Second Dallas Nurse With Ebola Released From Hospital

Head of World Bank urges thousands of medical professionals to travel to West Africa to fight outbreak

Tuesday, October 28, 2014

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Ebola

TUESDAY, Oct. 28, 2014 (HealthDay News) -- The second Dallas nurse who became infected with Ebola while caring for a Liberian man -- the first diagnosed case of the disease in the United States -- has recovered and was released Tuesday from the hospital.

Amber Vinson, 29, had been undergoing treatment at Emory University Hospital in Atlanta, which has successfully treated several Ebola patients already.

"I'm so grateful to be well. First and foremost, I want to thank God," Vinson said at an afternoon news conference at the hospital. "While this is a day for celebration and gratitude, I ask that we not lose focus on the thousands of families that continue to labor under the burden of this disease in West Africa," she added.

Vinson's release means there's only one patient in the United States currently being treated for Ebola -- Dr. Craig Spencer, a New York City physician who remains at Bellevue Hospital in Manhattan. He became infected while treating Ebola patients in Guinea, one of the three West African nations ravaged by the disease.

Vinson and fellow nurse Nina Pham became infected with the Ebola virus at Texas Health Presbyterian Hospital Dallas while caring for Thomas Eric Duncan, who died on Oct. 8.

Pham was released Oct. 24 from a National Institutes of Health hospital in Bethesda, Md. The Atlanta and Bethesda hospitals are among four U.S. hospitals with advanced biocontainment facilities designed to treat highly infectious diseases like Ebola.

It's not clear how either nurse became infected with the virus that has been wreaking havoc in the West African nations of Guinea, Liberia and Sierra Leone since the spring.

Vinson's case made headlines after it was revealed she flew from Texas to Ohio and back in mid-October to prepare for her wedding before she was diagnosed with Ebola. Officials have been monitoring 164 people in Ohio who were thought to have had some level of contact with her, the Associated Press reported.

Also Tuesday, the president of the World Bank appealed for thousands of doctors, nurses and other health care professionals to volunteer and travel to West Africa and help contain the growing Ebola outbreak.

Jim Yong Kim said at least 5,000 health professionals and support staffers are needed to contain the epidemic, which has already infected more than 10,000 people and claimed nearly 5,000 lives.

Many potential volunteers are too scared to travel to West Africa, Kim said, according to BBC News.

On Monday, U.S. health officials issued new guidelines for monitoring people at risk for Ebola exposure -- a move designed, in part, to combat some of the fear surrounding Ebola infection.

The new guidelines apply to health care workers, whether they're returning home from the West African outbreak zone or caring for patients in the United States.

The guidelines establish four levels of risk -- "high" risk, "some" risk, "low" risk and "no" risk -- and recommend the sorts of restrictions and health monitoring that should accompany each category, Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, said at an afternoon news briefing.

Under the guidelines, people at high risk of Ebola exposure would be confined to their homes in voluntary isolation, while people carrying some risk would have their health and movements monitored by local officials.

Those at high risk or with some risk would have daily in-person check-ups from state and local health departments for 21 days -- the outside limit for infection from Ebola. This active monitoring began Monday in the six states where approximately 70 percent of incoming travelers from West Africa are headed -- Georgia, Maryland, New Jersey, New York, Pennsylvania and Virginia.

The CDC issued the new guidelines after the governors of New York and New Jersey implemented controversial quarantine measures on Friday for medical workers returning from West Africa, then backed off after sharp criticism from much of the U.S. medical community.

Critics of the two states' proposals said the quarantines would discourage doctors, nurses and other health professionals from traveling to West Africa to combat the epidemic.

States aren't obligated to follow the new guidelines, although Frieden noted that most state public health officials weigh CDC guidance heavily in their decisions.

The "high-risk" category includes people known to have been exposed to Ebola, either by direct unprotected contact with a patient's bodily fluids or through an accident like a needle stick or a splash to the eyes, nose or mouth.

These people would be placed in isolation at home, and barred from public transportation, workplaces or public areas. They would receive in-person daily monitoring by a health official.

Health care workers returning from West Africa would fall within the moderate "some-risk" category if they did not have direct contact with the body fluids of an Ebola patient. Also in the "some-risk" category would be someone living in a house with an Ebola patient who didn't provide direct care to the sick person.

The CDC recommends that "some-risk" people also receive daily in-person monitoring from a local health official who could check for symptoms such as fever. Local health officials also would have the option of determining whether additional restrictions on travel or public activities are warranted on a case-by-case basis, Frieden said.

However, these restrictions would be much less stringent than the quarantines that New York and New Jersey had attempted to impose.

"We do have to recognize that if we do things that make it very difficult for people to come back [to the United States] -- if we turn them into pariahs instead of recognizing the heroic work they are doing -- a couple of things may happen that none of us want to happen," Frieden said. "They may be less likely to disclose their health care worker status, and then we would lose the opportunity to do that direct-active monitoring here that would protect them, their families and their communities. They may be less likely to go help stop it [the Ebola outbreak] at the source in Africa."

Hospital employees in the United States caring for Ebola patients here would fall within the "low-risk" category for exposure, as would travelers from the affected West African countries who have not been around any people sick with Ebola.

SOURCES: Oct. 27, 2014, news conference, with Tom Frieden, M.D., director, U.S. Centers for Disease Control and Prevention; Associated Press; BBC News

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