Inside the Hot Zone: A Soldier on the Front Lines of Biological Warfare

by Mark G. Kortepeter

2021 William E. Colby Award Finalist 

Inside the Hot Zone is a real life medical thriller and insider’s account of one of the scariest workplaces on earth: the United States Army Medical Research Institute of Infectious Diseases (USAMRIID) (a.k.a. the "hot zone"). Retired U.S. Army Col. (Dr.) Mark G. Kortepeter, a leading biodefense expert, recounts some of the most serious threats in modern germ warfare, including the specter of biological weapons during the Iraq War, the anthrax letters sent after 9/11, and a little-known crisis involving a presumed botulism attack on the president of the United States. Inside the Hot Zone is a shocking, frightening eye-opener as Kortepeter describes in gripping detail how he and his USAMRIID colleagues navigated threats related to anthrax, botulism, smallpox, Lassa, and Ebola.

The stories are real, but they could just as easily serve as plotlines in popular fiction or Hollywood thrillers. Kortepeter gives the reader a seat at the table as each crisis unfolds, with an unvarnished and personal perspective on the dangers, the drama, the fear, the frustrations, the irony, and the uncertainty he encountered as a physician in the role of “Biodefender."

Genres: Nonfiction, Science, Medicine, Military Fiction, History, Memoir

336 pages, Hardcover

First published January 1, 2020

About the author

Dr. Kortepeter is an infectious disease and public health physician, scientist, and retired Army colonel. He spent 7 1/2 years at the "hot zone" lab at Fort Detrick, Maryland. His career has spanned the hospital, the lab, the lecture hall, the corner office, the battlefield, and other remote field settings.

Reviews

[Aimee Dars · Rating 4 out of 5]

Most people who know about the United States Army Medical Research Institute of Infectious Diseases (USAMRIID) in Fort Detrick, Maryland have seen it in movies or (like me) read about it in books. USAMRIID’s is charged with researching countermeasures against biological warfare and investigating disease outbreaks or threats to pubic health. Scientists there work with the most dangerous substances on the planet—such as anthrax, smallpox, Ebola, and the plague—to keep others safe from them.

Retired U.S. Army Col. Mark G. Kortepeter was literally inside the “hot zone,” first, as Medical Director of USAMRIDD, responsible for the health of the employees working in the facility, then in the Virology department doing direct research, and finally as the deputy commander making daily operational decisions. His seven-and-a-half year tenure began in 1998, so he was on the front lines as USAMRIDD was alerted in the aftermath of 9/11, called to assist in the FBI investigation of anthrax letters, and deployed to protect soldiers serving in the 2003 Gulf War from potential bioweapon attacks.

Inside the Hot Zone operates as a memoir of Kortepeter’s time in the trenches and as revealing account of the inner workings of USAMRIID. Deftly weaving science and politics, Kortepeter’s book is astonishing and frightening both for how much we know about potential bioweapons and, even more, how much we don’t know. Washington squabbles, bureaucratic hurdles, and internecine conflicts often impeded effective operation of the organization.

Though Kortepeter highly identifies as a solider, his account doesn’t shrink from criticizing the armed forces apparatus, especially in the case of Bruce Ivins, a USAMRIID scientist accused by the FBI of sending the anthrax-laced letters in 2001 and believed by many of his colleagues to be innocent. He also reveals the frustrations of taking orders from commanders who don’t understand the science or medicine behind what they are demanding. Additionally, his account touches on the affect his all-consuming career had on his family.

Reading Inside the Hot Zone, you forget it’s nonfiction—and then you hope that it is the stuff of imagination. Instead, Kortepeter’s account is an all to true engaging if disturbing narrative and recommended for anyone interested in germ warfare or USAMRIID.

Thank you to NetGalley and University of Nebraska Press/Potomac Books for an advance reading copy in exchange for an honest review.

[Lori L (She Treads Softly) · Rating 4 out of 5]

Inside the Hot Zone: A Soldier on the Front Lines of Biological Warfare by Mark G. Kortepeter is a highly recommended look inside USAMRIID during 1998 to 2009.

Doctor and U.S. Army Col. Mark G. Kortepeter served as the deputy commander and a biodefense expert at the United States Army Medical Research Institute of Infectious Diseases, or USAMRIID, during the tumultuous years of 1998 to 2009. During his years of service the U.S. experienced some of the more frightening threats in modern germ warfare. Think about it, this was during the aftermath of 9/11 and the anthrax letters, the threat of biological weapons during the Iraq War, and a potential botulism attack on the President. USAMRIID is called out whenever the potential use of biological weapons of mass destruction (WMD) may be used and could cause unbelievable casualties. They have highly secured labs that go up to the Biosafety Level-4 maximum containment lab.

Kortepeter calls the six highest threats the Chessmen of Doom: the Pawn is botulism, the Rook is tularemia, the Knight is Ebola, the Bishop is plague, the King is smallpox, and the Queen is anthrax. He then discusses each of these and the threat they pose during different scenarios depending upon how the terrorist group weaponizes them, and the counter measures/treatments they have to have ready in case of any scenario. The account includes personal stories and the roles he and his colleagues took on, as well as the challenging and, quite frankly, sometimes unethical treatment experienced. (Okay, I was incensed at the FBI harassment of a colleague.)

This personable, entertaining account is part biography and part insider look at the Hot Zone. It is written in a manner that can be easily understood by the average reader and doesn't require an experts knowledge of biological agents or scientific research. Kortepeter clearly provides an insiders look at how complicated and detail oriented his job was, by necessity in today's political climate, and what it means to be called to action during a crisis, like the presidential botulism scare. This book will appeal to both the professional and the interested novice. The book includes 28 photos, notes, and an index.

Disclosure: My review copy was courtesy of Potomac Books.
http://www.shetreadssoftly.com/2019/1...

[S · Rating 5 out of 5]

I'm a biased reviewer. My biases include: insatiable appetite for medically fascinating stories, my 6 years active-duty USN (Nuclear propulsion), a significant interest in how people approach and navigate through their professional lives/careers. These three biases helped this book to easily earn the 5-star rating...for me. The author is a cool dude, plus he really appreciates his friends and colleagues; this is a huge bonus in the story.

Grossest term I encountered in book: "shedding virus"

Relevance to current events: Chose to read this book when "Covid-19" was a hot topic.

[Isabelle · Rating 5 out of 5]

Inside the Hot Zone by Mark G. Kortepeter is an inside account of one of the most dangerous workplaces in the US: USAMRIID, the United States Army Medical Research Institute of Infectious Diseases. Kortepeter speaks candidly of his experiences in several different positions at the Institute and in the field of infectious diseases. There are situations he tells of that may make you think you're reading a thriller, instead of real-life accounts of germ warfare, natural disease outbreaks, and dreadful investigations by the FBI.

As a fan of memoirs that involve diseases, this book had me hooked right from the start. While at points, the order of the chapters may seem somewhat disjointed, he does circle back to make the reader understand the importance of why he tells his story the way he does. Kortepeter has a talent for conveying the importance of the events as well as the reactions and feelings of those affected by them. As a reader, you can almost feel the frustration and horror, the excitement and anticipation, the love for science and the disappointment of those betrayed by the desk warriors that make major decisions that negatively affect every day life at USAMRIID.

If you enjoy action-packed novels or have been held back from memoirs because you expect them to be dry rather than exciting, then Kortepeter's book is the right one to dive into and be convinced otherwise. It will leave you with a great deal to think about the way organizations are run, how when it is convenient you may be treated as guilty until proven innocent rather than the opposite, and how reality can sometimes be more thrilling than fiction.

[Kristina · Rating 4 out of 5]

For several years, Kortepeter worked as the chief of the Medical Division and Deputy Commander at USAMRIID, The United States Army Medical Research Institute of Infectious Diseases, located at Fort Dietrich. The preface starts off with a bang, chronicling a researcher’s possible exposure to ebola and provides a nice cliffhanger for majority of the book. The initial chapter provides a biography of his life and his path to becoming a doctor with his chosen speciality. The next chapter describes what he calls the “Six Chessmen of Doom” in terms of infectious diseases, which was absolutely fascinating. Kortepeter chronicles his time being deployed in Iraq just prior to the war. It’s mind boggling to even imagine trying to vaccinate and/or provide medical care in such harsh conditions, and the writing was phenomenal during this section. The book goes on to describe the possible exposure to Ebola at USAMRIOD in depth and later, the author’s own experiences researching Ebola. A photo selection is included to enrich the author’s writing further.

I appreciated the author’s attention to detail and immersive writing. I adored The Hot Zone by Preston when it was assigned as required reading for a biology class in high school and have recommended it to many people since that time. I can vividly remember the anthrax attacks following 9/11, as well as prominent Ebola outbreaks, so this book was further fascinating to me. I also appreciated the author’s candor in his struggles to cut through government imposed red tape in treating patients efficiently and his struggles to explain the severity of situations to lay persons within the government. Kortepeter’s passion for infectious disease research shines throughout his writing in this hybrid memoir/scientific book. While the science is prevalent, I think this book is also accessible to anyone reading. Overall, this book was excellent and has reignited my love for biological/scientific writing.

Thank you to Netgalley and the publisher for providing an ebook of this riveting title for review!

[Maxine · Rating 5 out of 5]

Doctor and retired US Army Colonel Mark G. Kortepeter takes us inside the United States Army Medical Research Institute of Infectious Diseases (USAMRIID), the Hot Zone of the title, where he served as Deputy Commander and biodefense expert for seven and a half years. He outlines the most likely bio-threats and offers a fascinating, gripping, and frequently terrifying look at what is being done to try to combat them. He looks at what are considered the six most deadly possibilities to be used in germ warfare referred to as the Chessmen of Doom: botulism, tularemia, smallpox, anthrax, Ebola, and Plague. He explains their appearance, potency, and the reason they are likely weapons and he does it in language that makes it easily understood by those outside the science community.

He also talks about the people who work there and the daily dangers they face including what happened when a lab assistant comes in contact with the blood of an Ebola-infected lab animal as well as discussing the anthrax letters sent out through the mail after 9/11 and the tragic aftermath when the FBI decided, despite no medical knowledge or understanding of the security protocols of USAMRIID, that the anthrax was produced in one of their labs.

Inside the Hot Zone is a well-written and compelling book that breaks down in easily understood language the very real possibility of weaponizing diseases and the work being done to combat them. I recommend it highly.

Thanks to Netgalley and University of Nebraska Press for the opportunity to read this book in exchange for an honest review

[Bekah B · Rating 5 out of 5]

This is one that all the science lovers out there will appreciate. I loved this book so much and proper got my geek on. That being said, you don't have to have science / medical before going in as the book manages to give the reader a good enough understanding of scientific and military (the author works for the US Army) terms for you to comprehend and enjoy the book.
The book starts with a worker getting a needlestick injury whilst working with Ebola and this just draws the reader right in from the beginning. It then goes back to the author explaining his career journey to becoming the Doctor he was and working in the Hot Zone for Usamriid but it was done in a way that was quite brief and was more of an overview, which felt good as a reader as I wasn't getting bogged down in his personal history.
Throughout the book we see the author dealing with various events including terrorism and major outbreaks, and we get an insight in to the (sometimes ridiculous) beaurocracy and red tape that has to be dealt with even in emergency situations. The book was written so well that I could easily empathise with the workers and feel their frustrations.
If somebody (Big Brother?) decided to check my search history I dread what they might think of me. It's full of searches about Ebola symptoms, Anthrax bioterrorism, image searches of Botulism victims and much more! But I feel like that's exactly what this type of book should do to readers. It should spark our curiosity and drive us to learn more. When I find myself heading down rabbit holes on Google researching all sorts of stuff from a book I'm reading that's when I know I've got a 5 star read in my hands.
Well done to Dr Mark Kortpeter and thank you for this fascinating book!
Thank you to NetGalley and the publishers for an advanced copy of this book in return for an honest review.

[Chad Alexander Guarino da Verona · Rating 4 out of 5]

Inside the Hot Zone is a rare look behind the scenes of the United States Army Medical Research Institute of Infectious Diseases (USAMRIID) from Retired U.S. Army Col. Mark G. Kortepeter. Part memoir, part terrifying look into the mostly hidden world of infectious disease research, Kortepeter's long standing position within the USAMRIID allows him to pull the curtain back briefly on a lesser known but vital research department.

As with any science based book, I approached with a bit of skepticism, wondering if I was about to be bogged down in minutiae and endlessly complicated details beyond my amateur background. Thankfully, Kortepeter is a talented storyteller who avoids too much "science talk" and instead focuses on the human aspects of his experiences, be it Ebola in Africa, the grim realization that the President may have been exposed to botulism, or the twenty-one day quarantine of a colleague suspected of exposure. This combination of real life experience and engaging tone makes this a worthwhile look into an often hidden world.

**I was given a copy of this book by the publisher via NetGalley in exchange for an honest review. My thanks to University of Nebraska Press**

[Nina Harrington · Rating 5 out of 5]

Natural and man-made biological weapons are real.
So are the scientists and military staff around the world who handle samples of deadly pathogens every day so that the world can be a safer place.
This book provides a unique insight into how the US agencies control these samples of plague, anthrax, smallpox, botulism and hundreds of other diseases and control disease research in a world of bio-terrorism.
How easy is it to get hold of vials of these deadly pathogens?
This book makes it clear that it was not difficult at all in pre-terrorist days. Researchers could buy samples commercially as part of their work.
Now all shipments of pathogens have to be tracked and an up to date inventory must be made - made especially difficult when you have 600 freezers and fridges and over 70,000 vials of pathogens to count.
Ebola may have been identified in Guinea in 2013 but this book makes it clear that recent outbreaks in Africa will continue to provide serious challenges to our health systems and disease controls.

[Steve · Rating 5 out of 5]

Wonderful autobiography at the intersection of history and science

I loved this book. As an autobiography, it gives a good understanding of the author. Because the author was in the military for the time period covered by the book, I was initially concerned that the book would toe the company line but my concern was needlessly. Mark Kortepeter equally praises and criticizes the military where relevant. But that is not the book’s major strength. What I loved most about the book was the interplay between science and politics. The book reads more like a thriller than a work of nonfiction. I also liked the way Kortepeter related to the reader; he’s one of those rare authors that, when I finished the book, I felt like I had lost a friend. Although I liked Richard Preston’s “Crisis in the Red Zone” I found the book by Kortepeter more interesting and less bogged down by minutiae. I strongly recommend it.
Disclosure: I received a complimentary copy of this book via Netgalley for review purposes.

[Jennifer M. · Rating 5 out of 5]

I found the book for me. Inside the Hot Zone is a close examination of not just Ebola, but a few of the nastiest diseases on the planet. My dream job is to work closely with these diseases at USAMRID or the CDC. However, it just wasn't in the cards for me to get there. I suppose that's why it's a dream job. Kortepeter takes on us a scary, horrific journey of Ebola, smallpox, and shows us just how concerning these are. It's not a fear-mongering type of book. Just the opposite. It's real. It's informative. And for someone like me, freaking fascinating as all hell Most of the book is fast-paced, but there are slower parts. These help to catch your brain up to how insane these diseases can be.

The Hot Zone was written a while ago, and still is one of my favorite books to this day. Even though many things have changed in the last couple of decades, one thing that hasn't is the way Ebola interacts with us. If anything, it's even more dangerous to us.

Read Inside the Hot Zone and you won't regret it. I promise.

Publishes 1.1.20.

5/5 Stars

[Kim Cross · Rating 5 out of 5]

A fascinating first-person account that blends memoir with science writing, this book provides a glimpse not only inside BSL-4 laboratories but inside the bureaucratic systems that surround and contain them. It occurred to me while reading Kortepeter's story that a successful career inside The Hot Zone requires more than infectious diseases expertise and the courage to work with agents like Ebola virus; it requires the leadership and instinct to navigate political minefields in both military and civilian environments. With humility and accessible prose, Kortepeter recounts disasters and near-disasters and debunks myths surrounding biological warfare defense. It's chilling to know what deadly biological agents are out there—and how they might be used as weapons—but comforting to know the limitations of each, and how scientists at USAMRIID are working to develop countermeasures against them.

[Deborah Rotman · Rating 5 out of 5]

Who would think that a book about biological warfare could be a page turner, but it is, with each chapter ending in relief that a crisis was averted and a warning that another crisis was just around the corner. I am very thankful for the talented, dedicated, and highly skilled scientists and doctors who worked with Mark Kortepeter at the United States Army Medical Research Institute of Infectious Diseases (USAMRIID) to neutralize the six "Chessmen of Doom," deadly pathogens that can be used in biological warfare. Sadly, as I was reading Kortepeter's book, the coronavirus began infecting and killing people in China and spreading to the U.S., declared a global emergency by W.H.O. This book is a "must read."

[Jen Juenke · Rating 3 out of 5]

I was so excited to dig into the book and learn more about the big bad scary diseases that can occur in nature and in a lab.
I learned very little from this book. Richard Preston books can give a better, detailed understanding about a Hot Zone and what happens inside.
What I did appreciate is the bureaucracy that goes into managing a Hot Zone. I did not fathom how much pressure is on the Directors shoulders.
I was surprised that the counts were off and some samples were in the ICE.
Overall, I think this book is not a good overview of the Hot Zone as a private citizen would see it.
At times the book drug on....for instance...the lady quarantined inside the Hot Zone.

[Liz Greenleaf · Rating 5 out of 5]

A fascinating look inside the inner workings of USAMRIID and government response to infectious disease outbreaks. The author takes you cleverly behind the black fence and onto the front lines of dealing with a myriad of challenges associated with biological pathogens that can be weaponized with nefarious intent. It's scary to think that this can really happen but these unsung heroes don't get enough credit and recognition for their tireless commitment and sacrifice to keep us safe. I felt like I completed an exciting, well-taught college course by the time I finished this book, and I look forward to more "courses" from this outstanding professor.

[Drjudy Staveley · Rating 5 out of 5]

Dr. Mark Kortepeter is one of the bravest Doctors/scientist who worked in one of the most prestigious infectious diseases labs in the nation. Our U.S. military goes above and beyond to protect our warfighters/troops from such biological threats. Inside the Hot Zone communicates Dr. Kortepeters first-hand experiences inside one of the most dangerous places on the earth, which is known as the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) at Fort Detrick, Maryland. If you're a student majoring in Emerging Infectious Diseases or a health care professional, I highly recommend you reading this book. It's very informative and easy to read.

[emma · Rating 4 out of 5]

4.75 stars- i LOVED this book. it gave an inside account into many infectious disease disasters and really opened up my eyes about bioterrorism. i feel as if i learned so much, but it didn’t read like a textbook- it was so easy to read it flew by! also, reading about the questionable decisions the army made and hearing all of the complaints over the higher-ups decision making process was eye-opening. it really revealed just how necessary government agency cooperation is and the lack of those implantations. the only thing that irked me was the constant use of “” quote marks to signify a metaphor or joke. otherwise, probably one of my fav non-fics ever!!

[August · Rating 2 out of 5]

This was a SLOG to get though. There were some interesting bits, but overall the writing didn’t click with me, there were typos, and for some reason the author had to describe every person’s hair color and style? I don’t know.

[David Pulliam · Rating 5 out of 5]

Well written, the chapter on the chessmen alone is worth your money. Some of the stories got a little bogged down with too much detail, especially near the end. It was really interesting to read it post-COVID, makes me understand more clearly why the medical profession tends to push safety.

[Tyler · Rating 5 out of 5]

This book is excellent. An inside view of preparation efforts at USAMRIID for bioterrorism response. The author provides a first hand account of several important events, written in a style that is highly engaging and very informative.

[Zach O · Rating 5 out of 5]

Very interesting personal account of the DOD’s work. Shines a very interesting light on Bruce Ivins case as I would probably react the same way to getting hassled by the FBI like that. I’ve also met the author of this book and he’s pretty cool.

[Roberta Wall · Rating 2 out of 5]

Very repetitive of Demon in the Freezer and it absolutely drove me crazy how he had to do an elaborate physical description of each of the people he mentions.

[Istoria Lit · Rating 3 out of 5]

Fascinating! Really enjoyed this read as I never knew anything about the subject. Would recommend for history fans.

[E. Ragan · Rating 5 out of 5]

This is an awesome book. Part memoir, part mystery. Is a nail biter and a "must read," especially in light of the Coronavirus scare.

[Jim D · Rating 4 out of 5]

This is a top notch look at what happens inside one of the worlds most secure bio hazard facilities. Good stories, well paced and very informative. Not for the faint of heart though.

[Eloise · Rating 4 out of 5]

Following the author's career at the United States Army Medical Research Institue of Infectious Diseases (USAMRIID) and the fight against bio-weapons as bioterrorism. Covering the trails, tribulations, struggles and politics involved in keeping the world safe from outbreak.
Reading like fiction it is a terrifying and fascination look into the world of deadly science and its wide-reaching consequences.