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Texas Health Care Worker - Ms. Pham - Tests Positive for Ebola: Hospital - now virus free

Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Texas Patient Tests Positive for Ebola
News Release
Oct. 12, 2014

Texas Patient Tests Positive for Ebola

A health care worker at Texas Health Presbyterian Hospital who provided care for the Ebola patient hospitalized there has tested positive for Ebola in a preliminary test at the state public health laboratory in Austin. Confirmatory testing will be conducted by the Centers for Disease Control and Prevention in Atlanta.

The health care worker reported a low grade fever Friday night and was isolated and referred for testing. The preliminary ​test result was received late Saturday.

"We knew a second case could be a reality, and we've been preparing for this possibility," said Dr. David Lakey, commissioner of the Texas Department of State Health Services. "We are broadening our team in Dallas and working with extreme diligence to prevent further spread."

Health officials have interviewed the patient and are identifying any contacts or potential exposures. People who had contact with the health care worker after symptoms emerged will be monitored based on the nature of their interactions and the potential they were exposed to 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.
​
-30-​

(News Media Contact: Carrie Williams, carrie.williams@dshs.state.tx.us, 512-776-7119)​

Last updated October 12, 2014
https://www.dshs.state.tx.us/news/releases/20141012.aspx
 
Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Graupel has asked a very pertinent question on another thread. Did this result from the first or second time that Mr. Duncan went to hospital?
 
Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Ronan Kelly said:
Graupel has asked a very pertinent question on another thread. Did this result from the first or second time that Mr. Duncan went to hospital?
Click to expand...
Yes there are basically two groups. Those who interacted with the index case using PPE and those who did not. If the former it is a much bigger problem because it implies a weakness in the infection control protocols which will need to be found and addressed. This could take time as it may not be possible to know where the weakness is without more data, which may mean more cases. The other bit of information it would be good to have is if the new case came from within the high risk monitored contacts group, again if not this implies a weakness in the contact tracing procedure.
 
Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

CNN says on its television outlet that there will be a news conference in one hour in Texas. I think there will be several live feeds. I think CNN will be covering live.

Also, CNN is announcing that the CDC will make a comment later today.
 
Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

I fear the information management here is going to be counter productive. Waiting to announce that someone was tested and positive, without saying anything at the point they were symptomatic and in need of a confirmatory test, is not going to inspire public confidence that things are not being covered up. I understand why they did it I am just not sure it was their best course of action. At this stage of the game perception is probably as important as reality and conspiracy theorists don't need a lot to work with.
 
Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

It will be informative to see exactly what his/her exposure was. This case had onset the evening of October 10.

If the exposure is on the evening of September 25th into the 26th, when Duncan was misdiagnosed and sent home, the incubation period is 14-15 days. If the exposure is at admission on the 28th, it's 12 days. Either one of those would be longer than average for Ebola (where the average is 7-10 days) but quite possible.

Alternatively, it could be an exposure in the past 7-10 days, after the isolation of the patient, due a PPE breach, a happened in Madrid.

We shall see soon.
 
Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Lisa Schnirring ‏@lisaschnirring 11m 11 minutes ago
Looks like Dallas ABC affiliate WFAA will be broadcasting 7:30 am (CST) news conference on #Ebola in HCW http://bit.ly/1EKKnAK
 
Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

I'm watching the press conference now on CNN.

They have stated that all 48 previous contacts are still asymptomatic. This appears to mean, IMO, that this might have been a breakdown in isolation after September 28.
 
Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Conference now states that this was not one of the previous contacts, and not a previously recognized "high risk" contact.

Person was reportedly wearing PPE at time of contact.
 
Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

was an undefined in-hospital contact on 2nd visit - they refuse to say if it is a HCW or a support person - unless I missed that. Much crucial information was hidden behind the HIPAA veil just now.
 
Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

My notes. Please read from bottom up:

FluTrackers.com @FluTrackers ? 16s 17 seconds ago
Lost feed...conference over?

FluTrackers.com @FluTrackers ? 3m 3 minutes ago
Varga: This patient did not work last 2 days. Has been doing self monitoring via temperature since Duncan contact. #ebola

FluTrackers.com @FluTrackers ? 4m 4 minutes ago
Varga: This patients was wearing PPE per CDC directions when in contact with Duncan. Very concerned that this worker was infected. #ebola

FluTrackers.com @FluTrackers ? 6m 6 minutes ago
Varga: Health care worker infected in Duncan's 2nd hospital visit. #ebola

FluTrackers.com @FluTrackers ? 7m 7 minutes ago
Rawlings: Had an #ebola plan in place in case secondary Duncan contacts became infected.

FluTrackers.com @FluTrackers ? 8m 8 minutes ago
Rawlings: Isolated patient's car. #ebola

FluTrackers.com @FluTrackers ? 8m 8 minutes ago
Rawlings: Pet in patient's apt. Will check and take care of pet. #ebola

FluTrackers.com @FluTrackers ? 9m 9 minutes ago
Rawlings: Dallas hazmat team has cleaned up an apartment area + contacted residents w/info + locked patient's apt. #ebola

FluTrackers.com @FluTrackers ? 11m 11 minutes ago
Dallas Mayor Rawlings: Reassuring public. #ebola

FluTrackers.com @FluTrackers ? 12m 12 minutes ago
Jenkins: 48 in Duncan monitoring pool remain asymptomatic at this time. #ebola

FluTrackers.com @FluTrackers ? 12m 12 minutes ago
Jenkins: PCR test of #ebola patient has not been confirmed by CDC but confident it will be.

FluTrackers.com @FluTrackers ? 13m 13 minutes ago
Jenkins: CDC will be assisting w/ 48 people in Duncan monitoring pool. #ebola

FluTrackers.com @FluTrackers ? 14m 14 minutes ago
Varga: #Ebola patient is in stable condition.

FluTrackers.com @FluTrackers ? 15m 15 minutes ago
Varga: Hospital is on emergency dept diversion at this time. #ebola

FluTrackers.com @FluTrackers ? 15m 15 minutes ago
Dr. Varga: #Ebola test + last night on health care worker who treated Mr. Duncan. 1 family member also placed in isolation.

FluTrackers.com @FluTrackers ? 19m 19 minutes ago
Jenkins: Texas #Ebola Health care worker wants privacy and no name release.
 
Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

That's terrible for the case-patient. I can only hope this forces a serious reconsideration about exactly how 'sure' everyone is, especially if this patient wasn't even on the list of possible contacts.... 'tried and true" indeed. If they are on the list , perhaps....

"In this country, we have health care infection control and public health systems that are tried and true and will stop before there's any widespread transmission. The core of that, the way to stop Ebola in its tracks is contact tracing, and follow-up."

- Tom Frieden Oct 4.

http://www.cdc.gov/media/releases/2014/t1004-ebola-confirmed-case.html
 
Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

CNN is reporting this patient is a female nurse.
 
Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

So just to be clear - this (and I assume other staff) wore droplet precaution level PPE

such as:

15880-routinehighrisk.jpg


There is also ENHANCED droplet precaution PPE and procedures - here is a PDF reviewing this next level of safety:

http://www.wrha.mb.ca/extranet/ipc/files/manuals/acutecare/Rev1309-5.31.pdf

So it would be nice to know which sort was used in this case
 
Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

alert said:
CNN is reporting this patient is a female nurse.
Click to expand...

Also reporting that she was not a "high risk" contact. So maybe not in direct contact with Duncan? Not sure what this means....
 
Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

hat tip Michael Coston


News Releases
Statement from Dr. Dan Varga, Oct. 12, 7:30 a.m. CDT
10/12/2014


Ebola Virus


Statement from Dr. Dan Varga, Chief Clinical Officer, Senior Executive Vice President

Late Saturday, a preliminary blood test on a care-giver at Texas Health Presbyterian Hospital Dallas showed positive for Ebola. The healthcare worker had been under the self-monitoring regimen prescribed by the CDC, based on involvement in caring for patient Thomas Eric Duncan during his inpatient care that started on September 28.

Individuals being monitored are required to take their temperature twice daily. As a result of that procedure, the care-giver notified the hospital of imminent arrival and was immediately admitted to the hospital in isolation. The entire process, from the patient?s self-monitoring to the admission into isolation, took less than 90 minutes. The patient?s condition is stable. A close contact has also been proactively placed in isolation. The care-giver and the family have requested total privacy, so we can?t discuss any further details of the situation.

We have known that further cases of Ebola are a possibility among those who were in contact with Mr. Duncan before he passed away last week. The system of monitoring, quarantine and isolation was established to protect those who cared for Mr. Duncan as well as the community at large by identifying any potential ebola cases as early as possible and getting those individuals into treatment immediately.

Finally, we have put the ED on ?diversion? until further notice because of limitations in staffed capacity ? meaning ambulances are not currently bringing patients to our emergency department. While we are on diversion we are also using this time to further expand the margin of safety by triple-checking our full compliance with updated CDC guidelines. We are also continuing to monitor all staff who had some relation to Mr. Duncan?s care even if they are not assumed to be at significant risk of infection.

All of these steps are being taken so the public and our own employees can have complete confidence in the safety and integrity of our facilities and the care we provide.

Contact:

Wendell Watson, Director
Public Relations
682-236-6963


http://www.texashealth.org/news-alert.cfm?id=1629&action=detail&ref=1885
 
Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Not sure what this means....
Click to expand...

I'm not an expert, but some things I think we can infer from this and the Spanish nurse:

a. Ebola is easier to transmit when a patient is very sick than when he or she first presents.
b. PPE recommendations for those caring for ebola patients need to be re-evaluated.
c. Healthcare workers treating ebola patients need to be able to follow PPE guidelines perfectly, every time.
d. We aren't sure whether the hospital infections were due to equipment or training but we need to find out ASAP and take appropriate measures to ensure future infections of healthcare workers are prevented.
 
Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

Re: Texas Health Care Worker Tests Positive for Ebola: Hospital

http://www.centralmaine.com/2014/10/12/cdc-protocol-breach-in-treating-ebola-patient/

[CDC head, Dr. Tom Frieden] says the Ebola diagnosis in a health care worker who treated Thomas Eric Duncan at a Texas hospital shows there was a clear breach of safety protocol. [...]




This concerns me. I don't think there has been enough time to definitively determine the cause of the infection. Maybe a protocol breach is what happened, but maybe the CDC guidelines aren't sufficient. I hope they are urgently considering that possibility internally, at least.
 
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