A hazmat worker moves a barrel while finishing up cleaning outside an apartment building of a hospital worker in Dallas
A second health care worker at a Dallas hospital who provided care for the first Ebola patient diagnosed in the U.S. has tested positive for the disease, authorities said yesterday.
The worker reported a fever Tuesday and was immediate isolated at Texas Health Presbyterian Hospital, the Texas Department of State Health Services said in a statement.
Health officials said the worker was among those who took care of Thomas Eric Duncan after he was diagnosed with Ebola. Duncan died last Wednesday at the Texas hospital.
The department said a preliminary Ebola test was conducted late Tuesday at a state public health laboratory in Austin, Texas, and that confirmatory testing would be conducted at the federal Centers for Disease Control and Prevention in Atlanta.
The statement also said the health care worker, who wasn’t identified, was interviewed to quickly identify any contacts or potential exposures and that others will be monitored. It added that the type of monitoring will depend on the nature of their interactions with the health care worker and the potential of exposure to the virus.
Officials have said they don’t know how the first health worker, a nurse, became infected. But the second case pointed to lapses beyond how one individual may have donned and removed personal protective garb.
“An additional health care worker testing positive for Ebola is a serious concern, and the CDC has already taken active steps to minimize the risk to health care workers and the patient,” the CDC said in a statement released yesterday in Atlanta.
The federal agency said yesterday that it was conducting the follow-up testing to confirm the preliminary Texas lab result. And it said it also took part in interviewing the second health care worker to identify any contacts or potential exposures in the community.
Dr. Tom Frieden, head of the CDC, has acknowledged that the government wasn’t aggressive enough in managing Ebola and containing the virus as it spread from an infected patient to a nurse at a Dallas hospital.
“We could’ve sent a more robust hospital infection control team and been more hands-on with the hospital from day one about exactly how this should be managed,” he said Tuesday.
Frieden outlined new steps this week designed to stop the spread of the disease, including the creation of an Ebola response team, increased training for health care workers nationwide and changes at the Texas hospital to minimize the risk of more infections.
“I wish we had put a team like this on the ground the day the patient — the first patient — was diagnosed. That might have prevented this infection,” Frieden said.
The stark admission came as the World Health Organization projected the pace of infections accelerating in West Africa to up to 10,000 new cases a week within two months.
In a conference call late Tuesday, the nation’s largest nurses’ union described how the patient, Duncan, was left in an open area of the emergency room for hours. National Nurses United, citing unnamed nurses, said staff treated Duncan for days without the correct protective gear, that hazardous waste was allowed to pile up to the ceiling and safety protocols constantly changed.
RoseAnn DeMoro, executive director of Nurses United, refused to say how many nurses made the statement about Texas Health Presbyterian Hospital, but insisted they were in a position to know what happened.
A total of 76 people at the hospital might have been exposed to Duncan, and all of them are being monitored for fever and other symptoms daily, Frieden said. Nurse Nina Pham contracted the virus while caring for Duncan. Health officials are monitoring 48 others who had some contact with Duncan before he was admitted the hospital where he died. The Associated Press reported Monday that Pham was among about 70 hospital staffers who were involved in Duncan’s care after he was hospitalized, based on medical records provided by his family.
Frieden said some of the world’s leading experts on how to treat Ebola and protect health care workers are in the new response team. They will review several issues including how isolation rooms are laid out, what protective equipment health workers use, waste management and decontamination.
In Europe, the WHO said the death rate in the outbreak has risen to 70 percent as it has killed nearly 4,500 people, most of them in West Africa. The previous mortality rate was about 50 percent.
President Barack Obama, speaking at the end of a meeting with U.S. and allied military leaders, declared that the “the world is not doing enough” to fight Ebola.
Pham, 26, became the first person to contract the disease on U.S. soil as she cared for Duncan. The nurse released a statement Tuesday through Texas Health Presbyterian Hospital saying she was “doing well,” and the hospital listed her in good condition. She has received a plasma transfusion from a doctor who beat the virus and the hospital CEO said medical staff members remain hopeful about her condition.
Pham was in Duncan’s room often, from the day he was placed in intensive care until the day before he died.
“I’m doing well and want to thank everyone for their kind wishes and prayers,” she said.
Pham’s parents live in Fort Worth, where they are part of a close-knit, deeply religious community of Vietnamese Catholics. Members of their church held a special Mass for her Monday and her sorority sisters at the Texas Christian University held a candlelight vigil for her Tuesday.
Pham and other health care workers wore protective gear, including gowns, gloves, masks and face shields — and sometimes full-body suits — when caring for Duncan. Health officials have said there was a breach in protocol that led to the infections, but they don’t know where the breakdown occurred.
Among the changes announced Tuesday by Frieden was a plan to limit the number of health care workers who care for Ebola patients so they “can become more familiar and more systematic in how they put on and take off protective equipment, and they can become more comfortable in a healthy way with providing care in the isolation unit.”
Frieden said he was fully aware of the fear among health care workers in Texas and elsewhere about the risks of contracting the virus.
“Ebola is unfamiliar. It’s scary, and getting it right is really, really important because the stakes are so high,” he said. Emily Schmall and Nomaan Merchant, Dallas, AP
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