Ebola in Texas

[rbmrtn]

And, presumably, will take their "clean" gloved hand and touch the same plastic spigot that they turned with their dirty hand a few moments prior.

This is always a problem. Like Gumby, I spent many hours ( seems like years ) dressed in banana suit at the nuke plant. We had people ( HPs, health physics technicians ) assigned to monitor the donning and removal of the protective clothing and if were not done correctly there were consequences. We also had machines to monitor for contamination around the area leaving the restricted location.

I wonder if these places have the training and personnel needed just monitor the health workers activities.

 

[2B]

And, presumably, will take their "clean" gloved hand and touch the same plastic spigot that they turned with their dirty hand a few moments prior.

There have been repeated studies showing that doctors don't wash their hands between patients according to standards.

 

[Cassie]

Thoughtful article by a scientist who was involved in the discovery of Ebola in 1976:

'In 1976 I discovered Ebola - now I fear an unimaginable tragedy' | World news | The Observer

Thank you Meadbh, very interesting article. I visited Zaire (as it was called in 1983) and stayed in Kinshasa for 2 weeks. I remember the open air markets with dead monkeys (bush meat) and other things we don't see here. (I'm not judging) I went to the ER with my friend with whom I was staying to check on her friend. The conditions were not good, she told me if I got sick this is not where I would be brought, thank goodness. I remember reading about Ebola years ago, soon after my visit and thinking about those monkeys I saw because I think I remember reading that Ebola may have come from them 1st.....my little grey cells could be wrong.

 

[soupcxan]

Now that Jesse Jackson is involved in the Ebola situation, I'm sure everything will be straightened out ASAP.

http://www.nytimes.com/2014/10/12/u...column-region&region=top-news&WT.nav=top-news

 

[Fermion]

Lovely. Now a healthcare worker in Texas has tested positive for Ebola.

Still think this isn't very contagious?

 

[frayne]

Lovely. Now a healthcare worker in Texas has tested positive for Ebola.

Still think this isn't very contagious?

This is not good !

 

[Meadbh]

The fact that two health care workers (in Spain and the US) have now been diagnosed with Ebola speaks to how contagious it is. Infection control really needs to be OCD around this virus. Level 4 is way more than most healthcare workers are accustomed to. I honestly don't think most healthcare systems are ready for this level of infection control on a grand scale. They need to get ready now.

 

[MRG]

Lovely. Now a healthcare worker in Texas has tested positive for Ebola.

Still think this isn't very contagious?

Never did. I bet no monkey tartar was served either.

We don't know what we think we know about this disease.

 

[Moemg]

Thoughtful article by a scientist who was involved in the discovery of Ebola in 1976:

'In 1976 I discovered Ebola - now I fear an unimaginable tragedy' | World news | The Observer

Great article ! What is troubling me about Ebola is the health care workers contracting it . I have worked in the medical profession for forty years and I only ever heard of one healthcare worker who ever caught anything from a patient including many nurses who were stuck with aids contaminated needles . This virus is seriously scary .

 

[jetpack]

This is always a problem. Like Gumby, I spent many hours ( seems like years ) dressed in banana suit at the nuke plant. We had people ( HPs, health physics technicians ) assigned to monitor the donning and removal of the protective clothing and if were not done correctly there were consequences. We also had machines to monitor for contamination around the area leaving the restricted location.

I wonder if these places have the training and personnel needed just monitor the health workers activities.

The "nice" thing about nukes is that it's a lot easier to test for contamination. Radiation meters are pretty sensitive and can give you number on how bad off you are. Viruses on the other hand... You can't see it or measure it very easily.

 

[AnIntentionalRoad]

Lovely. Now a healthcare worker in Texas has tested positive for Ebola.

Still think this isn't very contagious?

This is way more troubling to me than previous cases. It is the first case of someone contracting Ebola within the US.

Worse, it shows that even CDC protocols being practiced by professionals under intense scrutiny are insufficient to contain it. Imagine if it gets into the general population.

 

[jetpack]

The more I think about it, the more I think my ebola Halloween costume is a good idea. Not only timely, but could save me an infection too.

 

[Senator]

Someone should tell that health care worker that she/he has a much higher likelihood of being struck by lightning, than dying from Ebola.

That might help...

 

[Meadbh]

Someone should tell that health care worker that she/he has a much higher likelihood of being struck by lightning, than dying from Ebola.

That might help...

It might also be untrue.

 

[Meadbh]

So, the CDC is saying that the infected nurse in Dallas must have inadvertently, innocently breached the protocol, and that all healthcare workers who cared for Mr. Duncan are now considered to be at risk. He was intubated and had dialysis, both invasive therapies.

Could it be that the protocol has vulnerabilities that have not been identified?

I worry about a couple of nightmare scenarios emerging.
1. Healthcare workers panicking because they do not trust the ability of current infection controls to protect them. Result: nobody to care for Ebola patients.
2. Ebola patients being shunned. Only comfort measures being offered.

The CDC is now examining cohorting of Ebola patients in a secure location with a small cadre of highly trained staff. But early identification and isolation is still required everywhere. And I do hope those vaccine trials go well!

 

[GrayHare]

IMO the risk is being downplayed, but perhaps I've read too much Michael Crichton.

 

[tmm99]

I am a bit confused.

This nurse in TX catches it but none of the family members of Duncan's who were with him living under the same roof when he had 103 temp? How about whoever ended up cleaning up his vomit outside his apartment? (I know this disease is not supposed to be contagious until the person has active symptoms but what is considered active symptoms??) Does this disease become more and more contagious as the disease progresses?

Another question is why this nurse got infected while tons of Doctors Without Borders treating hundreds of ebola patient day in day out are not getting infected (well except for a couple)?

Someone mentioned jello powder. I vote for that.


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[tulak]

So, the CDC is saying that the infected nurse in Dallas must have inadvertently, innocently breached the protocol, and that all healthcare workers who cared for Mr. Duncan are now considered to be at risk. He was intubated and had dialysis, both invasive therapies.

Could it be that the protocol has vulnerabilities that have not been identified?

I worry about a couple of nightmare scenarios emerging.
1. Healthcare workers panicking because they do not trust the ability of current infection controls to protect them. Result: nobody to care for Ebola patients.
2. Ebola patients being shunned. Only comfort measures being offered.

The CDC is now examining cohorting of Ebola patients in a secure location with a small cadre of highly trained staff. But early identification and isolation is still required everywhere. And I do hope those vaccine trials go well!

Sounds like damage recovery by the CDC. When I read quotes like this:

"While this is obviously bad news, it is not news that should bring about panic," Jenkins said. "We knew it was a possibility that a second person would contract the virus. We had a contingency plan in place."

Jenkins is Dallas County's chief executive and its Homeland Security director.

Did you really expect the 2nd person to be infected to be a health care worker? Oh. She must not have followed protocol. However, from the same article:

Dan Varga, chief clinical officer for the hospital group that includes Texas Health Presbyterian, confirmed that the woman had worn full protective gear when working with Duncan.

Hmm, so she was following protocol. Maybe she didn't have proper training with the equipment?

I agree with you. I think there are protocol vulnerabilities that aren't understood. This news is definitely not reassuring. I'm very skeptical that hospitals having the training and are able to deal with this effectively. My spouse is an RN and she's very worried about this and has reiterated the nightmare scenarios you mentioned above.

What's the benefit for dealing with an ebola patient? Especially if you're already wary that the facilities don't have the necessary precautions in place to protect the staff. And now you find our a nurse wearing full protective gear was infected. Not good.

On another note, my wife read an article that the initial ER nurse that admitted Duncan properly documented that the patient was from Africa. These notes should be read by physicians, etc, when determining how to proceed with patient care. But in reality, this doesn't happen, as shown by this case. All this does is help point out the communication breakdown that occurs in these facilities. All of them love to have their processes, but much like the finance industry, until it's put under strain, you don't see how well it holds up.

 

[Meadbh]

Well said, Kiki. And regarding why a nurse was infected while family members have not been (thus far), there is a difference in body fluid exposure. Blood and saliva are apparently highly infectious when the patient is sick with Ebola. The family would not have been exposed to Mr. Duncan's blood. If this nurse was involved in dialysis, and blood splashed on her gloves, or the junction between her gloves and her protective suit, or if she was suctioning Mr. Duncan's airway (essential nursing for an intubated patient) and got sputum on her mask.......I can so easily see it happening.

I think there are some very sweaty armpits in Dallas right now, and I don't just mean the healthcare workers in protective suits.


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[Moemg]

I do not buy the break in protocol .If you are a RN who works in an Infectious care unit you are super careful your life depends on it . IMO ebola is much more contagious than originally thought .

 

[sheehs1]

I think the jury may still out on the family members of Duncan. Isn't the quarantine a minimum of 21 days? While the family may not have been exposed to his blood, I would most certainly think exposure to his saliva or sweat would have been relatively easy, not to mention other possible ways such as tissues, towels, etc. I know they decontaminated the house but still.
What is disconcerting to me is the "reason" given for contracting this virus has been "a breach in protocols but they remained stumped as to where the breaches occur. Like Moemg said, you can be certain that nurse was extremely careful.

 

[Meadbh]

I do not buy the break in protocol .If you are a RN who works in an Infectious care unit you are super careful your life depends on it . IMO ebola is much more contagious than originally thought .

+1.

 

[MooreBonds]

What gets me is that they won't say which department they are in or how the healthcare worker that caught it cared for the Liberian. It should be fairly obvious to figure it out ASAP where the healthcare worker came across the patient (as a nurse directly caring for them, processing used medical instruments, etc.) Given that we haven't heard about any other people that came into contact with the initial patient developing Ebola (yet), it sounds like the healthcare worker had a lapse in their vigilance, rather than it being far more contagious than expected...but time will tell.

 

[Ronstar]

I don't think the hospital will release much info as to how the nurse contracted Ebola in an effort to avoid liability issues.


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[Bestwifeever]

What gets me is that they won't say which department they are in or how the healthcare worker that caught it cared for the Liberian. It should be fairly obvious to figure it out ASAP where the healthcare worker came across the patient (as a nurse directly caring for them, processing used medical instruments, etc.) Given that we haven't heard about any other people that came into contact with the initial patient developing Ebola (yet), it sounds like the healthcare worker had a lapse in their vigilance, rather than it being far more contagious than expected...but time will tell.

This information is out there, as reported on CNN (http://www.cnn.com/2014/10/12/health/ebola/):

The woman had on a gown, gloves, mask and a shield during her multiple visits with Thomas Eric Duncan.... The patient is a nurse at Texas Health Presbyterian Hospital in Dallas, an official who is familiar with the case told CNN.... She was involved in Duncan's care after he was placed in isolation -- his second trip to the hospital after coming to the United States from Liberia -- said Dr. Tom Frieden, the director of the CDC.

I have also read that the Dallas medical staff (per CDC protocol, I assume) was not wearing the full body-suit preventive clothing that those in Africa wear when dealing with Ebola patients.