Wednesday, May 23, 2018

U.S. doctor who had Ebola leaves Atlanta hospital

ATLANTA — To evaluate the condition of Dr. Kent Brantly, the American aid worker who became the first person to be treated for Ebola in the United States, all anyone needed to do Thursday was notice what he was not wearing.

Gone was the bulky white suit he had been put in upon his arrival on Aug. 2, amid heavy security, at Emory University Hospital here.

Instead, appearing trim and vibrant and wearing a button-down shirt and slacks, Brantly stood before reporters as he prepared to leave Emory after his doctors declared him recovered from the virus he contracted while working in Liberia.

"Today is a miraculous day," Brantly, his wife at his side, said in a steady voice that wavered when he thanked his health care team. "I am thrilled to be alive, to be well and to be reunited with my family."

Emory said Thursday that Brantly, who lived in Fort Worth, Texas, before going to Liberia, and Nancy Writebol, a missionary from Charlotte, N.C., who also contracted Ebola while in Africa this summer, had been released from the hospital's specialized isolation unit this week.

Writebol, who did not appear before reporters, was released Tuesday, but the hospital did not announce her discharge until Thursday morning. Her husband, David Writebol, said in a statement that "the lingering effects of her battle have left her in a significantly weakened condition" that required additional rest without an onslaught of public scrutiny.

Emory officials, whose decision to admit Brantly and Writebol prompted questions about whether their arrivals could spread the virus in the United States, on Thursday defended their actions.

"We understand that there are a lot of questions and concerns regarding Ebola virus and the infection that it causes," said Dr. Bruce S. Ribner, the Emory infectious diseases specialist who coordinated the treatment of Brantly and Writebol. "However, we cannot let our fears dictate our actions. We must all care."

Ribner said it was "the right decision" to evacuate the patients to Emory from Liberia, both because they could receive superior care in the United States and because the lessons learned in treating them could eventually assist doctors treating patients on the front lines.

Emory doctors were able to carefully monitor levels of electrolytes in the patients, as well as any abnormalities in their blood clotting, Ribner said.

It will be difficult, though, to apply such guidance in West Africa. Joanne Liu, president of Doctors Without Borders, said in an interview Tuesday that patients in their treatment centers received only a single blood test — a screening for the Ebola virus — between admission and death or recovery. There were no tests for electrolytes or clotting factors, she said, because it is simply too risky to handle the blood of Ebola patients, especially in conditions where doctors and nurses are stressed and overworked from an outbreak that has killed more than 1,200 people.

Even if electrolytes cannot be easily measured in the emergency field hospitals, Ribner said, the Emory experience showed the importance of replacing lost electrolytes in patients suffering from Ebola.

Ribner said there was no virus in Brantly and Writebol's blood and that they no longer had any symptoms. "We are confident they pose no public health threat," he said.

They are now considered immune to the Zaire strain of the virus, which is present in this outbreak. Assuming the two make a normal recovery, they would probably not be at risk for infection if they resumed caring for patients, Ribner said. They would be less protected against the four other strains of the virus.

Neither Brantly or Writebol have discussed what they plan to do next.

Although Ribner conceded Thursday that doctors "didn't know what to expect" about how Brantly and Writebol would fare in the United States, he said Emory officials had "always suspected that we had a good chance of helping these patients survive."

It remained unclear whether an experimental drug the two received while still in Africa had aided in their recoveries.

"Frankly, we do not know whether it helped them, whether it made no difference or even, theoretically, if it delayed their recovery," Ribner said.

But Thursday, Brantly focused on thanking the five doctors specializing in infectious diseases, the 21 nurses and many other sub-specialists Emory said were involved in caring for him and Writebol.

And then, before he hugged teary-eyed members of his medical team who stood behind him during his statement, he said, "Above all, I am forever thankful to God for sparing my life and I'm glad for any attention my sickness has attracted to the plight of West Africa in the midst of this epidemic."

 
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