A second Dallas health-care worker has tested positive for Ebola, and a medical worker in Madrid was diagnosed with the virus after treating patients there. Outside the hardest-hit countries in West Africa, where hospital staffs have been decimated by Ebola—as well as some cases in Nigeria, where medical staff caught the virus—health workers have safely treated patients without further transmission in Senegal and at Emory University Hospital in Atlanta. What went wrong in Dallas and Madrid?
The question is prompting the U.S. Centers for Disease Control to rethink how it responds to the disease and how hospitals should prepare f0r it. The agency is sending additional experts to Dallas, including people who have treated Ebola patients in Africa and at Emory. The CDC is “making immediate and specific improvements to processes and procedures at the Dallas hospital to reduce risk to health care personnel,” the agency said in an e-mail. An official will also be located on site in Dallas to continuously to monitor health workers as they put on and take off protective equipment, including gowns, gloves, and masks.
The CDC confirmed on Wednesday that a second infected staffer at Texas Health Presbyterian Dallas contracted Ebola after treating Thomas Eric Duncan, the Liberian man who fell ill and died of Ebola last week after coming to the U.S. to visit family. The newly diagnosed medical worker took a flight from Cleveland to Dallas on Monday evening, the day before the worker went to the hospital with a fever.
The CDC said it is now contacting passengers from Frontier Airlines flight 1143 and will monitor “individuals who are determined to be at any potential risk.” The crew saw no sign that the passenger was sick, according to the CDC. Frontier Airlines said the plane underwent its normal cleaning process overnight in Dallas and returned to service on Tuesday. It was cleaned again in Cleveland on Tuesday night.
The first hospital worker in Dallas who contracted Ebola while treating Duncan, nurse Nina Pham, is in “good condition,” the hospital said in an e-mail. While the exact cause of the Ebola infections at the hospital remains unclear, CDC Director Tom Frieden has emphasized that removing contaminated garb can be a risky process. “Sometimes health-care workers may think that more is better, so may put on additional sets of gloves, or additional coverings. And that may actually end up, paradoxically, making things less—rather than more—safe because it may be more difficult to remove those levels or layers that it inadvertently increases risk,” Frieden said during a briefing earlier this week.
Frontline health-care workers have raised alarms about safety in caring for Ebola patients. The National Nurse’s United union in the U.S. has charged the Dallas hospital with safety lapses, Bloomberg News reported. In Spain, meanwhile, nurses at the Carlos III hospital in Madrid said they have had to put on and remove protective gear in confined spaces that made it difficult to maneuver, according to the New York Times.
The CDC is also planning to send officials to any U.S. hospital at which an Ebola patient arrives within hours after a diagnosis is confirmed. “I wish we had put a team like this on the ground the day the first patient was diagnosed,” Frieden told reporters on Tuesday. “That might have prevented this infection,” he said, referring to Pham’s diagnosis. “But we will do that from today onward with any case, anywhere in the U.S.”
