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Dr. Rick Sacra may be immune to the Ebola virus, but he’s not going to push his luck by testing that natural defense.
Sacra was infected with Ebola in September while working in Liberia. Now, he’s headed back.
“In fact, the experts tell me I am immune,” Sacra said. “I don’t plan to test that but I am grateful for it.”
The University of Massachusetts emergency room physician survived the virus after he was flown to the University of Nebraska’s special treatment unit where he received every available treatment.
It’s been a long, tough road, Sacra said at a news conference. But the medical missionary for North Carolina-based SIM said he never doubted he’d be going back to help fight the epidemic that’s infected more than 21,000 people and killed more than 8,200.
He's the first American to return after having survived Ebola.
"I guess I am less nervous about this trip because I know what I am getting into more," he said. Like all volunteers, he had worried about catching Ebola. "The thing I was afraid of before, I’ve had it, thank God, and I am through it."
Sacra’s said all along he would go back. He won’t be working directly in an Ebola ward but in the emergency department of the missionary-run ELWA hospital outside the Liberian capital of Monrovia.
“In fact, the experts tell me I am immune. I don’t plan to test that."
He’ll also be teaching, and wearing protective gear to demonstrate that best practices will be part of his role.
“So I need to kind of exemplify the protocols,” Sacra said.
His immunity may get him some special jobs, however, Sacra said.
“I may be the go-to guy for unknown, risky-looking patients,” he said. Many doctors working in the region believe health care workers have been infected by patients that were not immediately diagnosed with Ebola. Sacra’s colleague, Dr. Kent Brantly, believes he may have been infected that way, and Sacra himself was not directly treating known Ebola patients when he became infected.
Health care workers are at special risk of infection from Ebola. The World Health Organization says more than 500 have been infected in the current epidemic.
“Ebola is both hard to get and easy to get,” Sacra said.
“It’s hard to get in community settings, normal settings like this or sitting in a restaurant or walking on the street. But in the health care setting, where you’re dealing with people who are very sick, dealing with blood and body fluids, it is very easy to get,” he added.
“Even when the proper precautions have been put in place, you still see health care workers getting sick with Ebola.”
Just hours before Sacra spoke, London’s Royal Free Hospital said one of the 500 infected health care workers, Scottish nurse Pauline Cafferkey, was better. “Royal Free Hospital is pleased to announce that Pauline Cafferkey is showing signs of improvement and is no longer critically ill. She remains in isolation as she receives specialist care for the Ebola virus,” the hospital said in a statement.
Cafferkey was diagnosed with Ebola in December after treating patients in Sierra Leone.
“We will never know if investigational drugs and convalescent plasmas contributed to her improvement, but it does, once again, highlight the huge benefits that modern, well-resourced critical care interventions can bring to those suffering from severe Ebola virus infection,” said Jonathan Ball, a professor of molecular virology at Britain’s University of Nottingham.
“That’s why treatments and vaccines might still be important in the longer-term fight in West Africa.”
Sacra was also given several different treatments, including an experimental drug made by the Canadian company Tekmira, blood serum from Brantly, and what’s called supportive care, including replacement of fluids and important minerals lost to the copious vomiting and diarrhea that Ebola causes.
“Ebola is both hard to get and easy to get."
Such intense treatment is rarely available to patients in West Africa, although ELWA hospital will test the so-called convalescent blood plasma for survivors. “We are going to see whether there’s a benefit in that,” Sacra said. And Doctors Without Borders, also known as Medecins Sans Frontieres or MSF, will test an antiviral pill called brincidofovir at a nearby treatment unit.
“These drugs and vaccines all offer such hope for Ebola,” Sacra said. But some of the high-tech treatments, like the Tekmira drug and an experimental therapy called ZMapp, won’t be easy to test or deploy as they must be kept frozen at all times.
“I think people are really hoping that the tablets will work because there’s so much less infrastructure that you are going to need,” Sacra said.
And even with treatment, recovery is hard. Sacra underwent weeks of physical therapy, got pneumonia and was re-hospitalized for that, and is still recovering from an eye inflammation called uveitis caused by his body’s attempts to fight off Ebola. Ebola survivors in Africa are battling such challenges, again, without U.S.-style healthcare and support, Sacra noted.
He’s getting together supplies to take with him for his three-week stint in Liberia.
“I got my yellow fever shot on Friday. I took my malaria pill this morning,” Sacra said.
“The UPS and Fedex trucks are frequent visitors at our house.”
But these supplies won’t help do what’s really needed in West Africa, and that’s building a strong healthcare system, Sacra said. The World Bank issued a report earlier Monday noting that Ebola’s worsened unemployment has hit and hurt the rice harvest in Liberia.
“Even after Ebola is finished in West Africa, if we don’t continue to be very strategic about strengthening the health system there, then they’ll be vulnerable to another epidemic, whether it is Ebola or whether it is another disease,” Sacra said.