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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13 Responses to “Ebola update: 2 American patients receiving experimental drug”

  1. MarilynRStroup says:

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  2. docsterx says:

    The CDC, in a paper from 2007, recommends that solid waste be double bagged before removing it from the isolation room. Then it recommends a number of possibilities including incineration, autoclaving, etc. For liquid waste (like vomitus) they discuss adding an agent like bleach to neutralize the virus or autoclaving. I didn’t look for information on treatment, if any, for water from a shower. The document is 225 pages long.

  3. Naja pallida says:

    With hand washing you’re generally not really looking to outright kill a bacteria or virus anyway, you’re just trying to get it off your body. Soap allows the natural oils in your hands, which is harboring the bacteria long enough for it to infect you, to become soluble and removed, hopefully taking the bacteria or virus with it and rinsing it down the drain. Repeated studies have shown that commonly available antibacterial soaps are no more effective than regular soaps, it’s the thoroughness of washing that makes the difference.

    Alcohol gels are effective at killing bacteria, but not so much for viruses, but they can make your hands a less hospitable environment by drying them out.

    To get something that is actually antibacterial, antifungal or antiviral, you have to take it a step further and get higher end commercial products that aren’t generally available at your local store. Working with animals, I’ve used chlorhexidine for years… but that’s not something you can get down at your local grocery store.

  4. Naja pallida says:

    Well, one saving grace is that most viruses cannot replicate outside their host. So that makes waste water a fairly inhospitable environment for them, and generally not a source of viral infection. Bacterial, fungal, and parasitic infections, most definitely, but not most viruses. But anyway, high-end medical facilities use many different methods of waste water treatment, due to relatively recent concerns about public sanitation, including various chemicals, nanofiltration, dissolved air floatation, membrane bioreactors, UV sterilization, and reverse osmosis. I’m sure each facility has a different protocol, and I’m sure the CDC isn’t taking any chances with these patients.

  5. GarySFBCN says:

    I’m somewhat familiar with some measures, such as negative pressure, used in hospital isolation. What I’m wondering about is if the waste water from the toilet and shower are chemically or thermally treated. Is there risk of ebola existing our sewage systems? Do we know what types of hosts are needed for the virus to thrive?

  6. bkmn says:

    A general good sense measure indeed. Use soap for you handwashing, preferably one that is not too hard on skin. Antibacterial soaps have ZERO effect on viruses (such as Ebola).

  7. docsterx says:

    Just FYI, Ebola enters the body through cuts on skin or by contacting mucous membranes (mouth, nose, eyelids, etc.) like some other viruses do (e.g. some cold viruses). In general, it’s a VERY good idea to wash hands frequently. We touch things contaminated with viruses, fungi, bacteria constantly. Things like doorhandles, desk tops, table tops, various sites on public transportation, in restaurants, bathrooms, etc.). Then frequently touch our faces. This can bring the pathogens into contact with those mucous membranes. Frequent, thorough hand washing with soap and water can be something useful that we can do to cut down on viral spread. Something good to do in general and not just with respect to Ebola alone.

  8. Silver_Witch says:

    I should have been clearer in my post – I was referring only to the three suspected cases in New York.

    Sorry to hear about the Nigerian doctor – seems it is moving through the African continent for sure. This is a tough one.

  9. docsterx says:

    Looks like the Nigerian doctor in Lagos has been confirmed with Ebola. I can’t find any updates on the other suspected cases there.

  10. docsterx says:

    It sounds like he has a low probability of having Ebola. With Ebola being so high profile, most facilities and doctors are much more likely to be overly cautious. Probably with his travel history to Africa, they are being extra careful. They are also probably working on tracking his contacts just in case.

  11. Silver_Witch says:

    Seems none of the three cases are Ebola. It is just hysteria. With one person coming back to america (via CDC isolation) and the crazies all screaming that we are all going to get it – I think people are just terrified. It is better to be safe and treat someone with similar symptoms as if they do have Ebola…until the tests reveal the truth…which to this point have all been negative.

    But with the crazies terrified the diseased illegal children (you know they have head lice …ahhhhh head lice – run for the hills) are spreading illness as well – it is just a weird period in our history where Americans (like Trump) are showing their assses.

  12. Silver_Witch says:

    Thank you for the continuing updates Doctor. You are doing a great job of making a complicated issue understandable and what it going on in the world. Keep up the good work!!!!

  13. heimaey says:

    What about this possible patient in NYC? What does that mean for us?

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