"Never mind Ebola, the hemorrhagic disease that was the main subject of Preston’s 1994 #1 bestseller, The Hot Zone. What we really should be worrying about, explains Preston in this terrifying, cautionary new title, is smallpox, or variola. But wasn’t that eradicated? many might ask, particularly older Americans who remember painful vaccinations and the resultant scars. Officially, yes, nods Preston, who devotes the first half of the book to the valorous attempt by an army of volunteers to wipe out the virus (an attempt initially sparked by ’60s icon Ram Dass and his Indian guru) via strategic vaccination; in 1977 the last case of naturally occurring smallpox was documented in Somalia, and today the variola virus exists officially in only two storage depots, in Russia and at the Centers for Disease Control in Atlanta (in the freezer of the title). To believe that variola is not held elsewhere, however, is nonsense, argues Preston, who delves into the possibility that several nations, including Iraq and Russia, have recently worked or are currently working with smallpox as a biological weapon. The author devotes much space to the anthrax attacks of last fall, mostly to demonstrate how easily a devastating assault with smallpox could occur here. He includes an interview with Steven Hatfill, who has received much press coverage for the FBI’s investigation of him regarding those attacks; his description of meeting Hatfill, hallmarked by a quick character sketch (“He was a vital, engaging man, with a sharp mind and a sense of humor.... He was heavy-set but looked fit, and he had dark blue eyes”) is emblematic of what makes this New Yorker regular’s writing so gripping. Preston humanizes his science reportage by focusing on individuals—scientists, patients, physicians, government figures. That, and a flair for teasing out without overstatement the drama in his inherently compelling topics, plus a prose style that’s simple and forceful, make this book as exciting as the best thrillers, yet scarier by far, for Preston’s pages deal with clear, present and very real dangers."   

-Publisher's Weekly (starred review)

Preston guides us deftly on another scary excursion (Hot Zone, 1994) into the world of really bad viruses-this time smallpox, with a side helping of anthrax. The author's steady, ominous voice gives the world of smallpox a particular grimness: Epidemiologists consider it the worst human disease on record, having killed perhaps a billion people over the last 100 years. The scourge went to the brink of extinction, having been targeted for erasure from the natural world through a comprehensive eradication program ("No greater deed was ever done in medicine, and no better thing ever came from the human spirit," declares Preston). Since the disease had last been seen in nature in 1979, during the Cold War, it was decided that samples of the various strains would be kept in both the US and in the USSR. After that, it wasn't long before the black absurdity of an even greater menace was conjured up by its specter as a bio-weapon-manipulable and dreadful. Preston takes readers through the eradication program, describing in clipped detail smallpox's effects. He outlines the potential of the virus as a biological weapon and explains why it is thought that Russia developed and deployed missiles outfitted with smallpox-laden warheads in the 1990s (he doesn't conjecture what the US may have been doing, if anything, along such lines during the same period) and suggests that anyone who believes that smallpox samples are held only by Russia and the US is living in a fool's paradise. Those doing research on smallpox-proposals to destroy the last known strains ran into bioethical conflicts-are the same as those detailed to handle the anthrax letters, and Preston takes up that latter subject before moving on to a discussion of super-lethal, vaccine-resistant, antiviral weapons. Nowhere to run, nowhere to hide from microscopic infectious agents? Welcome to Mr. Preston's frightening neighborhood.

-Kirkus (starred review)

"This book will give you nightmares. ... Richard Preston does for smallpox what he did for the deadly Ebola virus in his 1994 best seller, "The Hot Zone": by jump-cutting among narrative strands, he turns a story about science and medicine into a theme-park ride of a thriller."

- Michiko Kakutani, The New York Times