Sunday, October 12, 2014

Nurse who cared for Duncan appears to have Ebola; if so, first ever transmission of Ebola within the US


A second person, a female nurse who had worked with Thomas Eric Duncan at Texas Presbyterian Hospital, has been reported as testing positive for Ebola, after reporting a low-grade fever Friday (monitoring herself).  The story on ABCNews Sunday morning is here

This is the first-ever case transmitted within the United States.  ABC says “This is not over.”
    
CNN has a similar story here.  The test result will be checked by the CDC in Atlanta today.
  
The second patient’s history suggest that Ebola virus may show up in a test very early in symptoms.  
   
It is certainly desirable to have a “Western Blot” type test that could show infection before there are any symptoms at all.    
  
The patient was reported to be in stable condition early Sunday. It is possible that symptoms would not progress, particularly if the patient got supportive care, and particularly antiviral drugs or monoclonal antibodies immediately.  There is a tendency for the symptoms to become more severe over several days in almost all patients, but it is possible early intervention could change this.  The NBC cameraman being treated in Nebraska is apparently in good condition, still, although this is not clear.
  
The nurse was said to be properly geared and attired when treating Duncan on his second visit. 
   
Commentators are saying that not every hospital is equipped to handle Ebola properly, which is difficult to do.  But any emergency room would have to be able to put a patient in isolation with symptoms and a history of contact with other Ebola patients. 
     
Contacts of the nurse will be watched, and possibly isolated.
  
I live one very long block from a hospital.  So far, neighbors (not household members) of a patient have not been isolated in these cases (in Dallas or any city).  Could this change?   The concern is that if I ever were, the disruption could be extreme, and no one is entitled to compensation because of enforced isolation, even if cause by the negligence of others.  This wouldn’t be limited to Ebola; it might become a concern with a future outbreak of a more transmissible disease like a SARS-like disease, or avian influenza. 
  
Remember, Ebola is still hard to catch under ordinary circumstances. 
  
Some screening of passengers on international flights, at least based on connections from West Africa, has started today at JFK in New York, and will be added to Dulles, Atlanta, and O’Hare Chicago.  It would seem that Dallas DFW ought to be added.   

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