A surgeon who contracted Ebola while working in his native Sierra Leone has died in a US hospital.
Nebraska Medical Centre said Dr Martin Salia died as a result of the disease. Hospital spokesman Taylor Wilson said he died shortly after 4am today.
Dr Phil Smith, medical director of the centre's biocontainment unit, said: "Dr Salia was extremely critical when he arrived here, and unfortunately, despite our best efforts, we weren't able to save him."
Dr Salia arrived on Saturday to be treated at the Omaha hospital, where two other Ebola patients have been successfully treated.
He had advanced symptoms, which included kidney and respiratory failure, the hospital said. He was placed on dialysis, a ventilator and given several medications to support his organ systems.
"We used every possible treatment available to give Dr Salia every possible opportunity for survival," Dr Smith 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."
Ebola has killed more than 5,000 people in West Africa, mostly in Liberia, Guinea and Sierra Leone. Five other doctors in Sierra Leone have contracted Ebola and all have died.
The 44-year-old Dr Salia had been working as a general surgeon at Kissy United Methodist Hospital in the Sierra Leone capital of Freetown.
It is not clear whether he was involved in the care of Ebola patients. Kissy is not an Ebola treatment unit, but Dr Salia worked in at least three other facilities, United Methodist News said, citing health ministry sources.
Dr Salia, a Sierra Leone citizen who lives in Maryland, first showed Ebola symptoms on November 6 but tested negative for the virus. He tested positive on November 10.
His wife, Isatu Salia, said that when she spoke to her husband early on Friday his voice sounded weak and shaky. But he told her "I love you" in a steady voice, she said.
The two prayed together and their children, aged 12 and 20, are coping, she said. She said her husband was "my everything".
Mrs Salia also said she and her family were grateful for the efforts made by her husband's medical team.
"We are so appreciate of the opportunity for my husband to be treated here and believe he was in the best place possible," she said.
Dr Salia was given the experimental drug ZMapp on Saturday. He also received a plasma transfusion from an Ebola survivor, a treatment that is believed to provide antibodies to fight the virus.
The first two Ebola patients to return to the US, Dr. Kent Brantly and Nancy Writebol, were treated with ZMapp in August. Their treatments exhausted that supply of the drug and Dr Salia was treated using a new batch of the drug.
Of 10 people to be treated for the disease in the United States, all but two have recovered. Thomas Eric Duncan, of Liberia, died at a Dallas hospital in October.
Dr Salia graduated from the Pan African Academy of Christian Surgeons training programme in 2008. A fellow medical missionary, Richard Toupin, last week described his colleague as "one of the best-trained surgeons in his country".
Bruce Steffes, executive director of PAACS, said Dr Salia was free to practice anywhere but elected to work in Sierra Leone where the need for surgeons is immense.