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Stanford global health chief launches campaign to help contain Ebola outbreak in Liberia

Stanford global health expert Michele Barry, MD, has launched a fundraising campaign for supplies and personnel to help contain the Ebola outbreak in Liberia.

- By Ruthann Richter

Michele Barry is spearheading an effort at Stanford to raise funds for equipment to protect health-care workers in West Africa from the Ebola virus.
Steve Fisch

Michele Barry, MD, director of Stanford’s Center for Innovation in Global Health, has launched a fundraising campaign to help combat the Ebola outbreak in Liberia, which has claimed the life of a colleague who mentored residents in the Yale/Stanford Johnson & Johnson Scholars Program.

Samuel Brisbane, MD, was the first Liberian doctor to die in the outbreak, which the World Health Organization says is responsible for more than 700 deaths in West Africa and is the largest outbreak of the disease to date. Brisbane was an internist who treated patients at the John F. Kennedy Memorial Hospital in the capital city of Monrovia, the country’s largest hospital. A second medical officer has become ill at the hospital, one of the sites for the scholars’ program, Barry said.

Through the program, Brisbane mentored physicians from Stanford and other institutions who volunteer for six-week stints in resource-limited countries. He quarantined himself after showing signs of illness but died on July 26 after being transferred to a treatment center, said Barry, a professor of medicine and senior associate dean for global health at the School of Medicine.

Like HIV, the Ebola virus is spread through direct contact with blood or body fluids from an infected individual. Barry said Liberia is in desperate need of personal protective equipment for health-care workers, such as masks, gowns and gloves, as well as trained personnel who can do contact tracing and isolation of infected individuals. The Ebola virus has a 21-day incubation period, during which time an infected individual can transmit the virus.

Barry joined an informal fundraising campaign with her colleagues on July 29 to help Liberian health-care workers contain the spread of the disease, raising $11,000 in 48 hours. On July 31, she broadened the appeal in an email sent to all Stanford medical school faculty.

Outbreak follows different path

Barry has had experience fighting Ebola in Uganda, where she said outbreaks have been limited by isolating patients in outdoor, tented hospitals and where physicians and nurses have had access to good protective gear. In the past, she said the disease typically has had “hot spots” that last a month and then subside.

But the latest epidemic, which has affected patients in Guinea, Sierra Leone and Nigeria, as well as Liberia, has followed a somewhat different path.

“I think we are doing a better job of taking care of patients and keeping them alive longer, so they become more viremic — meaning the virus has spread through their bloodstream — and more infectious,” she said. “And with globalization, there is more traffic across borders so spillover to other countries occurs.”

The first American, Patrick Sawyer, fell victim to the disease on July 25 after contracting the virus during a visit to Liberia. He became seriously ill on the flight home to Minnesota, making a stop in Nigeria, where he died.

The disease, also known as Ebola hemorrhagic fever, is initially difficult to spot because the first symptoms — sudden fever, intense weakness, muscle pain, headache and sore throat — resemble a common flu. Patients then develop more serious problems, including vomiting and diarrhea and impaired kidney and liver function, according to the federal Centers for Disease Control and Prevention.

The disease has no cure, with fatality rates in the latest outbreak approaching 90 percent, according to the WHO. However, some patients are able to mount a significant enough immune response to recover from the infection.

Health-care workers typically become infected through needle sticks or blood splashes, Barry said. She said the best protection for health-care workers is to apply universal precautions — a practice begun in the early days of the AIDS epidemic in which caregivers treat all patients as potentially infectious, using masks, gloves and other protective measures.

“The difference is that HIV patients don’t bleed profusely, while at the end of a life of an Ebola patient, patients bleed everywhere,” she said.

Low threat in the United States

She said she does not see the disease as a major threat to the United States, where effective infection-control methods are widespread.

“I think we need to be vigilant, but I don’t think there needs to be any true concern that this is going to spread to the United States,” she said. “There’s always a risk of a patient coming in unknown to the hospital, but we practice good universal precautions because we have the equipment and we’ve been trained to treat HIV.”

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