The second diagnosis of Ebola in the United States means that “we have to rethink the way we address Ebola infection control,” the Centers for Disease Control and Prevention (CDC) Director Dr. Tom Frieden said Monday.The patient, identified later in the day as 26-year-old Nina Pham, is currently in clinically stable condition, Frieden said, and the CDC has brought in an additional team to help identify and monitor any people who may have had contact with her during the period that she was potentially infectious. So far, there is “one and only one” person who fits that description, Frieden said.
Additionally, CDC officials are conducting a detailed investigation into how Pham, a health care worker at the Texas Health Presbyterian Hospital in Dallas, contracted the disease. Frieden said he was “particularly concerned” about the process involved when health care workers take off their isolation equipment. He added that he was “sorry” if he gave off the impression that Pham was somehow at fault for not properly taking off her protective gear.
“I feel awful,” said Frieden of the second Ebola case. “All of us have to work together to do whatever’s possible to reduce the risk that any other health care worker becomes infected.”
Health officials confirmed Sunday that a nurse at the Texas Health Presbyterian Hospital in Dallas tested positive for Ebola after caring for Thomas Eric Duncan, the first person to be diagnosed with and die of the deadly disease on American soil. The case marks the first person-to-person transmission of Ebola in the U.S.
Duncan, a 42-year-old Liberian resident, died last Wednesday, a week and a half after first receiving treatment for the virus.
Frieden said Sunday that Pham contracted Ebola through an inadvertent breach of care protocol while helping to treat Duncan during his second visit to the hospital. The first time Duncan sought treatment for a fever and abdominal pain, his travel history fell through the cracks and he was sent home with antibiotics – a decision which has since called into question the level of care he received.
Pham “was following full CDC precautions – gown, glove, mask, and shield,” said Dr. Daniel Varga, chief clinical officer of Texas Health Resources, which operates the hospital. However, breaches can occur in the process of taking off personal protective gear.
“It’s possible that when you come out of a unit, that as you take off your gloves, you might even touch your face, or it’s possible that you take the suit off with clean hands and there might be Ebola on the outside of the suit,” Nancy Writebol, an American missionary who contracted and survived Ebola while working in Liberia, told msnbc’s Andrea Mitchell Monday. “But we were very careful in making sure that health care workers, the doctors and nurses, were sprayed down properly with bleach, and that we walked them through every step as they came out. It takes as long to get out of a suit as it does to get into a suit.”
President Obama received two briefings Sunday about the latest Ebola case, and called for federal authorities to beef up measures so that health care workers can better follow protocols for treating Ebola patients. The U.S. is sending up to 4,000 military personnel to West Africa, though any contact with the virus will be limited to specimen samples, not actual patients.
More than 8,000 cases of Ebola have emerged in Guinea, Liberia, and Sierra Leone over the course of the current outbreak – the worst in history – and over 4,000 people have died, according to the World Health Organization. The disease is spread through direct contact with the bodily fluids of a person who is symptomatic, which leaves those who care for the victims particularly vulnerable. The WHO estimates that at least 416 health care workers have contracted Ebola, and at least 233 have died.
In Spain, a nurse who contracted Ebola while treating a missionary is showing marginal signs of recovery, a government statement said Sunday. But her prognosis remains serious, and further complications cannot be ruled out. Like the Spanish nurse, the first person to become infected with Ebola outside of Africa, Pham has a dog. Health officials put down the Spanish nurse’s dog last week out of concern that Ebola could be transmitted through animals, but Dallas Mayor Mike Rawlings told USA Today there were no plans to the euthanize the Pham’s pet.