Error in Dallas may have exposed others to Ebola, CDC chief says

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This 2010 photo provided by Texas Christian University shows nurse Nina Pham, who has contracted Ebola.

The misstep that allowed a Texas nurse to contract Ebola while treating a patient may have exposed others to the virus, the nation’s leading healthcare official said Monday as experts stepped up scrutiny of medical workers at the hospital where the breach occurred.

The second case of Ebola diagnosed in this country came after American officials had insisted for weeks there was a minuscule chance of the virus penetrating the U.S. healthcare system. The case raised questions on several fronts: the preparedness of medical facilities to handle Ebola patients properly; the funding available for hospitals to ready themselves for pandemics; the policy of allowing people from the hardest-hit African nations to enter the United States.

In Dallas, officials were even faced with how to handle the ill nurse’s pet dog. Texas Health Commissioner David Lakey said officials had decontaminated the patient’s apartment and were looking for a location that would allow “proper monitoring” of the dog, a 1-year-old King Charles spaniel she referred to online as Bentley.

“One and only one” person is known to have had direct contact with the nurse, Nina Pham, said Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention. Neither that person, who is being monitored, nor the dog has shown symptoms of illness.

But Frieden said a “large number” of medical workers who worked with Pham while she was treating a Liberian man for Ebola could have been exposed to the deadly virus if they were affected by the same protocol breach that led to her illness. Pham became sick after treating Thomas Eric Duncan, who was hospitalized at Texas Health Presbyterian Hospital in Dallas on Sept. 28. He died Wednesday.

“We need to consider the possibility there could be additional cases, particularly among the healthcare workers who cared for the … patient when he was so ill,” Frieden said. “We’re concerned and unfortunately would not be surprised if we did see additional cases among healthcare workers.

“The thinking here is straightforward,” Frieden said. “If this one individual was infected … it is possible other individuals could have been infected as well.”

As Frieden spoke, CDC experts at Texas Health Presbyterian were watching hospital staff as they entered and left Pham’s room, and as they donned and removed the protective gloves, masks, hoods and cloaks required to treat Ebola patients.

Their goal was to learn what went wrong at the hospital, which is also facing questions about its treatment of Duncan on his first visit to the emergency room Sept. 25. Duncan, who arrived in the U.S. on Sept. 20, complained days later of abdominal pain and a fever. Both are Ebola symptoms.

We’re concerned and unfortunately would not be surprised if we did see additional cases among healthcare workers.- Thomas Frieden, CDC director

The hospital has said a nurse followed CDC protocol in asking whether Duncan had been in Africa recently. Duncan said he had, but was sent away with a prescription for antibiotics. Three days later, he returned in an ambulance and tested positive for Ebola.

A total of 48 people who had contact with Duncan are being monitored for fever or other symptoms until Sunday, the end of the 21-day Ebola incubation period. None has become ill.

Duncan’s fiancee, Louise Troh, is among them. Reached by telephone Monday, she said she was “feeling all right” but feared her connection to Duncan would stigmatize her.

“I don’t want people putting that on me, saying I have Ebola,” said Troh, who has lived in the U.S. for more than 15 years. She has been isolated from most of her relatives since Sept. 28. “I’m hurt; I don’t have anyone to cry on,” she said.

Frieden said officials didn’t know how many more people would need isolating as a result of Pham’s illness. He described Pham as “clinically stable.”

Friends of the family said Pham, 26, graduated from Nolan Catholic High School in Fort Worth in 2006. Four years later, she graduated from Texas Christian University with a nursing degree, a university spokeswoman confirmed.

A family friend, Tom Ha, described her as a “very devoted Catholic” for whom other people “always come first.”

Her priest, the Rev. Jim Ngo Hoang Khoi of Our Lady of Fatima Church in Fort Worth, said she had received a blood transfusion from an Ebola survivor, according to her mother, Ngoc “Diana” Pham. A survivor’s blood contains antibodies to the virus. The World Health Organization has endorsed such transfusions, although their usefulness as a treatment is unproven.

Dr. Kent Brantly has donated blood to two other Ebola patients. One has recovered and been released from the hospital; the other appears to be improving.

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A “no trespassing” notice is posted outside the apartment of a healthcare worker who tested positive for Ebola after treating Thomas Eric Duncan, who died from the disease. (Brandon Wade / Associated Press)

Samaritan’s Purse, the aid group that Brantly worked for in Liberia when he contracted Ebola this year, confirmed he had donated blood plasma to Pham. He had also offered to donate to Duncan, Samaritan’s Purse said, but their blood types did not match.

Pham is “very lucky” to be a match, her priest said.

Ngo said Pham’s mother is staying at a hotel near the hospital and has been communicating with her daughter via Skype and cellphone.

He characterized Pham as “very calm and hopeful.”

Written by Molly Hennessy-Fisk, Tina Susman
Read more at Los Angeles Times

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