Deadly viruses: from medical detectives


"Level 4: Virus Hunters of the CDC," by Joseph McCormick and Susan Fisher-Hoch. Turner Publishing. 379 pages. $22.95.

Again and again, the culprit is a virus. Its identity changes, along with its disguises, and the settings of the carnage. The victims resemble one another: terrified, poor, previously healthy people and the nurses and doctors who attempt to treat them. Tragically repeated are the circumstances of ubiquitous filth, ignorance and unsanitary medical practices.

In "Level 4" the authors describe their pursuits of lethal pathogens on several continents for a quarter century, writing in collaboration with Leslie Alan Horvitz. The physicians use their memoirs - sometimes vivid, often rambling - to drive home the human role in spreading infections, observing that "such social issues as overpopulation, poverty, and uncontrollable urbanization ... put pressure on the virus habitat."

The investigations range from early AIDS epidemiology to outbreaks of hepatitis C in the 1990s. But the most informed chapters recall the virologists' groundbreaking work with Ebola, Lassa fever and Crimean Congo hemorrhagic fever (CCHF).

Popularized accounts of several outbreaks of Ebola have familiarized Americans with its fatal profile, including copious bleeding. Lassa fever, which is transmitted by rats, is a similar, excruciating illness. CCHF is a bloody malady afflicting nomads exposed to ticks on sheep. The infectious agents thrive in remote places, brought disturbingly close to developed countries by modern air travel.

Dominating the pages are people like Peace Uba, a Nigerian nurse who contracted Lassa in the operating room. Her education was the hope of her rural family. She survived but with neurological damage and deafness. Another is Dr. Jamil Khan, a Pakistani who became infected with CCHF while performing surgery. The would-be bridegroom so feared bleeding to death that he stopped shaving. He and a colleague were saved after Dr. Susan Fisher-Hoch administered the drug ribavirin.

Dr. Joseph McCormick established the efficacy of ribavirin to treat Lassa in 1985, based on care of more than 1,500 patients in Sierra Leone. His description of that process is one of many inside views of unfolding science. Similarly, Dr. Fisher-Hoch's sleuthing for Legionella organisms amid the hospital plumbing is a public health parable.

The scientists took repeated risks, and they convey the experience of handling the most virulent microorganisms. Classified Level 4, these demand biosafety suits and scrupulous efforts to avoid needle pricks and torn gloves. Dr. Fisher-Hoch and Dr. McCormick each relate mishaps that could have cost their lives. However, the drama of Dr. McCormick's brush with Ebola is diminished by telling part of it in the prologue.

The writers clutter their memoirs with acronyms, irrelevant particulars, names and itineraries. They also err by too faithfully depicting the grueling minutia of their work, from troublesome centrifuges to ordeals preserving specimens for analysis at what was their home base, the Special Pathogens Branch of the U.S. Centers for Disease Control and Prevention in Atlanta.

Patricia Fanning, The Sun's science and medicine editor, joined the company 11 years ago as a financial editor. Previously she was a Time-Life books editor, a Wall Street Journal reporter and a National Observer columnist.

Pub Date: 7/21/96

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