A frantic, 36-hour effort to save the life of Dr. Martin Salia at the Nebraska Medical Center included a rare dose of the experimental Ebola drug ZMapp, hospital officials disclosed Monday.
The 44-year-old surgeon contracted the virus while treating patients in Sierra Leone and arrived in Omaha on Saturday in “extremely critical condition,” doctors there said. Salia succumbed to the disease at 4 a.m. Monday.
ZMapp was one of two unproven medical treatments health-care workers employed during a round-the-clock struggle to rescue him, officials said. The second was a transfusion of blood plasma from an unidentified Ebola survivor. Both treatments failed to reverse the course of Salia’s illness.
“When he arrived … he had no kidney function,” said Dr. Daniel Johnson, the hospital’s critical-care director. “He was working extremely hard to breathe and was unresponsive.”
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“Despite amazing care … he progressed to the point of cardiac arrest,” Johnson told reporters. “We really gave it everything we could.”
Neither ZMapp nor the transfusion of so-called convalescent plasma has been proved to fight Ebola in humans. However, researchers believe they might help by introducing useful virus-fighting antibodies into a patient’s bloodstream.
The hospital, which has successfully treated two other Ebola patients, was contacted by ZMapp’s sponsor after learning that Salia was being flown there for treatment, according to Dr. Christopher Kratochvil, vice chancellor for clinical research at the University of Nebraska Medical Center.
ZMapp was developed by Mapp Biopharmaceutical, of San Diego, and contains a cocktail of three monoclonal antibodies.
The drug is grown in tobacco leaves and takes months to develop. In August, the company announced that its supply had been exhausted.
Monday was the first time since then that officials had discussed its use in a patient.
ZMapp has been used in more than a half-dozen patients; until Monday, all but two recovered. That performance, along with promising clinical-trial results in animals, prompted the U.S. Department of Health and Human Services Biomedical Advanced Research and Development Authority (BARDA) to try to accelerate production of the drug.
“The first doses are undergoing testing and are expected to be available for clinical trial in January,” BARDA Director Robin Robinson said in an email Monday. “In addition, the company is working with Kentucky BioProcessing to produce additional doses that would be available later next year.”
Three doses of ZMapp are required for a single treatment course.
Robinson said enough of the drug would be produced “to treat 20-40 persons” in each of the upcoming clinical trials.
Erica Ollmann Saphire, a researcher at The Scripps Research Institute in the San Diego community of La Jolla, said that she and other scientists were studying ways of improving ZMapp and streamlining its production.
In a paper published Monday in the journal PNAS, Saphire and her colleagues reported that two of the monoclonal antibodies in ZMapp attached themselves to the same structure on the surface of the Ebola virus, which means there may be ways to make more of the drug more quickly.