SACHA PFEIFFER, HOST:
Ebola virus is a wily pathogen. It jumps to a new person through bodily fluids, then it goes straight for key immune cells. It essentially turns them off. It then spreads quickly, causing widespread havoc and killing about half the people it infects. And for the kind of Ebola currently spreading in Central Africa, there are no approved treatments. But as NPR's Jonathan Lambert reports, that high death rate is not inevitable if a patient gets the right care.
JONATHAN LAMBERT, BYLINE: Once Ebola sneaks into the body and has turned off those key immune cells, it causes a lot of damage as it spreads. John Connor is a virologist at Boston University. He says, first, it goes to the lymph nodes, then to the spleen, the liver and the kidneys.
JOHN CONNOR: Now the cleaning and garbage disposal units of the body are backing up, and that backs up into the blood system. That has a lot of negative consequences.
LAMBERT: By this point, the immune system still isn't targeting the Ebola virus itself, but it does know that something is wrong and spurs more general immune cells into action. With Ebola, this often goes overboard, causing even more damage. Krutika Kuppalli is an infectious disease physician who cared for Ebola patients in 2014. She saw some awful symptoms.
KRUTIKA KUPPALLI: You develop things like profuse diarrhea, where they'd be losing, you know, about 10 liters of fluid a day.
LAMBERT: Sometimes blood vessels become so damaged that they leak. Often, patients die because they simply lose too much fluid. Replacing those fluids was Kuppalli's No. 1 job in her Ebola treatment unit in Sierra Leone. She'd try to get patients to drink oral rehydration salts akin to Pedialyte, if they could keep it down. If they couldn't, an IV could replace the fluids and electrolytes.
KUPPALLI: It was really hard. I mean, I remember going in the first day, and I still have the picture in my mind of these three patients slumped over the bed, and I didn't know if they were alive or not.
LAMBERT: In the thick of an Ebola outbreak, healthcare workers are often taking care of dozens of patients at a time. Before any shift, they've got to don a heavy Tyvek suit, gloves and goggles to protect themselves, says Armand Sprecher, a physician with Doctors Without Borders.
ARMAND SPRECHER: When you sweat, it doesn't evaporate, and you don't get rid of heat. It just ends up being puddles in your boots.
LAMBERT: As a result, clinicians have little time with each patient. They do their best to monitor them and to try to keep up with the loss of fluids from vomiting or diarrhea. But in many clinics, it's too much, says Craig Spencer. He's a physician who treated Ebola patients in Guinea in 2014.
CRAIG SPENCER: People talk about 15 minutes with their doctor's not enough. Imagine, you know, five minutes with your doctor if you've got Ebola. And that was just a reality of not having enough providers and not having the resources that we needed.
LAMBERT: Spencer experienced a much different reality when he returned from Guinea with Ebola himself. After developing symptoms, he ended up at Bellevue Hospital in New York City.
SPENCER: In Guinea, I was taking care of 30 to 40 patients at any time. In the U.S., there were probably 30 to 40 providers on call at any time just to take care of me.
LAMBERT: Those staff were able to do all sorts of things that he couldn't do in Guinea - fancier lab tests, more tailored IVs to replace lost fluids, even dialysis to make up for damaged kidneys.
SPENCER: It was seemingly unlimited access to anything and everything that you might need to improve your chance of survival.
LAMBERT: The difference in outcomes is clear. Of the 11 people ever treated for Ebola in the U.S., nine survived. That's a dramatically higher survival rate than experienced at the epicenter of Ebola outbreaks in Africa. To Spencer, that difference illustrates how Ebola is a disease that's only as deadly as society allows it to be. Jonathan Lambert, NPR News.
(SOUNDBITE OF SUMMER WALKER SONG, "SPEND IT (RENT IS DUE)") Transcript provided by NPR, Copyright NPR.
NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.