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Sunday, October 12, 2014

Another American Ebola Victim

The Washington Post reports that one of the nurses that cared for Thomas Duncan (the Liberian that came to the U.S. after being infected with Ebola) has tested positive for Ebola. This despite wearing full protective gear. According to the report, "Thomas Frieden, director of the CDC, said that an unknown breach in protocol led to the Texas Health Presbyterian Hospital worker being infected and that federal officials are investigating." He also indicated that there may be additional cases. 

Frieden's explanation is similar to that given for a nurse in Spain coming down with Ebola--i.e., that some safety protocol had been violated. However, that a minor slip up could lead to transmission gives lie to the oft repeated statements that the virus does not easily spread. Moreover, the Washington Post story first cited above notes:
The CDC did not consider the nurse to be “high risk,” said Daniel Varga, chief clinical officer for Texas Health Resources, which operates Texas Health Presbyterian Hospital in Dallas. She treated Duncan, the Ebola patient, after his second visit to the emergency room, on Sept. 28, and was “following full CDC precautions,” including wearing a gown, gloves, a mask and a protective face shield.
The story relates that CDC protocols require protective gear to be removed in a particular order to avoid touching the skin or clothing, and, Frieden admitted, "[i]t's not easy to do right." (See also here).

The story goes on:
The hospital has put its emergency room on “diversion,” which means that ambulances are not currently bringing patients to the ER, though patients already in the hospital are still being cared for. 
Frieden said federal officials are working with the hospital to “ramp up training and education.” He noted that caring for Ebola patients requires “meticulous and scrupulous attention to infection control” and that an “inadvertent slip” can result in contamination and infection.
In other words, as others have noted recently, the biggest impact of Ebola in the United States may be that a relatively number of patients may overwhelm available medical resources. In this case, we have an entire E.R. out of action, and numerous health personnel now under observation.

The Associated Press article on this second infection contained this interesting tidbit:
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, like a cut or scrape or someone touching the nose, mouth or eyes with contaminated hands, or being splashed. The World Health Organization says blood, feces and vomit are the most infectious fluids, while the virus is found in saliva mostly once patients are severely ill. The whole live virus has never been culled from sweat.
(Underline added). Again, suggesting that it is spread more readily than officials are admitting.

Flashback: My first post on the Ebola outbreak, on March 23, 2014, where I noted that the outbreak was unusual because it had spread over a large geographic distance. At that time, the outbreak was still limited to Guinea.

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