Hospital Workers Being Watched for Ebola Exposure


From the WebMD Archives

By Dennis Thompson

HealthDay Reporter

TUESDAY, Oct. 14, 2014 (HealthDay News) — Public health officials are actively monitoring 76 Dallas hospital workers who may have been exposed to Ebola while treating Thomas Eric Duncan, the first patient diagnosed with the deadly virus in the United States.

Officials identified the workers after one of Duncan’s nurses, Nina Pham, tested positive for Ebola, opening up the possibility that others might have been exposed through contact with either Duncan or his bodily fluids, Dr. Tom Frieden, director of the federal Centers for Disease Control and Prevention, said during a Tuesday afternoon news conference.

To prevent future exposures of health care workers, Frieden pledged to send a team of top CDC infection-control experts to any U.S. hospital that must treat an Ebola patient.

“I’ve thought often about it. I wish we had put a team like this on the ground the day the first patient was diagnosed,” Frieden said. “That might have prevented this infection.”

Medical experts still haven’t determined how Pham became exposed to Ebola, Dr. David Lakey, commissioner of the Texas Department of State Health Services, said during the news conference.

Doctors diagnosed Duncan, a Liberian national, with Ebola on Sept. 28 at Texas Health Presbyterian Hospital in Dallas. He died 10 days later, on Oct. 8.

Liberia, Guinea and Sierra Leone are the three West African nations ravaged by the Ebola outbreak that began there last spring.

Two days following Duncan’s death, Pham returned to the hospital with a fever. The next day, tests revealed that she had contracted Ebola from her patient, and public health officials began a frantic investigation to determine who else at Texas Health Presbyterian might have been exposed.

Officials also are still monitoring 48 people who may have been exposed to Ebola through contact with Duncan prior to his hospitalization. But Frieden expressed optimism Tuesday that this first pool of potential exposures will emerge without a single infection.

Two-thirds of the 21-day maximum incubation period for Ebola has passed and no one from that group has developed any symptoms, he said.

“They’ve now passed through the highest risk period and it’s increasingly unlikely that they will develop Ebola,” he said.

Pham is in stable condition, and said herself that she is doing well in a statement released Tuesday.

“I’m doing well and want to thank everyone for their kind wishes and prayers,” Pham said.

Pham has received a blood transfusion from Ebola survivor Dr. Kent Brantly, a medical missionary who was infected while serving as an aid worker in Liberia.

“His plasma — the clear part of blood, centrifuged to separate it from red blood cells — is plentiful with antibodies accumulated during Brantly’s own fight against Ebola several months ago,” said Stefan Juretschko, director of Infectious Diseases Diagnostics at North Shore-LIJ Health System in Great Neck, N.Y. “The amount of antibodies from Brantly serve as weapons to the virus and is far superior to the yet to be formed antibodies of the Texas nurse herself as she fights the disease.”

Officials have identified only one person who may have been exposed to Ebola through contact with Pham after she fell ill. They also are monitoring her dog for symptoms, Lakey said.

The Ebola epidemic in West Africa continues to spiral out of control, with the World Health Organization warning there could be up to 10,000 new cases a week within two months.

The WHO updated its Ebola statistics on Tuesday, reporting that 4,447 people have died out of 8,914 reported cases of infection. Nearly all cases and deaths have occurred in Sierra Leone, Guinea and Liberia.

There have been about 1,000 new Ebola cases per week for the last month, WHO assistant director-general Dr. Bruce Aylward said during a news briefing Tuesday.

Aylward told reporters “a lot more people will die” if global response to the Ebola crisis doesn’t ramp up significantly within 60 days, the Associated Press reported. Experts now say the epidemic is doubling in size about every three weeks.

Overworked health workers on the ground in West Africa also are struggling to avoid infection from the patients they are treating. Doctors Without Borders said 16 of its employees have been infected with Ebola and nine have died, the AP reported.

To allay fears of hospital workers in the United States, Frieden said he is establishing a CDC Ebola response team that will be sent to “any hospital anywhere in this country with a confirmed case of Ebola.”

“We will put a team on the ground within hours, with some of the world’s leading experts” in infection control, laboratory science, protective equipment and management of Ebola units, Frieden said.

The CDC response to Duncan’s case mainly involved epidemiologists who assisted in tracking possible contacts, Frieden said Tuesday.

While some CDC infection-control experts did go to Texas Health Presbyterian, “we could have 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.

“We definitely should have put an even larger team on the ground immediately, and we will do that from now on anytime there’s a confirmed case,” Frieden concluded.

Meanwhile, U.S. customs and public health officials are preparing for stepped-up entry airport screening that will start Thursday at Washington Dulles International, O’Hare International in Chicago, Hartsfield-Jackson International in Atlanta and Newark Liberty International in New Jersey.

The screenings began Saturday at Kennedy International Airport in New York City, and have gone smoothly, Frieden said.

More than nine out of 10 travelers to the United States from the three West African nations hit hard by the Ebola epidemic enter through these five airports, with JFK alone receiving nearly half of all the travelers. On average, about 150 people a day travel to the United States from the three nations.

Show Sources

SOURCES: Oct. 14, 2014, news briefing with Thomas Frieden, M.D., director, U.S. Centers for Disease Control and Prevention, and David Lakey, M.D., commissioner, Texas Department of State Health Services; Stefan Juretschko, Ph.D., director, infectious diseases diagnostics, North Shore-LIJ Health System, Great Neck, N.Y.; Bruce Aylward, M.D., assistant director-general, World Health Organization; Oct. 14, 2014, statement, Nina Pham; Associated Press

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