Second Texas healthcare worker tests positive for Ebola

The newly diagnosed women is in isolation after contracting the disease while treating Thomas Eric Duncan last month

By Geoffrey Mohan, Michael Muskal
The Los Angeles Times

DALLAS — A second female healthcare worker at a Dallas hospital has tested postive for the Ebola virus, prompting the federal Centers for Disease Control and Protection to send in a team in a bit to halt further spread of the deadly disease.

The infection of the two healthcare workers, announced early Wednesday, raises new concerns over spread of Ebola, which has already killed more than 4,000 people in West Africa. It also raises questions about the protocols, practices and training given to doctors, nurses and laboratory technicians in the U.S. to deal with the virus.

Officials said they are still investigating how the workers contracted the virus, but quickly sought to calm people.

Judge Clay Jenkins, the top elected official in Dallas County, said local officials are now fighting a “two-front war” against Ebola in the wake of the second case.

“At the hospital, we have a situation, where two tested positive for Ebola. We have prepared contingencies for more,” he said at a Wednesday morning news conference.

“You can imagine the anxiety of these people. You can imagine the gut shot that this is to the hospital that has taken care of the community for many, many years.”

The city deliberately announced the new case in time to catch and reassure people as they were waking up, Mayor Mike Rawlings told reporters at the televised briefing.

The city has already begun decontamination efforts at the home of the woman most recently infected. She lives alone and has no pets, he said.

“I believe Dallas is anxious about this but we are not fearful,” the mayor said. “It may get worse before it gets better, but it will get better.”

Dr. Daniel Varga, of Texas Health Resources, which runs the hospital, discounted the possibility that the second case indicated a systemic problem at the health facility.

“Todays development while concerning and unfortunate is continued evidence that our monitoring program is working,” he told reporters.

“A lot is being said about what may or may not have occurred to cause some of our colleagues to contract this disease, but it is clear there was an exposure somewhere sometime in their treatment of Mr. Duncan,” Varga said.

“We’re a hospital that may have done things different – with the benefit of what we know today, but make no mistake, no one wants to get this right more than our hospital, the first to diagnose this insidious disease that now has attacked two of our own,” he said.

In statements, the Texas Department of State Health Services and the CDC said the unnamed healthcare worker helped treat Thomas Eric Duncan, who was diagnosed with Ebola after arriving in Texas from Liberia last month.

Duncan died Oct. 8 at Texas Health Presbyterian Hospital where he was initially sent home with antibiotics, only to be rushed back three days later on Sept. 28.

The newly diagnosed worker is in isolation at the hospital, as is Nina Pham, 26, a nurse who treated Duncan and was diagnosed with Ebola over the weekend. A contact of Pham was also in isolation, but has not had been diagnosed with the virus.

A preliminary Ebola test was conducted late Tuesday at a state public health laboratory in Austin, Texas, and came back positive during the night. The CDC will conduct additional tests, it was announced.

The CDC also said its experts had taken part in interviewing the second health care worker to identify any contacts or potential exposures in the community.

On Tuesday, Dr. Tom Frieden, head of the CDC, acknowledged that the government wasn’t aggressive enough in managing Ebola and containing the virus as it spread from an infected patient to a nurse in Texas.

The CDC also plans to launch a top-flight response team, which will go to any hospital that reports an Ebola case. It will include healthcare workers with experience in Ebola outbreaks, Frieden said.

“I wish we had put a team like this on the ground the day the first patient was diagnosed,” he added, referring to Duncan. “That might have prevented this infection. But we will do that from this day onward.”

Although the CDC sent infectious disease specialists to Dallas after Duncan’s diagnosis, Frieden said, “with 20/20 hindsight,” he might have sent “a more robust hospital infection control team and been more hands-on” at the hospital.

At least 76 people at the hospital might have been exposed to Duncan, and all are being monitored for fever and other symptoms daily, Frieden said.

That group is in addition to the 48 others who had some contact with Duncan before he was admitted to the hospital.

The original group includes 10 people who are friends and family of Duncan, who stayed with his fiancee in the Ivy Apartments in Dallas when he arrived in Texas on Sept. 20.

Nurses at Texas Health have described a confused and chaotic response to Duncan’s arrival in the emergency room, alleging in a statement Tuesday that he languished for hours in a room with other patients and that hospital authorities resisted isolating him.

In addition, they said, the nurses tending him had flimsy protective gear and no proper training from hospital administrators in handling such a patient.

The allegations, made under unusual circumstances, provided the first detailed portrait of Thomas Eric Duncan’s second trip to the emergency room, where he arrived by ambulance days after doctors had sent him home with a fever, a headache, abdominal pain and a prescription for antibiotics.

Tuesday’s claims about the initial response came during a conference call with reporters in which none of the nurses from Texas Health Presbyterian Hospital spoke directly or was identified to reporters.

A statement outlining a litany of critical assertions was read by Deborah Burger, co-president of National Nurses United. The Oakland-based nurses union does not represent the Dallas nurses, who are nonunionized, but has been vocal about what it says are hospitals’ failures to prepare for Ebola.

Pham became the first person in the United States to contract the disease on U.S. soil as she cared for Duncan.

In a statement released on Tuesday, she said she was doing well. The hospital listed her condition as good.

She also received a plasma transfusion from a doctor who recovered from the virus, and the hospital CEO said medical staff members remain hopeful about her condition.

LA staff writer Nicole Charky contributed to this story.


©2014 Los Angeles Times

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