San Francisco Chronicle - The Voice of the West, 901 Mission Street, San Francisco, CA 94119 - Sunday, August 4, 1996 - Page 1
REVIEWED BY, DAVID PERLMAN

Virus Hunters of the CDC By Dr. Joseph B. McCormick and Dr. Susan Fisher-Hoch, with Leslie Alan Horvitz Turner; 379 pages; $22.95

In 1974, "The Hot Zone" became the ultimate gory best- seller, warning of dangerous new viruses on the loose.

Later that year, Laurie Garrett's encyclopedic book, "The Coming Plague," provided the most lucid and dramatic account of how those emerging viruses threaten the modern world.

Now a book with the ominous title "Level 4" offers something quite different: Here is an intensely personal story of courage and persistence by two dedicated scientists, Dr. Joseph B. McCormick and Dr. Susan Fisher-Hoch, who for years have hunted down the viral sources of all the mysterious diseases that both terrorize and decimate the world's most defenseless human beings.

In an age of AIDS, when the global epidemic of the virus called HIV rages unchecked, the lesser-known killers like Ebola and Marburg, Lassa fever and Hantavirus (and all the other obscure organisms that trigger deadly hemorrhagic fevers) come to Western notice only when outbreaks on far-off continents rate scare headlines -- and are quickly forgotten.

The term Level 4 refers to the "hot labs" designed and built by scientists in Atlanta at the government's Centers for Disease Control and Prevention -- the CDC -- where researchers garbed in protective spacesuits and closed-circulation masks work in air-controlled facilities to study the secrets of viral diseases in monkeys and other animals.

Those high-tech labs may well be safe, but in the villages of Africa and Asia and South America where the diseases rage, hot labs don't exist. So virus hunters like McCormick and his wife, Fisher- Hoch, dispatched to the field from the CDC's Special Pathogens Branch, had to improvise. Often they had only intermittent electricity to power their microscopes, no adequate sterilization, no telephones that worked nor batteries for their radios to confer with colleagues far from their jungle research stations.

"Level 4" is an exciting adventure story that brings readers intimately into the dangerous regions where virus outbreaks occur, and even more intimately into the lives of the scientists and the despairing patients they seek to save.

Lassa fever, for example, struck John Kamara, a Sierra Leone native who had been one of McCormick's most valuable research assistants: "His body was wracked by a series of seizures as the virus proclaimed its victory over his brain," McCormick writes. As Kamara's wife watched him die, "she began to grow strangely calm, now that she'd accepted the inevitable. It was one of those times in medicine that humble all physicians. It reminds us: we make feeble gods."

These dedicated scientists, working on their meager government salaries, bring us vividly into contact with the miserable health facilities throughout the developing world. Here, for example, is Mama Yemo Hospital in Kinshasa, Zaire, where McCormick and his wife fought the AIDS epidemic: "The wards were generally choked with people afflicted with the most desperate illnesses. They were jaundiced, bloated, cachectic, comatose and vomiting. . . . They came in endless droves. Screams and moans echoed through the dank hallways. This is the face of disease and death for the world's poor."

Strong stuff, yet readers should not shy away, for the story these virus fighters tell is filled with excitement, too: tortuous journeys by Land Rover into the most remote communities -- one with a potholed dirt road nicknamed Hemorrhoid Hammer; sly victories over corrupt soldiers guarding outposts on the Sudan border; miracles of improvisation creating sources for electricity, for pure water, for sterile tools and bandages. Unforgettable is the image of Fisher-Hoch, a female scientist alone and unveiled, teaching astonished Saudi Arabian men how to investigate an outbreak of Crimean Congo hemorrhagic fever in the holy city of Mecca.

Nor are the authors unaware of the lessons they have learned from the viruses they hunt and the patients they try to save: "Keep in mind the role that humans play in the spread of these infections," they urge. "If we don't begin to deal with problems like overpopulation and poverty, we may end up looking back nostalgically on the late 20th century as a time of health and tranquillity. . . . In the world of viruses, we are the invaders."

Throughout this book the two veterans relate their stories in the first person, and occasionally it can be a bit unclear just which one is the narrator. But it really doesn't matter, because "Level 4" is an absorbing tale, packed with humor, danger, science, tragedy and even occasional triumph.

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