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British Ebola Patient Discharged From Hospital W.H.O. Concerned About Another Ebola Cluster in Nigeria
(about 9 hours later)
PARIS — A British nurse who contracted Ebola in West Africa has fully recovered and was discharged on Wednesday, the Royal Free Hospital in London said. The World Health Organization expressed worry on Wednesday about a second cluster of Ebola virus patients in Nigeria — in the center of its oil industry — because one of the three confirmed victims was a doctor who had treated patients and socialized after he became contagious.
The nurse, William Pooley, 29, contracted the disease in August while volunteering in Sierra Leone. He was flown to London for 10 days of treatment at the Royal Free Hospital, which has the only high-level isolation unit in Britain, the hospital said in a statement on its website. The doctor, in the southern city of Port Harcourt, died on Aug. 22, and his infection was confirmed five days later. On its website, the W.H.O. said that more than 200 people might be at risk.
Mr. Pooley was treated with the experimental drug ZMapp, although it is not known whether the drug contributed to his recovery. The W.H.O. said this second cluster had indirectly resulted from a quarantine lapse in the first cluster of Ebola cases that hit Lagos, the capital, in July, and was potentially far more serious. Tracing the spread of the disease in Port Harcourt, the statement said, revealed “multiple high-risk opportunities for transmission of the virus to others.”
In a separate statement from the hospital, Mr. Pooley said he counted himself fortunate to get the treatment he had received in London when compared to what he had seen while working in West Africa. Ebola has primarily afflicted three countries in West Africa — Guinea, Liberia and Sierra Leone — where hundreds of people have died in recent weeks in what W.H.O. officials have called the worst outbreak of the disease ever recorded. While the toll in Nigeria has been far more limited, officials are particularly worried about it because it is Africa’s most populous country.
“I was very lucky in several ways,'’ he said. “The standard of care I received was a world apart from what people are getting in West Africa, despite the best efforts of the health care workers out there. I’ve got friends who are sick at the moment and there is such a contrast.” The W.H.O. has been criticized by some other medical advocates for what they call its initial failure to mobilize adequately against Ebola when the outbreak surfaced in West Africa months ago.
ZMapp attracted global attention in August when it was used to treat two American aid workers who recovered after contracting Ebola in Liberia. The Lagos cases were traced to a traveler from Liberia, and Nigerian officials thought they had basically contained the spread. But the health organization’s statement said one person in Lagos escaped a quarantine in early August and sought treatment from a doctor in Port Harcourt, nearly 400 miles away. That doctor became infected and developed symptoms after a few days, was hospitalized on Aug. 16 and died of Ebola less than a week later.
Doctors at the time said it was not possible to know whether ZMapp was responsible for their recovery, but it nevertheless helped spur a debate about who should receive the drug, which is in short supply. The potential role of ZMapp in the aid workers’ recovery prompted calls to scale up production of the drug and to provide it to more patients, possibly in the form of clinical trials. Even as he developed symptoms, the statement said, the doctor “continued to treat patients at his private clinic, and operated on at least two.” Moreover, the statement said, before he was hospitalized the doctor “had numerous contacts with the community, as relatives and friends visited his home to celebrate the birth of a baby.”
Dr. Michael Jacobs, an infectious diseases specialist at the Royal Free Hospital who treated Mr. Pooley, said that Mr. Pooley had made a complete recovery and that there was no risk of infection to the public. It said visitors to his hospital room had included members of his church who performed a healing ritual that could have exposed them as well.
More than 3,500 cases of Ebola have been confirmed and more than 1,500 have died so far in the latest outbreak, the most extensive since the disease was first identified in 1976. A majority of the cases have occurred in three countries in West Africa – Sierra Leone, Liberia and Guinea. The other two confirmed cases in Port Harcourt are the dead doctor’s wife, who is also a doctor, and another patient at the same hospital. The W.H.O. statement said that epidemiologists were monitoring “more than 200 contacts” and that 60 were considered especially vulnerable.
ZMapp is made up of antibodies that are first harvested from mice exposed to a key Ebola protein. The antibodies are then genetically modified to make them more like human antibodies. The resulting antibodies are then manufactured in genetically engineered tobacco plants. It said the Ebola outbreak in Port Harcourt had “the potential to grow larger and spread faster than the one in Lagos.”
The primary developer of the drug is Mapp Biopharmaceutical, which is based in San Diego. Discovered in 1976, Ebola is an aggressive virus that causes high fevers, extreme weakness and internal bleeding, with a fatality rate as high as 90 percent.
In an study published in August by the science journal Nature, 18 monkeys exposed to a lethal dose of the Ebola virus survived after being given ZMapp, even when the treatment started five days after infection. The study was greeted with cautious optimism by some experts, who said that the results raised hopes that the drug could work on people. In Washington, the head of the W.H.O., Dr. Margaret Chan, said Wednesday at a news conference that there had been at least 3,500 Ebola cases, with more than 1,900 deaths. She called the outbreak “the largest and most severe and most complex we’ve ever seen in the nearly 40-year history of this disease.”
Last week, the organization, based in Geneva, said Ebola could afflict more than 20,000 people before it was brought under control.