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US - Texas: Mr. Duncan - Patient tests positive for Ebola in Dallas - traveled from Liberia -deceased

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

<TABLE style="MARGIN: 11px 17px; FONT-SIZE: 9pt" class=collapse><TBODY style="FONT-SIZE: 9pt"><TR style="FONT-SIZE: 9pt"><TD style="FONT-SIZE: 9pt" class=collapse>News Releases



</TD></TR><TR style="FONT-SIZE: 9pt"><TD style="FONT-SIZE: 11px" class="collapse content"><STYLE style="FONT-SIZE: 11px" type=text/css>@import url(module.css); font.metadetailtitle { font-size: 13pt; font-style: normal; font-family: Arial; font-weight: bold; color: black } </STYLE><TABLE style="FONT-SIZE: 11px" class=metadetail><TBODY style="FONT-SIZE: 11px"><TR style="FONT-SIZE: 11px" class=metadetail><TD style="FONT-SIZE: 12px" class=metadetail>Ebola Update
10/01/2014

<TABLE style="BACKGROUND-COLOR: #ccddeb; FONT-SIZE: 12px" border=0 cellPadding=10 align=right><TBODY style="FONT-SIZE: 12px"><TR style="FONT-SIZE: 12px"><TD style="FONT-SIZE: 9pt">Ebola Answers
What You Need to Know
about Ebola Disease Exposure


​
</TD></TR></TBODY></TABLE>Wednesday, Oct. 1, 2014 -- 3:25 p.m. CDT​

ARLINGTON, Texas ? The federal Centers for Disease Control and Prevention (CDC) has confirmed that a patient admitted to Texas Health Presbyterian Hospital Dallas has tested positive for Ebola Virus Disease (EVD). The hospital is following suggested CDC and Texas Department of Health recommendations to protect the safety of patients, hospital staff, volunteers, physicians and visitors.

We are working closely with representatives from the CDC, Texas Department of Health, Dallas County Health Department and the United States Department of Health and Human Services on coordinated responses and we are taking every step possible to manage this situation.

Texas Health Dallas has a robust infection-control system and our staff is trained and prepared to take care of patients with a variety of infectious diseases, including EVD. An Epidemiologic Emergency policy is in place at the hospital, and Infection Prevention and Emergency Management are working closely together to stay abreast of ongoing developments. The hospital is operating as normal, with clinicians caring for patients and other hospital employees supporting those caregivers as they do every day.

The patient originally presented at the hospital after 10 p.m. on Thursday, September 25. At that time, the patient presented with low-grade fever and abdominal pain. His condition did not warrant admission. He also was not exhibiting symptoms specific to Ebola. The patient returned via ambulance on Sunday, September 28 at which time EMS had already identified potential need for isolation. The hospital followed all suggested CDC protocols at that time.

Texas Health Presbyterian Hospital Dallas staff members are thoroughly trained in infection control procedures and protocols.
At Texas Health, our training, emergency preparedness, dedication and focus on safety and quality ? essentially everything we do ? is in preparation to handle these types of cases. We are caring for this patient because this person came to us for help and it is the right thing to do. Our mission is to improve the health of the people in the communities we serve and our focus on compassion is at the heart of what we do.

As health-care professionals this is what we train and prepare for.

http://www.texashealth.org/body.cfm?id=1629&action=detail&ref=1869


</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>​
 
Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Pathfinder said:
At that time, the patient presented with low-grade fever and abdominal pain. His condition did not warrant admission. He also was not exhibiting symptoms specific to Ebola.
Click to expand...

Not exhibiting symptoms specific to Ebola?

He was exhibiting "symptoms specific to Ebola"


Which is why travel history is so important.


http://www.texashealth.org/body.cfm?
http://www.cdc.gov/vhf/ebola/symptoms/index.html
 
Re: US - Texas: Patient tests positive for Ebola in Dallas - travel history to Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - travel history to Liberia

Jim Oliveros said:
I wonder if these assumptions will be proven wrong:

It is assumed that patients are only contagious when symptomatic.
It is assumed that developed countries can (and will) conduct appropriate contact tracing and contain any potential outbreak.
It is assumed that the vaccines under development will work.
Click to expand...

- As in every other infectious disease there is almost certainly wide individual variation in viral shedding and fever threshold.

- It's noteworthy that the CDC just sent 9-10 staff for contact tracing on 1 case. Let's say there are 2-3 new imports? Staffing becomes a major issue.

- Even if they work, scale-up and manufacturing is 6-9 months. absolute absolute minimum even with truncated/waived safety testing. The physical infrastructure for vaccine production is staggering.
 
Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Ray said:
Not exhibiting symptoms specific to Ebola?

He was exhibiting "symptoms specific to Ebola"


Which is why travel history is so important.


http://www.texashealth.org/body.cfm?
http://www.cdc.gov/vhf/ebola/symptoms/index.html
Click to expand...

i agree with you that travel history is important and apparently that is where they dropped the ball, but early symptoms really aren't specific to Ebola. I don't know if you are a health care provider or not, but in medical lingo "specific" means the symptoms are found only with the disease in question. His symptoms at the time were possibly consistent with any of a variety of infectious & noninfectious conditions.

Out of curiosity, I would like to know what kind of illness they thought they were treating, though. Since they were probably not considering malaria, either, it would be interesting to know what was in the list differential diagnoses.
 
Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Without the travel history, those symptoms could be just about anything. We are heading into flu season which will make it all that much more difficult to differentiate. This was/is a failure of preparedness. And of communication. Hoping for enhanced training, community awareness because this will not be the only case imported into the US, not as long as exponential growth continues in Liberia and Sierra Leone.

If clinicians are only on the lookout for symptoms specific to Ebola, that will be problematic, as few are. Travel history is critical.
 
Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

<IFRAME height=360 src="//www.youtube.com/embed/vuzguJw5AT8" frameBorder=0 width=640 allowfullscreen></IFRAME>

Gov. Perry Meets with State and Local Health Officials Responding to Ebola Case

Published on Oct 1, 2014

10/1/2014 - DALLAS - Gov. Rick Perry today joined state and local health officials at Texas Health Presbyterian Hospital to inform the public of the measures being taken to guard the public's health following the first diagnosed case of Ebola in the United States.

http://www.youtube.com/watch?v=vuzguJw5AT8
 
Re: Patient's friend, not hospital, called CDC

Re: Patient's friend, not hospital, called CDC

Anderson Cooper reporting that patient's friend, not the hospital, called the CDC.

"The close associate, who does not want to be identified because of the sensitivity of the case, contacted the CDC with concerns that the hospital wasn't moving quickly enough after Duncan's second hospital visit."

http://www.cnn.com/2014/10/01/health/ebola-us/index.html
 
Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

bwilde said:
http://mobile.reuters.com/article/idUSKCN0HP2F720141001?irpc=932


His whole family was screaming. He got outside and he was throwing up all over the place.

Wouldn't that mean some kind of trace on the apartment building?
Click to expand...

Welcome, bwilde! :)

Yes, they better see who had cleaned that up. How very traumatic for all involved. :( I'm hoping for recovery for that man and no other cases, if that is possible.
 
Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

bwilde said:
http://mobile.reuters.com/article/idUSKCN0HP2F720141001?irpc=932

His whole family was screaming. He got outside and he was throwing up all over the place.

Wouldn't that mean some kind of trace on the apartment building?
Click to expand...

Welcome to FT bwilde. That is a very disturbing report. I wonder if the vomit was cleaned up. If not, what if a raccoon or opposum gets into it?
 
Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Jim Oliveros said:
Welcome to FT bwilde. That is a very disturbing report. I wonder if the vomit was cleaned up. If not, what if a raccoon or opposum gets into it?
Click to expand...

That is a typical chaotic ems scene, assuming I have the correct apartment complex, there is a park (Harry Moss Park) nearby so yes small animals or local dogs probably cleaned it up.

Ivy Apartments is 1.1 miles (4 min) from the ER. Next door is Conrad High School and the park mentioned above. They also live within 1.5 miles (5 min) of several national chain stores (Walmart Superstore, Best Buy, Toy's R Us, JCPenney, Home Depot, Whole Foods, etc) and a movie theater, Fair Oaks Day School, several restaurants and ALOT of houses packed in on small lots. The potential for spread is huge if he went anywhere. Given that he knew he was exposed before he boarded that plane, I'm not convinced that he would be honest about contacts. But there is jet lag to consider, so hopefully that kept him home.
 
Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

From the Daily Mail (UK) - which quality sometimes leaves to be desired but has improved a lot in the last few years (emphasis mine):

"...During the afternoon a man in his 20s arrived at the apartment holding what appeared to be a roll of black garbage bags and went in to the house, suggesting the family are disposing of items which may have been infected..."​

And where might these items be disposed of? In the local trash? Burned? Abandoned somewhere?

"...The ambulance used by the Fire Station 37 crew has also been cordoned off - but there are concerns because it was used for two days after the patient was transported but before Ebola was confirmed.​

So, evidently, someone official must have been tracing the people who were carried in this ambulance? Yes? In what condition are these sick people? Have they been placed in some sort of isolation? Have the care people who subsequently looked after these people been put in observation? Family members of these sick people?

In addition, of course, to the already mentioned crew in quarantine. I hope?

Read more: http://www.dailymail.co.uk/news/article-2775608/CDC-confirms-Dallas-patient-isolation-testing-returning-region-plagued-Ebola-HAS-deadly-virus.html
Follow us: @MailOnline on Twitter | DailyMail on Facebook...
 
Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Emily said:
Opossums seem to have been exposed long ago.

http://www.wired.com/2010/07/ebola-in-genomes/

http://www.plospathogens.org/article/info%3Adoi%2F10.1371%2Fjournal.ppat.1001030

Species that have ebola sequences integrated into their genomes seem resistant.
Click to expand...

Thanks for the very interesting link, I was not aware that RNA viruses were coded in some animals' DNA. My first thought was, what if the viruses originally evolved as a defense mechanism for animals, for example, a bat colony would be left alone if any animal coming near the colony died. Instead of assuming that viruses evolved randomly, maybe they originally were a type of natural biological warfare agent that worked a little too well. Something to research anyway.
 
Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

hat tip Michael Coston

Texas Orders Family of Ebola Patient to Stay Home

News Release
October 2, 2014

Out of an abundance of caution, Texas and Dallas County health officials have ordered four close family members of the Dallas Ebola patient to stay home and not have any visitors to prevent the potential spread of disease.
?We have tried and true protocols to protect the public and stop the spread of this disease,? said Dr. David Lakey, Texas health commissioner. ?This order gives us the ability to monitor the situation in the most meticulous way.?
The local health department had previously instructed the family to stay home, but a strict public health control order is needed to ensure compliance. Ebola is not contagious until symptoms appear. The family members do not have symptoms at this time.
The orders were hand delivered to the family members Wednesday evening by local health officials. The orders legally require the family to stay at home and not have any visitors without approval from the local or state health department until at least Oct. 19. The order is in place until the incubation period has passed and the family is no longer at risk of having the disease.
The order requires the family to be available to provide blood samples and agree to any testing required by public health officials and to immediately report any symptoms to Dallas County Health and Human Services. Symptoms include fever above 100.5 degrees, headache, nausea, diarrhea or abdominal pain.
Texas law allows the state health department and the local health authority to issue control measures to a person who is ill with, has been exposed to, or is the carrier of a communicable disease. (Health and Safety Code ?81.083). Control measures by law can include isolation, quarantine and preventive therapy. If a person does not follow these orders, they can be enforced by the courts, and the person can face criminal charges.
-30-​
State Health Department Media Contact: Carrie Williams, 512-776-7119, carrie.williams@dshs.state.txus
Dallas County Contact: Dallas County Judge Clay Lewis Jenkins, 214-653-7949, Clay.Jenkins@dallascounty.org
DSHS Press Office on Twitter





https://www.dshs.state.tx.us/news/releases/20141001.aspx
 
Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

U.S. Ebola case: 80 monitored in Dallas

By Holly Yan and Gary Tuchman, CNN

updated 8:49 AM EDT, Thu October 2, 2014
Dallas (CNN) -- [Breaking news update, posted at 8:49 a.m. ET]

Health officials are monitoring not only the people the Dallas Ebola patient had contact with while he was contagious and not isolated, but also dozens of people that they subsequently contacted, Dallas County Health and Human Services spokeswoman Erikka Neroes said Thursday.

Eighty people -- the patient's contacts, plus people with whom they had contact -- are now being monitored for Ebola in the Dallas area, Neroes said. Earlier, Dallas Mayor Mike Rawlings said the patient's direct contacts numbered up to 20.

None has shown symptoms, and all are being given educational materials, Neroes said.

None of the 80 has been quarantined, Neroes said. However, Dallas County health officials have ordered four close relatives of the patient, Thomas Eric Duncan, to stay home and not have any visitors until at least October 19.
...
http://www.cnn.com/2014/10/02/health/ebola-us/index.html
 
Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

U.S. Close to Solution for How Hospitals Must Dispose of Ebola Waste

...Most U.S. hospitals are not equipped with incinerators or large sterilizers called autoclaves that could accommodate the large amounts of soiled linens, contaminated syringes and virus-spattered protective gear generated from the care of an Ebola patient, said Dr. Jeffrey Duchin, chair of the Infectious Diseases Society of America?s Public Health Committee.

Duchin said he is not aware of whether Texas Health Presbyterian Hospital in Dallas has its own incinerator or large autoclave, but if it does not, ?they are going to have to find a temporary solution for managing infectious waste. That puts the hospital in a very difficult situation.? The infected Ebola patient, Thomas Eric Duncan, who began showing symptoms after arriving from his native Liberia last month, remains in stable but critical condition at the hospital.

http://www.nbcnews.com/storyline/eb...ow-hospitals-must-dispose-ebola-waste-n216596
 
Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Officials: 100 'Potential Contacts' Linked To Dallas Ebola Patient

by Scott Neuman
October 02, 201410:39 AM ET

The number of "contact traces" for a man diagnosed with Ebola earlier this week in Dallas has risen to 100, officials say, as they add secondary contacts to a list of people being monitored for symptoms of the deadly virus.

Earlier today, Erikka Neros, a spokeswoman for the Dallas County Health and Human Services department, said the number of "contact traces" stood at about 80 because the 12 to 18 people known to have been directly exposed to the patient then had contact with others.

Hours later, a spokeswoman with the Texas Department of State Health Services said officials were "working from a list of about 100 potential or possible contacts."

"Out of an abundance of caution, we're starting with this very wide net, including people who have had even brief encounters with the patient or the patient's home. The number will drop as we focus in on those whose contact may represent a potential risk of infection," the spokeswoman, Carrie Williams, said in a statement.​
...
http://www.npr.org/blogs/thetwo-way...ntial-contacts-linked-to-dallas-ebola-patient
 
Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

I'm glad to see that Dallas County Health and Human Services is taking this contact tracing seriously.
 
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