"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

[BeachsideRN, ASN]

And didn't Brantley get infected despite use of PPE, but where was the CDC in throwing him under the bus? I rarely get angry with news reports--I'm a little more easy-going than that--but this is making me nearly tearful. Are we nurses that expendable to the PTB?

Yes! I think the CDC doesn't want to admit that the virus is likely mutating and transmission is changing. They did update the transmission warning to include bodily fluids through casual contact within 3 feet. I.e someone could sneeze on you depositing infectious saliva. It's very unsettling.

[caroladybelle, BSN, RN]

I don't get why regular floor nurses are taking care of these patients? Seems like the CDC would have nurses who've had extensive training and the best equipment for these patients.

The CDC was not the ones caring for the patients.

While CDC has isolated people on the premises, it has limited ability to do that on a regular basis (so is my understanding). This is Emory created the biohazard 4 unit and trained staff for it. Notably, none of them has been publicized as sick. The CDC has only limited ability to supervise the staff of another hospital. The guidelines for isolation is published and the hospital is suppose to have adequately educated them as well as support staff for cleaning.

This, the hospital would have assigned staff generally. If CDC is there, they may make recommendations, but the nurse manager would better know the staff, how physically Nd emotionally that they handle situations similar and can tolerate and use PPE well.

My question is where is USAMRID in this issue? I know they are military, but often assist in these issues.

[TheCommuter, BSN, RN]

Are we nurses that expendable to the PTB?

During the 2001 Anthrax outbreak scare, postal workers were obviously expendable and disposable to the PTB since they were the ones who directly handled the mail. Hence, it wouldn't surprise me at all if nurses received the same lip service treatment in 2014.

[rnkaytee]

I don't understand why there isn't more supervision/training/equipment/etc for this - the CDC treats this as a Level 4 virus in their research labs which requires a much higher standard of PPE but here I get the feeling (please correct me if I'm wrong) that these hospitals are kind of left to their own devices. Of course PPE isn't that difficult of a concept and any nurses should be responsible but I'd hate to be that nurse that shows up for their regular shift and draws the short straw.

[stablesystole]

I bet you hard cash that human ebola is droplet spread instead of pure contact like they claim.

However, here's the kicker. There is a non-human strain, ebola reston that is VERY airborne and has a higher lethality. So a close cousin to the current strain of concern is known to be airborne and now the human zaire strain is undergoing more viral replication and mutation in the past months than in the entire prior span of it's existence. Life finds a way.

[dudette10, MSN, RN]

Yes! I think the CDC doesn't want to admit that the virus is likely mutating and transmission is changing. They did update the transmission warning to include bodily fluids through casual contact within 3 feet. I.e someone could sneeze on you depositing infectious saliva. It's very unsettling.

So they updated it to droplet?

CNN just did an update, and they went to a NY hospital to talk about their protocols. The protocol is the standard droplet/contact PPE, with the blue gowns, clean gloves, surgical mask, and eye protection. Our hospital's protocol for droplet/contact (before all this, that is) DOES NOT include eye protection.

We all know how much those blue gowns cover and don't cover, and also how difficult they are to remove properly without touching the front with your bare hands. That's why good hand hygiene after doffing PPE is so important. What about footies? I took care of an active CDiff patient who **** all over the floor and wall (yes, wall) multiple times, and I tried to clean my shoes as best I could, but the order of doing things had me going, "Wait, shouldn't I do this next, rather than this..."

I think the PPE recommendations are inadequate.

[NurseJamie8]

They always blame the nurses! I can't see a nurse who knows she will care for a patient with Ebola not taking all the precautions necessary. While it could've been a simple honest mistake I feel that there is something missing to this story. Scary.

[SoldierNurse22, BSN, RN]

I bet you hard cash that human ebola is droplet spread instead of pure contact like they claim.

http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.html

The CDC's site now indicates that Ebola requires droplet, contact and standard precautions (updated as of 06 Oct).

http://www.cdc.gov/vhf/ebola/transmission/

As PPs have surmised, I'll bet you the virus itself is mutating as it spreads and transmission routes are changing. Give it some time and we'll have an airborne disease on our hands much like the aforementioned airborne animal strain.

After all, the link above indicates that they believe patient zero contracted Ebola from animal contact. How long until either an existing human strain becomes airborne or one of those nasty airborne animal strains becomes contagious to humans?

[BeachsideRN, ASN]

They always blame the nurses! I can't see a nurse who knows she will care for a patient with Ebola not taking all the precautions necessary. While it could've been a simple honest mistake I feel that there is something missing to this story. Scary.

Agreed. Experts, such as Dr Brantley who are contracting the disease makes me think that the virus is changing and transmission is changing... along with the increase in numbers of infected patients and deaths. Yes, PPE protocols can be breached but I just don't see it being something like that in these cases.

[Esme12, ASN, BSN, RN]

HAZMAT has been dispatched to Harvard Vanguard in MA

A hazmat situation was underway Sunday afternoon at Harvard Vanguard Medical in Braintree. The hospital was evacuated briefly due to a patient with possible Ebola symptoms.

Officials say the patient was recently in West Africa and experiencing muscle aches as well as a headache. He was isolated in an ambulance outside of the hospital, officials say.

The hospital released the following statement Sunday afternoon: "A patient who had been to Liberia presented himself today at the Harvard Vanguard Medical Associates Braintree practice complaining of headache and muscle aches.

Out of an abundance of caution we immediately notified authorities and the patient was securely removed from the building and put into an ambulance now headed to Beth Israel Deaconess Medical Center. The building was closed briefly but has now re-opened. We are working closely with the Department of Public Health who will determine next steps."

.REPORT: Patient with Ebola like symptoms being transported to Boston hospital

[Mulan]

How did the NBC photographer get it?

They don't know.

[SoldierNurse22, BSN, RN]

HAZMAT has been dispatched to Harvard Vanguard in MA

.REPORT: Patient with Ebola like symptoms being transported to Boston hospital

Wow. HAZMAT? Evacuating the hospital? Isolating a patient in an ambulance instead of in the hospital?

Just screams "US hospitals are prepared to handle Ebola", doesn't it?