Are we approaching the “Tipping Point” for Ebola?

I was talking with biologists yesterday, as part of a work project, and we all were becoming increasingly alarmed at the bureaucratic response to the reports that nurses in Dallas and Spain were stricken with Ebola.

I stated that the “tipping point” would be reached if one of the nurses spread the disease to someone else outside of the hospital setting. Presently, 76 Texas Health Presbyterian Hospital workers being monitored for potential infection with Ebola. Once someone outside the healthcare setting was infected, then the chances of this being a more serious health threat to the nation escalate.

We are coming perilously close to the tipping point, as it looks like an Alcon employee who is “closely associated” with the Dallas nurse, Nina Pham, is in isolation and under observation to determine if he displays “Ebola symptoms”.

The CBS Dallas-Fort Worth affiliate offers a video report and post.

Dallas nurse Nina Pham tested positive for the Ebola virus over the weekend. Pham was one of the medical workers who administered treatment to Ebola patient Thomas Duncan, who died from the virus last week. Pham first noticed that she had some of the symptoms on Friday, and her diagnosis was confirmed on Sunday.The Centers for Disease Control and Prevention confirmed on Sunday morning that one other person was in close contact with the nurse after her symptoms began to show. That person is now known to be an employee at the Fort Worth company Alcon. The company sent a message to all staff members, letting them know that one of their own was in isolation at Texas Health Presbyterian Hospital in Dallas.According to the emailed note, the Alcon employee was admitted to the hospital on Sunday and is being monitored for Ebola symptoms. However, the man has not shown any signs of being sick. The name of the Alcon worker was not released.

Here is a screen shot of the note, as offered by the CBS affiliate.

As the incubation period is potentially 21 days, the associate is going to be under observation for quite some time.

One of the benefits of having the infected American missionary doctor brought to Emory Hospital, a facility equipped to handle a pathogen as dangerous as Ebola, is that his antibody rich blood has been used to help Pham recover. Her current condition is reported as stable after she was given a transfusion yesterday.

Questions still remain about how Pham contracted the disease.

On Monday morning, an official with direct knowledge of the Texas nurse’s case told CNN that CDC disease detectives interviewed the nurse several times and thought there were “inconsistencies” in the type of personal protective gear she wore and with the process used to put the gear on and remove it.[Director of Disease Control and Prevention Dr. Tom] Frieden has spoken of possible ways she became infected. It could have happened when the nurse removed her protective gear — a bit of infected bodily fluid somehow touching her — or it she could have come into contact with infected fluid as Duncan received kidney dialysis or respiratory intubation.Those procedures were “a desperate measure to try to save his life,” Frieden said. “Both of those procedures may spread contaminated materials and are considered high-risk procedures.”He said, “When you have potentially soiled or contaminated gloves or masks or other things, to remove those without any risk of any contaminated material … touching you and being then on your clothes or face or skin … is not easy to do right.”

However, all of this is currently speculation. Finding out exactly how Pham became ill will be critical to all the healthcare professionals, so that other nurses and their associates do not become more victims.

It does look like Frieden regrets the less-than-robust response to the first Dallas infection, and seems to be making adjustments. The CDC is sending out a response to to the Dallas hospital where Pham and her “close associate” are located.

“I wish we had put a team like this on the ground the day the first patient was diagnosed. That might have prevented this infection,” Frieden added. “But we are prepared to do this in the future with any case anywhere in the U.S.” …Emory University, which successfully treated Ebola patients Dr. Kent Brantly and Nancy Writebol, said it would send two experienced nurses to help Texas Health Presbyterian Hospital in Dallas.”By sending two of our nurses who have been directly involved in the care of Emory patients infected with the Ebola virus, we hope to provide on the ground standard operating procedures for PPE usage, based on CDC guidelines,” Nancye Feistritzer, chief nursing officer at Emory University Hospital, said in a statement.“We also want to be a resource to other organizations who are facing the need to train direct care providers and to ensure adherence to protocols designed to keep the care team safe.”

Here’s to hoping that Pham and her associate recover and that the agency begins focusing on the “disease prevention” aspect of their responsibilities, instead of downplaying these incidents.

Tags: Ebola

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