Via The Dallas Morning News, a report by The Associated Press: Family questions quality of care for Ebola victim Thomas Eric Duncan. Excerpt:
Duncan's medical records, which the family shared with The Associated Press, note the smallest details of his treatment: what he ate, how he looked, the fluids and drugs pumped into his Ebola-ridden body.
The records probably reflect a fraction of the discussions over Duncan's care. Still, they say relatively little about experimental treatment. Five days passed from the time a doctor first suspected Ebola, when Duncan returned a second time to the ER on Sept. 28, until hospital officials noted they were trying to secure an experimental drug, brincidofovir, for Duncan on Oct. 3.
Worried about the delay, Weeks texted his hospital contact on Oct. 4.
"Is there an experimental treatment we need to speak about?" Weeks said in a text message exchange with a Presbyterian Hospital liaison, Jennifer Rainer.
"He has gotten a first dose," Rainer replied minutes later, adding that she could not say whether the drug was working.
Duncan received another dose of brincidofovir on Oct. 7 — the day before he died, records show.
Experts disagree on whether getting Duncan an experimental drug sooner, giving him a different drug or a blood transfusion would have made a difference.
"No real way to know, since there are absolutely no data on it," said Dr. Greg Moran, an emergency and infectious disease specialist at UCLA.
But Dr. Thomas Geisbert, an Ebola expert at the University of Texas Medical Branch in Galveston, said he had trouble understanding why four days elapsed between Duncan's confirmed test results on Sept. 30 and his first treatment. And he was surprised by the choice of experimental drug given to Duncan.
"The guys who do what I do, working in this field, find it puzzling," said Geisbert, a professor of microbiology and immunology who has been studying Ebola since the early 1990s and was consulted on two of the U.S. cases. "It kind of came out of left field. I think the jury is still out on why this would have any activity against Ebola."
Although treatments have varied, ZMapp and TKM-Ebola are the only drugs proven to protect nonhuman primates from Ebola, Geisbert said.
While the manufacturer of ZMapp ran out of the drug before Duncan's diagnosis, limited doses of TKM-Ebola were available, according to Julie Rezler, a spokeswoman for the drugmaker, Tekmira.
The latter was given to Dr. Rick Sacra, an American physician who was infected with Ebola in Liberia. He was treated at a Nebraska hospital and released healthy on Sept. 25, five days before blood tests confirmed Duncan's diagnosis.
Other survivors include American medical missionaries Dr. Kent Brantly and Nancy Writebol, who received doses of ZMapp in Liberia before they were flown to the United States.
Watson, the Presbyterian Hospital spokesman, said "one of the investigational medicines was felt to be too risky, one — ZMapp — we were told was not available."
"Permissions had to be obtained from the FDA, Institutional Review Board and others, and then the drug had to be located and obtained," Watson said. "That process moved as quickly as it could be done."
Brantly said he also offered his plasma to Duncan but that the two men's blood types did not match. The Dallas hospital said it could not find a matching blood type among Ebola survivors for a transfusion with Duncan, who was Type B-positive.