ATLANTA — While international health workers scramble to contain the deadliest Ebola outbreak in history, an American woman infected with the virus in Africa has arrived back in the United States — making her only the second human Ebola patient ever in the country.
Former Colorado resident Nancy Writebol “is still very weak” but has “showed signs of continued improvement,” Bruce Johnson, president of Christian mission group SIM USA, said Tuesday, citing her husband. Writebol had yogurt before her flight from Liberia to the United States, and although she was taken to the plane by stretcher, she stood up and entered the plane with assistance, Johnson said.
A specially equipped air ambulance delivered missionary Writebol to Georgia’s Dobbins Air Reserve Base late Tuesday morning, having left Liberia earlier in the day. She will be taken to Atlanta’s Emory University Hospital, where the other American Ebola patient, Dr. Kent Brantly, also is being treated.
Writebol and Brantly were caring for Ebola patients in Liberia last month when they became sick, and the same plane brought Brantly from Liberia to Georgia on Saturday.
Emory is just blocks from the Centers for Disease Control and Prevention, which helped Emory design an isolation unit — one of four of its kind in the United States designed to optimize care for those with highly infectious diseases.
“We’re just grateful and very cautiously optimistic about how she’s doing right now,” Bruce Johnson, president of SIM USA, a Christian mission group Writebol is affiliated with said.
Though there is no proven treatment or vaccine for Ebola, both Brantly and Writebol were recently given a experimental, U.S.-manufactured drug in Liberia while they were awaiting evacuation to the United States. Both have since shown significant improvement, sources said on condition of anonymity.
But the gruesome disease that can torment victims with profuse vomiting, uncontrollable bleeding and organ failure still is ravaging West Africa. Ebola is believed to have infected 1,603 people in Guinea, Liberia, Sierra Leone and Nigeria, killing 887 of them as of Friday, the World Health Organization said.
Concerns, testing spread outside Africa
A man hospitalized in New York City is now in strict isolation, waiting to learn whether he has the disease.
The patient became ill after recently traveling to West Africa, New York’s Mount Sinai Hospital said.
Doctors were trying to confirm the cause of the man’s high fever and gastrointestinal symptoms Monday. Results from an Ebola test are expected Tuesday or Wednesday.
But “odds are this is not Ebola,” said Dr. Jeremy Boal, chief medical officer of the Mount Sinai Health System. “It’s much more likely that it’s a much more common condition.”
About half a dozen people have recently returned from West Africa and gotten tested because of symptoms, but none of those cases has been confirmed as Ebola.
Doctors in Saudi Arabia are also taking precautions as they treat a 40-year-old man who recently returned from Sierra Leone.
The man was in critical condition Tuesday with symptoms of a viral hemorrhagic fever, the Saudi Health Ministry said.
The source of his infection remains unknown, but Ebola cannot be ruled out, the ministry said.
How Ebola spreads
Ebola doesn’t spread through the air or water. The disease spreads through contact with infected organs and bodily fluids such as blood, saliva and urine.
Historically, the odds have not been good. Previous Ebola outbreaks have had a morbidity rate of 90%, but the current outbreak in West Africa has a fatality rate of about 60%, perhaps due in part to early treatment.
There is no FDA-approved treatment for Ebola. Emory will use “supportive care” for its two Ebola patients, unit supervisor Dr. Bruce Ribner said.
That means carefully tracking a patient’s symptoms, vital signs and organ function and using blood transfusions and dialysis to keep patients stable.
The National Institutes of Health plans to begin testing an experimental Ebola vaccine in people as early as September. Tests on primates have been successful.
The secret serum
But the experimental drug ZMapp, which Brantly and Writebol received despite the medication never being subjected to clinical trials, is getting a lot of attention.
Just last Thursday, Brantly’s condition in Liberia had deteriorated so badly that he called his wife to say goodbye.
But three vials of ZMapp stored at subzero temperatures were flown into Liberia. Brantly and Writebol took the drug, and their conditions improved before they evacuated to the United States.
The medicine is thought to work by preventing the virus from entering and infecting new cells. It’s a three-mouse monoclonal antibody — meaning mice were exposed to fragments of the Ebola virus, and the antibodies generated within the mice’s blood were harvested to create the medicine.
While Brantly and Writebol’s conditions improved after taking the drug, the serum shouldn’t be viewed as a miracle cure, internist and gastroenterologist Dr. Jorge Rodriguez said.
“Let’s be cautious. We don’t even know really if this serum is working,” Rodriguez said. “I’m glad now that these patients were brought to a hospital where so many tests can be done, where they can see the response of their body to this serum. We don’t know if these patients are naturally getting better, or whether the serum is really doing something.”
Many have asked why the two Americans received the experimental drug when so many in West Africa also have the virus.
The World Health Organization says it was not involved in the decision to treat Brantly and Writebol. Both patients had to give consent to receive the drug, knowing it had never been tested in humans before.
The process by which the medication was made available to the American patients may have fallen under the U.S. Food and Drug Administration’s “compassionate use” regulation, which allows access to investigational drugs outside clinical trials.