Four weeks ago, after Charlotte missionary Nancy Writebol learned she had contracted the Ebola virus in Liberia, her husband described her condition as “dire” and prepared himself for the possibility that his wife of 40 years might die.
But this week, after an extraordinary journey that captured the attention of the world, Nancy Writebol quietly walked out of Atlanta’s Emory University Hospital, where doctors declared her cured of the often-deadly infectious disease and said she could return to a normal life with “no public health threat.”
Nancy Writebol’s recovery, along with that of Dr. Kent Brantly, a missionary with North Carolina-based Samaritan’s Purse, came in a surprise announcement Thursday at an Emory news conference in Atlanta.
“Today is a miraculous day,” Brantly declared.
Observers applauded as Brantly, 33, and his wife, Amber, hugged his doctors and nurses before leaving for “a period of time to reconnect, decompress and continue to recover physically and emotionally.”
Nancy Writebol, 59, who was discharged from Emory two days earlier, did not attend the news conference, and hospital officials said they had not announced her departure because she asked for privacy. Brantly said Writebol asked him to “share her gratitude” for the medical care and prayers they received. “All she could say was, ‘To God be the glory,’ ” Brantly said.
Officials of SIM USA, the Charlotte-based mission that sponsored the Writebols’ work in Liberia, said the couple have “gone to an undisclosed location to rest and spend time with one another.”
Photographs taken after her release and posted by SIM show the couple smiling, and Nancy Writebol appears as healthy as she was in pre-Ebola pictures. In a statement via SIM, David Writebol said she is free of the virus “but the lingering effects of the battle have left her in a significantly weakened condition. Thus, we decided it would be best to leave the hospital privately to be able to give her the rest and recuperation she needs at this time.”
Blood tests come back clean
Dr. Bruce Ribner, leader of the Emory infectious disease team, said decisions to discharge Nancy Writebol and Brantly were made after tests showed no sign of the virus in their blood and after they continued to improve for several days after that.
“There is no evidence of Ebola virus in their bodies,” Ribner said. Although they’ll need time to rest, just as anyone who has been hospitalized in intensive care, he said they should recover with no lasting effects.
“Most patients, if they have not had any substantial organ damage, will make a complete recovery,” Ribner said. “The general experience with patients in Africa is, once they have survived, they are not contagious … There is no evidence that once a patient has cleared the virus from their blood that they will relapse.”
Further, Ribner said patients who survive the infection are immune to that particular strain of Ebola virus. But he said there are five strains of Ebola, which was first detected in Africa in 1976. It’s not clear how much protection survivors have against other strains. “It would not be as complete as the strain you’ve been infected with,” Ribner said.
‘Didn’t know what to expect’
Nancy Writebol and Brantly are the first two Ebola patients treated in the United States. Both were infected while working at ELWA hospital in Liberia, where Brantly cared for Ebola patients and Writebol helped decontaminate protective gear worn by health care workers when they treated patients.
In Liberia as well as neighboring Guinea, Sierra Leone and Nigeria, the outbreak has killed 1,350 people and sickened 2,473. The disease is fatal in 50 percent or more of cases in the current outbreak. The virus is spread through direct contact with the bodily fluids of infected people who are having symptoms, such as diarrhea and vomiting.
Ribner said health officials don’t know how either of the American missionaries contracted the virus because they were following infection control protocols devised by the CDC and the World Health Organization.
When asked if he was surprised at their rapid recovery, Ribner said, “We frankly didn’t know what to expect … There has been very limited experience with treatment of people with Ebola virus disease in developed countries. But conversely, we always suspected that we had a good chance of helping these patients survive.”
Ribner said he and other U.S. health officials believe the mortality rate from Ebola disease would be lower in this country, in part because of the ability to provide “aggressive supportive care … at a better level than the facility they were in in Liberia.”
While caring for Nancy Writebol and Brantly, Emory doctors learned the importance of being able to test for loss of fluids and electrolytes, such as potassium, calcium and magnesium, because patients with serious diarrhea can become dehydrated quickly.
“Even if you can’t measure these things, you need to pay attention to (fluid) replacement,” Ribner said. “What we learned in caring for them will help advance the world’s understanding of how to treat Ebola infection.”
Both Nancy Writebol and Brantly received doses of an experimental drug, ZMapp, and Brantly had received a blood transfusion in Liberia from a teenager who survived Ebola infection. But when asked if those treatments aided the missionaries’ recovery, Ribner repeated what other doctors have said: “The honest answer is, we have no idea.”
David Writebol, who remained in Liberia for two weeks after his wife’s diagnosis, flew with two other SIM missionaries to Charlotte Aug. 10 on a private plane. Because they had been in contact with Ebola patients, they were quarantined, by order of the Mecklenburg County Health Department, on the 90-acre SIM campus off Carowinds Boulevard. David Writebol completed his 21-day quarantine Sunday without having developed symptoms of infection, and joined his wife in Atlanta.
The news that Nancy Writebol was released from the hospital and on the road to full recovery brought a jubilant reaction from the couple’s friends and fellow members of Charlotte’s Calvary Church.
“We’re excited, and we see it as an answer to prayer,” said the Rev. Jim Cashwell, pastor of missions and evangelism at Calvary, the Writebols’ home church since 1994. “Nancy is cured and alive. And we’re just grateful what the Lord has done.”
Bill Bailey, an elder at Calvary and one of the Writebols’ closest friends in Charlotte, said hearing that Nancy is Ebola-free “is among the happiest moments of my life. To think that my dear sister in Christ has been brought back from the brink of death confirms my great hope in our great God.”
Bailey said he and his wife, Laura, look forward to giving the Writebols the “warm embrace that two weeks ago would have been impossible.”
Calvary’s Cashwell said he talked with the Writebols Friday and said they expressed gratitude for all the prayers – from members of Calvary and people all over the world.
“Nancy sounded so strong and thankful,” Cashwell said. “We’ll look forward to the time that they’ll come worship with us in the near future.”