Surgeon from Sierra Leone treated for Ebola in Nebraska dies.

A surgeon who caught Ebola virus disease while working in Sierra Leone died early in the morning of 17 November while undergoing treatment in the biocontainment unit at Nebraska Medical Center in Omaha, Nebraska. Martin Salia, a Sierra Leone national and a permanent US resident, practiced as a surgeon at Kissy United Methodist Hospital in Freetown, Sierra Leone. He was flown to Omaha from Sierra Leone on 15 November. “Dr Salia was extremely critically ill when he arrived to our hospital,” Daniel W Johnson, director of critical care at the University of Nebraska Medical Center, said in a news conference. “He had no kidney function, he was working extremely hard to breathe, and he was unresponsive.” Salia was put on continuous renal dialysis but within 12 hours had progressed to respiratory failure requiring intubation and mechanical ventilation, Johnson said. Shortly thereafter Salia’s blood pressure dropped, and despite maximum support he went into cardiac arrest. It is not known how Salia had become infected. While in hospital Salia received convalescent serum from an Ebola survivor as well as the experimental Ebola drug ZMapp. He is the tenth person to be treated for Ebola in the United States. All have survived except Salia and Thomas Eric Duncan, a 42 year old Liberian national who fell ill in late September shortly after arriving in Dallas, Texas, from west Africa. To date, three patients with Ebola have been treated at the Nebraska facility, which is one of four high level biocontainment treatment units in the US. The two previous patients—Rick Sacra, a Massachusetts physician who contracted the disease while doing missionary work in west Africa, and Ashoka Mukpo, a freelance photojournalist who was working in west Africa for NBC News—were treated and discharged free of the disease. Phil Smith, medical director of the biocontainment unit and professor of infectious diseases at the University of Nebraska Medical Center, said that the medical team “used every possible treatment available.” He said, “As we have learned, early treatment with these patients is essential. In Dr Salia’s case, his disease was already extremely advanced by the time he came here for treatment.”