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Tracking the next pandemic: Avian Flu Talk

2nd person in U.S. tests positive for Ebola

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    Posted: October 12 2014 at 3:08am
2nd person in U.S. tests positive for Ebola
CNN) - A health care worker at Texas Health Presbyterian Hospital has tested positive for Ebola after a preliminary test, the state's health agency said in a statement.

Confirmatory testing will be conducted by the Centers for Disease Control and Prevention in Atlanta.

The employee helped care for Thomas Eric Duncan, the first person diagnosed with Ebola in the United States. Duncan died on Wednesday. www.cnn.com/2014/10/12/health/ebola/index.html


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Post Options Post Options   Thanks (0) Thanks(0)   Quote coyote Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 3:14am
Thanks. . I was just going to post that..
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Post Options Post Options   Thanks (1) Thanks(1)   Quote Schrödinger's Cat Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 3:27am
The originating press release: https://www.dshs.state.tx.us/news/releases/20141012.aspx


.....a little more info about the 2nd patient.
Texas Patient Tests Positive for Ebola

News Release 

A health care worker at Texas Health Presbyterian Hospital who provided care for the Ebola patient hospitalized there has tested positive for Ebola in a preliminary test at the state public health laboratory in Austin. Confirmatory testing will be conducted by the Centers for Disease Control and Prevention in Atlanta. 

The health care worker reported a low grade fever Friday night and was isolated and referred for testing. The preliminary ​test result was received late Saturday. 

"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 officials have interviewed the patient and are identifying any contacts or potential exposures. People who had contact with the health care worker after symptoms emerged will be monitored based on the nature of their interactions and the potential they were exposed to the virus. 

Ebola is spread through direct contact with bodily fluids of a sick person or exposure to contaminated objects such as needles. People are not contagious before symptoms such as fever develop. 


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 3:28am
We all knew a healthcare worker would be very likely. There will probably be a couple more.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote coyote Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 3:31am
Yes A, I'm expecting more. .
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Post Options Post Options   Thanks (0) Thanks(0)   Quote pheasant Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 3:35am
Funny they didn't announce the quarantine Friday, just the positive hit this am.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 3:43am
I somewhat thought they wouldn't announce a "suspected" case, and that they would announce a positive case instead.   Save a couple more days in panic and scrutiny,  Whenever possible, it's also ideal to announce this types of bad news on a Sunday.

Lovely.  Duncan's girlfriend and Jesse Jackson are suing the healthcare workers, after Duncan also gave them Ebola.  A rough couple weeks for those healthcare workers on the duncan transmission chain.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Schrödinger's Cat Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 3:48am
Agree, Albert, it'll be a rough couple of weeks for the staff. I wonder if this 2nd patient was from Duncan's first or second hospital visit?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote pheasant Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 3:53am
There having a press conference at 7:30 AM CST, they should be better organized this time as they have had 30+_ hours to prepare the message.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 3:54am
You would think from the first visit, but it could go either way. He was placed in immediate isolation on 2nd visit. Although they were probably still not equipped for it so there could be cases from each visit, you would think anyway. Also haven't heard any news about Duncan's girlfriend's health lately. Wonder if a couple more are starting to show flu like symptoms.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 3:55am
Pheasant - I agree. don't be surprised if they mention another suspected case.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote pheasant Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 4:03am
I promise i am not wearing my tin-foil hat right now, but i would bet a cup of coffee the girlfriend and kids are in Atlanta, or going to be brought there. First to lighten the load on the Dallas hospital, and second, to help take the media spotlight off the Dallas hospital. Its what i would do. Besides, is Presbyterian really equipped to handle 3-5 cases at once?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 4:17am
Good point. I was thinking of the irony of the gf and the healthcare workers all being treated together.who knows how large this cluster will be. I'm assuming there will be at least 2 - 3 health workers and possiblly a family member of theirs. No way is that one center equipped. Possibly make a quarantine treatment facility like in w Africa for this cluster, although those might not work well as we've seen. Jesse Jackson can be first in line for visiting gf.

They may announce another suspected case this morning.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Phylica1 Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 5:24am
Wonder if Jesse Jackson took precautions while visiting the family. I am surprised that the family hasn't showed any fever. Could they have been careful when dealing with Duncan. Was Jesse Jackson wearing protective girl around the girlfriend ? I don't recall the health care workers being placed in isolation after they confirmed Duncan testing positive?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Phylica1 Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 6:04am
Now, the second patient was wearing full face shield and CDC guidelines . This is scary.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Satori Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 6:21am

Originally posted by Phylica1 Phylica1 wrote:

Now, the second patient was wearing full face shield and CDC guidelines . This is scary.



can you provide a link confirming that info ?

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Hazelpad Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 6:22am
CNN identify her as a female nurse, low risk, was in self monitoring pool. Hospital have closed A&E.

http://edition.cnn.com/2014/10/12/health/ebola/index.html?hpt=hp_t1
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Post Options Post Options   Thanks (0) Thanks(0)   Quote pheasant Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 6:22am
Anyone else see the presser?

All i can say is.....chilling. Those people were scared, am i off base or did you all get the same impression?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote ParanoidMom Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 6:26am
CNN is reporting the nurse was in full protective gear. A few lines down it explains how difficult it is to actually catch this virus. This is beyond frustrating!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Phylica1 Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 6:35am
Can you feel confident that hazmat can clean areas. Is anyone testing surfaces to check for ebola after cleaning an area? Probably not!!! The name should be released of the ebola victim . Soon, they will just stop announcing the patients. Something has officials scared at the Dallas hospital.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Hazelpad Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 6:40am
That's the impression I get at press conference. It was like they were waiting to deliver a bomb shell, which they did....after the officials had left when the last doctor on the podium blurted out about the nurse wearing full protective gear as recommended by CDC...,.they hit the public with that statement and scampered off stage..
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Tinijocaro Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 7:01am
I did read that the nurse was caring for Duncan at his second hospital visit.  Sorry, it was a couple hours ago and i have no link to share.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Phylica1 Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 7:03am
It drives me crazy even how the news stations state that is was probably because they touched something while taking off the suit. Well , I can tell you if I was taking off a suit and knowing I was dealing with ebola I would be so careful. I am sure if these person had full protective gear on then they would have been careful also. Dallas will now stop talking to prevent panic. Not sure we can handle more cases.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Tinijocaro Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 7:03am
I read it onlCNN
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 7:08am
Looks like they might be putting another dog down soon, which is the pet of the new case.

Health Worker 2nd in US to Test Positive for Ebola

DALLAS — Oct 12, 2014, 9:52 AM ET
By NOMAAN MERCHANT Associated Press
Texas Health Presbyterian Hospital Dallas

A Texas health care worker who was in full protective gear when they provided hospital care for an Ebola patient who later died has tested positive for the virus and is in stable condition, health officials said Sunday. If the preliminary diagnosis is confirmed, it would be the first known case of the disease being contracted or transmitted in the U.S.

Dr. Daniel Varga, of the Texas Health Resources, said during a news conference Sunday that the worker wore a gown, gloves, mask and shield when they provided care to Thomas Eric Duncan during his second visit to Texas Health Presbyterian Hospital. Varga did not identify the worker and says the family of the worker has "requested total privacy."

Varga says the health care worker reported a fever Friday night as part of a self-monitoring regimen required by the Atlanta-based Centers for Disease Control and Prevention. He said another person also remains in isolation, and the hospital has stopped accepting new emergency room patients.

Duncan, the first person diagnosed with Ebola in the U.S., died Wednesday in Dallas.

"We knew a second case could be a reality, and we've been preparing for this possibility," Dr. David Lakey, commissioner of the Texas Department of State Health Services, said in a statement Sunday. "We are broadening our team in Dallas and working with extreme diligence to prevent further spread."

Health officials have interviewed the patient and are identifying any contacts or potential exposures. They said people who had contact with the health care worker after symptoms emerged will be monitored based on the nature of their interactions and the potential they were exposed to the virus.

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.

Dr. Tom Frieden, head of the Centers for Disease Control and Prevention, said the health care worker's Ebola diagnosis shows there was a clear breach of safety protocol. Frieden on Sunday told CBS' "Face the Nation" that all those who treated Duncan are now considered to be potentially exposed, though couldn't give an exact number. Health care workers treating Duncan were directed to follow CDC protocol that included wearing protective gear. Among the things CDC will investigate is how the workers took off that gear — because removing it incorrectly can lead to a contamination.

Judge Clay Jenkins, Dallas County's top administrative official, said the unidentified health care worker is a "heroic" person who "was proud to provide care to Mr. Duncan." He said the health care worker's family has requested privacy because they are "going through a great ordeal."

More than 4,000 people have died in the ongoing Ebola epidemic centered in West Africa, according to World Health Organization figures published Friday. Almost all of those deaths have been in the three worst-affected countries, Liberia, Sierra Leone and Guinea.

http://abcnews.go.com/Health/wireStory/state-health-officials-2nd-ebola-case-texas-26135213
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Hazelpad Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 7:16am


They don't say what pet is, hopefully not one of those fashionable pet micro pigs........pigs being superspreaders.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 7:26am
Here comes PETA....   We love our pets in these parts. 



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Post Options Post Options   Thanks (0) Thanks(0)   Quote Hazelpad Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 7:43am


In the statement from Dr. Dan Varga, Oct. 12, 7:30 a.m. CDT
10/12/2014 it was stated:

The healthcare worker had been under the self-monitoring regimen prescribed by the CDC, based on involvement in caring for patient Thomas Eric Duncan during his inpatient care that started on September 28.

So are they saying that the exposure could have occurred at any point during his inpatient stay, from admission to death ?

Also says she was low risk ( self monitoring), does that mean she had minimal contact, or just by the fact you wear PPE does that class you as low rusk even if procedures you carry out may be invasive etc.

They not making it very easy to understand.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 7:54am
We're going to have several more cases in this Duncan Transmission Chain and cluster. 

Interesting next few days coming up.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote nc_girl Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 7:55am
what I don't get is why no one has asked if she worked in the hospital (not necessarily coming into contact with Duncan) on his 1st visit to get care.  And if she worked in the days following his 1st visit. 

Since they didn't test him and didn't know he had it, it's possible that she was infected from touching a door knob, wheel chair, hand rail, etc that he touched.  Or that the bathroom I'm sure he would have used while there (he was stooling), wasn't cleaned with the proper care or before someone else used it.

Lots and lots of unknowns and unanswered questions here.

I agree with the immediate assumption she got it from not taking off her suit properly during his 2nd visit but I don't think they have fully vetted the 1st visit yet.

Dr Richard B on ABC News this morning flat out said the didn't think regular hospitals can care for ebola patients based on this new infection.  He said they are obviously not prepared.  Dr. Fauci didn't let him answer some of the reporters questions but you could tell that Dr. B has now 'turned' on his views on how easy/hard this is to catch.


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Post Options Post Options   Thanks (0) Thanks(0)   Quote onefluover Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 8:00am
Is it me or do I see bushes growing around that hospital?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Speed racer Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 8:02am
Very sad but no surprise

No way are the hospital nurses trained well enough in Biosafety Level 4 virus...take constant awareness and mistakes happen. That is why in the Biosafety Level 4 Laboratory there are always a person observing the other to make certain the protocol is not broken.

What is next
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Post Options Post Options   Thanks (0) Thanks(0)   Quote cobber Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 8:11am
That's big news!!!

Confirmed wearing CDC protective gear?  The guy being interviewed was door stopped by the media. Even still this is still big news. Lets see if others come forward...




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Post Options Post Options   Thanks (2) Thanks(2)   Quote CoderOne Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 8:13am
It would be interesting to know if the Hospital is union. Probably not since Texas is a "right to work" state. Otherwise the union would be advising health care workers to stay home. One more thing, who is going to reimburse the apartment building owners for loss of income, and who in their right mind would ever rent those apartments again. And a final question, what country is manufacturing all the components of a full containment outfit, I certainly hope these items are not being made in China.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote wenmalon Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 8:19am
It's too bad that all hospitals can't have this kind of set up in the link I have included below. It's a good read. We need our health care workers. We need them to protect themselves so when they go home they aren't infecting others. Hospitals need to follow this hospital's protocol.

http://www.nytimes.com/2014/10/10/us/ashoka-mukpo-ebola-nebraska-hospital.html?_r=0
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 8:21am
Looks like the space suits aren't going to afford a lot of protection with this any way you go.

On another note, any bets that Louise Troh (Duncan's gf) or her kids are starting to show flu-like symptoms?    Jesse Jackson better call off their date. 

I'm guessing they're now becoming symptomatic.
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This is all very concerning. We are told that it doesn't spread easily but consistently see that people in full protective gear are being infected. This virus, once it latches on.. REALLY latches.. Does it borough into the skin via pores, etc?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote nc_girl Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 8:26am
I agree with you Sleusha.  It appears to be very easy to get to me from watching it go.  and if just touching a suit for a second is enough to infect you, then it's easy to catch IMHO.

I can't believe he mentioned dialysis as a problem!  I told my coworkers the other day that I didn't see how that would NOT be problematic and one of them made fun of me and now Frieden just said it!

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 8:26am
Hi sleusha, Ebola is a super-bug of sorts.   Any virus this lethal is usually supped-up in all areas and very robust.   The perfect little bug and killing machine, aside of it not being airborne.  My own opinion.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 8:29am
Guys we are in trouble when a fully protected nurse gets Ebola. Doc Besser says hospitals are ready... NOT!   It is time to at least get ppe stuff so we can get to water if this spreads and infrastructure goes down.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Hazelpad Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 8:34am
During press conference they were specifically asked when she had contact with Duncan, and they said it was during his second visit and not the first visit. They never said why they came to this conclusion. Perhaps she wasn't working that shift, or is not an A&E nurse, it did seem the only thing they were confident about replying.

It is quite surprising that a HCW with full PPE becomes infected, yet the family members that cared for him with absolutely no PPE seem likely to have avoided it. ( they are still asymptomatic and well enough to be giving extensive press conferences, so I do believe the CDC on this. They also getting blood draws which are remaining negative)

This could indicate_

1) The infected nurse was exposed at a later date after admission or directly after death when viral load reached its peak, and was higher than when family were caring for him, touching and cleaning up after him.

2) Alternatively a frightening thought that the wearing of PPE actually increases your chance of being infected, especially as they deemed her involvement in Duncan's care as low risk. ( so no obvious mistake like needlestick injury, or obvious recorded breach or accident). I mean if Duncan had done a Sawyer ( Nigeria), and gone a mental she would have moved to high risk.

Perhaps taking the PPE off is at fault or perhaps the spraying of chlorine while they are doing this is creating aerosols, or wet facemasks is allowing virus to bind, or perhaps the concentration of chlorine is wrong, or virus has become more resistant to chlorine and needs other agents, ......I will shut up, but these are all things that need to be addressed.



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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 9:16am
The Madrid nurse of course was recently infected in the same fashion while wearing protective gear. Another similarity is that they each had a dog at home. Dogs are very affectionate and can probably suck down the bodily fluids by bulk via licking, and prior to symptoms.

Not looking good for the family pet.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Germ Nerdier Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 9:34am
I used the link provided by Hazelpad. It was heavily edited and overall only about 2 minutes of video.

Hazelpad, was the link you provided the original video? Or was it already edited when you posted to the forum?

..... because from where I sit it looks like CNN cropped out the damning bits.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Germ Nerdier Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 9:41am
In the written portion of the CNN piece, one thing jumps out at me:
They are no longer accepting patients via ER.
Do they suspect inadequate hazmat containment in their ER? Will they now be contacting patients who transitted the ER after the first visit? Second visit?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote sleusha Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2014 at 9:42am
WASHINGTON (AP) — Top federal health officials said Sunday that the Ebola diagnosis in a health care worker who treated Thomas Eric Duncan at a Texas hospital clearly indicates a breach in safety protocol.

But the unidentified worker has been unable to pinpoint where that breach might have occurred, according to Dr. Tom Frieden, head of the Centers for Disease Control and Prevention.

"Á single inadvertent slip can result in contamination," he said during a briefing.

He said the CDC has recommended that the hospital where the worker is being treated — and where Duncan died Wednesday — should keep "to an absolute minimum" those who care for Ebola patients and should perform only those procedures that are essential to a patient's treatment.

The agency also called on the hospital to put in place a "full-time individual responsible for oversight of infection control."

"In terms of safe and effective care, we had already begun several days ago to ramp up the education and training of health care workers at this facility," Frieden said.

He cautioned that additional health care workers could develop Ebola even as he expressed confidence that the "chain of Ebola" could be broken.

He said that the CDC, as part of its investigation on how the worker became infected, would look at dialysis and intubation, procedures with the potential for spreading infectious material, as well as the removal of protective gear. Removing it incorrectly can lead to a contamination, he said.

There is a balance in the use of personal safety equipment, Frieden said, and "putting more on isn't always safer. It may make it harder, to provide effective care."

Earlier, on CBS' "Face the Nation," Frieden said the worker was doing self-monitoring. "Immediately when they developed symptoms, they isolated themselves, they were promptly isolated at the hospital so that any further spread from that individual was stopped," he said.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said there "certainly had to have been an inadvertent, innocent breach of protocol of taking care of a patient within the personal protective equipment."

"We do know what when you do follow that protocol, it works," he told ABC's "This Week."

The virus that causes Ebola is not airborne and can only be spread through direct contact with bodily fluids — blood, sweat, vomit, feces, urine, saliva or semen — of an infected person who is showing symptoms.

In Spain, a nursing assistant diagnosed with the virus after caring for an Ebola patient recalled touching her gloved hand to her face while removing equipment and health authorities there are looking at that as a possible cause of infection.

"We know from many years of experience that it's possible to care for patients with Ebola safely without risk to health care workers," Frieden said. "But we also know it's hard."

Source: http://townhall.com/news/health/2014/10/12/cdc-protocol-breach-in-treating-ebola-patient-n1904107
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