The Hot Zone was listed as one of around 100 books that shaped a century of science by American Scientist. Listed as an “Exploration,” the criteria dictate that the book typically “seeks to engage with the context” elucidating the general topic rather than a specific nuance.
Many reviews of The Hot Zone exemplify the impact the book had on the public’s view of emerging viruses. A review in the British Medical Journal captures the paranoia and public panic described in this book. The reviewer was left “wondering when and where this enigmatic agent will appear next and what other disasters may await human primates.” This can also be seen in a review in the Public Health Reports which highlights the “seriousness of our current situation” and “our ability to respond to a major health threat.”
The Hot Zone has been criticized for exaggerating the threat of Ebola and causing viral panic. In an interview about his book about Ebola, David Quammen claimed that The Hot Zone had “vivid, gruesome details” that gave an “exaggerated idea of Ebola over the years” causing “people to view this disease as though it was some sort of preternatural phenomenon.”
The Hot Zone is described as a “romantic account of environmental transgression.” Reactions to this book could be seen not only in the public’s view of emerging viruses, but in the changes in the Centers for Disease Control and Prevention. In addition to the funding of public health infrastructure during the early 1970s, there were many public discussions of biodefense. This book continued to fuel the emerging diseases campaign. By connecting international health to national security, this campaign used The Hot Zone as a method of justifying increased intervention the global phenomena of disease.
The Hot Zone elicited a major response by the WHO by shedding light on the Ebola Zaire outbreak. The release of teams of experts was immediate and massive. Many countries tightened their borders, issued warnings to custom officials, quarantined travelers, and issued travel advisories.
In his blurb, horror writer Stephen King called the first chapter, "one of the most horrifying things I've read in my whole life." When asked whether any book "scared the pants off you" writer Suzanne Collins answered, "The Hot Zone, by Richard Preston. I just read it a few weeks ago. Still recovering."
The Hot Zone has received criticism for sensationalizing the effects of Ebola virus. In their memoir Level 4: Virus Hunters of the CDC, former CDC scientists Joseph B. McCormick and Susan Fisher-Hoch lambasted Preston for claiming that Ebola dissolves organs, stating that although it causes great blood loss in tissues the organs remain structurally intact. McCormick and Fisher-Hoch also dispute Preston's version of the CDC's actions in the Reston virus incident.