking and I would get more and more frustrated.
And: I know this was written in 1996 but yikes at Susan comparing her experience in Saudi Arabia to black people in South Africa. Just. So many yikes I can’t yikes enough.
From an epidemiology standpoint this book is fascinating, as the authors were in various countries of the world tracking down some very serious (level 4 being the worst) viruses over several decades. Plus the descriptions of makeshift labs in third world countries was also interesting. From a well-written book standpoint, it was lacking in cohesiveness and the interchanging of which author’s viewpoint was difficult many times to determine until multiple paragraphs were read. Definitely makes me want to read more epidemiology books though!
So my criticisms for this book remain. It seems to be a direct response to "The Hot Zone" by Richard Preston by continually saying things like "despite what popular fiction and non-fiction novels say Ebola does not 'melt the organs' they stay intact" which is fine. Maybe Preston exaggerated a bit, but the truth is that his writing is both compelling, exciting, and informative. This book suffers from too many narrative voices, as well as trying to be both clinical and compelling
"Public health" is far too often ignored / dismissed by my conservative kin. We functionally exterminated smallpox; why shouldn't we do similarly with the Malarias, Ebolas, and so on in the world? Of all the scary happenings in the world, pathogens are far worse than car bombs. Drs McCormick & Fischer-Hoch were both inspiring and heartbreaking. I felt like I was walking with and standing next to them through all the ups and downs of their incredible careers.
Every time I have a sore throat I'm going to think I'm dying of some viral hemorrhagic fever. I really liked learning about all these infectious diseases but did not realize this book is almost 20 years old until about halfway through. I wonder how many advances the world has made in tackling the disease covered in this book since it was published. I really hope there have been some advances and the general apathy shown by some of the governments has diminished.
This is a memoir written by two of CDC's experts in viral hemorrhagic fevers, who were there for the early work and discovery of Ebola virus in Africa. Although I enjoyed learning the inside story from their perspective, I found the different narrative voices of the two authors distracting and more long-winded than necessary. Although it is nice to have a glimpse of the personal side to understand the full picture, a glimpse was all I needed.
interesting and useful to understand the history of infectious disease epidemiology and public health approaches. I bailed on the last 15%, it got boring.
One major beef with this book is that it seemed to have 2 narrators but the chapters switched haphazardly with no pattern or any guideposts for the reader to figure out which person was meaning "I".
Not a must-read for anyone, but if you want to learn the history of CDC and infectious diseases from 1970 onward, it was decent.
I liked learning about how the authors found and studied the level 4 viruses like Ebola and Lassa fever. Learning about how they developed treatments to help people with these viruses was amazing and intriguing. However, this book could have used more editing. The paragraphs were choppy and jumped between the two authors' point of view leaving me confused as to who was talking.
Solid read but some of the science and language is outdated now. Like many other reviewers the swapping of narratives and timeline jumping negatively affected the book and I think could have used a stronger editing hand- as well as the end of the book which becomes a little meandering. Still, it was an interesting read and their careers contributed greatly to public health.
Engrossing history of the epidemiologists who worked to find the source and cure for Lassa fever, now known as Ebola after the river in Zaire (now the Democratic Republic of Congo) where it was first identified.
Good book with factual stories recanted touching on Ebola and lassa particularly. The last few pages provide a decent synopsis of these level 4 type viruses as well, making for great reference material.
The story told by these two virus hunters is fantastic and thrilling. I appreciate their devotion and contributions to science. Unfortunately, the translation process from print to ebook has left something to be desired. I do not blame the author's for this.
Not often you bump into a book that so specifically speaks to you. Written by two of my own person public health hero’s who have done what I want to do almost exactly. Reading their stories and about their work around the world was nothing but inspiring. The amount of times that they mention the Peace Corps and the volunteers that helped them around the world gave me a much needed boost in morale that I will continue to remember for the rest of my time as a volunteer.