The first of two Ebola patients to be treated in the U.S. has arrived from Liberia to receive medical attention at a specialized isolation center in Atlanta.
The plane carrying Kent Brantly, a doctor with the charity Samaritan’s Purse, landed today in Georgia. Brantly arrived at Emory University Hospital at 12:30 p.m., where he and a second infected aid worker are to be treated, Bruce Ribner, an infectious disease specialist, said at a briefing there yesterday. Emory said Samaritan’s Purse, based in North Carolina, had asked the hospital to treat the patients.
Liberia is one of three African countries where the deadly virus is raging in the worst outbreak ever recorded. The disease has killed 729 people since March, including at least 57 in the past week, according to the World Health Organization. The WHO announced a new, $100 million push to contain the outbreak yesterday.
That might not be enough to stop the situation from spiraling out of control, the International Federation of Red Cross and Red Crescent Societies said in a statement released today.
“The spread of the virus can only be halted with scaled-up support and coordinated action by all parties,” the group’s emergency health coordinator Panu Saaristo said in the statement. “We cannot continue to turn a blind eye on what is happening in western Africa. Inaction will cause the further spread of this deadly virus across the borders of this remote region, making true our fears.”
No ’Magical Mechanism’
The Red Cross is using money from its emergency fund to deploy a 22-person team to assist in Sierra Leone, the group said.
The facility at Emory is one of only four set up in collaboration with the Atlanta-based Centers for Disease Control and Prevention to deal with highly infectious diseases.
Ebola isn’t spread by “some magical mechanism,” Ribner said in the briefing, adding that the hospital is well designed to handle such cases. Ebola is a virus that infects mainly through person-to-person contact, the spread enabled in Africa as family members provided hands-on care for their loved ones, global health officials have said. The patients aren’t a serious risk to the U.S. public, Emory said in a statement.
The presidents of Sierra Leone, Liberia and Guinea agreed at an emergency meeting yesterday to isolate the border region where the three countries meet, according to an e-mailed statement from Sierra Leone’s health ministry. Police and military will be sent to the area, it said. The leaders also pledged to give incentives to medical staff to persuade them to help fight the virus’s spread.
The CDC, which confirmed the cases are the first ever on U.S. soil, is working with the hospital and transport company to make sure evacuation of the two patients goes safely, Barbara Reynolds, an agency spokeswoman, said by telephone.
“We’re here to make sure the transportation process and the care here in the U.S. ensures there’s no spread,” Reynolds said yesterday. “It’s important to remember this is not an airborne virus, it requires close contact with body fluids. It’s minimal risk as long as the people caring for the patient use meticulous procedures.”
Emory originally expected to receive just one patient, but roughly 20 minutes before yesterday’s briefing, Ribner received word the hospital would get both. The second patient is expected to arrive several days from now, Ribner said.
Flying Isolation Unit
Both will arrive in a non-commercial airplane with a medical isolation unit inside, CDC officials said. After landing, the patients are being transferred to Emory in a specially equipped ambulance staffed by two paramedics, said Alex Isakov, an emergency medical physician.
Emory will treat the patients in a special unit on the hospital’s lower level designed for highly infectious diseases. A patient with the SARS virus once was treated there, but the unit has been used only a handful of times since it was opened 12 years ago.
Staff members have been trained to prevent infectious agents from leaving the unit, and while human waste from the unit will go into the public sewer system, Ribner said there is little risk to the public from that.
Ribner and Isakov said they weren’t aware of what government approvals went into the decision to accept the two patients into the U.S. Ribner said he got a call Wednesday from air transport company Phoenix Air Group Inc. of Cartersville, Georgia, asking if Emory would take one or more patients.
’We Said Yes’
“They asked me, ‘Would we be able to care for these people if they were brought back to the United States?’” Ribner said. “And of course we said yes.”
The Gulfstream jet that Brantly traveled on is owned by Phoenix Air, and is equipped with a special tented isolation unit called an Aeromedical Biological Containment System, according to a statement from the company. The company has received about $214 million in contracts from the federal government since 2008, primarily for air charter services, according to government records. Contracts for charter service with the CDC totaled $14 million.
Palmer Holt, a spokesman for SIM USA, the Christian missionary group that built and runs the Liberian hospital where the two infected U.S. citizens worked, said that returning the patients to the U.S. could help them survive.
“It’s basically Emory University versus a missionary hospital in Africa that just doesn’t have the kind of facilities that they have in the U.S.,” Holt said.
The infected Americans were identified earlier this week as Brantly, a doctor, and Nancy Writebol, an aid worker. They have been treated in Monrovia, Liberia’s capital, the aid group said.
The two patients are in critical condition, according to SIM, and Writebol has been given an experimental serum to help her fight the disease. The treatment hasn’t been identified.
Medical care at Emory may take two to three weeks if all goes well, according to Ribner, speaking during the hospital briefing. It may be “prolonged” if patients suffer any kind of organ failure, he said.
There is no cure for Ebola. Patients are given fluids, blood transfusions and antibiotics to fight off infections that are related to the disease with the hope that their immune systems are strong enough to survive Ebola’s onslaught.
Johnson said the treatment at a medical center such as Emory University Hospital “would provide the additional support to prayerfully return them to full health.” The decision to transfer the two Americans was made by SIM doctors in Liberia, said Bruce Johnson, SIM USA president.
One at a Time
The plane can only carry one patient at a time, according to Holt, and will return to Liberia to transport Writebol.
The decision on who would be evacuated first depended on who needed more advanced care and whether they were stable enough to be moved, Johnson said yesterday.
“Right up to the time of when they will leave our SIM mission compound, that’s in the hands of the attending physician,” Johnson said.
Emory alerted the state of Georgia and the DeKalb County health officials to the incoming patients. Neither government body offered much discussion, Ribner said. “We don’t believe there is any likelihood of secondary cases as a result of these patients coming to the United States,” he said.
Still, Georgia Governor Nathan Deal’s office has received 85 calls and 7 e-mails from people worried about the disease in the state, Sasha Dlugolenski, a spokeswoman, said yesterday. Atlanta Mayor Kasim Reed’s office got about 10 calls from citizens concerned about the plan, spokesman Carlos Campos said.
“It’s important to note it’s out of our jurisdiction,” said Brian Robinson, the governor’s communications director. “This is not an action of the state of Georgia. It’s a mission of the United States.”
The plane carrying Brantly landed at Dobbins Air Reserve Base near Atlanta. Both patients will fly into that airfield, Department of Defense spokesman Rear Admiral John Kirby said at a briefing yesterday.
Faculty members and visitors to Emory, located in a hilly area of stately homes and winding streets, showed little sign of worry yesterday about the arrival of the two Ebola patients.
Lisa Garvin, associate dean of chapel and religious life, said most of the concern is coming from her Facebook friends who live outside of Atlanta. Students seem proud that their school is fulfilling its health and education mission, Garvin said.
“People think it’s cool that Emory’s helping solve a world crisis,” said Jeff Tate, who works in facilities and operations at Emory.
The Reverend Raphael Warnock of Ebenezer Baptist Church said he believes most Atlantans understand that Emory can provide safe care to the two victims.
“I think there are far more people in Atlanta who are proud that this is a place where these kinds of serious medical issues can be addressed,” Warnock said.
As the U.S. prepares to host leaders from about 50 African countries next week in Washington, President Barack Obama said the hosts are taking “appropriate precautions” to ensure Ebola isn’t transmitted to the U.S. via attendees.
“The issue of Ebola, this is something that we take very seriously,” Obama told reporters yesterday at the White House while noting the outbreak is only in “parts of three countries” and not most of the continent. “Keep in mind that Ebola is not something that is easily transmitted.”
Travelers to the summit from the three countries -- Liberia, Guinea and Sierra Leone -- will go through extra screening to make sure they’re healthy both before leaving home and after arriving in the U.S., he said.
Some experimental drugs have shown promise against Ebola in animal tests.
A safety trial could begin next year of an antibody cocktail developed by the National Microbiology Laboratory in Winnipeg, Canada, the U.S. Army and two drug companies, Mapp Biopharmaceutical Inc. of San Diego and Toronto-based Defyrus Inc., said Defyrus Chief Executive Officer Jeffrey Turner.
The National Institutes of Health also is working to quicken the pace of tests for an experimental Ebola vaccine.
David Heymann, a professor at the London School of Hygiene and Tropical Medicine, who has worked on Ebola since the first outbreak in 1976, said that in some outbreaks of the disease there was an attempt to use antibodies from people who had been infected and recovered.
“But that’s still quite risky because there could still be some virus in there,” he said, adding that some antibodies were stockpiled after the 1976 outbreak and potentially in subsequent outbreaks.