Third American With Ebola Evacuated to Nebraska

By Brenda Goodman, MA
WebMD Health News

Reviewed by Arefa Cassoobhoy, MD, MPH

Editor's note: This article was updated on Sept. 5, 2014.

Sept. 4, 2014 -- A doctor who became infected with Ebola while treating sick patients in Liberia has arrived at a Nebraska hospital for treatment.

Local news stations in Omaha saw an ambulance carrying Rick Sacra, MD, a missionary with the charity group SIM USA, arrive at Nebraska Medical Center around 6:40 a.m. local time. Reporters could not see Sacra as he was hustled into the building, the Associated Press reported.

He'll be treated in the hospital's 10-bed biocontainment unit, which was designed in consultation with the CDC. The isolation unit is one of four in the U.S. that are specially equipped to handle highly infectious patients. More than 30 doctors, nurses, and support staff will care for Sacra.

It will be the second time since the unit opened in 2005 that it has been activated. The first patient to be treated there was a suspected case of Ebola that turned out to be malaria, the hospital said.

His wife, Deborah Sacra, briefly spoke to reporters at a news conference on Thursday.

"I just had a call from the doctor who put Rick on a plane to come to the United States. And he said Rick is clearly sick but that he was in good spirits, and he walked onto the plane. So we are really encouraged by that," Deborah Sacra told reporters, her voice breaking briefly as she held back tears.

The 51-year-old doctor had returned to Liberia about a month ago to reopen ELWA hospital, his brother said in an interview with WebMD on Thursday.

"People were dying left and right of malaria and for lack of emergency C-sections, things that were highly fixable, but just there weren't any regular doctors doing regular work in hospitals," said Doug Sacra, recalling what his brother told him.

Reopening the hospital was difficult, he said. "All the hospitals had to be fully cleaned from top to bottom, and they had to get staff to come back to work, which was very hard.

"A lot of people said, 'If I go back to work (in West Africa), my husband won't let me come home because he thinks I'll bring home Ebola.' So there had to be a lot of cajoling and convincing to get local staff back," Doug Sacra added.

Debbie Sacra echoed those sentiments. She said her husband knew the dangers inherent in the work, but that he could not abandon the people he'd worked with for most of his life in their greatest time of need.

"He was so concerned with the children who were going to die from malaria without hospitalization and the women who had no place to go to deliver their baby by cesarean section. He's not someone who can stand back when there's a need to take care of," she said.

Sacra told his wife he thought he might have been infected by a patient with HIV who had also contracted Ebola, according to Doug Sacra.

One of the ways ELWA hospital tests patients for Ebola is by checking their temperature before they're admitted. If they're not running a fever, they're treated as being free of the disease, he explained.

A fever is one of the first symptoms of Ebola infection. It's the body's way of beginning to mount a defense against the virus.

A patient with HIV, who has a weakened immune system, may not have been able to run a fever in response to the infection, and thus would have mistakenly been thought to be Ebola-free.

Sacra believes he may have performed a C-section on such a patient, his brother said.

Debbie Sacra said her husband would want to pass on a message to everyone reading and hearing about the spreading infection.

"The need of West Africa is desperate," she said, reading a prepared statement. "There are resources that can be deployed to make sure all health care workers have enough gloves and gowns and boots and thermometers to protect themselves from possible Ebola exposures and to continue caring for those who need other medical care.

"Please find a practical way to meet the needs of Liberia and its neighbors in this time of suffering."

Sacra is the third American with Ebola to be evacuated to the U.S. for treatment. The other two, Kent Brantly, MD, and Nancy Writebol, were treated at Emory University Hospital in Atlanta in August and released.

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References
SOURCES: Deborah Sacra, wife of Ebola patient, Holden, Mass. Douglas Sacra, brother of Ebola patient, Holden Mass. News briefing, University of Massachusetts Medical School, Worcester.

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