Survival Rate Appears to be Higher in the West
Oct. 7, 2014
The Case Fatality Rate of Ebola (see West
African Ebola - What is the true Case Fatality Rate?) has been
estimated by the
WHO at around 60% during this West African outbreak. In previous
fatality rates as high as 90% had been observed. According to the
medical experts there is no treatment for the disease and all they can
do is treat symptoms of the disease as the virus multiplies wildly
within its host. The only potential control on this deadly viral
multiplication is the body's own Ebola-activated immune response. Those
patients who survive do so because their immune system is able to fight
off the virus, rather than because of any specific medication they are
given. This was the conventional wisdom, at least at the start of this
However the scanty data available from Ebola treatment in the West
during this outbreak appears to suggest at a minimum that immune
systems do much better in
Western hospitals than in their Mano River Union counterparts. A clear
majority of the
Ebola-infected in this outbreak who have been transferred to treatment
centers in the West have been able to survive their infection.
U.S. health workers Kent Brantley and Nancy Writebol
contracted Ebola in Liberia in July. They were repatriated to
the U.S. and have since recovered. Dr Rick Sacra, working for the
WHO contracted Ebola in Liberia, was repatriated to the U.S. and was
declared Ebola-free on Sept. 25 by the Nebraska Medical Center.
Liberian Eric Duncan, who travelled to the U.S. after contracting
Ebola in his native land is currently fighting for his life in a Texas
hospital. A fifth Ebola patient, a cameraman working for the US TV
company NBC has just been flown to the US for treatment. Kent Brantley
and Nancy Writebol were given the experimental drug Zmapp; supplies of
this have now been exhausted. Rick Sacra was reportedly given blood
donated by the first US Ebola survivor, Brantley, which would have
contained antibodies to the virus.
British nurse William Pooley was flown home in August from Sierra
Leone, where he had contracted Ebola. He has recovered after being
treated with Zmapp.
A Senegalese man working for the WHO contracted Ebola in Sierra Leone
in August and was sent to the University Medical Center, Hamburg, for
treatment. He has since recovered. A second Ebola patient is now being
treated in Frankfurt.
A French volunteer nurse for MSF in Liberia contracted Ebola and was
evacuated to a
hospital near Paris. She has
recovered and has left the hospital, the French health ministry said in
statement. She was given the experimental drug, Avigan (also called
Favipiravir), an anti-influenza drug manufactured by the Japanese
company Fujifilm. There are reports that France and Guinea are now
considering clinical trials of this drug, which is reportedly also
being given to the second Ebola patient in Germany.
In these four countries, all six patients whose outcomes have been
determined have survived. Among Western countries, however, Spain has
not been as effective in treating Ebola. Miguel Pajares, 75, died in
August in Spain after contracting the virus
in Liberia. He was reportedly also treated with Zmapp.
Manuel Garcia Viejo, 69, died in the hospital Carlos III de
Madrid on 25 September after catching Ebola in Sierra Leone.
So, from Ebola patients in the West whose outcomes are known, the
Case Fatality Rate, CFR, appears to be 2/8 or 25%. The survival rate is
Closer to home, during the Nigerian outbreak, which appears thankfully
to have been brought under control, the CFR, at 40% was noticeably
lower than it has been in Sierra Leone, Guinea and Liberia.
How are these countries managing to save more Ebola patients than we do
here in the Mano River subregion? Have the experimental drugs played a
role? Could hospital procedures and
techniques play an important and, as yet, little understood role in the
survival of Ebola-infected? In this regard, a look at Case Fatality
different Ebola treatment facilities should provide important clues.
When one looks at the CFRs of Ebola patients at the Kenema treatment
center and at the MSF facilities (West
African Ebola - What is the true Case Fatality Rate?)
one sees figures that are
substantially different. These particular facilities, operating in the
same region, have treated
hundreds of patients drawn from the same region and a closer
convergence of CFRs would be expected
from such a large sample. These sorts of differences should be the
subject of further, detailed study and would perhaps provide
significant clues as to the most efficacious treatment for Ebola.