Handwashing stations are appearing outside homes and businesses, such as at this bank in Monrovia, Liberia. Photos courtesy of Jarsea Burphy, Director of Public Affairs for Liberia Telecom Authority
Handwashing stations are appearing outside homes and businesses, such as at this bank in Monrovia, Liberia. Photos courtesy of Jarsea Burphy, Director of Public Affairs for Liberia Telecom Authority

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Members of a North Carolina-based medical missionary who have been exposed to the Ebola virus in West Africa are coming home.

By Rose Hoban

North Carolina-based workers who have been working with Ebola patients in West Africa will be returning to the Charlotte area in coming days, and they’ll be submitting to voluntary quarantine, just in case.

ELWA Hospital in Monrovia, Liberia is managed by workers from Charlotte-based SIM USA. Photo courtesy Tabitha Plueddemann, SIM USA

The missionaries, who work with the Christian organization SIM USA, will be returning to Mecklenburg County and keeping themselves from friends, family and the greater public as a precaution, said spokespeople from SIM USA and the Mecklenburg County Public Health Department, who held a joint press conference Sunday morning.

The missionaries who will be returning to North Carolina are all healthy and not showing signs of the disease, according to the organization.

“For precautionary measures, state and local public health officials are requiring a period of voluntary quarantine for the staff and other people who were exposed to Ebola and are returning to North Carolina within 21 days since their last exposure,” said a Sunday statement from SIM USA.

SIM USA workers manage and staff the ELWA Hospital in Monrovia, Liberia. The World Health Organization reports a count of 554 cases of Ebola with 294 deaths in that country.

Nancy Writebol, another SIM USA worker, is currently in isolation at Emory University Hospital in Atlanta, where she is said to be recovering from the Ebola virus disease. Writebol worked at ELWA Hospital.

Ebola outbreak response in West Africa, dated July 24, 2014. Map courtesy World Health Organization

In their latest update, dated Aug. 6, the WHO reports that four countries in West Africa have had a total of 1,779 cases with 961 deaths. Sierra Leone has the highest number of cases, followed by Liberia, Guinea and Nigeria.

Liberia has had fewer than 200 doctors to serve about four million people, said Dr. Frank Glover, who runs another medical missionary organization that works with SIM USA in Liberia.

“This Ebola outbreak in Liberia has exposed the country’s inherently weak health system,” Glover told representatives during a Congressional hearing on Ebola last week.

“After the outbreak in March of this year, that number plummeted to only 50 doctors. This occurred as the result of the exodus of 95 percent of the expatriate doctors,” he said.

One of the doctors who has been stricken with Ebola is Kent Brantley, a physician with Samaritan’s Purse, a Christian missionary organization based in Boone. Brantley is also being treated at Emory.

Voluntary quarantine

Mecklenburg County Medical Director Stephen Keener said SIM USA contacted his office about 10 days ago to let county officials know missionaries from their projects in West Africa would be returning to the area in coming days. Then late last week, Keener said, he got word that some of the missionaries were people who had contact with Ebola virus-diseased patients.

Citing privacy concerns, SIM USA declined to name the workers or say how many people would be quarantined.

The waiting room at the SIM USA-managed ELWA Hospital, located in Monrovia, Liberia, where patients with Ebola virus are being treated. Ebola virus is transmitted by direct contact with blood or body fluids of people infected with the disease. Photo courtesy Tabitha Plueddemann, SIM USA

Keener explained that quarantine is used for healthy people who may have been exposed to a disease but who are not showing symptoms. In this case, the workers will remain quarantined for 21 days.

“For Ebola virus disease, the time between exposure and detection of symptoms is eight to 10 days; but the outside limits are as long as 21 days, so we err on the side of caution,” Keener said. “If someone goes 21 days and they don’t get sick, we can be sure they’re not infected.”

Early symptoms of Ebola virus infection include primarily fever, along with headache, joint and muscle aches and weakness. Patients can also develop rash, red eyes, vomiting, diarrhea and bleeding.

Currently there is no specific treatment for Ebola other than supportive therapies such as keeping patients hydrated treating kidney and liver failure. The disease has a fatality rate of as much as 90 percent without treatment.

The disease is spread through direct contact with the blood or other body fluids of infected people. It cannot be transmitted through the air.

Even though North Carolina general statute gives Keener legal power to order people with disease into quarantine, he said he felt confident the returning missionaries would voluntarily “do the right thing.”

“They did this under the advisement of SIM to voluntary distance themselves from everyone else,” he said, noting that people from his department would be in contact with the quarantined people over the coming weeks.

Keener said quarantine is used more often than people think. The practice has been used in recent years to keep people exposed to measles, mumps and SARS away from others to limit the spread of disease.

Cover photo of handwashing stations that are appearing outside homes and businesses, such as at this bank in Monrovia, Liberia. Photo courtesy of Jarsea Burphy, director of public affairs for Liberia Telecom Authority.

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