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The reassuring news in the Texas Ebola cases

WASHINGTON POST

By Todd C. Frankel                         October 14

....The Dallas nurse, 26-year old Nina Pham,who helped treat Thomas Eric Duncan, the Liberian man who was the first person diagnosed with the dreaded disease in the United States became the first – and so far only – person infected by Duncan. In the wake of her infection, U.S. health officials have pledged to review how future Ebola cases are handled.

But the case is also noteworthy for another, potentially positive reason: Nearly 50 people were exposed to Ebola before the nurse, and none of them has been diagnosed with the disease.

This group of neighbors, family members and first responders are being watched carefully by health authorities. They had some degree of close contact with Duncan during the four-day period when he was contagious – from when he started showing Ebola symptoms on Sept. 24 to when the hospital finally admitted him on Sept. 28. They didn’t take any Ebola-specific precautions. They didn’t know he was infected.... Yet, so far, they have not gotten sick. And their 21-day Ebola incubation period started before Pham’s.

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Hospitals should ‘think Ebola,’ CDC director says

CDC: U.S. has to rethink the way it addresses Ebola infection control

ASSOCIATED PRESS                                                            Oct. 13, 2014

By Connie Cass

DALLAS --Every hospital must know how to diagnose Ebola in people who have been in West Africa and be ready to isolate a suspected case, Tom Frieden, director of the Centers for Disease Control and Prevention, said Monday.

He said the CDC is working to improve protections for hospital workers after a nurse caring for an Ebola patient in Dallas became the first person to become infected with the disease inside the U.S.

‘‘We have to rethink the way we address Ebola infection control,’’ Frieden said, ‘‘because even a single infection is unacceptable.’’

The CDC is scrambling to interview all staff of the Dallas hospital who could have been exposed to the patient, a Liberian man who became sick after traveling to the United States and died at the hospital. Anyone at risk will be monitored, he said.

‘‘We need to consider the possibility that there could be additional cases, particularly among the health care workers who cared for the index patient’’ — the Liberian man — ‘‘when he was so ill,’’ Frieden said.

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Obama orders CDC probe in 2nd Dallas Ebola case to move ‘as expeditiously as possible’

WASHINGTON POST

                                    October 12, 014 

President Obama received two briefings on the diagnosis of a second Ebola case in Dallas, according to White House officials, and Sen. John McCain (R-Ariz.) urged the president to appoint a "czar" to coordinate the administration's response to the disease.

Obama was briefed Sunday morning by Lisa Monaco, who serves as assistant to the president for homeland security and counterterrorism and is overseeing the interagency response to the disease. Later, according to White House officials, Obama also discussed the situation with Health and Human Services Secretary Sylvia Burwell.

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Ebola Protocol Was Likely Breached In Texas, Medical Officials Say

HUFFINGTON  POST                     Oct.12, 2014      11:08 AM
By

The Texas health care worker who contracted Ebola after providing care for an infected patient likely breached safety protocols, health officials said Sunday.

"Certainly there has to have been an inadvertent, innocent breach of the protocol of taking care of the patient within the personal protective equipment -- that extremely rarely happens," Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, told Martha Raddatz on ABC's "This Week" Sunday. "We've been taking care of Ebola patients since 1976. Groups like Doctors Without Borders who do that almost never have an infection, because of the experience of doing this."

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U.S. lacks a single standard for Ebola response

USA TODAY                                   Oct. 12, 2014

by Larry Copeland

ATLANTA — As Thomas Eric Duncan's family mourns the USA's first Ebola death in Dallas, one question reverberates over a series of apparent missteps in the case: Who is in charge of the response to Ebola?

The answer seems to be — there really isn't one person or agency. There is not a single national response.

The Atlanta-based Centers for Disease Control and Prevention has emerged as the standard-bearer — and sometimes the scapegoat — on Ebola.

Public health is the purview of the states, and as the nation anticipates more Ebola cases, some experts say the way the United States handles public health is not up to the challenge.

Read Full Story
http://www.usatoday.com/story/news/nation/2014/10/12/examining-the-nations-ebola-response/17059283/

CDC workers analyze Ebola details in the CDC's Emergency Operations Center in Atlanta.(Photo: David Tulis for USA TODAY)


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Dallas health worker who tested positive for Ebola wore ‘full’ protective gear

WASHINGTON POST                                                      OCT 12, 2014

DALLAS, TEX--  In the first apparent case of Ebola transmission in the United States, a Texas hospital worker who treated an Ebola-stricken Liberian man has tested positive for the deadly virus.

A police car drives past the entrance to the Texas Health Presbyterian Hospital in Dallas. (LM Otero/AP)

The preliminary test result was announced early Sunday, four days after the death of Ebola patient Thomas Eric Duncan in Dallas; the diagnosis has not been confirmed by the Centers for Disease Control and Prevention.

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As Ebola patient in Texas fights for his life, his family copes with stigma and isolation

EBOLA VICTIM IN DALLAS IS IN CRITICAL CONDITION WHILE FAMILY MEMBERS SUFFER FROM STIGMA AND ISOLATION

WASHINGTON POST

By DeNeen L. Brown, Abby Phillip and Sean Sullivan October 5 at 8:05 PM

DALLAS — As a Liberian man diagnosed with Ebola was fighting to survive Sunday in a Texas hospital, his worried family members and others who were in contact with him said they are being ostracized by the local Liberian community, which is struggling to cope with fear, isolation and the stigma associated with the deadly disease.

A cleanup crew on Sunday sanitizes the apartment where Ebola patient Thomas Eric Duncan was staying before being admitted to a hospital in Dallas. (Joe Raedle/Getty Images)

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U.S. nurses say they are unprepared to handle Ebola patients

REUTERS                         Oct 3. 2014

CHICAGO (Reuters) - Nurses, the frontline care providers in U.S. hospitals, say they are untrained and unprepared to handle patients arriving in their hospital emergency departments infected with Ebola.

Many say they have gone to hospital managers, seeking training on how to best care for patients and protect themselves and their families from contracting the deadly disease....

The U.S. Centers for Disease Control and Prevention has repeatedly said that U.S. hospitals are prepared to handle such patients. Many infectious disease experts agree with that assessment.

... Texas Health Presbyterian Hospital in Dallas that is now caring for the first Ebola patient to be diagnosed in this country had completed Ebola training just before Thomas Eric Duncan arrived in their emergency department on Sept. 26. But despite being told that Duncan had recently traveled from Liberia, hospital staff failed to recognize the Ebola risk and sent him home, where he spent another two days becoming sicker and more infectious.

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Dallas Hospital Alters Account, Raising Questions on Ebola Case

NEW YORK TIMES          Oct. 3, 2014

DALLAS TEX.      

On Thursday, the hospital, Texas Health Presbyterian Hospital in Dallas, released a statement essentially blaming a flaw in its electronic health records system for its decision to send the patient — Thomas E. Duncan, a Liberian national visiting his girlfriend and relatives in the United States — home the first time he visited its emergency room, Sept. 25. It said there were separate “workflows” for doctors and nurses in the records so the doctors did not receive the information that he had come from Africa.

But on Friday evening, the hospital effectively retracted that portion of its statement, saying that “there was no flaw” in its electronic health records system. The hospital said “the patient’s travel history was documented and available to the full care team in the electronic health record (E.H.R.), including within the physician’s workflow.”

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Dallas Hospital says software flaw led to initial release of Ebola patent

Update with additional information and text of the hospital statement  (scroll down).

 

5 NBC News Chicago

 Oct 3, 2014 • Updated at 7:53 AM CDT

The Dallas Hospital that sent Ebola patient Thomas Eric Duncan home said a software flaw, and not human error, caused doctors to miss the diagnosis, NBC News is reporting.

The electronic health records (EHR) system that the hospital uses has a separate workflow for physicians and nurses. The travel history of the patient was located in the nursing portion of the workflow within the EHR, but not in the physician's workflow.

“As result of this discovery, Texas Health Dallas has relocated the travel history documentation to a portion of the EHR that is part of both workflows," the hospital said.

Link to story

Source: http://www.nbcbayarea.com/news/national-international/Texas-Hospital-Software-Blame-Ebola-Patients-Misdiagnosis-277988141.html#ixzz3F5cyR89B

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