Ebola in the US: Did ‘Patient Zero’ Receive Second-Rate Treatment?

The patient Thomas Eric Duncan, who died in the United States, was prescribed only antibiotics in the emergency room and consequently lost precious time. Experts are calling the lack of the “miracle cure” ZMapp inexcusable.

Thomas Eric Duncan fought for his life for a total of 11 days at the quarantine station of the Texas Health Presbyterian Hospital in Dallas. Then his body, weakened by fever, gave up. The 42-year-old died from the demonic virus on Wednesday morning at 7:51 a.m. local time (2:51 p.m. Central European Summer Time), and will be remembered in the history books as the first documented person to die of Ebola in America.

But after the death of the Liberian citizen, the case seems to be far from finished. The well-known American civil rights activist Jesse Jackson, together with Duncan’s family, has called for a complete investigation into the circumstances that led to the death of the Ebola-infected patient. They have doubts that Duncan received the best and correct treatment, and are threatening to claim damages.

In Texas, meanwhile, there is fear about a second case and about the risk of the disease spreading. Just hours after Duncan’s death, a policeman with typical Ebola symptoms was admitted to the emergency department of Presbyterian Hospital and was quarantined. Sheriff Michael Monnig had been to Duncan’s home a week earlier, and had delivered an evacuation notice to the family along with two other health authority employees.

Incubation Period Is 21 Days

Monnig is said to have spent at least 30 minutes in the two-bedroom apartment where Duncan had fought a high fever for days after the onset of his illness on Sept. 24. Monnig was not wearing protective clothing during his visit. Nevertheless, Monnig later put his clothes in a plastic bag and left them with the authorities for disposal.

It is worrying that the police officer was not included among the group of 48 persons with whom Duncan had contact. The group is being observed by the health authorities with regard to possible symptoms of Ebola. Duncan’s girlfriend, Louise Troh, her 13-year-old son and two nephews who had lived with the Ebola patient in an apartment are considered to be “particularly vulnerable” and after their evacuation will be unable to leave their new apartment until Oct. 19. The incubation period for Ebola is 21 days.

Monnig woke up on Wednesday morning with severe stomach cramps and nausea and initially went to the emergency room of a hospital in Frisco, 30 minutes north of Dallas. There they immediately alerted the health authorities, who moved the man to Presbyterian Hospital. The family, as well as the 18 emergency room employees in Frisco, was placed under observation.

Monitoring at Five Airports

Presbyterian Hospital confirmed in the meantime that Ebola was suspected, but described the possible risk of infection with the deadly virus at this point as “low.” “At this time there is only one person in America who has been diagnosed with Ebola,” said Thomas Frieden, the head of the Centers for Disease Control and Prevention (CDC), in relation to Duncan, adding that there was a need to wait 48 hours until the CDC could be completely sure.*

Frieden has meanwhile announced that the CDC will test passengers from West Africa for possible symptoms at five airports in New York, Chicago, Washington D.C., Atlanta and Newark. Shortly after Duncan’s death, U.S. President Barack Obama announced mandatory fever controls on entry into the United States from the affected areas. Of all the travelers to the U.S. from Liberia, Guinea and Sierra Leone, “these five airports represent about 94, nearly 95, percent,” said CDC Director Frieden.

Thomas Eric Duncan initially entered the U.S. on Sept. 19, flying from the Liberian capital of Monrovia via Brussels to Washington before he flew on to Dallas. A screening of his body temperature was negative. Duncan showed no signs of Ebola infection. The first symptoms occurred four days after his arrival in Dallas. The doctors at the emergency room at Presbyterian Hospital sent the sick man back home with antibiotics due to a suspected “viral-type infection,” although he is said to have told a nurse several times that he was from Liberia.

A New Drug

“All I do know is that Mr. Duncan received late treatment and not the best drug,” said Jackson. “He got sick and went to the hospital and was turned away.” Might Duncan have been saved if he had not been sent back home on Sept. 25 and had gone immediately to the intensive care unit?

Frieden reiterated in a press conference on Wednesday that an early diagnosis is very important. “The earlier someone is diagnosed, the more likely they will be to survive.” In Duncan’s case at least, that did not happen, and this opens up the possibility for the family to claim damages.

“I trust a thorough examination will take place regarding all aspects of his care,” said Troh, Duncan’s girlfriend, in a written statement. But the 54-year-old also wants to know why the Ebola patient was not treated with the “miracle cure” ZMapp. Duncan instead received another experimental drug, Brincidofovir.

No ZMapp in Stock?

ZMapp is considered to be the lifesaver in the case of two U.S. missionary workers, Kent Brantly and Nancy Writebol, who were infected with Ebola this summer in Liberia and were later successfully cured at a clinic in Atlanta. Brantly is said to have additionally received a blood transfusion from an Ebola survivor in Liberia. This is said to have also increased his chance of defeating the virus. Duncan, on the other hand, received neither ZMapp nor a blood transfusion.

The health authorities said that there was a lack of ZMapp and that the drug is currently not available anywhere in the United States. For this reason, Duncan was not treated with it. Marc Siegel, a professor at New York University Langone Medical Center in New York, considers this to be a scandal. “It is inexcusable that while America has been researching Ebola for decades there is a shortage of promising medicine,” he said in a radio broadcast.

“They say that there is no more ZMapp. It’s hard to believe that there’s only enough ZMapp to treat two people in all of America,” said the civil rights activist Jackson. “They tried an experimental drug other than ZMapp which has been used to treat others and it didn’t work.” The U.S. authorities have announced a full investigation into the death and the treatment of America’s first Ebola victim.

*Editor’s Note: The original quote, accurately translated, could not be verified.