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| First responders guard the apartment of a healthcare worker Sunday, Oct. 12, 2014, in Dallas. The healthcare worker, who was caring for Ebola patient Thomas Eric Duncan, tested positive for the disease in preliminary tests. If the preliminary diagnosis is confirmed, it would be the first known case of the disease being contracted or transmitted in the U.S. |
DALLAS (AP)
-- A "breach of protocol" at the hospital where Ebola victim Thomas Eric
Duncan was treated before his death led to the infection of a health
care worker with the deadly virus, and other caregivers could
potentially be exposed, federal health officials said Sunday.
The
hospital worker, a woman who was not identified by officials, wore
protective gear while treating the Liberian patient, and she has been
unable to point to how the breach might have occurred, said Dr. Tom
Frieden, head of the Centers for Disease Control and Prevention. Duncan
was the first person in the U.S. diagnosed with Ebola.
The
CDC confirmed Sunday afternoon that the woman had tested positive for
Ebola - the first known case of the disease being contracted or
transmitted in the U.S.
The missteps with the
first patient and now the infection of a caregiver raised questions
about assurances given by U.S. health officials that any American
hospital should be able to treat an Ebola patient and that the disease
would be contained.
At a briefing in Atlanta,
Frieden said that at some point during Duncan's treatment, "there was a
breach in protocol, and that breach in protocol resulted in this
infection." He added that officials were "deeply concerned" by the
infection of the worker.
President Barack Obama asked the CDC to move as quickly as possible in investigating the incident, the White House said.
Dallas
police stood guard outside her apartment complex and told people not to
go inside. Officers also knocked on doors, made automated phone calls
and passed out fliers to notify people within a four-block radius about
the situation, although Dallas authorities assured residents the risk
was confined to those who have had close contact with the two Ebola
patients.
The worker wore a gown, gloves, mask
and shield while she cared for Duncan during his second visit to Texas
Health Presbyterian Hospital, said Dr. Daniel Varga of Texas Health
Resources, which runs the hospital.
Duncan,
who arrived in the U.S. from Liberia to visit family Sept. 20, first
sought medical care for fever and abdominal pain Sept. 25. He told a
nurse he had traveled from Africa, but he was sent home. He returned
Sept. 28 and was placed in isolation because of suspected Ebola. He died
Wednesday.
Liberia is one of the three West
African countries most affected by the Ebola epidemic, which has killed
more than 4,000 people, according to World Health Organization figures
published Friday. The others are Sierra Leone and Guinea.
Texas
health officials have been closely monitoring nearly 50 people who had
or may have had close contact with Duncan in the days after he started
showing symptoms but before he was diagnosed with the disease.
The health care worker reported a fever Friday night as part of a self-monitoring regimen required by the CDC, Varga said.
Another
person who was described as a "close contact" of the health worker has
been proactively placed in isolation, he added, without elaborating on
where that person is being monitored. The hospital said its emergency
department is diverting ambulances to other hospitals, though still
accepting walk-in patients.
Frieden said
officials are now evaluating and will monitor any workers who may have
been exposed while Duncan was in the hospital.
Among
the things the CDC will investigate is how the workers took off
protective gear, because removing it incorrectly can lead to
contamination. Investigators will also look at dialysis and intubation -
the insertion of a breathing tube in a patient's airway. Both
procedures have the potential to spread the virus.
"We
knew a second case could be a reality, and we've been preparing for
this possibility," said Dr. David Lakey, commissioner of the Texas
Department of State Health Services. "We are broadening our team in
Dallas and working with extreme diligence to prevent further spread."
Health
care workers treating Ebola patients are among the most vulnerable,
even if wearing protective gear. A Spanish nurse assistant recently
became the first health care worker infected outside West Africa during
the ongoing outbreak. She helped care for two priests who were brought
to a Madrid hospital and later died. More than 370 health care workers
in West Africa have fallen ill or died since the epidemic began earlier
this year.
In the health worker's
neighborhood, one police officer said an industrial barrel outside
contained hazardous waste taken from inside the building. Nearby
residents periodically came out of their homes to ask about the
commotion.
Kara Lutley, who lives a half-block
from the complex, said she never received a call or other emergency
notice and first heard about it on the news.
"I'm not overly concerned that I'll get Ebola," she said.
Officials
said they also received information that there may be a pet in the
health care worker's apartment, and they have a plan in place to care
for the animal. They do not believe the pet has signs of having
contracted Ebola. A dog belonging to the Spanish nurse was euthanized,
drawing thousands of protests.
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.
Duncan came to Dallas to visit his family.
The
trip was the culmination of decades of effort, friends and family
members said. But when Duncan arrived in Dallas, though he showed no
symptoms, he had already been exposed to Ebola. His neighbors in Liberia
believe Duncan become infected when he helped a pregnant neighbor who
later died from it. It was unclear if he knew about her diagnosis before
traveling.
On Saturday, customs and health
officials began taking the temperatures of passengers arriving at New
York's Kennedy International Airport from Liberia, Sierra Leone and
Guinea in a stepped-up screening effort.
The
screenings will expand to four additional airports - New Jersey's Newark
Liberty, Washington Dulles, Chicago O'Hare and Hartsfield-Jackson in
Atlanta - in the coming days.
