Angela Hewlett

Angela Hewlett is among a group of authors whose report will appear in a medical journal.

Twenty-two of 27 Ebola patients who were treated in American and European hospitals survived, including two of the three who were cared for in Omaha.

The ability to provide aggressive care — intravenous nutrition and fluids, lab tests to monitor and react to magnesium and potassium levels, and other strategies — made a difference, said Dr. Angela Hewlett, associate medical director of the Nebraska Biocontainment Unit.

Hewlett, an associate professor of infectious diseases at the University of Nebraska Medical Center, was one of more than 15 writers of an article on Ebola that appeared this month in the New England Journal of Medicine’s online edition. Hewlett said the article also will appear in the print version of the magazine.

Between 37 percent and 74 percent of Ebola patients in African hospitals died, depending on where they were treated. Nineteen percent of the 27 Ebola patients cared for in the U.S. and Europe died.

“This was a different type of care than was available in Africa at the time,” Hewlett said.

The paper said clinics in West Africa faced many challenges, including “overwhelming numbers of severely ill patients, limited medical and nonmedical supplies, insufficient numbers of caregivers” and other problems.

Hewlett said the African hospitals also lacked the intensive care units of the facilities in the U.S. and Europe. Only some African hospitals could provide intravenous fluids, Hewlett said.

More than 11,300 patients died of the Ebola virus through December.

Patients with the Ebola virus began to be moved to European and American hospitals in August 2014. Besides the Nebraska Medical Center, four American institutions treated Ebola patients — the National Institutes of Health in Maryland (two patients), Emory University Hospital in Atlanta (four), Bellevue Hospital in New York (one) and Presbyterian Hospital in Dallas (one).

It was the first time American hospitals had treated Ebola patients, Hewlett said. There was “a lot of uncertainty,” she said, and not much information about what laboratory results would look like or how patients would react to treatments.

Various experimental medications were used in the U.S. and Europe, but it was impossible to tell whether they made a difference, she said. Clinical trials are underway to determine whether those drugs are beneficial.

Each caregiver had to wear a face shield, a mask, three pairs of gloves and other protective gear before entering the patient room.

Hewlett said the Omaha team took heart when its first Ebola patient, Dr. Rick Sacra, turned the corner.

“We saw some improvement, which was very gratifying,” she said. “I was always in awe of our team members, especially our nursing staff.”

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