Two Doctors, One Infected, Recall Their Fight Against Ebola
[post_content]
Disclaimer: This article has been automatically aggregated from
The current Ebola outbreak in the Democratic Republic of Congo (DRC) has brought renewed attention to global outbreak preparedness and the perilous conditions frontline healthcare workers face.
This MedPage Today interview brings together Kent Brantly, MD, who contracted the virus while serving as medical director of an Ebola treatment unit in Liberia, and Linda Mobula, MD, MPH, the physician who treated him. They discuss the harrowing realities of the 2014 West African outbreak, and the nerve-wracking decision to administer an untested, experimental dose of ZMapp in hopes of pulling him back from the brink.
The following is a transcript of their remarks:
Kent Brantly, MD: I remember saying to the nurse who was at my bedside, “I don’t know how much longer I can keep this up, and I don’t know how you’re going to breathe for me when I quit breathing.”
Shannon Firth: Hi there. My name is Shannon Firth. I’m a reporter with MedPage Today. In 2014, Ebola hit West Africa, and from 2014 to 2016, more than 11,000 people died.
Today in this interview, we’ll have a fascinating look back at 2014 where we’re bringing together, probably for the first time, the doctor, Linda Mobula, and the patient — who is also a doctor — Kent Brantly, to talk about the experience of what it was like treating Ebola patients, and for Dr. Brantly, being cared for as an Ebola patient.
So Dr. Brantly, can you just talk about what it was like for you being a physician in Liberia, treating Ebola patients, to suddenly recognize that you were now sick with the virus as well and would be a patient?
Brantly: Sure. Just as a little bit of context, I had moved to Liberia in October of 2013 with my wife and two children, intending to work there at ELWA Mission Hospital long-term. And we did not move there as part of an outbreak response. We were living and working there when the outbreak began and came to our hospital.
I ended up being named medical director of our Ebola treatment unit that was being run by Samaritan’s Purse. I think we treated roughly 20 patients who tested positive for Ebola, but of those 20 patients, we had only one survivor. The other 19 or more had died.
So I woke up on Wednesday, July 23, 2014, not feeling well, had an upset stomach, a little bit of diarrhea. But by that afternoon, I had taken multiple malaria tests that were negative and I began to develop a fever and I didn’t want to believe that it was Ebola. I really hoped that I had malaria. And over the course of the next 10 days or so, my condition deteriorated dramatically with all of the same symptoms I had seen in my patients who had died.
Firth: And Dr. Mobula, what was it like for you coming to Liberia, and when was it that you first learned that Dr. Brantly was sick?
Linda Mobula, MD, MPH: Thank you, Shannon. I arrived 1 to 2 days after Kent had developed symptoms, and I was informed that he had developed symptoms as soon as I arrived at the Ebola treatment unit. And his temperature was higher, his rash was getting worse. His heartbeat was fast, he was tachycardic, and just his mental status wasn’t the same.
He had the presence of mind to call me, but I could tell just clinically that he was getting worse. I called Lance Plyler, who was actually getting ready to administer ZMapp to Nancy Writebol.
Brantly: And Nancy was not a healthcare worker, but she volunteered to fill the role of hygienist. So neither one of us really knew how we contracted Ebola, but we made that decision to give Nancy the first dose because it was logical. She was older, she was more vulnerable, and so that was my thought process: I’m younger and I have a better chance of surviving this with no treatment.
I remember saying to one of our colleagues, one of us is going to die. There’s no way that she and I are both going to survive this. Just statistically speaking, one, if not both of us are not going to survive.
Mobula: It had been Kent’s decision to have Nancy receive that first dose, and there was only one clinical course of treatment, so three doses that we had in Liberia. And we made a quick decision to give the ZMapp to Kent instead.
I was very nervous because there had only been data from animal studies, but it had never been used in a human being before. And as I was administering the dose to him via his intravenous line, I had to count the number of drips that were going in per minute, and I was very nervous, thinking if I get this wrong, something bad could happen.
After we completed his treatment, he was able to get up and walk 2 hours after he received ZMapp. And in my view —
Brantly: Which I hadn’t been able to do for days.
Mobula: You had been lying in bed for days, but that next morning you were a different person and you were stable enough to fly to Atlanta.
Brantly: Yeah. As Linda said, my condition stabilized after that first dose of ZMapp. I was not better though. It was not like I was suddenly well. I was still very sick and that flight was very difficult. I was very dehydrated, super thirsty. I was still having a lot of diarrhea. It was a really difficult trip.
Firth: When did you know that you were out of the woods, that you were going to make it?
Brantly: I could tell you it was not immediate. Being evacuated, I felt a great sense of relief. It wasn’t because I knew that I was going to survive at that point. It was because I thought at least if I die, I’m going to be near my family.
The first couple of days in Atlanta were still a little touch-and-go.
Firth: Do you recall anything specific about being under the care of Dr. Mobula? Any interactions that you remember?
Brantly: Honestly, I would not have been able to pick Linda out of a lineup. I had never met her before except when she was caring for me and all I could see was just her eyes.
I do remember the first time I met Linda after the fact. My wife tapped me on the shoulder and I turned around like, “What? I’m talking to people.” And she said, “Kent, this is Linda.”
I’m so thankful for you, Linda. Thank you for taking care of me. And I’m grateful for these 12 years of friendship we’ve had since then.
Mobula: Thank you, Kent. Thank you for taking care of those patients. You were one of the first physicians that responded to the outbreak in Liberia.
Firth: So powerful. I want to ask you both, looking now at the current outbreak in the Democratic Republic of Congo — what lessons from the 2014 outbreak are being applied, and are there things that we’re missing?
Brantly: From my perspective, there are a lot of similarities between this outbreak and the 2014 West African outbreak in the way that this outbreak has started. It was detected late. It’s got all of the markings that were concerning in West Africa. And it’s a different strain than has caused most of the other big outbreaks of the past. And so there aren’t any targeted treatments or vaccines for this strain of Ebola. It feels like we’re stepping back a dozen years.
Mobula: I think it’s really important to listen to these communities and to consider lessons learned, having trust in public health practitioners and clinicians, the community will not participate in the response and the response will not be effective.
for informational purposes only. We do not claim ownership, accuracy, or liability for the content provided. All rights belong to the original publisher.