“It’s your worst nightmare,” Nancy Writebol says.
“There’s vomiting. There’s diarrhea. There’s weakness… There’s fever. There’s a rash.
“It just attacks the body and begins to attack your organs. And as the disease progresses, a lot of people do bleed out.”
Writebol, a missionary working with Ebola patients in Liberia, was one of the first Americans to be diagnosed with Ebola and evacuated to the United States. While working in the region, she’d seen what the virus had done to many people in West Africa.
Writebol describes the virus that nearly killed her without a hint of bitterness. Her stamina may not be what it once was, and there’s a lingering pain in her joints that makes stairs particularly difficult, but the loving mother and grandmother is grateful to be alive.
She expected to die.
But Writebol received an emergency dose of an experimental drug called ZMapp and spent two weeks in an isolation unit at Emory University Hospital in Atlanta.
Dr. Kent Brantly, who worked with Writebol at the same hospital in Liberia, began showing symptoms of Ebola a few days before she did. He was also given ZMapp, before being evacuated to the United States and undergoing treatment at Emory.
“I really believe that God saved us,” Writebol says. “But God uses means. And he used the ZMapp. And he used doctors and nurses and an evacuation plan. And he used the prayers of his people.”
Writebol was released from Emory on August 19, 2014. Less than a year later, she and her husband of more than 40 years, David, returned to Liberia with the international Christian organization Serving in Mission. They are determined to help the country’s residents recover from 15 years of civil war and a devastating epidemic.
“Liberia’s very much like an onion… there’s layer after layer after layer of trauma and grief,” Writebol told CNN before returning to West Africa. “So we’re going back to not only read into that but, as a survivor, to bear that burden with the Liberians who have come through that.”
Liberia was one of three primary countries affected by what the World Health Organization has called the “largest, longest and most complex” Ebola outbreak in history.
During the outbreak’s peak, in August and September 2014, Liberia was reporting 300 to 400 new cases a week. As of August 23, Liberia had recorded 10,672 cases of Ebola, with 4,808 deaths. Its neighbors, Guinea and Sierra Leone, have recorded an additional 17,333 cases, including 6,479 deaths. Ebola also arrived in Italy, Mali, Nigeria, Senegal, Spain, the United Kingdom and the United States, via infected travelers or medical evacuations.
“Ebola has destroyed lives and families, left deep scars, and ripped at the social and economic fabric of Guinea, Liberia and Sierra Leone,” Doctors Without Borders wrote in its March 2015 report, “Pushed to the Limit and Beyond: A year into the largest ever Ebola outbreak.”
The aid organization deployed more than 5,300 staff members to fight the epidemic. Twenty-eight contracted the virus; 14 died. Overall, more than 500 health care workers have died during the outbreak.
While no one would ever say they’re happy to have had Ebola, Writebol recognizes that she and Brantly played a crucial role in bringing the epidemic to the world’s attention. Though more than 600 people had already died in West Africa before Writebol and Brantly were diagnosed, their evacuation to the United States pushed the international community into action. With their diagnoses, the world realized the contagious virus with an estimated 60% death rate could — and would — spread beyond Africa.
Writebol remembers one conversation with a colleague in Liberia: He said, “Nancy, if you and Kent had not gotten sick I don’t know that the international community would’ve ever been here to help us.”
“So it did give us a platform on which to speak and to raise the level of answer for West Africa,” Writebol said.
Overall, 10 people were treated for Ebola in the United States — two of whom died — and one more without the virus would start a national conversation about infectious disease control.
Writebol and Brantly were followed by Dr. Rick Sacra and a mystery patient later revealed to be Dr. Ian Crozier. Thomas Eric Duncan, a Liberian man visiting relatives in Dallas, died on October 8. A freelance cameraman named Ashoka Mukpo was brought to and released from Nebraska Medical Center.
Then the world learned that two nurses in Dallas who had treated Duncan — Nina Pham and Amber Vinson — had also contracted the disease. Two additional healthcare workers who had been in West Africa, Dr. Craig Spencer and Dr. Martin Salia, were also diagnosed later in the year. Salia passed away on November 17, 2014.
These are the faces and names that most Americans will remember from the Ebola outbreak.
Where are they now?
Working with Ebola survivors at SIM’s Trauma Healing Institute in Monrovia, Liberia, Nancy Writebol says she has a “respectful fear” of the virus, though doctors believe she’s now immune. Scientists are still studying her to track the long-term effects of the disease.
Her husband David is participating in a clinical trial designed to test an Ebola vaccine. In July, the World Health Organization announced that trials of the single-dose VSV-EBOV vaccine in Guinea proved the vaccine was highly effective, and that no one who received it has developed Ebola.
Dr. Kent Brantly told NPR in December that it took months for him to feel like himself again. Since leaving Emory, the father of two has traveled the country to tell others what still needs to be done to combat Ebola.
“This outbreak is a threat to the health of the world in a way we haven’t seen in recent decades,” he told NPR. “And it’s bringing to light the fact that there is no well-organized international response for something on this scale. Hopefully those lessons will not be learned in vain.”
In the months following his release from Nebraska Medical Center, Dr. Rick Sacra dealt with a bad cough and blurry vision. They were the only lingering signs of the virus that ravaged his body for weeks.
Sacra has been back to Liberia several times, most recently in July. He’s been quite vocal about his vision of establishing a residency program for future Liberian doctors.
“Being back in Liberia was a bit surreal at first,” he wrote in an email to CNN. “I guess I am just amazed at the Liberian people whom I work with — their selfless service, their grit — to keep working in the face of such risks.”
When he’s in the United States, Sacra serves as a clinician at the Family Health Center of Worcester and as assistant professor at the University of Massachusetts Medical School.
“I’ve only had a few instances where strangers steered clear of me or didn’t want to be near to me,” he says. “Unfortunately, some others, both in the U.S. and here in Africa, have been badly stigmatized and are struggling to put their lives back together.”
Dr. Ian Crozier was, by far, the sickest Ebola patient to arrive at Emory University Hospital in Atlanta, administrators said. He was placed on a ventilator and underwent kidney dialysis. He spent 40 days in the isolation unit.
Less than two months after being discharged, Crozier started experiencing problems with his vision. He returned to Emory, and doctors were stunned to find traces of the virus in fluid from his eye. They were even more surprised to watch as his eye turned from its original blue color to a greenish hue.
Crozier received steroids and an antiviral agent and his eye gradually returned to normal. Doctors at Emory advised their colleagues in West Africa to watch Ebola survivors for eye problems.
“You can imagine an Ebola survivor who’s already been through their own personal hell,” Crozier said at the time. “And as they emerge from that place, to then in a sense face the tragedy of going blind; it’s a story that we must pay attention.”
Ashoka Mukpo worked for years with the advocacy group Human Rights Watch, and news organizations like VICE and NBC, before contracting Ebola in Liberia while he covered the story there. Mukpo was evacuated to the Nebraska Medical Center and was declared free of the virus on October 21.
“I think physically I’m fine,” Mukpo, a practicing Buddhist, told Lion’s Roar in February. “Emotionally, it’s been a little delicate. I’ve been through a lot of trauma, but I feel pretty strong physically, psychologically, and spiritually right now.”
He recently wrote a report titled “Surviving Ebola” for International Alert, based on interviews and surveys of people living in Liberia.
Nina Pham, one of the nurses who treated Liberian Ebola patient Thomas Eric Duncan at Texas Health Presbyterian Hospital Dallas, spent less than two weeks at the National Institutes of Health before being declared free of Ebola. She visited the White House and got a hug from President Barack Obama.
She asked for privacy, and said she would return to Texas to “try to get back to a normal life and reunite with my dog, Bentley.”
Bentley gained nearly as much attention as Pham during his three-week quarantine, and was still getting letters and well-wishes as recently as February, the Dallas News reported.
After her recovery, Pham sued the company that owns the hospital where she worked, saying it had failed to properly train and protect workers against the threat posed by the Ebola virus.
The lawsuit is pending.
Like Pham, Amber Vinson fell ill with the Ebola virus after treating Duncan.
She was diagnosed October 15 after returning to Dallas from Cleveland, Ohio, on a commercial airline flight. She drew criticism from some for taking those flights, but insisted that she followed all protocols in place at the time.
Doctors declared Vinson virus-free in November after she was successfully treated at Emory University Hospital. She’s largely dropped out of the limelight since her recovery, but the impact of her travels has lingered.
On May 30, the bridal store Vinson visited during her trip to Cleveland closed, according to its Facebook page. The store’s owner said in January that the stigma associated with Vinson’s visit had cost her store more than $100,000.
Nurse Kaci Hickox never had Ebola. But upon returning from Sierra Leone in October 2014, Hickox was forced to spend several days in an isolation tent under a new mandatory quarantine policy put in place by New Jersey Gov. Chris Christie.
Hickox hired a lawyer and was discharged after testing negative for Ebola. But when she traveled home to Maine, she again faced a government order to be quarantined for 21 days. Maine was one of several states, including New York and Illinois, that had implemented mandatory 21-day quarantine periods for any health care worker returning from West Africa.
Kickox fought back, going on a very public bike ride with her boyfriend. She said policies like these were not a “sound public health decision” — that Ebola cannot be transmitted until an infected person is exhibiting symptoms. A judge ruled in her favor, asking her to submit only to active monitoring for symptoms.
Hickox now works in Oregon as a clinical nurse educator.
“The United States had a chance to respond to Ebola with humanity, reason and strength,” she wrote in the Journal of Health and Biomedical Law earlier this year. “We had the opportunity to lead this fight and be in the vanguard of beating Ebola. Instead, we reacted with cowardice and ignorance.”
In an article for the New England Journal of Medicine in March, New York’s first (and so far only) Ebola patient, Dr. Craig Spencer, chronicled his experience with the deadly virus:
“One day, I ate only a cup of fruit — and held it down for less than an hour. I lost 20 lbs, was febrile for 2 weeks, and struggled to the bathroom up to a dozen times a day.”
“Ebola is frightening not just because of its high fatality rate,” he wrote,” but also because of how little we know about it. We cannot explain exactly what it does to our bodies, nor tell patients who survive it how it may affect them in the future.”
In March, Spencer returned to Guinea to advise other doctors about Ebola treatments.
“For many politicians, the current Ebola epidemic ended on November 4, 2014, the day of midterm elections (and, coincidentally, the day my fever broke),” he wrote. “For the U.S. media, it ended a week later, when I walked out of Bellevue Hospital and the country was officially Ebola-free. But the real Ebola epidemic still rages in West Africa.”