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Nation & World

Originally published October 13, 2014 at 5:53 AM | Page modified October 13, 2014 at 9:32 AM

Health care workers monitored after Ebola caseHealth officials are intensifying the monitoring of hospital workers who provided care to the firstperson to be diagnosed with Ebola in the U.S. after one of them was infected with the virus despitewearing protective gear.

By NOMAAN MERCHANT

Associated Press

DALLAS —

Health officials are intensifying the monitoringof hospital workers who provided care to thefirst person to be diagnosed with Ebola in theU.S. after one of them was infected with thevirus despite wearing protective gear.

Tests confirmed the first known case of Ebolatransmitted in the nation, raising questionsabout assurances by health officials here thatthe disease will be contained and any Americanhospital should be able to treat it.

Dr. Tom Frieden, head of the Centers forDisease Control and Prevention, said Sunday

AP

CDC Confirms Dallas Woman Positive for Ebola

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there had been a breach of protocol that led theworker to become infected while treatingpatient Thomas Eric Duncan, but officials arenot sure what occurred. Duncan, who traveledfrom Liberia to visit family, did not get sickuntil he arrived in the U.S. He diedWednesday.

The worker, who has not been identified, hasnot been able to point to how the breach mighthave occurred.

President Barack Obama asked the CDC toquickly investigate the incident, the WhiteHouse said.

Dr. Anthony Fauci, director of the NationalInstitute of Allergy and Infectious Diseases wasasked on ABC's "Good Morning America" iffederal health authorities should considerrequiring that Ebola patients be sent only tohighly specialized "containment" hospitals.

"That is something that should be seriously considered," Fauci said.

Dallas police barred entry to the health care worker's apartment complex Sunday. Officers alsoknocked on doors, made automated phone calls and passed out fliers to notify people within afour-block radius about the situation, although Dallas authorities assured residents the risk wasconfined to those who have had close contact with the two Ebola patients.

The worker wore a gown, gloves, mask and shield while she cared for Duncan during his secondvisit to Texas Health Presbyterian Hospital, said Dr. Daniel Varga of Texas Health Resources,which runs the hospital.

Duncan, who arrived in the U.S. from Liberia Sept. 20, first sought medical care for fever andabdominal pain Sept. 25. He told a nurse he had traveled from Africa, but he was sent home. Hereturned Sept. 28 and was placed in isolation because of suspected Ebola.

Liberia is one of the three West African countries most affected by the Ebola epidemic, which haskilled more than 4,000 people, according to World Health Organization figures. The others areSierra Leone and Guinea.

Texas health officials have been closely monitoring nearly 50 people who had or may have hadclose contact with Duncan after he started showing symptoms but before he was diagnosed withthe disease.

The health care worker reported a fever Friday night as part of a self-monitoring regimen requiredby the CDC, Varga said.

Another person described as a "close contact" of the health worker has been proactively placed inisolation, he added, without saying where. The hospital said its emergency department is divertingambulances to other hospitals, though is still accepting walk-in patients.

"We knew a second case could be a reality, and we've been preparing for this possibility," said Dr.David Lakey, commissioner of the Texas Department of State Health Services. "We are broadeningour team in Dallas and working with extreme diligence to prevent further spread."

Frieden said officials will monitor any workers who may have been exposed while Duncan was in

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the hospital.

Among the things the CDC will investigate is how the workers took off protective gear, becauseremoving it incorrectly can lead to contamination. Investigators will also look at dialysis andintubation -- the insertion of a breathing tube in a patient's airway. Both procedures have thepotential to spread the virus.

Fauci said on CNN that the CDC is examining procedures like dialysis to see if they "heightengreatly" the risk of health care workers contracting Ebola. He suggested that in cases where thepatient has deteriorated to the point where he or she cannot be saved, such high-risk proceduresshould not be done.

Every emergency room needs to be prepared to isolate and take infection control precautions,because no one can control where an Ebola patient might show up, said Dr. Dennis Maki,University of Wisconsin-Madison infectious disease specialist and former head of hospitalinfection control.

However, only large hospitals such as those affiliated with major universities truly have theequipment and manpower to deal with Ebola correctly, Maki said.

Health care workers treating Ebola patients are among the most vulnerable, even if wearingprotective gear.

Nurses at many hospitals "are alarmed at the inadequate preparation they see," says a statementfrom Rose Ann DeMoro, executive director of the union National Nurses United.

A Spanish nurse assistant who helped care for two patients is the first health care worker infectedoutside West Africa in this outbreak. More than 370 health care workers in West Africa have fallenill or died since the epidemic began earlier this year.

Officials said they were told there may be a pet in the Texas health care worker's apartment, andhave a plan to care for the animal. They do not believe the pet has signs of having contractedEbola. A dog belonging to the Spanish nurse was euthanized, drawing thousands of complaints.

Ebola spreads through close contact with a symptomatic person's bodily fluids, such as blood,sweat, vomit, feces, urine, saliva or semen. Those fluids must have an entry point, such as a cut orscrape or someone touching the nose, mouth or eyes with contaminated hands, or being splashed.

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