A second health care worker at Texas Health Presbyterian Hospital in Dallas who provided care for Thomas Eric Duncan has tested positive for the potentially deadly disease, according to the Texas Department of State Health Services.
Her grandmother told The Dallas Morning News the nurse is 29-year-old Amber Joy Vinson, a registered nurse in Texas.
Vinson reported a fever Tuesday and was immediately isolated at the hospital within 90 minutes, officials said. If confirmed by the Centers for Disease Control and Prevention, she will be the second case of Ebola spread within the United States.
As with Nina Pham, a nurse who was the first known person to contract Ebola in the U.S., Vinson was among the workers who took care of Duncan ahead of his Oct. 8 death.
It is not clear how Pham or Vinson contracted the virus, leading the CDC to say, "an additional health care worker testing positive for Ebola is a serious concern."
Health and city officials cautioned that more cases could surface among those involved in Duncan's treatment. They are currently monitoring 75 additional hospital employees for symptoms.
"We are preparing contingencies for more and that is a very real possibility," Dallas County Judge Clay Jenkins said Wednesday.
Jenkins said the latest patient is heroic person "dealing with this diagnosis with the grit and grace and determination that Nina has dealt with the diagnosis." He said the protocol for identifying symptoms of the virus worked well in both new cases.
"We pray that, like Nina, she will get on a good track," Jenkins said.
Dallas Mayor Mike Rawlings said he wanted to reassure Dallas residents who he knows might be afraid at the moment.
"The only way we are going to beat this is person by person, moment by moment, detail by detail," Rawlings said. "It may get worse before it gets better, but it will get better."
Breach of Protocol
The CDC has said Pham's infection was the result of a "breach of protocol" and warned in recent days that more cases could surface among other workers who may have been exposed during Duncan's care.
The confirmation of a second 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. It also highlights the need to quickly determine how the health care workers contracted the virus and how many of the other 75 who treated Ebola patient Thomas Duncan, who died Oct. 8, are at risk.
"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.
DeMoro refused to say how many nurses made the statement about Texas Health Presbyterian Hospital, but insisted they were in a position to know what happened.
"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.
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 also might reveal which body fluids pose the greatest risk.
The latest diagnosis comes one day after the CDC announced additional measures and precautions for fighting and containing the virus on U.S. soil, including plans to immediately send a team of experts to any hospital where a case is confirmed. CDC Director Tom Frieden said the agency is also stepping up training and education for health care workers and providing more infection control supervision at the Dallas hospital to minimize risk of transmission during Pham's treatment.
“I wish we had put a team like this on the ground the day the first patient was diagnosed," Frieden said. "That might have prevented this infection."
Frieden said initially that safety measures in place at the hospital should have prevented the virus' spread. But some have questioned how ready and equipped the hospital in Dallas was to treat Duncan and prevent spread of the illness there and whether patients should instead be routed to special facilities that have successfully treated Americans who fell sick with Ebola while abroad.
On Tuesday, a national nurse's union claimed the nurses in Dallas did not have proper protective gear and worried about exposure to Duncan's bodily fluids. The hospital did not respond to the specific claims but said it will continue to review and respond to concerns raised.
"I want to be very clear. We want to trust our health care workers and we want to protect our health care workers," Dallas County Health and Human Services Director Zach Thompson said.
Second Patient's Apartment Cleaned
Emergency responders in hazardous materials suits began work before dawn Wednesday to decontaminate the Dallas apartment of the second hospital worker. Officials said she lives alone with no pets.
Notices handed out to neighbors advise them that "a health care worker who lives in your area has tested positive for Ebola."
Ryan Fus, 24, who lives in the same building as the blocked-off apartment, said police knocked on his door before 6 a.m. to notify him and make sure he was doing OK.
"It's a little scary. It's a little shocking that it's right near me," he said. "But I'm not afraid or anything like that. I'm not gonna run away."
Containing the Virus
Ebola is spread through direct contact with bodily fluids of a sick person or exposure to contaminated objects such as needles. People are not contagious before symptoms such as fever develop, CDC officials say.
"What this case further illustrates, these two heroic women, is that Ebola comes from the body fluids of a symptomatic Ebola patient," Jenkins said.
Health officials are once again completing "contract tracing" to identify potential exposures in what they say is now a "two-front fight" against the virus. Officials are actively monitoring 75 additional hospital workers, as well as several dozen individuals who may have had contact with Duncan or a close associate outside the hospital. Those who may have been exposed before Duncan's hospital stay are nearing the end of the monitoring period and are now less likely to show symptoms of the virus.
"This is not going to be a situation where we’re going to put protective orders on 75 heath care workers," Jenkins said. "The system right now is working. If they have any temperature or any loose stool or any other symptom, they immediately go to isolation in the hospital and they are tested."
The preliminary Ebola test was run late Tuesday at the state public health laboratory in Austin, and results were received at about midnight. The CDC is conducting a confirmation test.
Dallas police set up a media center at the Bend East in The Village apartment complex at 5454 Amesbury Drive. Authorities went door to door distributing information about the Ebola virus to residents.
Photo Credit: NBC 5 News
This story uses functionality that may not work in our app. Click here to open the story on our mobile site.