One of the nation's top health officials said Wednesday that the second health care worker in Dallas who tested positive for Ebola a day after she was on a plane "should not have been allowed to travel."
As a result of this patient — a nurse who cared for the first U.S. diagnosed Ebola patient at Texas Presbyterian Hospital Dallas — traveling on a plane from Cleveland to Dallas/Fort Worth International Airport Monday night, the Centers for Disease Control and Prevention plans to interview the 132 other people who were on Frontier Airlines flight 1143.
A Frontier Airlines employee wears gloves as she directs passengers where to go at Cleveland Hopkins International Airport Wednesday, Oct. 15, 2014, in Cleveland. Ohio health officials aren't sure how many people came into contact with a Texas nurse as she visited family in the Akron area days before being diagnosed with Ebola in Dallas. The Ohio Department of Health says she visited family from Oct. 8-13 and flew Monday from Cleveland to Dallas. (AP/Tony Dejak)
Tom Frieden, director of the Centers for Disease Control and Prevention, said during a briefing Wednesday afternoon that the 77 self-monitoring health care workers who helped serve Thomas Eric Duncan, the Liberian man who died in the Dallas hospital last week, should have only "controlled movement."
Despite her flying on a domestic plane when she should not have been, Frieden said he doesn't think fellow travelers are at risk.
"The fact that the patient did not have a fever until the next day and did not have nausea or vomiting until the next day suggests to us that the risk to anyone around the individual on the plane would be extremely low, but we'll always put in extra margins of safety," Frieden said.
"She did not vomit. She was not bleeding. So the level of risk to those around her would be very low," he reiterated.
Dr. Amesh Adalja, a representative of the Infectious Disease Society of America, echoed this same sentiment to TheBlaze Wednesday.
"If a person is incubating Ebola and does not have symptoms, they are not contagious," he said. "Since her travel occurred before she developed symptoms, there would be no risk to passengers."
Ebola is transmitted through direct contact with infected bodily fluids. Adalja said that based on the current understanding of Ebola, while the virus is incubating it is "sequestered away in certain organs."
"Based upon what we know of the virus ... there’s no pre-symptomatic spread," he said.
Only when the virus is ready to be spread does it cause symptoms — like bleeding, vomiting and diarrhea — which allow it to be expelled from the body and thus possibly infect others.
The virus can be spread through other bodily fluids, such as saliva and urine, as well. Adalja said you can make up extreme, but unlikely, situations regarding a case of an Ebola patient traveling on a plane.
Like this hypothetical situation: a person with Ebola leaves saliva on a plastic soda cup that is then touched by a flight attendant coming to collect garbage. The flight attendant would have to have a cut in her hand or allow the virus into her body in some way to then become infected herself.
Adalja reiterated that the patient who traveled shortly before testing positive for Ebola was asymptomatic though and should not have been able to spread the virus through any of her bodily fluids. He said that even if a hypothetically infected and contagious traveler were sitting next to someone on a plane, the risk of transmitting the virus, unless direct contact with bodily fluids is made, is "very minimal."
"Ebola is not spread through casual contact," Adalja said.
The first patient to test positive Sunday for Ebola after caring for Duncan, despite protective measures, was identified as nurse Nina Pham. She was reported to be in good condition this week. The second nurse to be infected, announced Wednesday, was identified by a relative to Reuters as 29-year-old Amber Vinson. It was Vinson who traveled on the Frontier Airlines flight before she was isolated on Tuesday for a low-grade fever and later tested positive for the virus.
A security guard checks the ID of a resident walking in the parking lot of The Village Bend East apartments where a second health care worker lives that tested positive for Ebola, Wednesday, Oct. 15, 2014, in Dallas. (AP/LM Otero)
While the CDC plans to continue treating Pham at Texas Health Presbyterian Hospital for the time being, Frieden said that the second patient will be transferred to Emory University Hospital in Atlanta. This hospital already has experience with the first two Ebola patients brought back to the U.S., both of whom recovered and were released.
Health officials in Dallas and Texas took measures to clean the apartments and common areas of the complexes where the two nurses lived. Those who also lived in the complexes and the nearby areas, as well as those who had contact with each woman, were alerted by the authorities. The CDC is monitoring individuals that it deems as possibly being exposed.
It is unclear how either of these women became infected while caring for Duncan, but during the news conference Wednesday Frieden said that it has been reviewing records kept since Duncan first went to the hospital. Within these records, they have found some cases where health care workers were not using personal protective equipment properly.
"Some health care workers were putting on three to four layers of PPEs [believing] this would be more effective," Frieden said.
Mathew Jacob, a maternal newborn nursing student, has help removing a gown during a refresher course on personal protective equipment procedure taught at the Brookhaven College School of Nursing in Farmers Branch, Texas, Tuesday Oct. 14, 2014. Nursing, EMS and radiological sciences students will all take the refresh course. (AP /The Dallas Morning News, Andy Jacobsohn)
He added that putting on more layers actually makes them harder to take off after interactions with an infected patient and thus increases the risk for possible contamination during removal.
While the case of two hospital workers becoming infected after caring for one patient in Texas is "unprecedented," as several U.S. health officials have put it, the inability it contain and slow the spread in West Africa has world officials concerned.
The World Health Organization estimates that if the epidemic is not slowed in West Africa soon, there will be up to 10,000 new infections per week starting in December. As of Oct. 15, WHO estimated there were nearly 9,000 Ebola infections that resulted in nearly 4,500 deaths.
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