"Houston we have a problem" This just got very real

[Esme12]

And so it begins....

A health care worker who treated Thomas Eric Duncan, the first person in the U.S. diagnosed with Ebola who later died, has preliminarily tested positive for the deadly virus, the Texas Department of State Health Services said in a statement today.

The health care worker at Texas Health Presbyterian Hospital has been isolated since reporting a low-grade fever Friday, the department said. The Centers for Disease Control and Prevention will conduct further testing to confirm the diagnosis.

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

http://abcnews.go.com/Health/texas-health-care-worker-tests-positive-ebola/story?id=26135108

[Sloan RN]

So here are a few studies about Ebola and similar viruses on surfaces:

Sagripanti JL, Rom AM, Holland LE. Persistence in darkness of virulent alphaviruses, Ebola virus, and Lassa virus deposited on solid surfaces. Arch Virol2010; 155:2035-203

Sagripanti JL, Lytle DC. Sensitivity to ultraviolet radiation of Lassa, vaccinia, and Ebola viruses dried on surfaces. Arch Virol 2011; 156:489-49

Bausch DG et al. Assessment of the Risk of Ebola Virus Transmission from Bodily Fluids and Fomites. J Infect Dis 2007; 196:S142-7

Piercy, T.J., Smither, S.J., Steward, J.A., Eastaugh, L., Lever, M.S. (2010) The survival of filoviruses in liquids, on solid substrates and in a dynamic aerosol. J Appl Microbiol. 109(5): 1531-9.

The information from Emory I was told by the head of Infection Control at my hospital during an Ebola training session; I don't have a source in writing yet, but I'm hoping when the transcript of the CDC's COCA webinar on Ebola (it was yesterday) is posted, it will contain some of that information. When it's posted it can be found here: http://www.bt.cdc.gov/coca/calls/2014/callinfo_101414.asp

[Sloan RN]

Okay the Doctor's without Borders and the Samaritans Purse seem to have this care to an art and have a much more better safety record than the US hospitals. So who would you trust them or the CDC?. They don't seem to have the equipment and supplies available and still are having a better safety record. Why re-invent the wheel? Let examine their protocols and get this under control. Again if the administration what our Healthcare workers to work in these questionable conditions. I say have them come into the zone right beside the nurses. Its well over time for these hospital administrators to stop treating us like "were a dime a dozen".

16 Doctors Without Borders staff have contracted Ebola during the current outbreak, and that info is coming from the organization itself.

There have been 404 cases of Ebola in healthcare workers, and 232 have died. TWO of them contracted it in the United States, and neither are dead.

I get that we should be concerned and make sure we all understand proper precautions, but we should also be basing our opinions on actual facts and evidence.

[dnnc52]

OK WE HAD 1 pt and 2 nurses so far infected,and Africa has had about 8000 cases and Bout 405 Health Care Workers infected. I did not address the the level of tx. My target of comment was based upon the safety of the Health Care Workers made considering the amt of cases and years of working in these conditions they learn to do a lot with a little workforce and equipment so I think, and still beleive that when considering the amt of cases the Doctors without Borders and Samaritan Purse, have dealt with that they have a better system in place and better protocols. Its a matter projecting the math at our rate. Also the WHO feels that the cases of Health Care Workers who do contract the disease is due to improper use of protective equipment and the exhausting demand on the limitted workers. I do not feel that the CDC is giving us the real story. BTW there is a great article and info on the New York Times web site with all the stats and facts....

[RedWeasel, RN]

Just read the statement from NNU on behalf of the Texas nurses ( Statement by RN’s at Texas Health Presbyterian Hospital as provided to National Nurses United | National Nurses United ) and it's pretty clear what the breach was....

"For their necks, nurses had to use medical tape, that is not impermeable and has permeable seams, to wrap around their necks in order to protect themselves, and had to put on the tape and take it off on their own. "

That is in zero way part of any protocol put out by the CDC or anyone else, and if such tape were to get contaminated it would be virtually impossible to take it off without a very high risk of contaminating yourself. This is an example of hospitals not communicating clear protocols, and leaving staff to make up their own, which makes them even more at risk.

Some hospitals may be ready for Ebola (I do think my hospital has done a pretty good job but could do much better), but it's obvious that this particular hospital was not. To be fair, Duncan was an index case....Ebola being initially diagnosed in the US wasn't really on anyone's radar until he got here. In that way he kinda did us a favor...he's forcing us to get prepared.

Exactly. I just think it is the CDCs job for it to be on the radar...twenty years ago. They needed plans in place. Ten plus 'teams' ready to fly out to whatever hospital gets the index patient to take over care of that patient. Do not leave it up to the staff. They were the experts. Their job is to plan for this stuff and they just haven't at every turn. I just think to myself, if I was watching all this at a movie theater, I would walk out half way through the movie. It would just seem too unrealistic. I would think to myself, "No one could be this stupid. The Govt, the CDC, the hospital administrators. They would have suspended flights, or at least quarantined anyone whose passport had those countries listed, or was in contact with someone with ebola here in the states." No one could be this stupid and stay in charge. Tom Frieden needs to step down, yesterday.

[Esme12, ASN, BSN, RN]

If the PPE we don for every day contact precautions was adequate, these health care workers wouldn't be getting sick.

I am not a in a panic or hyped up about this. I honestly don't think this country is going to see an epidemic because I KNOW it's not airborne. I am concerned about the health care workers not being given proper PPE for a disease from which THIS country has never dealt with.

A report by CIDRAP Center for Infectious Disease Research and Policy and the University back in September believed differently

We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.¹

The minimum level of protection in high-risk settings should be a respirator with an assigned protection factor greater than 10. A powered air-purifying respirator (PAPR) with a hood or helmet offers many advantages over an N95 filtering facepiece or similar respirator, being more protective, comfortable, and cost-effective in the long run.

We strongly urge the US Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) to seek funds for the purchase and transport of PAPRs to all healthcare workers currently fighting the battle against Ebola throughout Africa--and beyond.

COMMENTARY: Health workers need optimal respiratory protection for Ebola | CIDRAP

[Esme12, ASN, BSN, RN]

Hospitals vs CDC . . . I am not laying all this on CDC. CDC works on a national level; hospitals work on a community level.

CDC can only make recommendations to hospitals. It made these recommendations . . . the hospital did not follow them. CDC relied too much on hospitals managing on the local level by making certain they and their employees were protected. Now that hospitals realize they are woefully prepared to manage Ebola, they are more receptive to CDC interventions and probably begging for it. Again, my thoughts.

I am blaming the CDC they know all about this virus they have has recommendations from Sept, 2014

COMMENTARY: Health workers need optimal respiratory protection for Ebola | CIDRAP

[CrunchRN, ADN, RN]

The Ebola frenzy here is nuts. Closing schools and all kinds of nuttiness. The only people who have caught it are the 2 nurses who cared for the patient at his sickest with improper protection provided. If it was easy to catch his family and hundreds more would have it. People need to look at it logically! Ok, off soap box

Bless those nurses. i wish them well.

Also, it is being reported here that nurse Amber was moved to Emory because the Presb. nursing staff threatened to walk off the job if they did not do that. Good for them. Obviously Emory has the resources to protect their staff that we do not have here.

[merilynRN]

Thank you for posting. Excellent information from the Center for Infectious Disease Research and Policy. And to think this commentary was posted back on September 17th! One would think it should have been widely disseminated information by public health officials by now.

COMMENTARY: Health workers need optimal respiratory protection for Ebola | CIDRAP

[Spidey's mom, ADN, BSN, RN]

The Ebola frenzy here is nuts. Closing schools and all kinds of nuttiness. The only people who have caught it are the 2 nurses who cared for the patient at his sickest with improper protection provided. If it was easy to catch his family and hundreds more would have it. People need to look at it logically! Ok, off soap box

Bless those nurses. i wish them well.

Also, it is being reported here that nurse Amber was moved to Emory because the Presb. nursing staff threatened to walk off the job if they did not do that. Good for them. Obviously Emory has the resources to protect their staff that we do not have here.

I agree - and ran across an opinion piece this morning talking about the frenzy.

http://www.nytimes.com/2014/10/15/opinion/frank-bruni-scarier-than-ebola.html?_r=0

We Americans do panic really well.

We could use a few pointers on prudence.

Do me a favor. Turn away from the ceaseless media coverage of Ebola in Texas — the interviews with the Dallas nurse’s neighbors, the hand-wringing over her pooch, the instructions on protective medical gear — and answer this: Have you had your flu shot? Are you planning on one?

[kbrn2002, ADN, RN]

Cripes! I am so sorry about an earlier comment indicating that nurse was a flaming fool for getting on a plane with a fever after knowing she was exposed...I hadn't seen the whole story yet.

Now I have to redirect those comments to the flaming idiots at the CDC! What on earth were they thinking telling her it was ok to get on that plane??? Sounds like she did the right thing and asked, it's the CDC that cleared her to fly. Shame on whoever told her to get on that plane!

Is the CDC just trying to secure more funding by ensuring that this disease spreads so they remain needed? Good gosh...now I'm sounding paranoid, and that's not me!

[Thimbalina]

yeah me… eating my words… redirect them all to the CDC (Center of Denial and Confusion)

[AdamantiteEnigma]

This is not good...

I'm reading on my mini break on the CNN main page that there is a possibility of two more cases. One being a person in Ohio who had contact with Ms. Vinson. And the other being an unidentified Yale Doctoral student.

Granted this is completely unsubstantiated information at this time. Take it with a grain of salt. But please, think good thoughts for these people anyway.

http://www.cnn.com/2014/10/16/health/us-ebola/index.html?hpt=hp_t1

(CNN) -- [breaking news published at 12:40 p.m. ET]

In northeast Ohio, one person has been quarantined and six others have quarantined and are monitoring themselves for Ebola after coming into contact or being in the vicinity of Ebola-stricken Texas nurse Amber Vinson, said Ohio Department of Health spokesman Jay Carey.

• A Yale doctoral student who recently returned to Connecticut from Liberia and has a fever is in isolation at Yale-New Haven Hospital and is being tested for Ebola, officials at the hospital said Thursday, adding that results should be available within 24 hours.