Ebola update: 2 American patients receiving experimental drug

The Nigerian Ministry of Health announced that they are awaiting confirmation of another case of Ebola there. This new case is one of the doctors who treated Patrick Sawyer. Sawyer was the Liberian-American who flew into Lagos, Nigeria, and became ill. He was diagnosed with Ebola and later died.

The Nigerian government says that there may be three other cases of Ebola related to Sawyer. These people all took part in caring for him after he became ill in Lagos. The government is awaiting confirmation of the diagnoses in all of these patients.

The Nigerian Ministry of health has been following 70 people who had contact with Sawyer. The doctor and three other suspected cases are now in quarantine in Lagos. The Ministry is looking to quarantine another four people who may have symptoms of Ebola.

Nigeria is also prohibiting bodies of Ebola victims from being flown into Nigeria, either for burial there or transport onward. You’ll recall, as I wrote earlier, there are some concerns about a possible risk of transmission with some of the local rituals for preparing the bodies of the dead.

The government in Nigeria is also considering limiting vehicular traffic into that country from other countries.

Nigerian flag via Shutterstock

Nigerian flag via Shutterstock

If these cases in Nigeria are confirmed, they may lead to a larger local outbreak. Lagos is a city of approximately 21,000,000 people, living in close proximity to each other. While it does have somewhat better healthcare facilities that the other countries involved, it would still be almost impossible for the country to cope with a large outbreak without specialized assistance from other countries. Additionally, Nigeria has a booming economy and is an area hub for business travel both locally and internationally.

In the original three countries where Ebola cases continue to mount, the local governments are trying to isolate cases and protect health care workers. Government troops are manning checkpoints on roads and enforcing quarantine precautions in some areas. Those kept in quarantined areas will be supplied with food.

Police and military are also being used to protect health care workers, some of whom had been targeted by the local populace. Some people believe that health care workers are spreading the disease. Threats have been made against workers and some clinics and hospitals. In some areas, it has been mandated that the bodies of Ebola victims be cremated immediately after death. Customs of many people in the area cause the families of the dead to prepare them for burial. Friends and relatives often kiss the deceased on the lips. Since that could lead to infection, authorities are going to prevent the families from these funeral practices.

The governments in all three nations, Sierra Leone, Guinea and Liberia say that their finances and resources are severely stretched. They meed money, equipment and people to contain the outbreaks.

Regarding the 2 US patients infected with Ebola, Dr. Brantly is reported to be doing somewhat better at Emory Hospital. Ms. Writebol is supposed to be landing in Atlanta tomorrow and will join him in the isolation unit there.

It’s been reported that both received a monoclonal antibody treatment called ZMAPP, made by MAPP Biopharmaceuticals in San Diego. The drug acts to block the virus and prevent its spread to other cells in the infected patient. It has not been approved for use by the FDA, but apparently was given to these two patients after they were informed that it had not been tested in humans. Data had shown that the drug worked very well in a limited number of experiments in non-human primates. Both patients showed some improvement after they received the medication.


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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