2 U.S. Ebola Patients Released From Hospital
By Brenda Goodman, MA
Reviewed by Brunilda Nazario, MD
Aug. 21, 2014 -- Two Americans infected with Ebola as they cared for patients in West Africa have fully recovered and have been discharged from the Atlanta hospital where they were treated, officials said.
"After a rigorous course of treatment and thorough testing we have determined, in conjunction with the Centers for Disease Control and state health departments, that Dr. [Kent] Brantly has recovered from the Ebola virus infection and he can return to his family, his community, and his life without public health concerns," said Bruce Ribner, MD, the infectious disease specialist at Emory University Hospital who supervised his care.
The hospital also announced that Nancy Writebol, 58, was released from the hospital on Tuesday. Writebol and her husband are together at an undisclosed location. She was serving as a missionary for the Christian mission organization SIM, on a joint team with Brantly, when she contracted Ebola.
"There is no evidence of Ebola virus infection in their bodies," Ribner said.
He said there is also no evidence that people who are free from the virus can continue to be carriers of the disease or that their infections could return.
At an emotional news conference at Emory on Thursday, Brantly, 33, thanked the doctors and nurses who cared for him during his illness, the people who helped him get an experimental drug, thousands of well-wishers who have been praying for his recovery, and God.
"Today is a miraculous day. I'm thrilled to be alive, to be well, and to be reunited with my family," he said.
"I'm glad for any attention my sickness has attracted to the plight of West Africa in the midst of this epidemic," he said.
Richard Furman, MD, a retired surgeon and board member with Samaritan's Purse, the organization Brantly was working for in Liberia when he was infected, predicted Brantly will return to Africa.
"I can't say he'd go back to ELWA Hospital, but that's the plan," he said.
Furman said the organization is poised to deploy 23 more young doctors like Brantly to its mission hospitals.
Ribner said that based on 40 years of experience with Ebola infections, he believes it's unlikely that Brantly could catch the same strain again, though he would not be immune to other strains of the disease.
The six doctors and 21 nurses who cared for Brantly beamed and applauded as he finished his remarks. Brantly and his wife, Amber, who is a nurse, hugged each member of his care team before walking through a gauntlet of cameras as they left.
"We need some time together after spending more than a month apart," he said.
Americans Got Experimental Drug
Ribner said he does not know what role, if any, the experimental treatment the two received, ZMapp, played in their recovery.
"They are the very first individuals to ever receive this agent," he said. "Frankly, we do not know if it helped them, if it made no difference, or even, theoretically, if it delayed their recovery."
Since Writebol and Brantly received their doses of ZMapp, two doctors and one nurse in Liberia have received it, according to the World Health Organization (WHO). "The nurse and one of the doctors show a marked improvement," the WHO said. "The condition of the second doctor is serious but has improved somewhat."
A 75-year-old Spanish priest who contracted Ebola in Liberia died despite getting ZMapp.
On Aug. 12, drugmaker Dreyfus reported on its web site that the supply of ZMapp has been exhausted.
Life After the Hospital
Ribner said the decision to discharge Ebola patients is made on a case-by-case basis, but guidelines say blood tests need to show patients are free from the virus and they need to be free of symptoms for 2 to 3 days before their release.
Ribner said they did not test other body fluids, even though studies have shown that in rare cases the virus can live in fluids like semen and breast milk for months after infection.
"That's not a likely mode of transmission," Ribner said.
Also, he said the CDC has developed guidelines for patients to be counseled about the use of prophylactics like condoms and that both patients had been given that guidance.
Ribner said both patients may need some time to regain their strength, but that neither should have long-term complications.
"This is a fairly devastating disease. But most patients, if they have not had any substantial organ damage, will make a complete recovery," he said.
Ribner declined to give specifics of what the medical team had learned by treating the two patients, but said they were in the process of gathering that information. He said he hopes to publish some of the details of their clinical experience in medical journals. The rest will be sent more rapidly to doctors who are working on the front lines of the epidemic.
"We are in the process of developing several new guidelines which will be disseminated to the practitioners in Africa," he said.
SOURCES: Kent Brantly, MD.Bruce Ribner, MD, director, infectious disease unit, Emory University Hospital, Atlanta. Richard Furman, MD, board member, retired surgeon, Samaritan's Purse, Boone, NC. News conference, Emory University Hospital, Atlanta. Atlanta Journal-Constitution: "Spanish priest given access to Ebola drug dies." www.defyrus.com. World Health Organization.