The two Ebola virus patients coming to Emory University Hospital from Liberia — one is expected to arrive Saturday — pose no threat to the general public, federal health officials and infectious disease experts said Friday.
Even so, plans to treat the gravely ill American aid workers in Atlanta sparked concerns, and in some cases outrage, among many metro-area residents. Experts say people shouldn’t be concerned because Ebola is not transmitted through the air, as with other viruses like flu.
“Ebola, because it’s an exotic disease and something that’s rare – certainly unknown here in the United States – it can be frightening,” said Barbara Reynolds, a spokeswoman for the Atlanta-based U.S. Centers for Disease Control and Prevention. “It would take close personal contact of an exchange of body fluids for someone to become infected with Ebola.”
Officials also said that evacuating Dr. Kent Brantly and missionary Nancy Writebol to a U.S. facility is their best chance of survival.
The two remained in serious condition Friday, according to the North Carolina relief organization, Samaritan’s Purse, Brantly works for. They were expected to arrive at Dobbins Air Reserve Base in Cobb County. (Emory would not identify the two patients, citing privacy concerns.)
While there is no cure for Ebola, improving the patients’ level of care may markedly improve their chances, said Dr. Bruce Ribner, the infectious disease specialist at Emory who will be treating them.
“The body has to be given a chance to live long enough to kill the virus,” Ribner said.
Simply monitoring the patients’ level of hydration accurately and watching for bleeding are part of that effort, he said. The survival rate for the current Ebola outbreak has been around 40 percent.
Brantly and Writebol contracted Ebola while working in Liberia — one of three African nations stricken by the worst known outbreak of the disease. Identified in March, the virus has claimed 729 lives and shows no signs of abating, according to the World Health Organization. Another 1,323 confirmed or suspected cases have also been reported.
Leaders of the West African nations under siege by the virus were set to meet with WHO on Friday to discuss a $100 million plan to deploy hundreds more medical professionals to the ravaged region. Sierra Leone and Liberia have also announced emergency measures, including closing schools, conducting house-to-house searches for infected people and deploying the army and police.
‘This is supposed to make us feel better?’
The impending arrival of the two American aid workers has raised worries among residents about how officials plan to prevent the disease from spreading and why the Ebola patients are being brought here in the first place.
They will be treated in a special isolation unit built by Emory in collaboration with the CDC. The unit, one of only four of its kind in the country, is located away from other patients. (The other units are in Nebraska, Montana and Maryland.)
That doesn’t make Atlanta resident Mercy Wright feel any better, especially considering the recent safety lapses at the CDC in handling anthrax and a dangerous strain of flu.
“This is supposed to make us feel better?” Wright said. “The CDC, which already is mismanaging its supplies of dangerous diseases, is now entrusted with the most dangerous virus of them all?”
People have a right to be uncomfortable with the decision to bring the patients here, said Dr. Ford Vox, who works with brain injuries, not infectious diseases, but has ties to Emory.
“As a medical professional, I don’t have confidence in any hospital — even a unit run in collaboration with the CDC such as Emory’s — as having absolute safety,” he said.
Dr. Ribner, CDC officials and other infectious disease experts say there is little risk to the public of bringing the Ebola patients to Atlanta.
In fact, there is nothing about Ebola that necessarily requires the use of such a specialized treatment unit like the one at Emory, said Reynolds, the CDC spokeswoman, in an interview with The Atlanta Journal-Constitution Friday.
“Ebola is a viral disease that is not transmitted from person to person through the air,” Reynolds said. “We have other diseases that can be quite frightening and deadly that do transfer through the air.”
The virus is instead passed through bodily fluids. A person with Ebola, which is a type of hemorrhagic fever, can’t infect others until he is showing signs of the illness, such as vomiting or diarrhea, she said.
‘Under strict protocols for infectious diseases’
Flying Americans home after contracting diseases in foreign countries isn’t new.
Special resources were used in both the SARS outbreak of 2002 and the Marburg Viral Hemorrhagic Fever outbreak in Angola in 2009 to bring Americans back to the states while still protecting the community at large, according to the U.S. Department of State.
“The safety and security of U.S. citizens overseas is our highest priority,” the agency said in a statement. “These are U.S. citizens who are returning to the United States for medical care. They are being returned under strict medical protocols for infectious diseases.”
There have been at least five cases in the U.S. of people who suffered from other types of hemorrhagic fever, not Ebola, and were successfully treated without any secondary transmission, Reynolds said.
“The health care system worked,” she said.
Bringing the patients here is probably the right thing to do, said Richard Ebright, a biosafety expert at Rutgers who has been critical of the CDC’s safety lapses in handling dangerous disease samples. For one thing, Ebright said, it’s a humanitarian gesture that is also an opportunity to test out technologies developed for isolating and transporting these patients.
And though Atlanta residents may not be enthusiastic about the situation, they shouldn’t be overly concerned, he said. It’s a high-profile case and every precaution will be taken, Ebright said.
“None of the carelessness that has happened with the low-profile, routine, ongoing day-to-day laboratory operations at the CDC and CDC-regulated labs should be expected to occur in a case like this,” he said. “Management will be on top of this.”
‘Rest assured that all eyes are on the CDC’
The Emory doctors, Ribner and an emergency medical specialist, Alexander Isakov, said the patients were expected to arrive separately. When they do, Isakov will set out to meet the plane with a specially equipped ambulance.
Medical waste coming out of the unit will be sterilized, but the patients’ personal wastes will go into the county sewage system just like any other patient’s. That is safe and standard protocol even for viruses like this one, Ribner said, as the standard county sewage treatment is strong enough to eliminate any danger.
Ribner added that he is not concerned about being infected as a health care worker caring for an Ebola patient, as these patients themselves were.
It’s logical that the patients would be brought to Atlanta because the CDC is there, said U.S. Sen. Johnny Isakson, R-Ga. They’re also American citizens, he said. “If I got ill overseas and needed that care that was highly specialized, I would hope that my country wouldn’t not let me back in.”
Isakson added that he’s been in touch with CDC Director Tom Frieden and has full confidence in the CDC.
“I’m following this on a daily basis with the CDC,” he said. “People can rest assured that all eyes are on the CDC and all eyes are on these two patients to make sure everything is done properly.”