Second Dallas Health Care Worker Diagnosed with Ebola
She had flown to Dallas from Cleveland on Oct. 13, and CDC is asking all 132 passengers on that flight to get in touch so they can be interviewed.
A second health care worker at Texas Health Presbyterian Hospital Dallas has tested positive for Ebola, the Texas Department of State Health Services confirmed Oct. 14. The worker provided care for Thomas Eric Duncan, the Liberian national who died there of Ebola last week. A nurse who also was involved in his care, Nina Pham, has been diagnosed with the disease.
CDC and Frontier Airlines issued a joint statement Oct. 15 that the second woman to test positive traveled on Frontier Airlines' flight 1143 from Cleveland to Dallas on Oct. 13, the day before she reported symptoms, according to CDC. "Because of the proximity in time between the evening flight and first report of illness the following morning, CDC is reaching out to passengers who flew on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth Oct. 13," the statement said. CDC is asking all 132 passengers on the flight, which landed at Dallas/Fort Worth International Airport at 8:16 p.m. Central time, to call 1-800-CDC INFO (1-800-232-4636). The statement says public health professionals will interview passengers about the flight, answer their questions, and arrange follow-up, and any individual who is determined to be at any potential risk will be actively monitored.
The statement from the airline says CDC notified Frontier about this development at approximately 1 a.m. MDT on Oct. 15. "The flight landed in Dallas/Fort Worth at 8:16 p.m. local and remained overnight at the airport having completed its flying for the day at which point the aircraft received a thorough cleaning per our normal procedures which is consistent with CDC guidelines prior to returning to service the next day. It was also cleaned again in Cleveland last night. Previously the customer had traveled from Dallas Fort Worth to Cleveland on Frontier flight 1142 on October 10. Customer exhibited no symptoms or sign of illness while on flight 1143, according to the crew. Frontier responded immediately upon notification from the CDC by removing the aircraft from service and is working closely with CDC to identify and contact customers who may [have] traveled on flight 1143," it stated.
CDC has sent a second team of 16 to Dallas to train and assist the hospital in infection control and the monitoring of employees who had contact with Duncan, with the team including experts in infection control, Ebola and other infectious diseases, PPE, and hospital epidemiology, according to a CDC news release.
The team will examine what PPE is being used and how it is being put on and taken off, what medical procedures were done on Duncan that may have exposed the workers, decontamination processes for workers leaving the isolation unit, the oversight and monitoring of all infection control practices, particularly putting on and taking off PPE, and whether enhanced training or changes in protocol are needed.
National Nurses United, an AFL-CIO union based in Oakland, Calif., and with 185,000 members nationwide, held a conference call Oct. 14 sharing the concerns that registered nurses at the Dallas hospital voiced about their readiness to confront this disease, with leaders of the organization saying they want to raise the alarm about the lack of preparedness of U.S. hospitals and health care facilities for Ebola. The nurses' statement said Duncan waited several hours after being admitted in a location where at least seven other patients were present. It described the PPE that nurses caring for him wore, including "optional" N95 respirators and faceshields, and said nurses weren't told how many layers of protective gloves to wear. Nurses coping with Duncan's illness did so while using the PPE they had on hand, it stated. The statement described the lack of protocols and that some hospital personnel entered and exited the isolation unit where he was treated without necessary PPE, and there was no training about how to treat a patient with this disease.
U.S. House Energy and Commerce Committee Chairman Fred Upton, R-Mich., and Subcommittee on Oversight and Investigations Chairman Tim Murphy, R-Penn., announced the subcommittee will hold a hearing Oct. 16 to examine the U.S. public health response to the Ebola outbreak at a Dallas hospital. The hearing is scheduled to begin at noon EDT in the Rayburn House Office Building in Washington, D.C.
"Ebola has been on the world's radar screen since March, and yet the United States and the international community are still scrambling to stay ahead of and stop this outbreak. We remain gravely concerned about this ongoing threat, and the committee will continue diligently investigating the response efforts and preparedness plans," Upton said. "The stakes could not be any higher and as I have said before, we cannot afford to look back at this point in history and say we could have done more."
"Questions continue to emerge as this outbreak has continued, further heightening our concerns about the response and preparedness efforts both at home and abroad," Murphy said. "Just a few weeks ago there was an urgent need to quickly stop the spread of Ebola in Africa, but now we also need to assure Americans that we are able to stop the spread here at home. There is no room for error when it comes to Ebola."
The witness list for the hearing includes CDC Director Dr. Thomas Frieden; Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases in the National Institutes of Health; Dr. Robin Robinson, director of the Biomedical Advanced Research and Development Authority, part of HHS; and Dr. Daniel Varga, chief clinical officer and senior vice president of Texas Health Resources, the parent organization of Texas Health Presbyterian Hospital Dallas. Frieden's prepared testimony is available here; Varga's testimony indicates he will not be present at the hearing. He explains how the hospital has changed its Emergency Department intake procedure and electronic health records to highlight travel or exposures by any arriving patient that could be linked to Ebola, and he also outlines the steps THR took prior to Duncan's admittance to inform and prepare staffers for the risks of treating an Ebola patient.