Texas Ebola case flew in from Liberia, disclosed recent travel to hospital

ebola-us

Texas Ebola case flew in from Liberia, disclosed recent travel to hospital (Al Jazeera, Updated Oct 2, 2014):

School-age children being monitored after first case of disease diagnosed in US; man had been sent home by hospital

A man in Texas who was found to be infected with Ebola flew from Liberia to visit family in the U.S. and had contact with children, who are now being monitored for signs of the disease, authorities confirmed Wednesday.

The man first went to the emergency room at Texas Health Presbyterian Hospital in Dallas on Thursday but was sent home with antibiotics. He returned on Sunday, was admitted and subsequently tested positive for Ebola — the first such diagnosis to take place in the U.S.

Authorities believe the patient could have exposed others in the U.S. to the deadly virus. “It is certainly possible someone who had contact with this individual could develop Ebola in the coming weeks,” said Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention (CDC). But, he added, “I have no doubt we will stop this in its tracks in the United States.”

Nonetheless it emerged Wednesday that others in the U.S. were being observed for indication of Ebola infection.

Texas Gov. Rick Perry told reporters, “Some school-age children had contact with the patient and are now being monitored at home for signs of the disease.” He assured reporters that the situation was under control and was being strictly monitored.

“This case is serious. Rest assured that our system is working as it should. Professionals on every level of the chain of command know what to do to minimize this potential risk to the people of Texas and this country,” Perry said.

He emphasized that people cannot transmit the disease until they have symptoms and that Ebola cannot be spread through the air but only through contact with an infected person’s bodily fluids, such as blood, diarrhea and tears.

Health officials stress that facilities in the state are well equipped to deal with the case.

“This is not West Africa. This is a very sophisticated city. This is a very sophisticated hospital,” said Dr. David Lakey, commissioner of the Texas Department of State Health Services.

Texas is one of only 13 states certified by the CDC to conduct diagnostic Ebola testing, said Perry. “We have the health care professionals and the institutions that are second to none. The public should have every confidence that the highly trained professionals involved here will succeed in this very important mission,” he said.

But questions have emerged over the initial handling of the case. The sister of the patient told The Associated Press that he had initially been sent home despite informing hospital staff that he had been to an area affected by the Ebola outbreak.

Authorities said that the man was visiting family members in the U.S. and that they were tracking down anyone who may have come into contact with him. Frieden said there was likely no threat to any airline passengers because the patient had no symptoms during his flight. Asked whether the patient was a U.S. citizen, he described the person as a visitor to family in the country.

Liberia’s minister for information, Lewis Brown, said the government in Monrovia was “concerned” about the development, adding that there are “stringent screening measures” in place at the capital’s international airport.

Brown added that the incident demonstrated the “clear international dimension of this Ebola crisis.” Underscoring this sentiment, the Liberian government later confirmed that the U.S. patient traveled through Brussels en route to the United States.

The man sought treatment six days after arriving in Texas on Sept. 20, Frieden said, although the hospital later corrected the initial hospital visit to Thursday, not Friday. He was admitted two days later to an isolation room at Texas Health Presbyterian Hospital.

The hospital cited the patient’s privacy as the reason for not identifying him. However, Gee Melish, who said he was a family friend, identified the man as Thomas Eric Duncan.

The New York Times said that Duncan, in his mid-40s, helped transport a pregnant woman suffering from Ebola to a hospital in Liberia, where she was turned away for lack of space. He helped take the woman back to her family’s home and carried her into the house, where she later died, the newspaper reported.

Four days later, Duncan left for the United States, the Times said, citing the woman’s parents and neighbors.

“His whole family was screaming. He got outside, and he was throwing up all over the place,” Mesud Osmanovic, 21, said on Wednesday, describing the chaotic scene before the man was hospitalized, according to Reuters.

The patient is now in serious but stable condition, according to a Texas Health Presbyterian Hospital executive at the conference.

The emergency responders who transported the man to the hospital have been quarantined, according to a statement from Dallas city officials.

Separately on Wednesday, citing a “heightened sense of awareness of Ebola,” the Queens Medical Center in Honolulu said it was treating a patient in isolation.

“At this time, the patient’s history and clinical presentation do not appear to be consistent with Ebola, and the patient may be diagnosed with a number of conditions other than Ebola,” the statement said.

At least 3,091 people have died from Ebola in the worst outbreak on record — the World Health Organization says it’s moving faster than efforts to contain it — which has been ravaging Liberia, Sierra Leone and Guinea in West Africa. More than 6,500 cases have been diagnosed, and the CDC has warned that the number of infections could rise to as many as 1.4 million people by early next year without a massive global intervention to contain the virus.

Ebola symptoms generally appear two to 21 days after infection, meaning there is a significant window during which infected people can escape detection and travel. Symptoms include fever, vomiting and diarrhea.

The CDC said that an Ebola outbreak in Nigeria, which started after a Liberian-American man traveled there while sick, has been stopped, NBC News reported.

“During the outbreak, there were 19 laboratory-confirmed and one probable Ebola cases in two Nigerian states. Nearly 900 patient contacts were identified and followed; all but three have completed 21 days of follow-up period without Ebola symptoms,” the CDC said. “There have been no new cases since Aug. 31, and the last three patient contacts will exit their 21-day follow-up on Oct. 2 — strongly suggesting the outbreak in Nigeria has been contained.”

The current outbreak has killed about half its victims. In past outbreaks, fatality rates have been as high as 90 percent.

Frieden said that CDC personnel and other health officials were discussing whether to treat the Ebola patient in Texas with an experimental drug.

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