Ebola diagnosis deeply concerning, health officials admit-US

Federal health officials in the US admitted on Sunday they were deeply concerned by a “breach in protocol” after it was revealed that a healthcare worker who treated Thomas Eric Duncan in Dallas had become the second person to be diagnosed with Ebola in the US.

Four days after Duncan died in an isolation unit, after arriving in Dallas last month from Liberia, secondary tests confirmed that a female employee at Texas Health Presbyterian hospital has the virus, in the first case of Ebola transmission in the US and the second outside Africa.

Texas officials earlier said preliminary tests showed the worker had been exposed to Ebola, but they were awaiting confirmation from the Centers for Disease Control and Prevention (CDC). Confirmation followed on Sunday afternoon.

The White House said President Barack Obama had been updated about the case.

Hospital officials said the employee had worn full protective clothing during all contact with Duncan. Dr Tom Frieden, the CDC director, warned in a media briefing on Sunday that other hospital staff could also have been exposed to the virus and may show symptoms in the coming days.

“The healthcare workers who cared for this individual may have had a breach of the same nature,” Frieden said. “It is certainly very concerning and it tells us there is a need to enhance training and make sure protocols are followed.

“The protocols work … but we know that even a single lapse or breach can result in infection.”

The White House said Obama had asked the CDC to move as quickly as possible in investigating the apparent breach of infection control procedures, and told federal authorities to take more steps to make sure hospitals and healthcare providers are ready to follow the proper procedures in dealing with an Ebola patient.

The woman infected by Ebola in Dallas, who was identified in media reports as a nurse, treated Duncan after he fell gravely ill and was admitted to hospital on 28 September, his second visit to the hospital.

Hospital chief clinical officer Dr Daniel Varga said in a statement: “Individuals being monitored are required to take their temperature twice daily. As a result of that procedure, the caregiver 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.”

The Texas health commissioner David Lakey said the test that confirmed the woman’s infection was conducted in a laboratory in Austin and came back positive on Saturday evening, but showed lower levels of the virus than in Duncan’s case.

“It’s deeply concerning that this infection occurred,” Frieden said. “We can’t let any hospital let its guard down.”

The woman was not among the 48 people officials are monitoring during the virus’s 21-day incubation period who may have contact with Duncan and are so far asymptomatic. Lakey said health officials were working to identify people who may have had contact with her once she started showing symptoms and as a result became contagious.

Frieden said that so far they had found only one such person, who was “under active monitoring”, but “it is possible that other individuals were exposed”.

He said that the woman had “extensive contact … on multiple occasions” with Duncan following his second visit to the hospital, where he was admitted and isolated.

Teresa Romero, a 44-year-old Spanish nurse, contracted Ebola after caring for a priest who had been repatriated from west Africa. She is being treated in a Madrid hospital and has told El Pais that she believes she may have made a mistake when taking off her protective suit, perhaps touching her face with her gloves.

Frieden said the second patient in Dallas has been interviewed but so far “that worker has not been able to identify a specific breach” which may have resulted in her exposure. The CDC said that on Friday the worker, who had been self-monitoring for Ebola symptoms, reported a low-grade fever and was referred for testing. She was promptly isolated, officials said.