N.Y. doctor, free of Ebola, discharged from hospital

NEW YORK — Craig Spencer, a New York doctor whose hospitalization for Ebola stirred fears that the disease might spread throughout Manhattan, was declared free of the virus Tuesday and released from the hospital.

"Dr. Spencer is Ebola-free and New York City is Ebola-free," said a beaming Mayor Bill de Blasio, who hugged the doctor at a news conference attended by nurses and doctors at Bellevue hospital.

"He's suffered a lot these last few weeks, but he's come back really strong," the mayor said.

The release of the 33-year-old physician, who tested positive for the virus Oct. 23, means there are no longer any known Ebola cases being treated in the United States.

The volunteer with Doctors Without Borders contracted the disease while treating Ebola patients in Guinea in West Africa.He thanked the doctors and nurses and declared, "Today, I am healthy and no longer infectious."

"My recovery from Ebola speaks to the effectiveness of the protocols in place for health staff returning from West Africa at the time of my infection," he said, reading from a prepared statement. "I am a living example of how those protocols work and of how early detection and isolation is critical to both surviving Ebola and ensuring that it is not transmitted to others."

In emotional remarks, Spencer called on the public to turn its attention back to West Africa and ensure that "medical volunteers and other aid workers do not face stigma and threats upon their return home."

"Volunteers need to be supported to help fight this outbreak at its source," he said.

Spencer's case touched off a firestorm of controversy when the governors of New York and New Jersey instituted mandatory quarantine orders for travelers from West Africa, particularly Ebola aid workers, after learning that Spencer had taken the subway and gone bowling the night before he tested positive for the virus.

From the outset, De Blasio urged New Yorkers not to be alarmed by Spencer's diagnosis, saying that those not exposed were not at risk. The mayor emphasized again Tuesday that the disease is "very, very difficult to contract and that New Yorkers understood that."

"People actually got it — 8.4 million people got it and just went about their lives," he said.

De Blasio praised the doctor for his strength during his illness and for his volunteer work.

"(He) showed us what it means to help our fellow human beings, and that spirit was met and answered by the extraordinary team here at Bellevue, especially these nurses and the medical team," the mayor said.

Ram Raju, president of the New York City Health and Hospitals Corp., also praised Spencer. "We have been able to cure a hero," he said.

"We've got your back," he told him.

Mary Bassett, commissioner of the New York City Department of Health, called Spencer's release "a very happy occasion."

She pledged that the city would continue to be vigilant, saying the Ebola crisis was still a threat in New York and the United States, though not at the same level now that medical protocols and travel controls are in place.

Spencer was treated in a specially designed isolation unit. His condition was upgraded from serious to stable last week.

His fiancee and two friends were quarantined initially but were released and are being actively monitored.

The initial alarm over Spencer's diagnosis was unnecessary, experts said. An October report in The New England Journal of Medicine suggested that patients may not be contagious until two to three days after first showing symptoms.

Nearly four decades of experience with Ebola shows that the virus is not transmitted through casual contact and cannot spread until a patient has symptoms, says Amesh Adalja, senior associate at the Center for Health Security of the University of Pittsburgh Medical Center.

All eight Americans who have been treated for Ebola in U.S. hospitals have survived, a striking contrast to the 70% mortality rate in West Africa. The high survival rate in U.S. hospitals illustrates the value of aggressive care in an advanced intensive care unit, Adalja said.

Unlike doctors in West Africa, who sometimes lack access to running water and soap, doctors in the USA have a variety of ways to support patients with Ebola and manage serious side effects, such as low blood pressure and dehydration.

Beyond that supportive care, Spencer also received an experimental medication and a blood donation from Ebola survivor Nancy Writebol, a missionary who contracted the virus in Liberia and was treated at Emory University Hospital in Atlanta.

Adalja said it's notable that the only two Americans to be infected with Ebola while in the USA have been medical workers caring for the first Ebola patient, Thomas Eric Duncan, who died in Dallas Oct. 8.

Ebola patients are not highly contagious in the early days of the illness, when levels of the virus in their blood are very low. They become more contagious as the illness progresses — and as they develop heavy diarrhea and vomiting — as the levels of virus in their blood rise. By this point, patients are usually hospitalized or bedridden, says Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine.

Spencer asked people to "focus your attention where it is most urgently needed, at the source of the Ebola outbreak in West Africa."

More than 13,000 people have been infected with Ebola in the three countries, and 4,960 have died, according to the World Health Organization.

Stanglin and Szabo reported from McLean, Va.