Thursday, October 16, 2014

Public Health : CDC Sending Team of 16 Ebola Experts to Dallas

A second hospital worker in Dallas has tested positive for the Ebola virus.

CDC Ebola training
A licensed clinician is decontaminated before disrobing at the end of the simulated training session on Oct. 6, 2014, in Anniston, Ala. The Centers for Disease Control and Prevention has developed an introductory training course for licensed clinicians. (AP Photo/Brynn Anderson)

(MCT) — A female hospital worker in Dallas tested positive for the Ebola virus, the U.S. Centers for Disease Control reported early Wednesday.

A statement from the CDC says the preliminary test was performed overnight at the Texas public health laboratory in Austin on a specimen from another worker who cared for Thomas Eric Duncan, the Liberian man who died at Texas Health Presbyterian Hospital in Dallas a week ago.

The second worker, who was being monitored, was isolated at Presbyterian after first reporting a fever, according to a separate statement from the Texas Department of Health Services. That statement also says confirmation testing is being done at the CDC lab in Atlanta.

The CDC has interviewed the worker to identify contacts or potential exposures, but the CDC statement released at about 4:30 a.m. does not say whether any were identified.

Dallas County Judge Clay Jenkins said at a 7 a.m. press conference that the second worker was isolated and being tested within 90 minutes of finding she had a fever.

The worker, Dallas officials said, lives alone and has no pets. As Dallas fire and rescue workers started decontamination at the apartment, workers were going door-to-door at her apartment complex at Skillman and Village Bend, informing residents that an Ebola patient lived there.

Dallas Mayor Rawlings reiterated that another positive result was not unexpected, but the CDC appeared to be scrambling to seal up holes in the Ebola treatment procedures, sending a team of 16 people to monitor and help at Presbyterian.

An initial team of 10 was sent Sept. 30 and another 16 are being added. The second team includes experts in infection control, Ebola control, lab science, personal protective equipment, hospital epidemiology and workplace safety, the fact sheet says.

The team includes experts who successfully controlled outbreaks in Africa in the past two decades, including some who have worked with Doctors Without Borders; and two infection control nurses from Emory University hospital who have experience treating Ebola patients without infecting health-care workers.

Dallas County Health and Human Services director Zachary Thompson urged residents to remain calm in an interview on News 8 Daybreak Wednesday.

"I've got to remind Dallas County residents: Let's not get into the fear factor and panic," he said. "It should be contained within the health care workers, and hopefully we don't see any more cases, but don't be surprised."

The first worker who tested positive is nurse Nina Pham, who is isolated at Presbyterian.

Said Rawlings: “We are not fearful. It may get worse before it gets better, but it will get better.”


Investigation


The fact sheet says the team is looking into what protective equipment is being used; “what medical procedures were done on the index patient that may have exposed the healthcare worker;” decontamintion for workers; and ensuring oversight of infection control.

The sheet says the CDC also is making “specific improvements” in Dallas including: standardizing personal protective equipment, “possibly using only full-body suits”; using a type of hood that protects the workers’ necks; and adding “enhanced and detailed” step-by-step hand disinfection “with specific sequencing for removal of each piece of equipment and the hand washing.”

It adds, “The single most important aspect of safe care of Ebola is to have a site manager at all times who oversees the putting on and taking off of PPE and the care given in the isolation unit. A site manager is now in place and will be at the hospital 24/7 as long as Ebola patients are receiving care.”

CDC Director Tom Frieden acknowledged Tuesday that his agency was slow to respond to Duncan’s case. He admitted that may have meant workers at Presbyterian did not use the latest techniques to prepare themselves for work around Ebola in its most highly contagious state.

The total number of people being monitored for Ebola symptoms, including contacts or possible contacts with both Pham and Duncan, is now 125, Frieden said. That number includes an employee of the Alcon medical company in Fort Worth who had direct contact with Pham, according to the state public health department.

Pham’s condition was upgraded to good Tuesday at Presbyterian, and infectious disease officials said 48 others being monitored are past the time when they were most likely to develop symptoms.

Pham, 26, the first known patient to acquire Ebola in the U.S., released a statement Tuesday saying, “I’m doing well and want to thank everyone for their kind wishes and prayers.” Pham graduated from the nursing program at Texas Christian University, where a candlelight vigil was held Tuesday night.

The CDC also announced it has widened the possible Ebola contacts list to include 76 healthcare employees — Pham’s co-workers at Texas Health Presbyterian Hospital. All cared for Thomas Eric Duncan, the Liberian man who died Wednesday at the same hospital.

Pham’s dog, a Cavalier King Charles Spaniel named Bentley, was still being cared for and monitored. Her east Dallas apartment was decontaminated.


New go-team


Going forward, Frieden said, the CDC will assemble a go-team that can immediately respond to Ebola cases.

“I wish we would have put a team like this on the ground the day the first patient was diagnosed,” Frieden said during a news conference Tuesday. “That might have prevented infection. But we will do that from now on.”

Two nurses from Emory University Hospital’s Communicable Disease Unit in Atlanta are in Dallas to provide support and oversee the use of personal protective equipment donned by those treating Pham, or any other patients who may emerge with Ebola symptoms and be placed in isolation.

The 76 workers exposed to Duncan are “self-monitoring” for symptoms and have been directed by the CDC to immediately report any changes in their health.

The contact who works at Alcon, who was not identified, was admitted to the hospital Sunday with no symptoms, company spokeswoman Elizabeth Harness Murphy said in a statement. The employee is being hospitalized as a precaution, the statement said.

“The Alcon associate has not shown any signs or symptoms of the Ebola virus. After consultation with the Texas Department of Health, we are confident that there is no risk for Alcon associates. We are working closely with the Centers for Disease Control and Prevention and the Texas Department of Health to ensure we are following proper public health measures.”

Alcon is a medical company that specializes in eye-care products.


‘A faithful, purple family’


At TCU’s Robert Carr Chapel Tuesday night, about 40 people gathered for candlelight vigil to pray for Pham and others stricken with Ebola.

Pham, 26, attended Nolan Catholic High School in Fort Worth and graduated from TCU’s nursing program in 2010 before she moved to Dallas.

The song Amazing Grace filled the church as people lit candles and offered prayers.

“We are a family,” said the Rev. Angela Kaufman, minister to TCU. “We are a faithful, purple family.”

The Rev. Erin Taylor, who helped organize the vigil, did not leave Pham’s dog Bentley out.

“We love you and we are praying for you and your dog,” Taylor said in a message to Pham.


Help in many forms


Earlier Tuesday, Facebook founder Mark Zuckerberg said he is donating $25 million to fight Ebola.

“The Ebola epidemic is at a critical turning point,” Zuckerberg wrote on his Facebook page. “It has infected 8,400 people so far, but it is spreading very quickly and projections suggest it could infect 1 million people or more over the next several months if not addressed.

“We need to get Ebola under control in the near term so that it doesn’t spread further and become a long-term global health crisis that we end up fighting for decades at large scale, like HIV or polio.”

Zuckerberg announced that he and his wife, Priscilla Chan, were making the donation to the Centers for Disease Control Foundation.

Pham also received help in the form of plasma from Dr. Kent Brantly, who survived the virus, a spokeswoman at the Samaritan’s Purse charity said Tuesday.

Brantly, a missionary doctor who completed his residency at John Peter Smith Hospital in Fort Worth, stopped at a blood center in Kansas City, Mo., and donated blood for her, Devon McMillion said.

©2014 the Fort Worth Star-Telegram. Distributed by MCT Information Services.
www.emergencymgmt.com 

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