Second nurse in Texas tests positive for Ebola, was cleared for air travel

Dallas: The Ebola crisis in the US took another alarming turn Wednesday with word that a second Dallas nurse caught the disease from a patient and flew across the Midwest aboard an airliner the day before she fell ill, even though government guidelines should have kept her off the plane. Amid growing concern, President Barack Obama canceled a campaign trip to address the outbreak. Though it was not clear how the nurse contracted the virus, the case represented just the latest instance in which the disease that has ravaged one of the poorest corners of the earth — West Africa — also managed to find weak spots in one of the world’s most advanced medical systems. The second nurse was identified as 29-year-old Amber Joy Vinson. Medical records provided to The Associated Press by Thomas Eric Duncan’s family showed she inserted catheters, drew blood and dealt with Duncan’s body fluids. Duncan, who was diagnosed with Ebola after coming to the US from Liberia, died 8 October. Kent State University in Ohio, where three of Vinson’s relatives work, confirmed she was the latest patient. Even though the nurse did not report having a fever until Tuesday, the day after she returned home, the director of the Centers for Disease Control and Prevention said she should not have boarded a commercial flight. The nurse also knew before heading home that another nurse, Nina Pham, had been diagnosed with Ebola, and she had a slightly elevated temperature — 99.5 degrees, according to government officials. [caption id=“attachment_1759109” align=“alignleft” width=“380”] A hazmat cleaning crew confer in the parking lot of The Village Bend East apartments where a second healthcare worker lives who also tested positive for Ebola. AP[/caption] While in Cleveland, she was contacted by health officials and told that her health would need to be more closely monitored for Ebola, the CDC said. Agency spokesman David Daigle said Wednesday evening that Vinson spoke to a CDC official before she boarded a plane back to Dallas, reporting her temperature was below 100.4 degrees and that she had no symptoms. The official, a contact tracer responsible for monitoring Vinson, cleared her to fly. From now on, CDC Director Tom Frieden said, no one else involved in Duncan’s care will be allowed to travel “other than in a controlled environment.” He cited guidelines that permit charter flights or travel by car but no public transportation. Ebola patients are not considered contagious until they have symptoms. Frieden said it was unlikely that other passengers or airline crew members were at risk because the nurse did not have any vomiting or bleeding. Even so, the CDC is alerting the 132 passengers aboard the Frontier Airlines Flight 1143 from Cleveland to Dallas-Fort Worth on Monday “because of the proximity in time between the evening flight and first report of illness the following morning.” Officials are asking them to call the health agency so they can be monitored. The woman flew from Dallas to Cleveland on Oct. 10. Kent State said it was asking the workers related to Vinson to stay off campus for 21 days “out of an abundance of caution.” The nurse reported a fever Tuesday and was in isolation within 90 minutes, Dallas County Judge Clay Jenkins said. “We are looking at every element of our personal protection equipment and infection control in the hospital,” said Dr. Daniel Varga, chief clinical officer for Texas Health Resources, which operates Texas Health Presbyterian Hospital Dallas. In his most urgent comments on the spread of the disease, Obama also warned that in an age of frequent travel, the disease could spread globally if the world doesn’t respond to the “raging epidemic in West Africa.” Vinson was transferred Wednesday to a special bio-containment unit at Emory University Hospital in Atlanta, where other Ebola patients have been treated successfully. Pham will be monitored in Dallas to determine the best place for her care, Frieden said. The CDC has acknowledged that the government was not aggressive enough in managing Ebola and containing the virus as it spread from an infected patient to a nurse at a Dallas hospital. “We could’ve sent a more robust hospital infection control team and been more hands-on with the hospital from day one about exactly how this should be managed,” he said Tuesday. The second case may help health officials determine where the infection-control breach is occurring and make practices safer for health workers everywhere. For example, if both health workers were involved in drawing Duncan’s blood, placing an intravenous line or suctioning mucus when Duncan was on a breathing machine, that would be recognized as a particularly high-risk activity. It might also reveal which body fluids pose the greatest risk. Frieden outlined new steps this week designed to stop the spread of the disease, including the creation of an Ebola response team, increased training for health care workers nationwide and changes at the Texas hospital to minimize the risk of more infections. The new case lends support to nurses’ claims this week that they have inadequate training and in some cases, protective gear, to take care of Ebola patients. “They’re not prepared” for what they are being asked to do, said RoseAnn DeMoro, executive director of National Nurses United, a union with 185,000 members. Based on statements from nurses it did not identify, the union described how Duncan was left in an open area of the emergency room for hours. It said staff treated Duncan for days without the correct protective gear, that hazardous waste was allowed to pile up to the ceiling and safety protocols constantly changed. Associated Press