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CDC: Second Dallas Nurse 'Should Not Have Traveled'

The entrance to the emergency room at Texas Health Presbyterian Hospital Dallas, where Thomas Eric Duncan was treated before he died from Ebola a week ago. Two health care workers who treated Duncan have tested positive for the disease.
LM Otero
The entrance to the emergency room at Texas Health Presbyterian Hospital Dallas, where Thomas Eric Duncan was treated before he died from Ebola a week ago. Two health care workers who treated Duncan have tested positive for the disease.

Updated at 8:43 p.m. ET

A second health care worker who has tested positive for the Ebola virus was airlifted from a Dallas hospital, where she became infected, to Emory University hospital in Atlanta for continued treatment on Wednesday.

Dr. Thomas Frieden, the director of the Centers for Disease Control and Prevention, says Amber Vinson, whom public records indicate is a nurse in Dallas, is "clinically stable" and that she was "quickly isolated" after her first test for Ebola came back positive on Tuesday.

In a statement following a meeting with his cabinet, President Obama said that a rapid spread of the disease was not imminent and if procedures are followed, the risk of an outbreak in the United States are "very, very low."

Nurse Nina Pham, 26, who cared for Duncan, became the first person to contract the disease within the United States. She is reportedly in "good condition" after receiving blood from an Ebola survivor.
/ AP
Nurse Nina Pham, 26, who cared for Duncan, became the first person to contract the disease within the United States. She is reportedly in "good condition" after receiving blood from an Ebola survivor.

Obama went on to use a personal story about his visit to the Emory hospital that treated one patient with Ebola.

"I shook hands with, hugged, and kissed, not the doctors but a couple of the nurses at Emory, because of the valiant work that they did in treating one of the patients," Obama said. "They followed the protocols; they knew what they were doing and I felt perfectly safe doing it."

Obama did say that authorities need to monitor the disease in a "much more aggresive way."

Frieden said Vinson, along with critical care nurse Nina Pham, had had "close contact" with Thomas Eric Duncan, the first Ebola patient to have been diagnosed in the United States. Duncan died a week ago.

During a late afternoon briefing, Toinette Parrilla, said Vinson was in Cleveland to visit her mother in a preparation for a wedding.

Frieden said both Pham and the newest patient were exposed to Duncan in the days "prior to diagnosis and prior to a CDC team being on the ground.

"I will just say that the second patient, as well as the first, had extensive contact with [Duncan] in the stage while there was a lot of vomiting," he said.

Frieden said the first test was positive for Ebola and that he expected the confirmatory test from the CDC would come back positive "very soon."

Secretary of Health and Human Services Sylvia Mathews Burwell, who appeared with Frieden, said: "We need to stop this epidemic at its source — in West Africa."

At an earlier news conference, Dallas County Judge Clay Jenkins said the second health worker, whom he did not identify but referred to as "her," faced the diagnosis with the same "grit and determination" that critical care nurse Pham, who tested positive for the disease on Sunday, has shown.

He said "we are preparing contingencies for more" Ebola patients, "and that is a very real possibility."

In a statement earlier, the CDC said the newest patient had been on a commercial flight from Cleveland to Dallas the day before reporting symptoms.

"Because of the proximity in time between the evening flight and first report of illness the following morning, CDC is reaching out to passengers who flew on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth Oct. 13," the statement read.

Asked why the woman, who was self-monitoring her temperature, was allowed to board an airplane after exposure to the index patient, Frieden said: "The patient traveled to Ohio before it was known that the first health care worker [Pham] was sick."

Pressed on the question, he said: "She should not have traveled on a commercial airliner" and noted that "from this moment forward we will make sure that any individual who is being monitored" should not travel on public transportation.

Frieden said she had an elevated temperature (99.5F) on the flight home to Dallas, although it was short of the fever threshold. The CDC believes she presents a low risk to fellow passengers, he said.

The virus is not contagious until a person starts showing symptoms, and the likelihood of its being passed on an airplane is considered extremely low.

Jenkins said during the news conference that the 47 original "contact traces" who had contact with Duncan were nearing the end of the Ebola incubation period and were all symptom-free. The possibility that any of them would become symptomatic at this point, he said, is "extremely remote."

Dallas Mayor Mike Rawlings said that cleaning at the newest patient's apartment was "done as soon as possible" and that the patient "lived alone and without pets."

Rawlings said of the situation in the city: "It's going to get worse before it gets better. But it will get better."

Dr. Daniel Varga, the chief medical officer for Texas Health Resources, which runs Texas Health Presbyterian Hospital Dallas, said he saw no systemic problems with the response.

"A lot is being said about what may or may not have been done," he said. "We may have done some things differently given what we know now.

"No one wants to get this right more than we do," he said.

The Texas health department quoted a CDC statement: "An additional health care worker testing positive for Ebola is a serious concern, and the CDC has already taken active steps to minimize the risk to health care workers and the patient." An additional 77 individuals, all but two of them health workers who were exposed to Duncan, are being monitored for Ebola symptoms, said Jenkins, the Dallas County judge.

Pham, 26, is in "good condition," according to the hospital where she was quickly isolated after reporting a fever.

A day after Pham's diagnosis, she received a blood transfusion from Ebola survivor Kent Brantley, an aid worker who contracted the disease while working in West Africa.

"I'm doing well and want to thank everyone for their kind wishes and prayers," Pham said in a written statement released by the hospital. "I am blessed by the support of family and friends and am blessed to be cared for by the best team of doctors and nurses in the world here at Texas Health Presbyterian Hospital Dallas."

On Tuesday, Frieden acknowledged that more could have been done to prevent Pham's infection.

"We did send some expertise in infection control," Frieden said. "But I think we could, in retrospect, with 20/20 hindsight, have sent a more robust hospital infection control team and been more hands-on with the hospital from Day 1 about exactly how this should be managed."

The Associated Press writes: "Officials have said they don't know how [Pham] became infected. But the second case pointed to lapses beyond how one individual may have donned and removed personal protective garb."

Meanwhile, nurses at the Texas hospital have described the response to Duncan's arrival in the emergency room as chaotic, saying he "languished for hours in a room with other patients and that hospital authorities resisted isolating him," according to The Los Angeles Times.

The newspaper reports: "In addition, they said, the nurses tending him had flimsy protective gear and no proper training from hospital administrators in handling such a patient."

Member station KERA is following this story in a live blog on its website.

The World Health Organization says there are a total of 8,997 "confirmed, probable or suspected" cases of Ebola in seven countries, with 4,493 deaths.

Update at 3:30 p.m. ET. Large Scale Outbreak Unlikely:

During his regular briefing, White House Press Secretary Josh Earnest sought to put the current situation in Dallas in context.

An outbreak on a "large scale is exceedingly unlikely," Earnest said, adding that the situation in Dallas is a "far cry" from the situation evolving in West Africa.

When asked if he thought the federal response to the Ebola cases in the United States had been successful, Earnest echoed CDC director Frieden, who said looking back, he would have sent a bigger team to Dallas.

Of course, he said, there were some "shortcomings" in the federal response to the cases but as the situation has evolved, the federal government has deployed a "tenacious response."

Copyright 2021 NPR. To see more, visit https://www.npr.org.

Scott Neuman is a reporter and editor, working mainly on breaking news for NPR's digital and radio platforms.
Eyder Peralta is NPR's East Africa correspondent based in Nairobi, Kenya.
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