Ebola news 10/13

[Buster's Uncle]

News Guide: Hospital workers monitored for Ebola
Associated Press
By The Associated Press  2 hours ago



Police stand guard outside the apartment of a hospital worker and a yellow barrel, left, that holds hazardous materials, Sunday, Oct. 12, 2014, in Dallas. The Texas health care worker, who was in full protective gear when they provided hospital care for Ebola patient Thomas Eric Duncan, who later died, has tested positive for the virus and is in stable condition, health officials said Sunday. (AP Photo/LM Otero)



Hospital workers who cared for the first person diagnosed with Ebola in the U.S. are being closely monitored after a Texas nurse was infected with the virus despite wearing protective gear. Tests confirmed the nation's first known case of Ebola being transmitted here and raised questions about assurances that the disease would be quickly contained.

A look at the top Ebola developments worldwide:


THE LATEST

The World Health Organization on Monday called the Ebola outbreak "the most severe, acute health emergency seen in modern times." The disease has killed more than 4,000 people, mostly in the West African countries of Liberia, Sierra Leone and Guinea.

In Liberia, health workers reported for duty at hospitals, largely defying calls for a strike that could have further hampered the country's ability to respond to the epidemic. Nurses and other health workers — though not doctors — had threatened to strike if they did not receive the higher hazard pay they had been promised by the government.


THE U.S. INVESTIGATION



Police tape and a "No Trespassing" notice are posted, Monday, Oct. 13, 2014, in Dallas, at the apartment of a healthcare worker who treated Ebola patient Thomas Eric Duncan and tested positive for the disease. (AP Photo/Brandon Wade)


In the case of the infected nurse, the Centers for Disease Control and Prevention planned to investigate how workers took off protective gear, because removing it incorrectly can lead to contamination. Investigators will also look at dialysis and intubation — the insertion of a breathing tube in a patient's airway. Both procedures have the potential to spread the virus.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said the CDC is also examining procedures such as dialysis to see how much they heighten the risk of health care workers contracting Ebola. In cases where a patient cannot be saved, he suggested such high-risk procedures should not be done.


THE WAY IT SPREADS

The virus that causes Ebola is not airborne and can only be spread through direct contact with bodily fluids — blood, sweat, vomit, feces, urine, saliva or semen — of an infected person who is showing symptoms.


WHERE TO TREAT PATIENTS


Liberian health workers queue to enter one of the largest Ebola treatment units at the Island Clinic Monrovia ,Liberia. Monday, Oct. 13, 2014. Some nurses in Liberia defied calls for a strike on Monday and turned up for work at hospitals amid the worst Ebola outbreak in history. In view of the danger of their work, members of the National Health Workers Association are demanding higher monthly hazard pay. The association has more than 10,000 members, though the health ministry says only about 1,000 of those are employed at sites receiving Ebola patients. (AP Photo/ Abbas Dulleh)


The CDC's director, Dr. Thomas Frieden, has said that any U.S. hospital with isolation capabilities can care for an Ebola patient. But his stance seemed to soften Sunday, when asked whether officials would now consider moving Ebola patients to specialized units.

"We're going to look at all opportunities to improve the level of safety and to minimize risk, but we can't let any hospital let its guard down," because Ebola patients could turn up anywhere, and every hospital must be able to quickly isolate and diagnose such cases, he said.

Moving patients to specialized units carries risks of exposing more people to the virus, doctors say.


TRAVEL SCREENING

Over the weekend, New York's Kennedy Airport began checking some arriving passengers for fever. Passengers traveling from Liberia, Sierra Leone or Guinea are to be screened using no-touch thermometers. Over the next week, the screenings will expand to Newark Liberty, Washington Dulles, Chicago O'Hare and Hartsfield-Jackson in Atlanta. Together, those airports receive more than 90 percent of passengers from the three nations.


THE HUNT FOR A CURE

There are no approved medications for Ebola, so doctors have tried experimental treatments, including drugs and blood transfusions from Ebola survivors.

An experimental Canadian-made Ebola vaccine that has shown promise in tests on primates is beginning clinical trials on humans in the U.S. The vaccine was to be tested on healthy individuals Monday to see whether there are side effects and what the proper dosage is, Health Minister Rona Ambrose said.

A possible Ebola vaccine developed by the U.S. government is being tested on up to 40 medical workers in the West African nation of Mali, which shares a border with Guinea. If safety tests go well, larger trials could be done in the outbreak zone early next year. The vaccine also is being safety tested in the United States and Britain.


http://news.yahoo.com/news-guide-hospital-workers-monitored-ebola-171644179.html

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Liberia health workers strike over Ebola
AFP
By Zoom Dosso  2 hours ago



Red Cross workers carry away the body of a person suspected of dying from the Ebola virus, in the Liberian capital Monrovia, on October 4, 2014 (AFP Photo/Pascal Guyot)



Monrovia (AFP) - Health workers across Liberia went on strike on Monday to demand danger money to care for the sick at the heart of a raging Ebola epidemic that has already killed dozens of their colleagues.

Doctors, nurses and carers in west Africa are on the frontline of the worst-ever outbreak of Ebola, which has killed more than 4,000 people, mostly in Guinea, Sierra Leone and the hardest-hit, Liberia.

The Liberian walkout came as the World Health Organization warned that the Ebola crisis was "the most severe acute public health emergency in modern times".

Meanwhile, officials in the United States said the country must "rethink" its approach to Ebola after a female nurse in Texas contracted the tropical virus, in the first case of contamination on US soil and the second outside Africa.

As the new US case fuelled global jitters, EU ministers called a meeting for Thursday to discuss screening travellers from Ebola-hit west Africa, in line with steps taken by Britain, the United States and Canada.

In Liberia, the chairman of the national health workers' union, Joseph Tamba, said his strike call had been "massively" followed.

"Health workers across the country have downed tools as we asked them to do," Tamba told AFP.

In the capital Monrovia, where staff at Island Clinic, the largest government-run Ebola facility, have been on a "go slow" for three days, a patient quoted on local radio described scenes of desolation with the sick deserted by staff.



The entrance to the Ebola Island Clinic in Monrovia, seen on October 11, 2014 (AFP Photo/Zoom Dosso)


"We are at the Ebola Treatment Unit and no one is taking care of us," the unnamed man said. "Last night several patients died. Those who can walk are trying to escape by climbing over the fence."

Journalists have been banned from Liberia's Ebola clinics, making the situation there difficult to ascertain.


- Risk bonus -

Ninety-five Liberian health workers have died so far in the epidemic, and their surviving colleagues want pay commensurate to the acute risk of dealing with Ebola, which spreads through contact with bodily fluids and for which there is no vaccine or widely-available treatment.

Danger money aside, Tamba said many workers were not even being paid their regular wage to combat an epidemic that has killed more than 2,300 in Liberia and overwhelmed its skeletal health service.

He said that at the Island Clinic -- which is backed by the World Health Organization -- staff were promised a monthly wage of $750 (595 euros) for nurses and lab technicians, and $500 for other carers, but they have received a third less.

"It's as if the government was piling on extra staff without having to pay them a wage," Tamba charged.



An ambulance is readied by technicians wearing biological hazard protective clothes to transport a Guinean patient suspected of having contracted Ebola, in Cascavel, Brazil, on October 10, 2014 (AFP Photo/Luiz Carlos Cruz)


- 'Rethink approach' -

Both cases of contamination reported so far outside Africa -- in Spain last week and now in the United States -- have involved health workers who fell ill despite stringent safety protocols surrounding Ebola.

Authorities in the United States confirmed a female nurse had tested positive for the disease following "extensive contact" with a Liberian Ebola patient, Thomas Eric Duncan, who died on Wednesday.

The nurse at Texas Health Presbyterian Hospital in Dallas is in isolation and said to be in stable condition.

The US Centers for Disease Control and Prevention said it believed there had been a "breach in protocol", although her employers insisted she had followed CDC precautions, which would have included wearing a mask, gown and gloves.

"We have to rethink the way we approach Ebola infection control because even a single infection is unacceptable," said CDC director Tom Frieden on Monday.

President Barack Obama called for "immediate additional steps" to ensure hospitals were ready to follow Ebola protocols, as nurses' representatives demanded protective equipment, including hazardous materials suits, and specialised Ebola training.

While the CDC was working to track down other health workers who may have been exposed in Dallas, Frieden said he would "unfortunately not be surprised" to see more cases.


- Spain 'Ebola-free by Oct 27' -

The United Nations says aid pledges have fallen well short of the $1 billion needed, leading WHO chief Margaret Chan to warn of "many more cases" to come for Guinea, Sierra Leone and Liberia without radical action by the international community.

But Chan voiced confidence that developed nations would be able to contain the virus.

"We do not expect the countries with a good system of health to experience a situation like in the three countries of west Africa."

In Spain, a crisis cell set up when Madrid nurse Teresa Romero fell sick after caring for two missionaries with Ebola said there was "reason to hope" she could recover.

Fifteen other people are under observation in Madrid's Carlos III hospital for symptoms of the disease, which include fever, diarrhoea, vomiting and bleeding.

The hospital's director, Antonio Andreu, told Spanish radio that Spain will be free from the threat of further contagion from Ebola on October 27 if all those who had close contact with the infected nurse remain without symptoms by then.

The disease has an incubation period of up to 21 days.


http://news.yahoo.com/liberia-faces-healthcare-strike-over-ebola-130520281.html

[Buster's Uncle]

WHO tells East Asia Pacific to bolster Ebola defences
AFP
19 minutes ago



Volunteers arrive to pick up bodies of people who died of the Ebola virus, on October 8, 2014 in Freetown (AFP Photo/Florian Plaucheur)



World Health Organisation chief Margaret Chan on Monday urged East Asian and Pacific countries to strengthen defences against the Ebola outbreak, warning that the whole world may be at risk.

The region of 1.8 billion has been a hotspot for many emerging diseases including Severe Acute Respiratory Syndrome and bird flu, but is so far free from the Ebola virus ravaging parts of West Africa.

"In the simplest terms, this outbreak shows how one of the deadliest pathogens on earth can exploit any weakness in the health infrastructure," Chan told an annual meeting of Western Pacific health officials in a speech read for her.

"You cannot build these systems up during a crisis. Instead they collapse. A dysfunctional health system means zero population resilience to the range of shocks that our world is delivering, with ever greater frequency and force."

Chan added: "(W)hen a deadly and dreaded virus hits the destitute and spirals out of control, the whole world is put at risk."

More than 4,000 people have died from Ebola in seven countries since the worst outbreak of the virus began in West Africa early this year.

Thirty-seven countries and territories including China, the rest of East Asia, Australia, New Zealand, parts of Southeast Asia and the Pacific island states comprise WHO's Western Pacific region.

WHO regional director Shin Young-soo told the meeting an imported Ebola case in the region, home to a quarter of humanity, "is certainly a possibility" with its huge transportation hubs and vibrant trade and travel.

"If Ebola did hit the region, the consequences could be huge... we must openly confront the challenges our region faces to manage this threat effectively," Shin said.

Philippine President Benigno Aquino outlined the potential Ebola threat faced by his nation of 100 million as he delivered a speech at the start of the five-day WHO meeting.

"For the Philippines specifically, the fact that we have 10 million of our countrymen living and working abroad makes these kinds of outbreaks a paramount concern," he said.


http://news.yahoo.com/tells-east-asia-pacific-bolster-ebola-defences-192342237.html

[Buster's Uncle]

Obama calls for action to ensure U.S. medical system can handle Ebola
Reuters
October 12, 2014 2:04 PM



U.S. President Barack Obama gets an update on the response to the Ebola diagnosis in Dallas during a call with U.S. Health and Human Services Secretary Sylvia Burwell, in the Oval Office in Washington October 12, 2014. REUTERS/Jonathan Ernst



WASHINGTON (Reuters) - President Barack Obama wants federal authorities to take additional steps to ensure the American medical system is prepared to follow correct protocols in dealing with Ebola following news of an apparent breach in Dallas, the White House said in a statement Sunday.

Obama was briefed about the diagnosis of a second case of Ebola in Texas, where a healthcare worker has contracted the virus after treating a Liberian who died of the disease at a Dallas hospital last week.

Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, said on Sunday that at some point during the care of the original patient there was a breach in protocol which resulted in the infection of the healthcare worker.

Obama said federal authorities should "take immediate additional steps to ensure hospitals and healthcare providers nationwide are prepared to follow protocols should they encounter an Ebola patient."

(Reporting by Valerie Volcovici; Editing by Jim Loney and Lisa Shumaker)


http://news.yahoo.com/obama-calls-action-ensure-u-medical-system-handle-180431116.html

[Buster's Uncle]

Texas case forces US to 'rethink' Ebola approach
AFP
1 hour ago



Centers for Disease Control and Prevention Director Tom Frieden is urging hospitals to diligently watch for patients with fever or symptoms of Ebola who have traveled from the three Ebola-stricken African nations in the past 21 days. (Oct. 13)



Washington (AFP) - The United States must "rethink" its approach to controlling the Ebola virus after a Texas health care worker was infected with the often deadly virus, health authorities said Monday.

"We have to rethink the way we approach Ebola infection control, because even a single infection is unacceptable," said Centers for Disease Control and Prevention director Tom Frieden.

Frieden spoke to reporters a day after Texas Health Presbyterian Hospital Dallas announced one of its staff members had contracted Ebola -- marking the first case of infection inside the United States.

However, he gave few specifics about what precisely was going to change.

"What we will be doing in the coming days and weeks is doubling down on the amount of education, training, outreach and support we provide," Frieden said.

He also said experts still don't know exactly how the woman was infected while caring for Liberian Thomas Eric Duncan, who died of Ebola on Wednesday and was the first person diagnosed with Ebola outside Africa.



A Health worker wearing protective equipment works in a ward for patients suspected of having Ebola virus, at Rokupa Hospital, Freetown, October 6, 2014. More than 4,000 people have died of the viral haemorrhagic fever in West Africa, mostly in Liberia, neighbouring Sierra Leone and Guinea. Picture taken October 6, 2014. REUTERS/Christopher Black/WHO/Handout via Reuters


Local media WFAA identified the woman as Nina Pham, a 26-year-old who had recently completed the nursing program at Texas Christian University.

She treated Duncan multiple times during his hospital stay and had extensive contact with him, but had worn extra safety gear including a mask, face shield, gown and gloves according to CDC guidelines, officials have said.

Duncan was hospitalized September 28 and died of Ebola on Wednesday.



CDC official discusses how hospitals across the U.S should prepare for the possibility of dealing with Ebola in their facilities. Photo: iStock/Bumbasor.
 

- More cases possible -

Frieden said CDC workers are still interviewing other health workers at the hospital to see if anyone else is experiencing Ebola symptoms or is at risk of infection.

"We have to consider the possibility that there could be additional cases particularly among health care workers," said Frieden, adding that he would "unfortunately not be surprised" to see more such cases.

A prominent nursing group, National Nurses United, lashed back at the CDC on Sunday, saying that hospitals needed to provide better protection to health care workers.

Holding signs that said "Stop Blaming Nurses" at a press conference, members called for proper training against Ebola and hazardous materials suits to guard against the virus.



No trespassing signs and warning tape mark the apartment where a second person diagnosed with the Ebola virus resides, on October 12, 2014 in Dallas, Texas (AFP Photo/Mike Stone)


Ebola has killed more than 4,000 people in West Africa since the start of the year, and is spread through close contact with bodily fluids.

Frieden said the latest Texas case "doesn't change the fact that we know how Ebola spreads. It doesn't change the fact that we know how to take care of Ebola safely.

"But it does change substantially how we approach it."

Frieden said Sunday that a "breach of protocol" was the reason for the infection of the woman who helped care for Duncan.

On Monday, he apologized for appearing to place the blame on her when he cited a lapse of safety procedures.

"Some interpreted that as finding fault with the hospital or the healthcare workers, and I am sorry if that was the impression given. It was certainly not my intention," said Frieden, telling reporters he felt "awful" upon learning of the case.

"All of us have to work together to do whatever is possible to reduce the risk that any other healthcare worker becomes infected."


http://news.yahoo.com/texas-case-forces-us-rethink-ebola-approach-170405665.html

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U.S. CDC head criticized for blaming 'protocol breach' as nurse gets Ebola
Reuters
By Julie Steenhuysen  4 hours ago






CHICAGO (Reuters) - Some healthcare experts are bristling at the assertion by a top U.S. health official that a “protocol breach” caused a Dallas nurse to be infected with Ebola while caring for a dying patient, saying the case instead shows how far the nation’s hospitals are from adequately training staff to deal with the deadly virus.

    Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, made the declaration on Sunday at a news conference and called for an investigation into how the unidentified nurse became infected while caring for Liberian national Thomas Eric Duncan, the first Ebola patient diagnosed in the United States. Duncan died last week at Texas Health Presbyterian Hospital.

Healthcare and infection control experts said that hospital staff need to be coached through the stages of treating an Ebola patient, making sure they have the right safety equipment and know how to use it properly to prevent infection.

It was not immediately clear whether the Texas hospital prepared its staff with simulation drills before admitting Duncan, but a recent survey of nurses nationwide suggests few have been briefed on Ebola preparations. Officials at the hospital did not respond to requests for comment.

Some experts also question the CDC’s assertion that any U.S. hospital should be prepared to treat an Ebola patient as the outbreak ravaging West Africa begins to spread globally. Given the level of training required to do the job safely, U.S. health authorities should consider designating a hospital in each region as the go-to facility for Ebola, they said.

"You don't scapegoat and blame when you have a disease outbreak," said Bonnie Castillo, a registered nurse and a disaster relief expert at National Nurses United, which serves as both a union and a professional association for U.S. nurses. "We have a system failure. That is what we have to correct."     



Centers for Disease Control and Prevention (CDC) Director, Dr. Thomas Frieden, speaks at the CDC headquarters in Atlanta, Georgia September 30, 2014. U.S. health officials said on Tuesday the first patient infected with the deadly Ebola virus had been diagnosed in the country after flying from Liberia to Texas, in a new sign of how the outbreak ravaging West Africa can spread globally. The patient sought treatment six days after arriving in Texas on Sept. 20, Frieden told reporters on Tuesday. He was admitted two days later to an isolation room at Texas Health Presbyterian Hospital in Dallas. REUTERS/Tami Chappell


    More than 4,000 people have died in the worst Ebola outbreak on record that began in West Africa in March.

    In recent months, the CDC has published detailed guidelines on how to handle various aspects of Ebola, from lab specimens and infectious waste to the proper use of protective equipment.

    How that information gets communicated to frontline workers, however, varies widely, Castillo said.

    In many cases, hospitals "post something on a bulletin board referring workers and nurses to the CDC guidelines. That is not how you drill and practice and become expert," she said.

    CDC spokesman Tom Skinner said the agency is still investigating the case of the Dallas nurse, but stressed that "meticulous adherence to protocols" is critical in handling Ebola. "One slight slip can result in someone becoming infected."

    Skinner said the CDC is going to step up its education and training efforts on how to triage and handle patients, and may consider designating specific hospitals in each region as an Ebola treatment facility.



Ebola outbreak in west Africa, Nigeria and aboard as of Oct. 10, 2014. (World Health Organization/Yahoo News)


"We've been doing a lot over the past few months, but clearly there is more to do," he said. "The notion of possibly transporting patients diagnosed with Ebola to these hospitals is not something that is out of the question and is something we may look into.”


LEGAL RECOURSE

Dr. Gavin Macgregor-Skinner, an expert on public health preparedness at Pennsylvania State University, also disagreed with the talk of a breach of protocol, saying it just puts the onus on the nurse.

"I think that is just wrong," said Macgregor-Skinner, who helped the Nigerian government train healthcare workers when a traveler from Liberia touched off an outbreak of Ebola this past summer.

“We haven't provided them with a national training program. We haven't provided them with the necessary experts that have actually worked in hospitals with Ebola," he added in reference to U.S. hospital staff.

    Legal experts said the Dallas nurse may be entitled to compensation if the hospital carries workers' compensation insurance. If it doesn’t, she would have the right to sue the hospital for damages under Texas law, said Jay Harvey, a lawyer in Austin, Texas.     



Liberian children read a leaflet with guidelines to protect the community from the Ebola virus, in Monrovia, Liberia. Monday, Oct. 13, 2014. Some nurses in Liberia defied calls for a strike on Monday and turned up for work at hospitals amid the worst Ebola outbreak in history. In view of the danger of their work, members of the National Health Workers Association are demanding higher monthly hazard pay. The association has more than 10,000 members, though the health ministry says only about 1,000 of those are employed at sites receiving Ebola patients. (AP Photo/Abbas Dulleh)


    Her ability to show that the hospital was negligent by, for example, not providing proper training, would be key to winning such a suit, Harvey said.

    Sean Kaufman, president of Behavioral-Based Improvement Solutions in Atlanta, helped train healthcare staff at a special isolation unit at Atlanta's Emory University which treated U.S. aid workers Dr. Kent Brantly and Nancy Writebol, the first two Ebola patients to be treated on U.S. soil.

He would observe the nurses and doctors as they cared for patients and keep detailed notes when someone would accidentally touch their sleeve or mask with an infected glove.

    He then helped coach them through the process of carefully removing their infected gear. Facilities caring for Ebola patients are encouraged to use a buddy system so that colleagues are watching each other to make sure they don't take risks.

    "Doctors and nurses get lost in patient care. They do things that put themselves at risk because their lens is patient-driven," Kaufman said. In Dallas, "I suspect no one was watching to make sure the people who were taking care of the patients were taking care of themselves," he said.

CDC and Texas health officials said the nurse who became infected had been wearing the recommended personal protective gear for Ebola, which consists of gloves, a gown, a mask, and a shield to protect the eyes from possible splatters from the patient.

    According to experts, that gear offers the minimum level of protection. When an Ebola patient enters the latter stages of the disease, as Duncan did, they become so-called fluid producers, Kaufman said.

    "Towards of end of the illness, the virus is trying to live and thrive. It's trying to get out of the person's body. It's producing massive amounts of fluid," he said.

    At that point, caregivers need to add more layers of protective gear, such as double gloves and a respirator or a full bodysuit. Those kinds of decisions need to be made by managers who are constantly assessing the risk to healthcare workers, Kaufman said.

    Macgregor-Skinner said all U.S. hospitals must be ready to identify and isolate an Ebola patient, but should also be able to turn to a regional facility that is better prepared to receive them.

“Every hospital can then prevent the spread of Ebola, but not every hospital in the U.S. can admit a patient in the hospital for long-term care,” he said.

(Reporting by Julie Steenhuysen; Additional reporting by David Ingram in New York; Editing by Michele Gershberg and Martin Howell)


http://news.yahoo.com/cdc-head-criticized-blaming-protocol-breach-nurse-gets-040454561.html

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Health officials urge hospitals to 'think Ebola'
Associated Press
By NOMAAN MERCHANT  16 minutes ago



DALLAS (AP) — Federal health officials on Monday urged the nation's hospitals to "think Ebola" and launched a review of procedures for treating infected patients, while the World Health Organization called the outbreak "the most severe, acute health emergency seen in modern times."

Public-health authorities also intensified their monitoring of Dallas hospital workers who cared for a man who died of Ebola. Their stepped-up efforts came a day after a nurse was tested positive for the virus.

The nurse, who was wearing protective gear when she took care of Thomas Eric Duncan, became the first person to contract the disease within the United States.

Centers for Disease Control and Prevention Director Tom Frieden said he would not be surprised if another hospital worker who cared for Duncan becomes ill because Ebola patients become more contagious as the disease progresses. The CDC now is monitoring all hospital workers who treated Duncan and planned to "double down" on training and outreach on how to safely treat Ebola patients, Frieden said.

When asked how many health care workers are being checked, Frieden said officials "don't have a number."

Health officials have relied on a 'self-monitoring' system when it comes to U.S. health care workers who care for isolated Ebola patients and wear recommended protective equipment. They expect workers to report any potential exposures to the virus and watch themselves for symptoms.

Besides the workers, health officials continue to track 48 people who were in contact before Duncan was admitted to the hospital and placed in isolation. They are monitoring one person the nurse was in contact with while she was in an infectious state.

None has exhibited symptoms, Frieden said.

The case involving the infected nurse raised questions about assurances by American health officials that the disease will be contained and that any U.S. hospital should be able to treat it.

Frieden has said a breach of protocol led to the nurse's infection, but officials are not sure what went wrong. The nurse, who has not been identified, has not been able to point to any specific breach.

President Barack Obama asked the CDC to investigate.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases was asked on ABC's "Good Morning America" if federal health authorities should consider requiring that Ebola patients be sent only to highly specialized "containment" hospitals.

"That is something that should be seriously considered," Fauci said.

Dallas police barred entry to the nurse's apartment complex Sunday. Officers also knocked on doors, made automated phone calls and passed out fliers to notify people within a four-block radius about the situation, although authorities assured residents the risk was confined to those who have had close contact with the two Ebola patients.

The nurse wore a gown, gloves, mask and face shield while she cared for Duncan during his second visit to Texas Health Presbyterian Hospital, said Dr. Daniel Varga of Texas Health Resources, which runs the hospital.

Duncan, who arrived in the U.S. from Liberia Sept. 20, first sought medical care for fever and abdominal pain Sept. 25. He told a nurse he had traveled from Africa, but he was sent home. He returned Sept. 28 and was placed in isolation because of suspected Ebola. He died last week.

Among the things the CDC will investigate is how the workers took off protective gear, because removing it incorrectly can lead to contamination. Investigators will also look at dialysis and intubation — the insertion of a breathing tube in a patient's airway. Both procedures have the potential to spread the virus.

Fauci said on CNN that the CDC is examining procedures like dialysis to see if they "heighten greatly" the risk of health care workers contracting Ebola. He suggested that in cases where the patient has deteriorated to the point where he or she cannot be saved, such high-risk procedures should not be done.

Every emergency room needs to be prepared to take action because no one can control where an Ebola patient might show up, said Dr. Dennis Maki, University of Wisconsin-Madison infectious disease specialist and former head of hospital infection control.

However, only large hospitals such as those affiliated with major universities truly have the equipment and manpower to deal with Ebola correctly, Maki said.

Health care workers treating Ebola patients are among the most vulnerable, even when wearing protective gear.

Nurses at many hospitals "are alarmed at the inadequate preparation they see," read a statement from Rose Ann DeMoro, executive director of the National Nurses United union.

More than 370 health care workers in West Africa have fallen ill or died since the epidemic began earlier this year.

Officials said there is a dog in the nurse's apartment, and they are trying to find a location to monitor and care for the animal. They do not believe the pet has any signs of Ebola. A dog belonging to an infected Spanish nurse was euthanized, drawing thousands of complaints.

In a statement read to a regional health conference in the Philippine capital of Manila, WHO Director-General Margaret Chan said staff members of the global health organization "are very well aware that fear of infection has spread around the world much faster than the virus."

Ebola has killed more than 4,000 people, mostly in the West African countries of Liberia, Sierra Leone and Guinea, according to WHO figures published last week.

The virus spreads through close contact with a symptomatic person's bodily fluids, such as blood, sweat, vomit, feces, urine, saliva or semen.

___

Associated Press Medical Writer Mike Stobbe in New York contributed to this story.


http://news.yahoo.com/dallas-nurse-contracts-ebola-man-died-050229624.html