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Dallas Ebola Patient on Ventilator, Getting Dialysis
Health officials report no other infections in the cityTuesday, October 7, 2014
TUESDAY, Oct. 7, 2014 (HealthDay News) -- The first Ebola patient diagnosed in the United States is in critical but stable condition, with machines performing life-sustaining functions as he struggles with the deadly virus, federal officials said Tuesday.
Liberian national Thomas Eric Duncan is on a ventilator and receiving kidney dialysis, part of the supportive care that many advanced Ebola patients require as the virus attacks their vital organs, Centers for Disease Control and Prevention Director Dr. Tom Frieden said during a new conference.
"What we've learned about Ebola is how important it is to get the patient's basic care right, so we're treating their fluid and electrolyte balance well," Frieden said. "That's critically important to survival."
Duncan also is receiving experimental treatment with the drug brincidofovir, Texas Health Presbyterian Hospital Dallas reported in a news release. The drug is a broad-spectrum antiviral that has shown promise against Ebola in laboratory experiments and currently is in animal testing.
No one who came into contact with Duncan after he arrived in Dallas from Liberia last month has come down with a fever or any other symptoms of Ebola, Frieden said.
Public health workers are monitoring 10 people confirmed to have contact with Duncan after he fell ill with Ebola and became contagious, as well as 38 other suspected contacts. The 10 include several members of Duncan's family living in Dallas and the ambulance crew that transported him to the hospital.
CDC officials also are working to develop advanced screening procedures for people entering the United States from the West African nations affected by the Ebola epidemic: Liberia, Guinea and Sierra Leone, Frieden said.
President Barack Obama ordered additional screening measures after meeting with top security and health advisers on Monday.
Frieden did not provide specifics, but said the CDC can track people entering the United States from those nations even if they take an indirect flight, by working with customs and border control officials.
Screening methods for travelers could include a fever check and a detailed questionnaire to cover their potential exposure to Ebola, Frieden said.
"We will be taking additional steps and we will be making those public in the coming days, once we work out the details," he said.
Checking a passenger's temperature can help detect Ebola, but many people with other illnesses also will be unnecessarily detained. Frieden said that 77 people have been prevented from flying to the United States from Liberia, many of them due to fever, but none ended up with Ebola.
Instead, most came down with malaria. "If you're finding fever in people from West Africa, the most common single cause of that will be malaria," Frieden said.
Officials also addressed Monday's revelation that a nurse in Spain has become the first person known to catch Ebola outside of West Africa. She was part of a medical team that treated a 69-year-old Spanish priest who died in a Madrid hospital last month after being flown back from Sierra Leone.
Spanish health officials have quarantined four people at the hospital where the woman became infected and have decided to euthanize her dog, according to published reports.
Dr. David Lakey, commissioner of the Texas Department of State Health Services, said the Spanish case has reinforced the commitment to careful infection control procedures for the people now caring for Duncan.
"I've looked at the protocols they're following at Presbyterian Hospital, and they take this really, really seriously," Lakey said. Doctors and nurses are caring for Duncan in an otherwise vacant ward being guarded by security, and wear layers of protective clothing that they take on and off using a prescribed method.
Viral transmissions can take place if a health care team is overburdened and "they're dealing with so many patients or have such a staff shortage that it's possible that even the best and most meticulous people can cut corners," Frieden said.
"That's why we've emphasized to global partners who are working in West Africa that really four or at most six weeks is the maximum deployment time," after which health workers should be rotated out, he said.
During the news briefing, Frieden also countered fears that Ebola might mutate into an airborne form. "We do not see airborne transmission in the outbreak in Africa," he said, adding that the Ebola virus has proven very genetically stable during the decade since its discovery, with a mutation rate much lower than other viruses.
"Furthermore, we know that most viruses do not change the way they spread," Frieden continued. "To do so would require a very large genetic change."
Duncan entered the United States on Sept. 19, apparently healthy and without any symptoms. He first developed Ebola symptoms Sept. 24 and sought care two days later at Texas Health Presbyterian Hospital Dallas, but was released from the hospital.
Duncan was taken back to the hospital on Sept. 28 after his condition worsened. People who later rode in the same ambulance are being monitored as low-risk contacts.
As many as 4,000 U.S. troops could be deployed to West Africa to combat future spread of the virus. Troops have been slowly building up in the affected nations, including advance forces who are directing the deployment to places of need.
The top U.S. general overseeing operations in Africa said Tuesday that if any service members contract Ebola, they will be transported back to the United States on a specially designed plane and get treatment there.
The Ebola epidemic in West Africa is the worst outbreak ever of the disease. So far, an estimated 7,500 people have become infected and an estimated 3,439 people have died in Guinea, Liberia and Sierra Leone, according to the World Health Organization.
SOURCES: Oct. 7, 2014, news briefing, with Tom Frieden, M.D., M.P.H, director, U.S. Centers for Disease Control and Prevention, and David Lakey, M.D., commissioner, Texas Department of State Health Services
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