In U.S., good medical care leads to high Ebola survival rate

Two weeks after admission to an isolation unit at Bellevue Hospital Center for intensive Ebola care, Dr. Craig Spencer was already on an exercise bicycle pumping toward recovery. Tuesday, after less than three weeks of treatment, he was cured.

It was yet another example of Ebola care and cutting-edge medicine.

Although the sample size is minuscule, the Ebola survival rate in this country is nearly 90 percent, a sharp contrast to survival in West Africa where the epidemic continues to grow exponentially with no end in sight, according to the World Health Organization.

Survival in West Africa is about 63 percent and care relies on a largely ad hoc group of doctors and nurses. Experts expect the death rate to climb as the epidemic continues to unfold in three affected countries: Liberia, Guinea and Sierra Leone.

Eight people have been treated for Ebola in the United States; seven, including Spencer, have recovered within a matter of a few weeks. All have had access to the best medicine can offer. Spencer received antibody infusions, a flood of infection-fighting proteins from an Ebola survivor, doctors say. He was the recipient of antibodies from Nancy Writebol, an American missionary cured in August.

To date, the only U.S. death has been that of Liberian national Thomas Eric Duncan, who succumbed to the infection last month at Texas Health Presbyterian Hospital in Dallas after initially being misdiagnosed in the facility's emergency room. Duncan was sent home with a useless prescription for antibiotics, only to return days later sicker and less likely to survive, experts say.

Two of his nurses, whose protective gear proved insufficient, caught Ebola from Duncan. Both were successfully treated and are doing well.

Despite the U.S.'s overall success in treating Ebola, an enormous problem remains in West Africa. And if cases continue to spiral out of control there, the potential looms for new Ebola hot spots elsewhere in the world, experts say.

"Ebola is not a public health crisis in America," said Dr. Philip Alcabes, a professor of public health at Adelphi University in Garden City. "The Ebola virus is not infectious except through direct contact with a person who is seriously ill.

"Is it a safety issue for nurses and other caregivers? Yes, absolutely. But it is not a crisis for the American public," Alcabes said.

The crisis, he said, is in Africa and, like other experts in global health, he contends that any highly infectious condition is just an air flight away.

Sophie Delaunay, executive director at the Manhattan headquarters of Doctors Without Borders, the humanitarian organization that sponsored Spencer's medical mission to Guinea, Tuesday commended the Bellevue Hospital medical team that treated the young physician. However, she said the toughest challenges remain ahead.

"Tackling this crisis requires a twofold commitment from medical volunteers and the public," Delaunay said. "Upon their return home, health workers must diligently monitor their health condition -- as Craig did -- while the public must not stigmatize and even threaten these volunteers."

Ebola has created an indelible political divide in this country, with some nonmedical pundits claiming that it is a genetically engineered virus.

Dr. Samuel Stanley, president of Stony Brook University and an expert in microbiology, said during a symposium last week that the public should rely only on information from credible sources, such as the Centers for Disease Control and Prevention.

Stanley, who served as the keynote speaker at an Adelphi symposium on Ebola, called for a corps of American doctors to fight infectious diseases around the globe similar to the way groups of Cuban doctors fly to disease outbreaks to provide a trained cadre of medical personnel. About 400 Cuban doctors are in West Africa, according to WHO.

"Global health is America's health," Stanley said. "We can no longer make a separation and think we are safe because of geography."