Marching to the Order of Ebola

It was morning shift for me with 17 patients handed over to us and by the end of the shift, 2 more new patients were admitted to the suspected ward, full at the beginning of the morning with no one for discharge so these two might end up in the Probable Ward.  Most of the patients in the Suspected Ward had one negative Ebola test and hopefully their second test would remain negative as well.

The Temne–speaking nurse and I did the majority of our rounds outside the fence as most of the patients in the Suspected and Probable Wards were stable and were sitting outside after their breakfast.  With us asking questions over the fence would mean there was no way one would pass HIPPA in America. The two patients I sent from St. John yesterday looked well, although one of them remained anorexic.  We donned PPE to round mainly in the Confirmed Ward.

The three sickest patients were in the Confirmed Ward.  The 22-year-old Aminata who lost two of three children; 5 month-old baby and 2 year-old Emmanuel again did not look as devastated as I would imagine her to be; she did not like the food served and asked for fufu and peppered soup.  She looked so young that she could almost pass for a teenager and she behaved like one.  Her 4-year-old Ishmael struggled with diarrhea, thankfully no longer bloody, and pulled out his naso-gastric tube a few times.  Her father Emmanuel Senior struggled with his breathing and we finally helped him to bring up a thick mucus plug and raised the head of his bed higher; he seemed more comfortable.   In the next room, the 70-year-old Rosemarie only responded to verbal stimuli, now only subsisted on IV fluids.  She seemed to have lost her will to fight.

Again we seemed powerless against the marching course of Ebola infection despite treating the patients symptomatically.  We would need to have an antiviral or to have an armamentarium that would boost the immune responses of the patients against Ebola.