A week ago, Charlotte missionary David Writebol was thinking about funeral arrangements as his wife Nancy battled a potentially deadly Ebola virus infection contracted in West Africa.
But on Tuesday, after Nancy Writebol arrived in Atlanta for care in a special isolation unit at Emory University Hospital, her husband and missionary colleagues reacted with relief and hope.
“Nancy is still very weak,” said Bruce Johnson, president of SIM USA, the Charlotte-based Christian missionary group that sponsors the Writebols’ work in Liberia. “But she’s showing signs of progress and is moving in the right direction.”
Johnson choked up when he recalled talking with David Writebol, who remains in Liberia but will join his wife as soon as he can. He quoted David Writebol: “We still have a long ways to go but we have reasons for hope. We are cautiously optimistic.”
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Nancy Writebol, 59, the second American aid worker recently diagnosed with Ebola in Liberia, traveled on the same specially equipped charter plane that brought her colleague, Dr. Kent Brantly to Atlanta on Saturday. Brantly, 33, from Texas, also contracted the virus in Liberia while caring for Ebola patients and is being treated at Emory.
Brantly’s wife, Amber, said Tuesday she has been able to see her husband daily, and “he continues to improve. I am also thrilled to see that Nancy arrived safely in Atlanta today. Our families are united in our faith in Jesus, and we will walk through this recovery time together.”
Unlike Brantly, who walked into Emory hospital on his own with help, Writebol was carried on a stretcher. She and the attendants pushing her wore white protective clothing, similar to Hazmat suits. But Johnson said Nancy Writebol had been able to stand and walk onto the plane the day before in Liberia.
The Writebols’ two grown sons, Jeremy and Brian, have also arrived in Atlanta and were waiting to visit their mother.
Johnson said Nancy Writebol ate yogurt before leaving Liberia and has been hungry for potato soup. “That’s a positive sign to see her appetite return,” Johnson said.
Both Brantly and Writebol are reported to have received an experimental serum that doctors hope will help fight off the Ebola virus.
The drug, known as ZMapp, was developed by Mapp Biopharmaceutical Inc., based in San Diego, according to the Associated Press. The drug has shown promise in animals but testing in human is not expected to begin until later this year. It was identified as a potential treatment only earlier this year, thanks to a longstanding research program by the U.S. government and the military, the AP reported.
Although both Brantly and Writebol have recently improved, experts say it’s impossible to know whether the drug is responsible or if they are recovering on their own, the AP said.
The treatment is made of antibodies from mice that have been exposed to pieces of the Ebola virus, according to Dr. Katie Passaretti, medical director for infection prevention at Carolinas HealthCare System, who is not involved in the patients’ care. By injecting the antibodies into humans, doctors hope to prevent the virus from entering healthy cells and replicating.
The drug is made in tobacco plants at Kentucky BioProcessing, a subsidiary of Reynolds American Inc., in Owensboro, Ky. The tobacco “serves like a photocopier,” and the drug is extracted from the plant, company spokesman David Howard told the AP.
Death toll rising
Liberia is one of four West African nations dealing with the world’s largest Ebola outbreak. This week, the World Health Organization said the death toll had increased from 729 to 887 deaths in Guinea, Sierra Leone, Liberia and Nigeria.
SIM’s Johnson said the Centers for Disease Control and Prevention has not determined how Nancy Writebol became infected. She did not have direct patient contact, but she had been serving as a hygienist, which means she used a sprayer to decontaminate the protective suits health care workers wore when treating infected patients.
Johnson said SIM has spent nearly $1 million since the diagnoses of Writebol and Brantly, who works for the Boone-based international relief group Samaritan’s Purse. Johnson said Samaritan’s Purse has spent more than $1 million.
But he added that all SIM missionaries have “medical evacuation insurance” which will provide some reimbursement. “Our number one priority was to get them back (to the United States). We’ll figure out the finances after this,” Johnson said.
Why bring to the U.S.?
While some have criticized mission groups and the federal government for bringing Ebola to the United States for the first time, public health officials say health care providers in this country can safely care for Ebola patients while protecting the public.
“It’s understandable that people are worried,” said Dr. Marcus Plescia, Mecklenburg County’s health director. “This is the first time we’ve had Ebola cases on American soil. That’s true. And we should take it very seriously. But this is something we can handle.”
Plescia said Ebola is contagious but much less easily transmitted than influenza or SARS, which are spread by coughing and sneezing. Ebola is spread by contact with an infected person’s bodily secretions.
There is no known cure for Ebola, which causes fever, vomiting, diarrhea and uncontrolled bleeding. Treatment amounts to “supportive care,” including IV fluids to keep patients hydrated. Patients with internal or external bleeding can receive blood platelets and clotting factors.
“You get them through the period where the infection is putting them at risk of death,” Plescia said. “(The intent is to) keep them going until their body can mount an effective response. We do that extremely well in this country.”