2 well in U.S., but in Africa aid pleas rise

Ebola victim Dr. Kent Brantly stands with his wife, Amber, during a news conference after being released from Emory University Hospital, Thursday, Aug. 21, 2014, in Atlanta. Another American aid worker, Nancy Writebol, who was also infected with the Ebola virus, was released from the hospital Tuesday. (AP Photo/John Bazemore)
Ebola victim Dr. Kent Brantly stands with his wife, Amber, during a news conference after being released from Emory University Hospital, Thursday, Aug. 21, 2014, in Atlanta. Another American aid worker, Nancy Writebol, who was also infected with the Ebola virus, was released from the hospital Tuesday. (AP Photo/John Bazemore)

The two U.S. health workers who were infected with Ebola in Liberia and treated at Emory University Hospital in Atlanta have been released after having fought off the deadly virus.

Meanwhile, international aid workers in West Africa pleaded for help in getting food and water to people in areas that have been quarantined to stop the spread of the disease.

Kent Brantly, an American doctor who was infected with Ebola in Liberia, was discharged from the hospital Thursday. Nancy Writebol, an aid worker, was released Tuesday, the hospital said in a statement. The two had been evacuated to the U.S. for treatment and are expected to make full recoveries.

"Today is a miraculous day," Brantly said at a news conference in Atlanta. "I am thrilled to be alive, to be well, to be reunited with my family."

As he left the news conference to rejoin his family, he hugged many of the five doctors, 21 nurses and other hospital workers who helped care for him and Writebol at Emory.

"If the hugging transmitted the feeling that we don't think he's contagious, that would be correct," said Bruce Ribner, the physician who led the care of both patients. The decision to release the patients was based on U.S. guidelines that call for a patient to have no virus in his blood and improved symptoms for two to three days, he said.

Brantly and Writebol had been receiving medical care at the Atlanta hospital since early August, after each was flown in on a medical isolation jet from Liberia. Before the flight, each received an experimental treatment developed by San Diego-based Mapp Biopharmaceutical Inc.

It's not known whether the treatment, known as ZMapp, or a blood transfusion that Brantly received from a 14-year-old Ebola survivor played any role their recoveries, Ribner said. The outcomes were improved by the supportive care they received at Emory, he said, including the replacement of fluids and electrolytes and the monitoring of their blood for clotting.

"Limited knowledge of the Ebola virus, especially in our country, has created a lot of fear," Ribner said. "However, we cannot let our fears dictate our actions. We must all care. As grateful as we are today, our work is far from over."

The patients will continue to receive follow-up care. Both are now believed to be immune to the strain of Ebola spreading in West Africa, though not four other known strains, Ribner said.

Brantly will be spending time with his family to "reconnect, decompress and continue to recover physically and emotionally" before sharing more about his experience with the media, he said. He didn't say where he would be going next.

Writebol didn't appear at Thursday's news conference and has been at an undisclosed location since her hospital discharge, the missionary group she was working for in Liberia said in a statement.

"Nancy is free of the virus, but the lingering effects of the battle have left her in a significantly weakened condition," her husband, David Writebol, said in a statement. "Thus, we decided it would be best to leave the hospital privately to be able to give her the rest and recuperation she needs at this time."

Brantly said Writebol asked that he share with the public her gratitude.

"As she walked out of her isolation room, all she could say was, 'To God be the glory,'" Brantly said.

Ribner said Emory is putting together guidelines on what they learned from caring for the two patients that can be shared with health care workers in Africa.

"Because we have the infrastructure our colleagues in Liberia don't have, we have always had a strong feeling the mortality rate of around 50 percent or so wouldn't be our experience," said Ribner.

The World Health Organization has declared Ebola an international public-health emergency.

As of Monday, the virus had killed 1,350 people in Guinea, Liberia, Nigeria and Sierra Leone since the outbreak started in December, according to the Geneva-based agency. That makes it the worst Ebola epidemic on record.

The international response to the outbreak, criticized as being too slow, has since intensified, with several countries quarantining areas that have reported high numbers of infections.

Quarantine measures in the area where Guinea, Sierra Leone and Liberia meet have inflicted "extreme hardship" on more than 1 million people but are essential to contain the spread of the virus, Margaret Chan, the WHO's director general, wrote Wednesday in an editorial in the New England Journal of Medicine.

"No one is talking about an early end to the outbreak," Chan wrote. "The international community will need to gear up for many more months of massive, coordinated, and targeted assistance."

The Ebola virus is spread through direct contact with bodily fluids from an infected person. The virus causes fever, diarrhea, throwing up, muscle pain and, as it progresses, bleeding from the eyes, ears and nose.

There is no approved cure. Standard treatment is to keep patients hydrated, replace lost blood and use antibiotics to fight off opportunistic infections. The goal is for the body's immune system to eventually beat the disease.

Ebola has historically killed as many as 90 percent of those who contract it, with most patients dying from multiple organ failure. The current outbreak has claimed the lives of about 55 percent of the victims.

A World Health Organization panel recently declared that the use of experimental treatments for Ebola patients in West Africa is ethical even though it is not known whether untested treatments such as ZMapp are effective or even harmful. The WHO said five such treatments were being considered for "compassionate use."

The organization said Thursday that two Liberian health care workers who also received ZMapp have shown some improvement, the WHO said Thursday.

In a statement, the international health agency said doctors working in Liberia told them a doctor and nurse have shown "marked improvement" after receiving the experimental treatment. A second doctor being treated with the drug in Liberia remained in serious condition, the statement said, but "has improved somewhat."

The three health care workers received the last known doses of ZMapp, and were the first Africans to receive the experimental medication, which had never been used in humans before it was given to the two American aid workers.

Another patient who received ZMapp, a Spanish priest, later died after being evacuated to his home country.

The medication, made by Kentucky BioProcessing for San Diego-based Mapp Biopharmaceutical, was in extremely short supply, but the Liberian government was able to obtain three doses.

The manufacturer said Aug. 12 that all supplies of the treatment had been exhausted, and that it will take months to produce more. The company has said it is working on accelerating production.

Aid to quarantined

In Liberia on Thursday, government officials handed out bags of rice and sachets of drinking water to residents of an impoverished slum in Monrovia where tens of thousands of people have been quarantined to stop the spread of Ebola.

International aid workers warned that more help is needed as the country battles not only the virulent disease but also hunger as travel restrictions have blocked food from getting to parts of the seaside capital.

In the tense township of West Point, hundreds of residents lined up to receive government provisions a day after authorities put up barbed-wire barricades and enforced a blockade of the area that kept market traders from entering or leaving.

Prices were skyrocketing inside the community on a peninsula, with the price of water quadrupling in a matter of days in the slums where there is no clean running water.

"At the moment West Point is stuck at a standstill and is in an anarchy situation," said Moses Browne, who works for aid group Plan International in Liberia.

"We need food, we need water," he said, appealing for international support. "We're not just fighting Ebola here, we are fighting hunger, too."

On Wednesday, residents of West Point clashed with police and soldiers hours after the neighborhood was sealed off, furious that they were being cut off from markets and jobs. The situation calmed down Thursday, though fears remained about how much food and water would be sent into the half-mile-long peninsula, which houses tens of thousands of people.

By afternoon, hundreds of anxious residents lined up at the food distribution point to await their rations. The World Food Program said it also would begin distributing food in the area in the coming days.

Liberia is being hit especially hard by the dreaded virus that has killed 1,350 people in West Africa, accounting for 576 of the deaths.

Several counties and districts in Sierra Leone and Liberia have been cordoned off, and there are concerns that this is slowing the supply of food and other goods to these areas. The World Food Program is preparing to feed 1 million people affected by such travel restrictions.

Senegal announced late Thursday that it was closing its border with Guinea because of the outbreak, according to a government statement carried by APS, the national press agency.

Several airlines also have suspended flights to the affected countries, despite the WHO's statements that Ebola is unlikely to spread through air travel.

Guinea's president, Alpha Conde, met airline representatives and foreign diplomats Wednesday to reassure them that Guinea is screening passengers leaving the country for fever and other symptoms, in line with WHO recommendations.

Information for this article was contributed by Makiko Kitamura, Shannon Pettypiece and Michael Buteau of Bloomberg News; by Christine Mai-Duc of the Los Angeles Times; and by Jonathan Paye-Layleh, Krista Larson, Wade Williams and Boubacar Diallo of The Associated Press.

A Section on 08/22/2014

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