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Texas Health Worker Tests Positive For Ebola
Thomas Eric Duncan, the first person to have been diagnosed in the U.S. with Ebola, and who subsequently died of the disease, was treated at Texas Health Presbyterian Hospital in Dallas. Now, in a second diagnosis for the U.S, an unidentified health-care worker from the hospital has tested positive for Ebola as well. According to the linked Reuters story, Texas officials did not identify the worker or give any details about the person, but CNN said it was a woman nurse.
The worker was wearing full protective gear when in contact with Duncan, Texas Health Resources chief clinical officer Dan Varga told a news conference.
"We are very concerned," Varga said. "We don't have a full analysis of all of the care. We are going through that right now."
...
The worker was self-monitoring and has not worked during the last two days, Varga said.
The worker was taking their own temperature twice a day and, as a result of the monitoring, the worker informed the hospital of a fever and was isolated immediately upon their arrival, the hospital said in a statement.
(Also covered by the Associated Press, as carried by the Boston Globe, which notes that "If the preliminary diagnosis is confirmed, it would be the first known case of the disease being contracted or transmitted in the U.S.")
As someone who lived through the SARS panic in Asia, I would say no, we're not "there" yet. Apparently it has taken a bit longer than it should have for the rank-and-file health workers in the USA to get clued in on this, but I would venture to say that the number of them who remain unaware of this threat today is approximately zero. If anything, I'd expect to see a lot more "false alarms" than actual infections in the next few weeks.
Once the public is aware, the infection rate will plummet. Because of SARS, I still avoid doorknobs and elevator buttons whenever possible (use your keys, lighter, sleeve, etc. to buffer such contact), it just makes sense to do so. Once the protocols for avoiding Ebola become widely known, this so-called "epidemic" will quickly dissipate.
XML is like violence. If it doesn't solve your problem, you're not using enough of it. --AC
The fact that the nurse in Spain, and the one in Dallas both contracted the disease despite wearing full protective gear - and in full knowledge that the patient was infectious - is pretty scarey. You have to imagine that both of those people were fully aware of how dangerous the situation was and were doing their very best to avoid doing anything to compromise their own safety. Clearly we either need better suits or better training, or some kind of a 'buddy system' where two people watch each other to ensure that they don't accidentally do something wrong.
There was a piece on NPR a few days ago that said that the Doctors Without Borders people use a buddy system like this - and despite having hundreds of people on the ground in Africa for a month or more, have only had three staff infections.
Without some improved level of protection, asking doctors and nurses to expose themselves to a disease with a 70% mortality rate (latest WHO estimate...up from 60%), no immunization and no known cure, is asking a lot. Clearly we aren't going to be able to make a vaccine or a cure in any reasonable timescale - so we really need to be working hard to improve protection. The idea of using robots for at least some of the jobs is interesting - but probably impractical for all but the simplest tasks.
We know that this disease can spread exponentially the "base reproduction" figure (the number of people who catch the disease from one infected person) is between 1.7 and 2.3, and it takes 2 to 3 weeks for the infected person to develop symptoms and pass it on. So there is a potential for the disease to double every 3 weeks. We have just a couple of victims in the USA right now, so in a year, we could have a million victims and 700,000 deaths. Clearly, we have to reduce that base reproduction number below 1.0 - but if...with proper protection gear and highly aware workers...both the Spanish and Dallas initial cases were able to spread to one additional victim, we're clearly not going to get anywhere close to a 1.0 rate anytime soon.
What I don't understand: Wouldn't it be possible to put the wearer through a disinfectant decontamination shower before he or she takes off the suit?
well no, I bet a dollar there was a tear in his suit. Simplest explanation is always right.
Be prepared to lose a dollar. The protocol for donning and removing the protective gear is very complex, and very hard to get perfect. When putting the suit on, it's possible to get gaps between the goggles and suit without even knowing it.
Goggles?! - Proper biohazard suits are full-body and pressurized, with a full-head hood and absolutely
no openings in the vicinity of the head. Or any place on the front side of the body for that matter.
And when taking it off, a tiny flap of the contaminated suit brushing against a clean surface is almost impossible to detect.
Eh, again? - There's a multi-step decontamination procedure before taking off the suit.
Taking off a still-contaminated suit would be a major fuckup, and a (potentially) contaminated suit should never
be in an environment where any "un-suited" contact can happen.
Have a look at how this works at the BSL-4 level (skip to about minute 13).
What kind of amateurs are running this place?