1st Dallas Nurse With Ebola Headed to NIH Facility in Maryland

Second nurse has also been transferred from Dallas hospital that has been criticized for its handling of Ebola patient

THURSDAY, Oct. 16, 2014 (HealthDay News) -- The first Dallas nurse to contract Ebola after treating a patient infected with the often lethal disease is to be moved to a specialized National Institutes of Health medical center in Maryland, officials reported Thursday.

Nina Pham, 26, had been undergoing treatment at Texas Health Presbyterian Hospital in Dallas, where she was part of a team of caregivers that treated Thomas Eric Duncan, the first person to be diagnosed with Ebola in the United States. Duncan became infected in his native Liberia before arriving in Dallas last month. He died on Oct. 8.

The NIH facility has one of four so-called biocontainment units in the United States that are designed to treat highly infectious diseases like Ebola. Pham was said to be in good condition.

The second Dallas nurse who tested positive for Ebola after treating Duncan -- 29-year-old Amber Joy Vinson -- was transferred Wednesday night to another of the four biocontainment facilities: at Emory University Hospital in Atlanta. Emory successfully treated two other patients with the disease.

Texas Health Presbyterian Hospital has come under sharp criticism for the way it treated Duncan. And nurses there said this week that they had been given inadequate training and equipment to handle a patient infected with a disease as deadly as Ebola.

Dr. Daniel Varga is chief clinical officer and senior executive vice president for Texas Health Resources, which operates Texas Health Presbyterian Hospital. In prepared testimony to be delivered Thursday before a Congressional hearing into the response to Ebola in the United States, he said: "Unfortunately, in our initial treatment of Mr. Duncan, despite our best intentions and a highly skilled medical team, we made mistakes. We did not correctly diagnose his symptoms as those of Ebola. We are deeply sorry."

To allay fears of hospital workers across the United States, Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, said Tuesday that he was 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.

Meanwhile, U.S. customs and public health officials on Thursday began stepped-up entry screening at four more airports for travelers arriving from West Africa. The airports are 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 Wednesday.

The five airports handle 94 percent of the roughly 150 travelers who arrive daily in the United States from Guinea, Liberia and Sierra Leone, Frieden said. Kennedy Airport receives nearly half of those travelers. Those three countries have borne the brunt of the Ebola outbreak in West Africa.

Vinson, the second Dallas nurse, flew on a domestic, commercial airline flight on Monday evening -- less than 24 hours before she reported Ebola symptoms to hospital staff in Dallas, federal health officials said Wednesday.

Health officials said the risk was low that Vinson exposed her fellow passengers to Ebola during Frontier Airlines flight 1143 from Cleveland to Dallas/Fort Worth.

"The fact that patient number two did not have a fever until the next day, did not have nausea or vomiting on the plane, suggests to us that the risk to any around that individual on the plane would have been extremely low," Frieden said during a Wednesday news conference.

U.S. health experts have maintained that Ebola can only be transmitted by a person who is exhibiting symptoms, such as fever or vomiting.

Nonetheless, the CDC is working with Frontier to identify and notify all 132 passengers on the flight, which landed in Dallas on Monday at 8:16 p.m. CT, as an "extra margin of safety," Frieden said.

Vinson already was in Ohio when she learned that fellow nurse Pham had been diagnosed with Ebola. Vinson violated CDC safety guidelines by boarding the flight back to Dallas, Frieden said.

"Because at that point she was in a group of individuals known to have exposure to Ebola, she should not have traveled on a commercial airline," he said.

A self-check prior to boarding the plane revealed that her temperature was elevated, at 99.5 degrees, Frieden said. Even though Vinson had not reached the fever threshold of 100.4 degrees, her temperature, combined with her potential exposure to Ebola, should have kept her off the plane, Frieden said.

"By both of those criteria, she should not have been on that plane," Frieden said. But, he added, "She did not vomit. She was not bleeding. So the level of risk to people around her would be extremely low."

Anyone who was on the flight is asked to call 1 800-CDC INFO (1-800-232-4636).

Officials have identified three people other than the passengers on the flight from Cleveland who may have been exposed to Ebola through Vinson, Frieden said. All will be monitored, he said.

Health officials also are monitoring one person who could have been exposed through Pham, as well as 76 health care workers potentially exposed while caring for Duncan at the Dallas hospital. The CDC is working with state and local officials to track the movement of these people, Frieden said.

Officials also are still monitoring 48 people who may have been exposed to Ebola through contact with Duncan prior to his hospitalization in Dallas. But Frieden said Tuesday that he was optimistic 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 Tuesday.

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

The Ebola epidemic in West Africa -- the worst in history -- 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 Wednesday, reporting that 4,493 people have died out of 8,997 reported cases of infection. Nearly all cases and deaths have occurred in Guinea, Liberia and Sierra Leone.

More information

For more on Ebola, visit the U.S. Centers for Disease Control and Prevention.

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