You must have been wondering why some people survive Ebola and some don't. Well it is certain for now that There is no cure for Ebola. So why have some patients walked away healthy while others in the West died?
Dr. Kent Brantly, Nancy Writebol and Dr. Rick Sacra all contracted the disease while working in Liberia -- and all survived.
Spanish nurse's aide Teresa Romero Ramos got the virus while tending to stricken patients. She too lived.
unLike some patients , Thomas Eric Duncan and Spanish priest Miguel Pajares also
received treatment in the West. Yet they died.
While there might not be a single, conclusive answer, a series of factors may contribute to survival.
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Early, high-quality treatment
This may be the most critical factor in beating Ebola.
The survivors in the
United States all have one thing in common -- they were rushed to two of
the country's four hospitals that have been preparing for years to
treat a highly infectious disease such as Ebola.
Brantly and Writebol were
successfully treated at Emory University Hospital in Atlanta; Sacra was
released from the Nebraska Medical Center in Omaha.
Duncan didn't go to one
of those four hospitals. He went to Texas Health Presbyterian Hospital
in Dallas with a fever and told them he'd recently returned from
Liberia. Yet the hospital initially sent him home with antibiotics.
Then, after he returned
to the hospital much more ill, two nurses became sick with the virus.
They have since been moved to more specialized facilities such as Emory
and the National Institutes of Health in Maryland.
But that doesn't mean patients are doomed just because they go to a different hospital.
"Keep in mind that this
is still a very deadly disease," said Dr. Sanjay Gupta, CNN's chief
medical correspondent. "In West Africa, the mortality rates are above
60%. I think it is better in the United States. But they're not going to
be zero, I think no matter where somebody is."
Quick rehydration
After finding a hospital capable of treating Ebola, those who survive are usually rehydrated quickly.
"The most important care
of patients with Ebola is to manage their fluids and electrolytes, to
make sure that they don't get dehydrated," said Dr. Tom Frieden,
director of the Centers for Disease Control and Prevention. "And that
requires some meticulous attention to detail and aggressive rehydration
in many cases."
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And if an infected patient getting proper care normally has a strong immune system, the chance of surviving goes up.
But what may seem basic
in the United States can be difficult to come by in West Africa, where
Ebola has already killed more than 4,500 people -- largely because
access to health care is limited.
Yet Nigeria has successfully eradicated Ebola from the country, the World Health Organization said Monday.
Unlike in Guinea,
Liberia and Sierra Leone -- the combined epicenter of the oubreak -- all
identified contacts in Nigeria were physically monitored every day for
21 days, WHO said.
Plasma transfusions
Three Ebola patients --
Sacra, NBC cameraman Ashoka Mukpo and Texas nurse Nina Pham -- all
received plasma donations from Brantly. And all three have survived.
The theory is that Brantly's plasma contains the antibodies necessary to fight the virus.
"It's very fortunate
that the three patients I've been able to donate to, they and I share
the same blood type," Brantly told CNN's Anderson Cooper.
"I'll keep doing it as much as it's needed, as much as I can."
There was some
controversy about why Brantly didn't give plasma to Duncan. But the
problem came down to blood type, Texas Health Presbyterian Hospital
said.
Experimental drugs
Medication that hasn't
gone through clinical trials can be risky. But with a mortality rate of
50% in the current Ebola outbreak, a WHO panel said it is ethical to
offer drugs to fight the virus -- even if their effectiveness or adverse
effects are unknown.
The experimental drugs at the center of this Ebola outbreak are ZMapp, Favipiravir, Brincidofovir and TKM-Ebola.
Brantly and Writebol both took ZMapp, and both survived. But Pajares also took ZMapp, and he died.
The director of Emory's Infectious Disease Unit cautioned against viewing ZMapp as a surefire cure.
"They are the very first
individuals to have ever received this agent," Dr. Bruce Ribner said.
"There is no prior experience with it, and frankly, we do not know
whether it helped them, whether it made no difference, or even,
theoretically, if it delayed their recovery."
Spanish nurse's aide
Teresa Romero Ramos took the anti-viral drug Favipiravir and also
received antibodies from a survivor in West Africa. She is now free of the virus.
In addition to getting a
blood transfusion, Sacra received an experimental drug called
TKM-Ebola, which the Food and Drug Administration recently approved for
wider use.
Duncan took a different untested drug, Brincidofovir. But he didn't receive it until six days after being admitted to the Texas hospital. Had he taken it earlier, the outcome might have been different.
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