Obama Administration incompetence may kill thousands

CDC confirms first case of Ebola in US

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June 20, 2014: The Centers for Disease Control sign is seen at its main facility in Atlanta, Georgia. (Reuters)

The Centers for Disease Control and Prevention (CDC) confirmed on Tuesday that a patient being treated at a Dallas hospital has tested positive for Ebola, the first case diagnosed in the United States.

The patient left Liberia on September 19 and arrived in the United States on September 20, CDC director, Dr. Tom Frieden told reporters at a press conference Tuesday. It’s the first patient to be diagnosed with this particular strain of Ebola outside of Africa.

“[The patient] had no symptoms when departing Liberia or entering this country. But four or five days later on the 24th of September, he began to develop symptoms,” said Frieden.

The patient, who was in the U.S. visiting family in Texas, initially sought care on September 26, but was sent home and was not admitted until two days later. He was placed in isolation at Texas Health Presbyterian Hospital of Dallas, where he remains critically ill, according to Frieden.

“The next steps are basically threefold,” said Frieden.  “First, to care for the patient … to provide the most effective care possible as safely as possible to keep to an absolute minimum the likelihood or possibility that anyone would become affected, and second, to maximize the chances that the patient might recover,” said Frieden.

Frieden said the CDC and Texas health officials were working to identify and monitor anyone who may have come in contact with the patient.

“It’s only someone who’s sick with Ebola who can spread the disease,” said Frieden. “Once those contacts are all identified, they’re all monitored for 21 days after exposure to see if they develop a fever.”

Frieden added that while it is possible that someone who had contact with the patient could develop Ebola in the coming weeks, he has no doubt the infection will be contained. At this point, he said, there is zero risk of transmission to anyone on the flight with the patient because he was not showing any symptoms at the time of travel.

It’s unclear how the patient became infected, but health officials said he “undoubtedly had close contact with someone who was sick with Ebola or who had died from it.”

The patient will stay at Texas Health Presbyterian Hospital for treatment, where epidemiologist Dr. Edward Goodman, said medical staff have a plan in place for some time now in the event that a traveler brought Ebola to the United States, noting that the team had a crisis preparedness meeting just one week before the patient arrived at the facility.

Hospital officials are currently evaluating different treatment options, including experimental therapies which have been successful in other patients, according to Frieden.

Both the CDC and the Texas Department of State Health Services performed lab testing that is said to be highly accurate for detecting the Ebola virus disease.

“Our lab has a specially trained team to handle high-risk patients like this,” said Dr. David Lakey, commissioner of Texas Department of State Health Services. “We have no other suspected cases in the state of Texas at this time.”

Zachary Thompson, director of Dallas County Health and Human Services urged residents to rest assured the agency was doing everything they could to ensure the safety of the community, and that they would be working closely with the CDC and local health officials to follow up and track possible contacts of the patient.

Texas Health Presbyterian Hospital of Dallas officials said in a statement Monday that an unnamed patient was being tested for Ebola and had been placed in “strict isolation” due to the patient’s symptoms and recent travel history, and that the facility was taking measures to keep its doctors, staff and patients safe.

The hospital had announced a day earlier that the patient’s symptoms and recent travel indicated a case of Ebola, the virus that has killed more than 3,000 people across West Africa and infected a handful of Americans who have traveled to that region.

The CDC has said 12 other people in the U.S. have been tested for Ebola since July 27. Those tests came back negative.

Four American aid workers who have become infected while volunteering in West Africa have been treated in special isolation facilities in hospitals in Atlanta and Nebraska, and a U.S. doctor exposed to the virus in Sierra Leone is under observation in a similar facility at the National Institutes of Health.

The U.S. has only four such isolation units but the CDC has insisted that any hospital can safely care for someone with Ebola.

According to the CDC, Ebola symptoms can include fever, muscle pain, vomiting and bleeding, and can appear as long as 21 days after exposure to the virus.

Jason McDonald, spokesman for the CDC, said health officials use two primary guidelines when deciding whether to test a person for the virus.

“The first and foremost determinant is have they traveled to the region (of West Africa),” he said. The second is whether there’s been proximity to family, friends or others who’ve been exposed, he said.

U.S. health officials have been preparing since summer in case an individual traveler arrived here unknowingly infected, telling hospitals what infection-control steps to take to prevent the virus from spreading in health facilities. People boarding planes in the outbreak zone are checked for fever, but symptoms can begin up to 21 days after exposure. Ebola isn’t contagious until symptoms begin, and it takes close contact with bodily fluids to spread.

Frieden said there may be a handful of potential patient contacts who need monitoring in the United States. He compared that with the nearly 900 contacts who were monitored when an infected patient brought the Ebola virus to Lagos in July, reiterated his confidence in health officials’ ability to control the disease.

“The bottom line here is that I have no doubt that we will control this importation or this case of Ebola so that it does not spread widely throughout this country,” Frieden said. “There’s no doubt in my mind, we will stop it here.”

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2 thoughts on “Obama Administration incompetence may kill thousands

  1. Comment ebola

    Stopping air flights is not the answer. Sensible quarantine of arriving travelers is. How hard can it be? Who is the JERK at CDC who did not think that arriving nationals from Liberia should be placed in quarantine for the first 21 days in the US or at a minimum monitored twice daily as they did in Nigeria when they had their imported case?

    And what about the ER doctor/nurse at West Texas Presbyterian who sent a recently arrived Liberian national with a two day history of Ebola symptoms HOME !!! to infect all and sundry for another 48 hours!!! He/she should be shot. Didn’t he take a patient history? A travel history? West Texas claims they had an ebola crisis meeting just the week previously !! What for? They overlooked the most elementary precautions! Where was their health and travel questionnaire? That patient should have been quarantined INSTANTLY. What did they think, that he had a cold? The patient did not try to hide. He tried to get help and he was ignored and sent home! WHAT were the ER doctor/nurse and the contingency planners at West Pres thinking? How could they be so complacent? That person was formally a “suspected case” the moment he presented himself on Sept 24. He had a travel history in an affected country and he had symptoms and a time line compatible with Ebola. Hell, he has more than a travel history, he is apparently a national! Ebola is a Class IV biohazard!! How could they send him home!

    7 people at least in Nigeria died, 19 got ebola and 900 had to be monitored because of an imported case there. West Pres knew this ! How DARE they permit a suspected case back into the community!

    And clinical care is all very well, but what are West Texas’ plans for disposing of infectious waste!!! Have they bothered to think about that? They should. According to Dept. of Transportation (DOT) regulations, waste disposal workers have to wear Haz Mat suits when handling it! Emory University, the top infectious disease facility who treated Dr. Kent Brantly, was still wrangling with DOT about this in September and who knows if it is solved. At that time they had an isolation room filled with sealed Rubbermaid trash cans holding infectious waste. They could not get it collected by their medical waste contractors because the company refused, citing these DOT regulations! And DOT as of then were still being bureaucratic ***holes and saying “rules are rules” and refusing to cooperate to find a solution. I have NO sympathy with the bastards at DOT who are happy to expose others to unnecessary deadly risk as long as they themselves can hide behind their rule books and obstruct rather than assuming a shared responsibility for the safety of the nation. Maybe they should be shot, too.

    1. Update on comment:

      1: Thomas Eric Duncan (now identified) the Ebola patient, did not arrive in Dallas from Liberia. There are no flights. He flew from Monrovia to Belgium and thence from Brussels to Washington Dulles where he caught a flight to Dallas. This shows how impossible it is to contain such a virus by stopping air flights. ALL airflights all over the world? That is what it would take. Not an option.

      2. He was exit screened in Monrovia but showed no symptoms. But exit screening does not work that well anyway. Check this out:

      “During the outbreak of Severe Acute Respiratory Syndrome in 2003, WHO recommended screening passengers with questionnaires and thermal scanners, and few sick travelers were detected.

      Hong Kong screened 36 million passengers and detected two cases. Australia screened 1.8 million people arriving, and four cases were detected by border screening, according to a 2005 medical study. Canada screened 4 million passengers and detected no cases. Singapore screened 400,000 people entering the country and detected no cases, according to the study.”

      http://www.usatoday.com/story/news/nation/2014/10/01/ebola-flights-screening-travel-airlines/16527697/.

      3. West Texas Presbyterian even had and used a travel questionnaire, and when Duncan showed up at the ER with fever and joint aches and was asked, he replied honestly that he had been in Liberia.

      4. Where WTP unforgiveably fell down on the job is when the nurse who took the history did not pass on “the full information” that he had been in Liberia whatever that means. Maybe she forgot to say. Maybe the overworked doctor forgot to pay attention. Duncan was sent home Thursday night at 10 pm with antibiotics and in the next two days managed to have some kind of contact with between 12 and 80 people, ranging from family members to friends and 5 schoolchildren (possibly in the family).

      It is no excuse that the “syptoms were not typical” of Ebola. OF COURSE THEY WEREN’T! That IS typical of Ebola in the early stages that it mimics other diseases, the flu, etc. Fever, muscle and joint pains, sore throat. Given that Duncan presented with a fever and was sent home with antibiotics they knew he was infected with something and they definitely suspected a bacterium, because that is what antibiotics treat. So Duncan probably had a severe sore throat–one of the first symptoms of Ebola– to go with his fever. The doctor, with his brain in sleep mode, probably dismissed it as strep throat, a bacterial infection that is well known for producing fever and a severe sore throat.

      Now there is a well know saying in medicine, “when you hear hoofbeats, think horses not zebras”. That is however no excuse. Here is a man from Africa coming from the worst hit city in the worst Ebola epidemic in history, CDC is on Class 1 alert, WTP just had a goddamned crisis meeting on the subject the week before, ebola is notoriously vague to diagnose AND hideously dangerous, Duncan probably had ALL of the initial symptoms and they decided not to err on the side of caution!?!!!!

      One thing is sure, ERs are stressed these days, usually understaffed and count every penny. jAdministrators make it very clear to staff that they prefer one admission too few to one too many.

      It is certainly time for the emergency rooms of the nations hospitals to wake up. And if we are to be honest, maybe it is time for hospital administrators to wake up, too and think about what is going to cost them more in malpractice suits, death and bad publicity–to find a bed for a suspected case or to turn him loose on the streets?

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