Better Staffing Seen as Crucial to Ebola Treatment in Africa

NEW YORK TIMES                               Nov. 1, 2014

By Denise Grady

...The stark difference in the care available in West Africa and the United States is reflected in the outcomes...., In West Africa, 70 percent of people with Ebola are dying, while seven of the first eight Ebola patients treated in the United States have walked out of the hospital in good health. Only one died: Thomas Eric Duncan, a Liberian, whose treatment was delayed when a Dallas hospital initially misdiagnosed his illness.

Dr. Rick Sacra, a missionary who was infected with Ebola in Liberia and was successfully treated at the Nebraska Medical Center. Credit Brendan Sullivan/Omaha World-Herald, via Associated Press

The survival gap can and should be narrowed, experts say, and they agreed that the single most important missing element is enough trained health workers to provide the kind of meticulous intensive care that saved Dr. Sacra and the others treated here. West Africa is starved of doctors, nurses, hospitals and equipment, so more outside help is urgently needed, they said....

Doctors say the key to surviving Ebola, and what has saved the patients in the United States, has been a higher level of “supportive care” to treat deadly symptoms like severe fluid loss and organ failure. That means the patients received intravenous fluids and salts to replace what they lost through vomiting and diarrhea, a fluid loss that can reach five to 10 quarts a day during the worst phase. Without the fluids, blood pressure can crash, and the patient can quickly go into shock and die....

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