Ebola update: 2 Americans seriously ill

Here’s the latest on the Ebola outbreak that’s threatening west Africa, and has already infected several Americans in the region.

The two Americans in Liberia infected with Ebola, Dr. Kent Brantley and Nancy Writebol, are still seriously ill with the disease. Plans are being made to bring them out of Liberia and back to the US.  A long-range commercial jet, equipped with an isolation pod, has been sent to Africa to transport them.  The CDC, US State Department and the Liberian Government have been working together to coordinate the transfer.  The patients will be housed in biocontainment transfer units that will keep them sealed off from others.  The patients will be placed in the units, sealed inside, and the external surfaces will be decontaminated before they are loaded into the plane.

This is the kind of biocontainment unit they use to transport the patients:

Patient isoliation unit, courtesy of Gentex.

Patient isolation unit, courtesy of Gentex.

Upon arrival, at least one of the patients will be transferred to Emory Hospital in Atlanta, close to the CDC.  Emory is one of the few hospitals that has a high-level containment unit to house patients who are infectious.  The unit is separate from the main parts of the hospital where other patients are housed.  The hope is that these two patients will do better in facilities that are better equipped to deal with serious medical illnesses. (Dr. Brantley’s wife and children, who were in Liberia with him but returned to the US before he broke with Ebola, are still healthy but they are under “fever watch” precautions at their home in Texas. “Fever watch” means they monitor oral temperatures (one assumes) several times per day, and the patients are told to immediately report any symptoms like fever, headache, nausea, vomiting, diarrhea, muscle aches, etc. to the doctors/agency who is supervising them so that they can get assessed for Ebola immediately.)

If you look at the pictures from the Samaritan’s Purse site you can see that the hospital there is not very well equipped.  The chapel, shown in one of the photos, has been converted to an isolation ward.  This hospital, and others, are sadly lacking in equipment, supplies, medicines, laboratory facilities, etc.

[The US Army Medical Research Institute of Infectious Diseases (USAMRIID) used to have a unit that could be used to isolate patients with dangerous infections.  It was a high-level containment unit, virtually a mini hospital. However that was closed down. The Department of Defense had a similar facility, the Aeromedical Isolation Unit, that has also been closed down.]

Mrs. Writebol was also given an experimental serum.  The details of the serum are unknown, but usually when the term “serum” is used in an article about an infectious disease, it implies that the serum contains antibodies that may help the patient fight off the virus. Apparently, the serum has not been tested in other patients and there was some controversy as to whether it should be used at all.  If the patient has a serious reaction to the serum itself, it could make her even more ill or, possibly, cause death. Reportedly, there was some controversy among experts as to whether the serum should be used in such a seriously ill patient because of such possible side effects.

Dr. Brantley was given a transfusion of blood from a young boy who survived Ebola.  The boy, cared for by Dr. Brantley, wanted to show his gratitude for recovering from the virus.  The medical personnel on site may be hoping that the boy’s blood contains anti-Ebola antibodies that might help the doctor. Theoretically, if the serum and/or plasma in the transfused blood has anti-Ebola antibodies, it can decease the amount of virus circulating in the patient. And maybe buy him more time to stay alive till he can produce antibodies on his own.

Some of the medical missionary groups are now withdrawing their personnel from the stricken areas.  Other groups have stopped sending people into the area all together.  And the CDC has upgraded its travel alert for the area.  It now recommends that, unless someone has a pressing need to travel to Guinea, Sierra Leone or Liberia, that they avoid going there at all.


Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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  • HelenRainier

    What’s sad/pathetic about what you say is that it is absolutely true. Any branch of service should be self-sustaining and able to take care of its own needs. It is less expensive for the military to take back the work they used to do (transportation, facilities, and messing) and save the taxpayers money. Same with intelligence operations.

  • GreenEagle

    I hope people can keep this in perspective. At its height, AIDS was killing 10,000 people a day worldwide. Influenza in 1918 killed more people than World War I.

    Ebola is so virulent that it kills most victims before they can spread the disease very far; thus, in this case, the worst Ebola outbreak on record, it’s killed about 600. The previous outbreaks all together added up to about 1,000. Ebola’s symptoms make for a very frightening story, but as a health threat it is pretty low on the world’s list.

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  • http://www.americablog.com/ Naja pallida

    Florida has also issued a warning about Vibrio vulnificus, a bacteria from the warm ocean water that has been infecting beach goers. It causes gastrointestinal symptoms if ingested, but if it gets into an existing skin lesion, it can develop into nasty skin ulcers which can be bad enough to require significant debridement or even amputation. Fatality rate is nearly 25% if it isn’t caught and treated quickly, two people have already died. 11 last year.

    Though there hasn’t been enough research done yet, it has already been hypothesized that that the increase in the bacteria to dangerous levels, which has only happened in recent years, is a direct consequence of warming. They’ve also found significant amounts of the bacteria in tar balls from oil spills in the Gulf of Mexico.

  • http://wicca.com/celtic/wicca/wicca.htm Colin

    And now I have just read that Toledo is under a state of emergency due to a toxic algae bloom. They are saying don’t drink , don’t feed to your pets , don’t even wash in this stuff.

  • tamarz

    I wasn’t speaking for all of white America — I was talking about myself. I don’t disagree that the majority of white America doesn’t pay attention until an American is affected. However, it is interesting that when the Palestinian-American teen was so badly beaten by Israeli soldiers, Americans were upset even though he is “not white” by many people’s standards. Gave me a little bit of hope. (though there were the requisite trolling comments on articles claiming the boy was not a *real* American).

  • tamarz

    Actually, I think they started paying attention when some celebrities were affected.

  • 1jetpackangel

    The thought of being cooped up in that tube with all the wall-mounted gloves hanging down is seriously messing with my claustrophobia. But I really, really hope one of these treatments work.

    (Although I did have to scoff at “what if the serum kills her?” Ebola already has a 50%-90% mortality rate.)

  • TampaZeke

    No, when middle-class, white, HETEROSEXUAL WOMEN started getting HIV it became big news. Thousands of middle class, white, gay men died before anyone outside of the gay community, including the US government, considered it a problem.

  • http://www.americablog.com/ Naja pallida

    These days US military can’t even house and feed itself anymore without a train of war profiteering contractors, much less contribute to the assistance of someone else.

  • nicho

    People should be cautious about rushing headlong into an epidemic lacking proper isolation and sanitation facilities. But you’re wrong. In the mind of white America, the fact that two white Americans are infected makes this a big story. When it was just thousands of black Africans, people didn’t really care. It’s just like when thousands of Africans were getting sick and dying from a mystery virus back in the ’70s, no one here even knew about it. When middle-class white Americans started getting HIV, it became big news.

  • tamarz

    It is serious but not because Americans are more valuable. Read my comment above — the infection of these two workers will mean fewer people will be willing to risk working on this outbreak. The recent death of top doctor Sheik Umar Khan from Ebola was not only a huge loss to the effort to fight Ebola, but probably also frightened many health workers away from participating in the effort.

  • tamarz

    I’ve read some concerns about what the melting of the Arctic ice might bring in terms of bacteria and viruses never seen before.

  • tamarz

    In addition to our concern for our Americans who have been infected, the fact of this infection means many many fewer health workers will be willing to work in the parts of Africa affected by Ebola. That means the hundreds of people fighting for their lives will have even less care than they do now. Perhaps, instead of things like spending $trillions on invading Iraq, we should establish high level and well-supplied mobile medical services that can handle these most serious infections. I know we have some of that now through CDC, but my bet is that it could be boosted and improved if we committed the funds needed. And lots of top-notch protective equipment might mean more health workers would be willing to work in this area.

  • http://wicca.com/celtic/wicca/wicca.htm Colin

    LOL Isn’t it always our fault.

  • http://wicca.com/celtic/wicca/wicca.htm Colin

    I wish the best for Dr. Brantley and Nancy Writebol, and I am wondering about the changing of the climate and how many little bugs are going to find comfortable habitat outside their natural homes.
    I believe that migration is becoming an issue and I would love more info on what the scientific community might be thinking along these lines. Ebola could be the least of our worries.

  • nicho

    Or you just didn’t pray hard enough. It’s your fault.

  • nicho

    What? Two Americans infected? OK, now this is serious. Let’s pull out all the stops.

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    That’s what Jesus is for. He heals if he thinks you’re worthy. If you die then he just loved you so much he wanted you with him.

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    Instead of some Missionaries going over to convert people….why don’t they help more with healthcare needs.

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  • NMRon

    “US Army . . . used to have a unit that could be used to isolate patients” Back in the old days when America was a nation. Before the 1%’s austerity agenda dictated that we must have planes we don’t need instead of hospitals that we do . . .

  • Gindy51

    With all the leaks of infectious material here, I am not sure I trust anyone with this crap.

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