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Second Health Care Worker Tests Positive for Ebola at Texas Hospital
In a media statement issued October 15, the Centers for Disease Control and Prevention (CDC) has reported that a second health care worker at Texas Presbyterian Hospital who provided care for the index patient has tested positive for Ebola, according to preliminary tests performed overnight by the Texas Department of State Health Services’ laboratory.
The patient was isolated after an initial report of a fever and remains so. Confirmation testing at the CDC’s laboratory is being conducted, and the health care worker is being monitored for fever and symptoms.
The hospital and the patient were notified of the positive test result. In addition, the CDC has interviewed the patient to identify contacts or potential exposures in the community.
The CDC says that it is not unexpected that there would be additional exposures.
The agency acknowledged that an additional health care worker testing positive for Ebola is a serious concern, and says it has taken steps to minimize the risk to health care workers and the patient.
On October 14, the CDC announced a series of actions related to hospital preparedness for Ebola treatment, both in Dallas and in hospitals around the country. These steps include:
- Sending an additional team to Dallas, including experts who successfully controlled outbreaks of Ebola in Africa in the past two decades, including in health care settings. Team members have worked with Doctors Without Borders on infection control protocols and have trained others in Africa to follow those protocols. This expertise is being directly shared with the hospital. In addition, two infection control nurses from Emory University hospital who have experience treating Ebola patients without infecting health care workers are joining the response at the Dallas hospital to provide peer-to-peer training and support. This combination of training will help hospital staff across a range of care and management experiences, the CDC says.
- Making immediate and specific improvements to processes and procedures at the Dallas hospital to reduce the risk to health care personnel. The CDC notes that care for a patient with Ebola requires meticulous attention to detail, and refining these steps makes it safer and easier.
- Having a site manager in place and at the Dallas hospital 24/7 as long as Ebola patients are receiving care, to oversee the putting on and taking off of PPE and the care given in the isolation unit.
- Establishing a dedicated CDC response team that could be on the ground within a few hours at any hospital with a confirmed patient with Ebola. The CDC Response Team would provide in-person, expert support and training on infection control, health care safety, medical treatment, contact tracing, waste and decontamination, public education, and other issues. The CDC Response Team would help ensure that clinicians, and state and local public health practitioners, consistently follow strict standards of protocol to ensure safety of the patient and healthcare workers.
- Providing more opportunities for U.S. health care providers to receive additional training and to get their questions answered by CDC experts. On October 14, the CDC held a partner conference call in which more than 5,600 clinicians from across the country joined. Later this week, the agency will host a call with the American Nurses Association to discuss how to better prepare frontline nurses for Ebola; and another call with the American Hospital Association. Next week, the CDC will host a live event in New York City with the Partnership for Quality Care and the Greater New York Hospital Association/1199SEIU Healthcare Education Project to educate frontline health care workers on Ebola; the event will be streamed live to hospitals across the country.
The CDC says that while this is troubling news for the patient, for the patient’s family, and for colleagues and the greater Dallas community, both the agency and the Texas Department of State Health Services remain confident that wider spread in the community can be prevented with proper public health measures, including ongoing contact tracing, health monitoring among those known to have been in contact with the index patient, and immediate isolations if symptoms develop.
Ebola is spread through direct contact with the bodily fluids of a sick person or through exposure to objects, such as needles, that have been contaminated. The illness has an average 8-to 10-day incubation period (although it could be from 2 to 21 days); therefore, the CDC recommends monitoring exposed people for symptoms for a complete 21 days. People are not contagious during the incubation period (i.e., before symptoms, such as fever, develop).