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Doctors Working to Save Third American With Ebola

By Brenda Goodman, MA
WebMD Health News

Reviewed by Brunilda Nazario, MD

Sept. 3, 2014 -- The third American infected with Ebola will be coming back to the U.S., although it is not yet known when that will be, says Kristen Nordlund, a CDC spokesperson.

The doctor, identified Wednesday as 51-year-old Rick Sacra, MD, will be transported in an aerobiomedical containment system, otherwise known as "the pod," Nordlund says. The State Department and SIM USA, the missionary group Sacra was working with, have contracted with Phoenix Air to transport Sacra. Phoenix Air also transported two other American patients infected with the Ebola virus.

It is not yet known where Sacra will be hospitalized. The two other American patients, Kent Brantly, MD, and Nancy Writebol, were treated and released from Emory University Hospital. The hospital houses a special isolation unit for people with infectious diseases.

SIM USA president Bruce Johnson said at a press conference Wednesday that Sacra was clad in protective gear as he delivered babies at ELWA Hospital in Liberia -- and he was not treating patients known to have the virus.

Public records show Sacra is a family practice physician from Holden, MA. He and his wife, Debbie, have three children.

Sacra has been working with SIM since the late 1980s, Johnson said. He volunteered to go back to Liberia a month ago after he heard that his colleagues Brantly and Writebol had caught the disease.

In an interview with NBC, Brantly described Sacra as "a dear friend."

Johnson said Sacra's point of contact with the Ebola virus isn't yet known, though staff members at ELWA Hospital are working with CDC investigators to figure out how he got sick.

"They check patients at our hospital before admittance for Ebola symptoms," Johnson told reporters. "There's a strong possibility that the Ebola symptoms were masked."

Sacra is being treated at the Ebola isolation ward at ELWA Hospital, a 35-bed facility that's overcrowded, according to Will Elphick, country director for SIM Liberia, who also spoke at the news conference.

Despite the cramped conditions, Johnson said Sacra is getting excellent care and is in good spirits. "Many of those who are caring for Rick are those he has taught and mentored in his medical practice," he said.

While there are currently no firm plans to bring him back to the U.S., Johnson said the organization was "exploring all opportunities and options."

When asked if Sacra might receive a dose of the experimental drug ZMapp, Johnson said it was his understanding, based on news reports, that there is no more ZMapp in the world. Mapp Biopharmaceuticals, the company that developed ZMapp, released a statement last month saying supplies of the medication are exhausted.

So far, seven health care workers are known to have received doses of ZMapp, a 12-hour infusion of Ebola-fighting antibodies. Two have died, despite treatment. The latest to get the drug was British nurse William Pooley, who was discharged from a London hospital Sept. 3.

While it's not clear if the drug helped, the BBC reported that his doctors said the levels of Ebola virus in Pooley's blood fell after treatment. And last week, a study of 18 monkeys infected with Ebola showed all survived after they received the drug.

On Sept. 2, the U.S. Department of Health and Human Services announced it had awarded a $25 million contract to Mapp Biopharmaceuticals to speed up the testing and making of ZMapp.

A Survivor Breaks Her Silence

Shortly before SIM released details of Sacra's condition, Nancy Writebol, a missionary with SIM, spoke to reporters for the first time, describing her own "dark days" with Ebola. Writebol was brought back to the United States for treatment in August and has since recovered.

"When we got to the airport, I really was very, very sick, and pretty much in and out of it. The only way they could get me on the airplane was to put me on the baggage conveyor belt," she said, laughing. "I could feel the movement of what was happening."

As she waited to board the specially equipped aircraft that would carry her home, Writebol said she recalled thinking, "I don't even know if I'm going to make it back to the U.S."

Once at Emory University Hospital, in Atlanta, doctors told her that because of lingering pain she was feeling in her legs and feet, she might need special treatment in a rehabilitation hospital after she was released from isolation.

"They didn't know if I was going to be able to walk," she said.

But one day, Writebol said, she was determined to take a shower and started to climb off the bed to get to the bathroom. Nurses on duty stopped her and helped her.

"Oh, that shower was wonderful," she said. Each day after that, her legs got stronger.

Writebol said she is often asked what she believes saved her -- whether it was returning to the U.S. for treatment, an experimental medication, her deep faith, or the supportive care she received from doctors in Liberia.

"My answer to that question is all of the above," she said.

"God uses means. God uses doctors, and I can tell you again, amazing doctors. God uses experimental drugs. We don't know whether the ZMapp helped. We don't know. We don't know if it was the supportive care. The supportive care was very, very necessary," she said.

"All of those things played a part in saving our lives."

SOURCES: Bruce Johnson, president, SIM USA, Charlotte, N.C. Will Elphick, Country Director, SIM Liberia, Charlotte, N.C. Nancy Writebol, missionary, SIM USA, Charlotte, N.C. News conference, SIM USA. Kristen Nordlund, CDC spokesperson.

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