first_imgEbola nearly killed Nancy Writebol in July—and it also made her famous, which helped broadcast to the world that it needed to respond more aggressively to what had grown from a small outbreak into an out-of-control epidemic.Writebol, a clinical nurse associate, became ill with the disease while working for the missionary group SIM in Monrovia. She and her husband David spoke with Science on 24 September about a topic that has yet to receive much attention: How do health care workers who are trained to protect themselves nevertheless become infected with the Ebola virus? The Writebols also discuss how the outbreak grew into an epidemic, as well as the treatment she received both in Liberia and then at Emory University Hospital in Atlanta. Questions and answers have been edited for clarity and brevity.Q: Any idea how you became infected?Sign up for our daily newsletterGet more great content like this delivered right to you!Country *AfghanistanAland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia, Plurinational State ofBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, The Democratic Republic of theCook IslandsCosta RicaCote D’IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and Mcdonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People’s Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People’s Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia, The Former Yugoslav Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMartiniqueMauritaniaMauritiusMayotteMexicoMoldova, Republic ofMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorwayOmanPakistanPalestinianPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarReunionRomaniaRussian FederationRWANDASaint Barthélemy Saint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzania, United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuela, Bolivarian Republic ofVietnamVirgin Islands, BritishWallis and FutunaWestern SaharaYemenZambiaZimbabweI also wish to receive emails from AAAS/Science and Science advertisers, including information on products, services and special offers which may include but are not limited to news, careers information & upcoming events.Required fields are included by an asterisk(*)N.W.: I don’t know how I became infected and how I contracted it. There are some thoughts about how I might have gotten it. Nobody is really sure, least of all me. I never felt like I was unsafe and I never felt like I walked into a situation where I was being exposed. I was on the low-risk side of things. I never was in the crisis or the Ebola center. I was always on the outside. I made sure doctors and nurses were dressed properly before they went in, and I decontaminated them before they went out. We kept a close check on each other about whether people felt safe.We had an employee who was doing the same job that I was doing. He got sick and I didn’t know he was sick. He didn’t tell anybody. He actually thought he had typhoid. The day that I started having symptoms, at least a fever, was the last day I saw him. He did have Ebola. He did not survive.I never remember touching him, although it’s possible he could have picked up a sprayer to decontaminate someone, and I could have picked up the sprayer. Or we touched the same thing. I never touched him.Q: You were educated about Ebola transmission?N.W.: Oh my goodness, yes.Q: Did you have sufficient personal protective equipment (PPE)?N.W.: Yes, we did. It was my responsibility to make sure they were dressed properly in PPEs before they ever went into the isolation. I didn’t want any of our doctors or nurses getting infected. I mean, I saw people dying of Ebola. We had PPEs and followed every single protocol that [Doctors Without Borders (MSF)] had in their manual—and we had been trained by MSF.Q: Were you wearing PPE in your job, disinfecting doctors and nurses? N.W.: No, I was wearing gloves and a disposable apron. There were times I had a mask on. I was behind a line where I did the disinfecting. They were on one side of a line and I was on the other side. I never crossed those lines. We just don’t even have a clue what happened.I’ve often wondered if I was back there now, having been through the experience, what would I do differently. The only thing is I took temperatures of family members who would come to see patients. I never had to turn anybody away because they had a temperature, but it’s possible I might have come in contact with somebody on the outside who had Ebola and maybe shook a hand? Although we weren’t really shaking hands with anybody. Most people had a fear of even us. They felt like to be involved with Ebola, you had it.Q: On what date did you start feeling symptoms?N.W.: Tuesday, 22 July. That afternoon I started running a fever. I felt like I had malaria. I contacted an SIM doctor. We did a malaria test and it was positive. I had malaria medication at home, and I went home and I stayed home. I was weak. I had the headache. Had the fever. Those were my symptoms. I took malaria medications but was just not shaking the fever at all. On Saturday, our doctor came over and she said, “We’re just going to do the Ebola test to relieve everyone.” I was just thinking still malaria. They did another malaria test and it showed negative, because I had taken the medication. Then they did the Ebola test that Saturday morning, and Saturday night the result came back that I was positive.Q: Do you think you had malaria coincident with Ebola?N.W.: I did. I tested positive for it.Q: What happened next?N.W.: They left me at home for the next 10 days.Q: Was David there?N.W.: Yes. It’s just the grace of God that David did not come down with Ebola. For the whole 4 days that they thought it was just malaria, David did the cooking at our home. I just didn’t feel good. We were still sharing our bedroom. Our doctor was exposed and she had dinner with us the night she told us I had Ebola. I’d had malaria once that year. I knew what it felt like and it was so similar.D.W.: They isolated me after that. For a few days, I went in to see Nancy in a PPE. Our home became an isolation unit. Then they said, “We can’t let you do that anymore because you can’t get back to the United States by commercial aviation.” They kept me out.N.W.: Thankfully there was a window near where my bed was and David could stand outside and talk to me.Q: David, did you check your temperature every few hours?D.W.: Yep. I got close to 99.2° [37.3°C], but I realized after I took my temperature that I’d just had a cup of coffee.Q: What happened with Kent Brantly?N.W.: I got sick the 22nd and Kent on the 23rd. Kent was actually much sicker to begin with, and then I took a turn for the worse. Kent went out on Saturday the 2nd. I left August 4.Q: You and Kent Brantly both received ZMapp. Do you think it helped?N.W.: It’s given at three different times. I had two of the doses in Liberia, and the third at Emory. I don’t know that I can say when I was given the ZMapp it made a dramatic difference in how I was feeling. I think I was very, very, very sick, critically sick. I’m not saying it didn’t help—I do think it had some benefit to it—but it wasn’t this huge, dramatic “I had this ZMapp and now I can sit up and take a shower.”They give ZMapp via IV and they give it slowly and then turn it up a little. When they turned it up on me, my hands started itching terribly and then they turned it back down so I wouldn’t have a reaction to it. That’s the only thing I remember about the ZMapp.Q: Were you very ill when you left Liberia?N.W.: I didn’t know whether I would survive the flight.D.W.: I wasn’t sure either. She had to be carried into the aircraft. She didn’t walk in or walk off.N.W.: I was in PPE the whole trip back. And I was dehydrated. They were having a terrible time in Liberia finding a vein in which to run fluid. At one point they decided to try and do an IV into the bone. That was very painful. They don’t really know what happened, whether the needle bent when it went into the bone, but once they tried pushing fluid, it was excruciating and they decided to stop. When I got to Emory they just put a central line in.Q: Would you go back again and work in an Ebola treatment unit?N.W.: I’ve done some reading on that and talked to doctors at Emory about that. My doctors at Emory are not sure how long immunity would last. It’s not been studied. I’ve read that even if a survivor was willing and able to help with the care for Ebola patients, because there are so many strains of Ebola, it would still be very wise and necessary to operate in PPEs and not just assume you’re immune.Q: What do you think of your own role in this epidemic and the fact that it wasn’t until you and Kent Brantly became ill that the world began to take notice that something was seriously amiss?N.W.: Never in my life would I have dreamed this would happen. We’d been in Liberia for a year and had a doctor come into the country in March or April who laid out a graph of other Ebola timelines and how the disease had gone along in Congo and Uganda, and how it was just this steady little disease working its way along—and then it spikes and spikes again and grows into a mushroom. He overlaid where Liberia was on that graph. He made the observation that we had not seen the worst of it yet.D.W.: People were calmed down and thought it was over. In early June, Monrovia started getting the multiple cases from Foya [a town in the north that borders both Sierra Leone and Guinea, the two other hard-hit countries].N.W.: We hadn’t started to hit the mushroom at all. And then Samaritan’s Purse had an epidemiologist who came into the country who sat with us and said, “I went to Foya. You have not seen the end of this. It’s going to get bad.”D.W.: All along, we were concerned there was not a larger response. It’s the publicity that was generated from Nancy’s story and Dr. Brantly that woke things up. That was astonishing.Q: You knew it was wildly out of control?N.W.: I would have never predicted the numbers WHO [the World Health Organization] and CDC [the Centers for Disease Control and Prevention] are predicting now. I looked at that and thought, “Oh my goodness”; we had no clue it was going to go to that extent. You’re talking a half-million in Liberia alone.Q: What did you think of the media coverage of ZMapp?D.W.: Initially it seemed a bit sensational: This is the magic bullet. That’s what they do, they gravitate toward that, but they’ve also backed off that and had a more balanced approach. It’s promising, but don’t put too much hope into it until more studies are done.N.W.: I think they understand, too, that nobody really knows how much it helped. Because there were so many other things playing into it. There were blood transfusions. The other care given to us.Q: Did you have a blood transfusion?N.W.: I did. I had blood transfusions in Liberia and Emory. Neither was convalescent serum, though. There wasn’t a match.Q: How’s your health now?N.W.: I’m recovering. I’m regaining my strength. When I left Emory, I could hardly walk up steps at all. I have some neuropathy in my feet. While I was in Emory it was excruciating. They couldn’t even put sheets or blankets on my toes. That’s much better.I wear out easily. And of course there’s just the emotional side of it. I was on that job from the 11 June case, that first patient we had, to 22 July, and I saw about 40 people and we saw one survivor during that period of time. To watch the rest of those people die was difficult. I was dealing with some of their families and trying to encourage them and pray with them. To watch families watch their loved ones die, that’s hard, too.For a story about Ebola’s infection risk for health care workers, click here.*The Ebola Files: Given the current Ebola outbreak, unprecedented in terms of number of people killed and rapid geographic spread, Science and Science Translational Medicine have made a collection of research and news articles on the viral disease freely available to researchers and the general public.last_img

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first_imgPlayers named include David Mead and Rod Griffin for PNG; Sisa Waqa and Akuila Uate for Fiji; Feleti Mateo and Joe Ofahengaue for Tonga and Sam Kasiano partnering with Frank Pritchard again, this time for Samoa.Fans can look forward to two blockbuster matches between four Pacific nations, with Fiji taking on PNG in the first match, before Samoa takes on Tonga to round out the Pacific double header.The Junior Kangaroos will also play at Pirtek Stadium on Saturday against the Junior Kiwis, with the match in honour of the ANZACs.All four Pacific Test teams will spend the week in Western Sydney, with the city of Parramatta and Destination New South Wales ensuring plenty of excitement and activities leading into the Test matches.Pacific ambassadors including Roy Asotasi, Joe Galuvao and Nigel Vagana will visit a series of schools on Monday and teams will host fan days later on Thursday throughout western Sydney.Westfield Parramatta will host a Pacific showcase, also on Thursday, with cultural activities on display from all four competing Pacific nations. In further activity, a number of Pacific youth from western Sydney will take part in a Youth Summit on Friday and Saturday, celebrating cultural diversity and developing leadership amongst Pacific communities.On game day, a ‘Big Island Festival’ will take over Centenary Square in Parramatta, with plenty of food, fun and festivities for all, before the Junior Kangaroos and Kiwis kick off the first of three matches.NRL CEO Todd Greenberg said the week-long celebrations and matches on Saturday would be well supported by the games Pacific players and fans.“Many of our players in the NRL come from Pacific heritage and our Pacific fans make up a huge supporter base for Rugby League, so we are very much looking forward to some exciting and passionate football on Saturday,” said Mr Greenberg.Tickets are still available, starting from $20 for a single pass, with family passes for as little as $60 to see all three matches.Papua New Guinea Kumuls1 David Mead (Gold Coast Titans)                                                     2 Justin Olam (SP Hunters)                                                    3 Kato Ottio (Canberra Raiders)                                                        4 Nene Macdonald (Gold Coast Titans)         5 Stargroth Amean (SP Hunters)6 Ase Boas (SP Hunters)      7 Watson Boas (SP Hunters)             8 Luke Page (Burleigh Bears)9 Wartovo Puara Junior (SP Hunters)10 Henry Noki (SP Hunters)11 Edward Goma (SP Hunters)12 Rod Griffin (Wests Tigers)13 Adam Korave (SP Hunters)14 Adex Wera (SP Hunters)15 Brandy Peter (SP Hunters)16 Willie Minoga (Townsville Blackhawks)17 Kurt Baptiste (Canberra Raiders)18 Timothy Lomai (SP Hunters)Coach: Michael Marum Fiji Bati (squad)Sisa Waqa (Canberra Raiders)Tyrone Phillips (Canterbury-Bankstown Bulldogs)Junior Roqica (Cronulla Sharks)James Storer (Illawarra – Port Kembla)Fabian Goodall (Manly Warringah Sea Eagles)Brayden Wiliame (Manly 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first_imgYesterday’s early dismissal of Barbados Pride opener Kraigg Brathwaite lifted the spirit in the Jamaica Scorpions camp and now they have a fighting chance of topping the visitors in their West Indies Cricket Board Regional First-Class match at Sabina Park.Brathwaite lasted just an additional nine minutes and 11 balls on yesterday’s second day before he was stumped by wicketkeeper Chadwick Walton off the bowling of spinner Nikita Miller without adding to his overnight score.With Brathwaite gone, the rest of the Barbados Pride batting struggled against Miller and they were dismissed for 217 in their first innings.The Scorpions, who scored 177 in their first innings, then ended on 22 for two at the close, 18 runs in arrears, after rain forced the abandonment of some of the second and all of the third session of play.”Overnight, I was thinking about it I was thinking I have to get rid of Kraigg early in the morning as he is the person his team basically bats around,” stated Miller, who, in another outstanding spell of left-arm spin bowling, finished with eight for 67.”The plan, therefore, was to go hard at him and get him out, and it worked. I am happy for the team,” said Miller, who extended his lead atop the tournament’s bowling charts to 56.Meanwhile, looking at the state of the game, which is scheduled to resume at 9:30 a.m. today, Miller said the Scorpions remain hopeful.DRIVING SEAT”I think Barbados are in the driving seat now,” he said. “We are still in the negative and need to get a lead before we lose anymore wickets.”Brathwaite, meanwhile, whose overnight partner Royston Chase, after resuming on nine went on to score a 53, said with the wicket good for spin bowling, he will be looking to his spinners in Jamaica’s second innings.”Our batting did not do as well as we had expected as, from day one, the pitch has been taking some spin and is not an easy wicket to bat on,” he said.”Jamaica also have an experienced bowler such as Miller, who kept it tight.”But we have some spinners that can come into play, and once we can string those dot-balls and build pressure, I think we will come out on top.”Other scores:At the National Cricket Centre, Trinidad and Tobago: Leeward Islands Hurricanes 225 all out; Trinidad and Tobago Red Force 264 for six.At Beausejour Stadium, St Lucia: Windward Islands Volcanoes’ 216; Guyana Jaguars 310 for seven.SCOREBOARDSCORPIONS 1st Innings 177PRIDE 1st Innings(overnight 103 for three)*K. Brathwaite st Walton b Miller 66R. Chase c wkp Walton b Miller 53+S. Dowrich lbw b McCarthy 5K. Stoute lbw b Miller 17J. Greaves c and b Miller 14J. Warrican lbw b Miller 3H. Walsh Jr c Campbell b McCarthy 22M Cummins not out 8Extras (b1, nb8) 9TOTAL (all out, 83.3 overs) 217Fall of wickets: 1-46, 2-58, 3-71, 4-108, 5-113, 6-134, 7-162, 8-166, 9-199, 10-217.Bowling: Dawes 12-3-39-0 (nb4), Gordon 7-1-18-0 (nb4), D Thomas 2-0-20-0, Miller 37-11-67-8, Jacobs 11-3-28-0, Campbell 9-1-27-0, McCarthy 5.3-1-17-2.SCORPIONS 2nd InningsS. Thomas c Brathwaite b Warrican 5*J. Campbell not out 10K. Edwards c Chase b Warrican 2A. McCarthy not out 5TOTAL (2 wkts, 12 overs) 22Fall of wickets: 1-6, 2-10.Bowling: Warrican 6-2-10-2, Cummins 2-0-3-0, Chase 4-0-9-0.Position: Scorpions trail by 18 runs overall.Toss: Scorpions.Umpires: Christopher Wright, Nigel Duguid.last_img

first_imgView comments MOST READ Sports Related Videospowered by AdSparcRead Next LATEST STORIES It’s too early to present Duterte’s ‘legacy’ – Lacson Don’t miss out on the latest news and information. Alora determined to finally beat Cambodian rival if they meet in AIMAG Learning about the ‘Ring of Fire’ It was a heartbreaking defeat for Letran, which had to fight back from a 75-72 deficit at the 14.2 second mark of regulation before Bong Quinto banged in the game-tying triple with 4.4 seconds to spare to tie the game at 75.JP Calvo paced the Knights with 21 points, seven rebounds, two assists, and two steals, while Quinto got 15 markers, six boards, and two dimes before fouling out at the 1:43 mark of the extra period.Nambatac also got 15 points, 12 rebounds, and two assists in the defeat, which sent Letran down to 5-5.The Scores:PERPETUAL 88 – Eze 21, Dagangon 21, Ylagan 18, Coronel 10, Pido 9, Cabiltes 4, Hao 3, Yuhico 2, Mangalino 0, Sadiwa 0, Clemente 0, Lucente 0, Tamayo 0.ADVERTISEMENT Carpio hits red carpet treatment for China Coast Guard PLAY LIST 02:14Carpio hits red carpet treatment for China Coast Guard02:56NCRPO pledges to donate P3.5 million to victims of Taal eruption00:56Heavy rain brings some relief in Australia02:37Calm moments allow Taal folks some respite03:23Negosyo sa Tagaytay City, bagsak sa pag-aalboroto ng Bulkang Taal01:13Christian Standhardinger wins PBA Best Player award A costly, catty dispute finally settled The lanky forward drilled two crucial jumpers over Rey Nambatac to push his side from a 77-all deadlock to an 82-77 advantage with 3:01 left in OT, and stifled the Knights’ late rally as he blocked Nambatac in the final minute before AJ Coronel put the game out of reach with his freebies.Dagangon finished with 21 markers, five boards, three assists, and two blocks in the win.FEATURED STORIESSPORTSRedemption is sweet for Ginebra, Scottie ThompsonSPORTSMayweather beats Pacquiao, Canelo for ‘Fighter of the Decade’SPORTSFederer blasts lack of communication on Australian Open smogGJ Ylagan chimed in 18 points and three rebounds, while Coronel added 10 markers, four boards, three dimes, and three steals.“We play with no pressure. We’re free-wheeling, no one’s hesitant, especially on offense. We had some lapses, but at least, we survived it in the overtime period,” said Gican, as the Altas improved to 4-6. Winning start End of his agony? SC rules in favor of Espinosa, orders promoter heirs to pay boxing legend For the complete collegiate sports coverage including scores, schedules and stories, visit Inquirer Varsity. LETRAN 82 – Calvo 21, Quinto 15, Nambatac 15, Vacaro 9, Balanza 8, Taladua 7, Bernabe 3, Mandreza 2, Gedaria 2, Pamulaklakin 0, Balagasay 0, De Villa 0, Caralipio 0, Pascual 0.Quarters: 18-12, 32-33, 57-52, 75-75, 88-82. Photo by Tristan Tamayo/INQUIRER.netFinally playing with a sense of urgency, Perpetual weathered a mighty challenge from Letran and came away with an 88-82 overtime victory Thursday in the NCAA Season 93 men’s basketball tournament at Filoil Flying V Centre in San Juan.MVP frontrunner Prince Eze showed his worth with 21 points and 19 rebounds, but it was Gab Dagangon who came up with the big shots in extra time to salvage the Altas.ADVERTISEMENT OSG plea to revoke ABS-CBN franchise ‘a duplicitous move’ – Lacson Mayweather beats Pacquiao, Canelo for ‘Fighter of the Decade’ Break new ground End of his agony? SC rules in favor of Espinosa, orders promoter heirs to pay boxing legendlast_img

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