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Ebola Patient Shouldn't Have Boarded Plane, Officials Say

Ebola Patient Shouldn't Have Boarded Plane, Officials Say
Arthur Delaney
By 

Senior Reporter, HuffPost

WASHINGTON -- Top health officials said Wednesday that a nurse infected with Ebola never should have boarded a plane.

The Centers for Disease Control and Prevention had announced earlier Wednesday that a second nurse who had cared for Thomas Eric Duncan, the first person to die from Ebola in the United States, had contracted the disease -- and also that the nurse had flown from Cleveland to Dallas on Monday, the day before she fell ill.

"She should not have traveled on a commercial airline," CDC director Tom Frieden told reporters during a conference call. "The CDC guidance in this setting outlines the need for what is called controlled movement. That can include a charter plane, that can include a car, but it does not include public transport."

Frieden said the nurse shouldn't have flown because she was one of the 76 nurses who had cared for Duncan, all of whom are under observation. He added that there was probably little risk of other people on her flight contracting Ebola, which is spread via contact with bodily fluids, but the CDC is nevertheless reaching out to other passengers.

“The fact that the patient number two did not have a fever until the next day, did not have nausea or vomiting on the plane, suggests to us that the risk to any around that individual on the plane would have been extremely low," Frieden said. "But we are going and will always put in extra measures of safety.”

Frieden and other health officials initially said they didn't know how Nina Pham, the first nurse at Texas Health Presbyterian Hospital Dallas to get sick, contracted Ebola other than that there must have been a "breach in protocol." On Wednesday, Frieden suggested they had a better idea of what went wrong.

"The second patient as well as the first had extensive contact with the patient [Duncan] when they were having substantial amounts of both vomiting and diarrhea," Frieden said. "The assessment of the team is that in those first several days [of Duncan's stay] at the hospital a variety of forms of personal protective equipment were used."

On Tuesday, National Nurses United, the largest union representing registered nurses, said workers at the Dallas hospital had complained of insufficient training and equipment after Duncan arrived.

"Nurses had to interact with Mr. Duncan with whatever protective equipment was available at the time when he had copious amounts of diarrhea and vomiting, which produces a lot of contagious fluid," union co-director Deborah Burger said.

The union essentially said Texas Health Presbyterian and hospitals everywhere haven't been following the CDC's Ebola protocols. Asked by HuffPost to respond to the claim, Frieden said the CDC is working closely with the hospital.

"We have staff there around the clock," Frieden said. "There are intensive efforts underway to train and retrain and supervise the staff."

Frieden added that the government has installed a site manager to monitor how nurses put on and take off personal protective equipment. Sylvia Burwell, director of the Department of Health and Human Services, said the Obama administration has established "go teams" that can rush to any hospital where Ebola turns up.

More than 4,000 people have died from Ebola since March, mostly in West Africa. The two nurses infected at the Dallas hospital represent the first transmissions of the virus in the U.S.

Before You Go

1
Ebola is highly infectious and even being in the same room as someone with the disease can put you at risk
ASSOCIATED PRESS
Not as far as we know. Ebola isn't contagious until symptoms begin, and it spreads through direct contact with the bodily fluids of patients. It is not, from what we know of the science so far, an airborne virus. So contact with the patient's sweat, blood, vomit, feces or semen could cause infection, and the body remains infectious after death. Much of the spread in west Africa has been attributed to the initial distrust of medical staff, leaving many to be treated at home by loved ones, poorly equipped medics catching the disease from patients, and the traditional burial rites involving manually washing of the dead body. From what we know already, you can't catch it from the air, you can't catch it from food, you can't catch it from water.
2
You need to be worried if someone is sneezing or coughing hard
ASSOCIATED PRESS
Apart from the fact that sneezing and coughing aren't generally thought to be symptoms of Ebola, the disease is not airborne, so unless someone coughed their phlegm directly into your mouth, you wouldn't catch the disease. Though medical staff will take every precaution to avoid coming into contact with the body of an infected person at all costs, with stringent hygiene there should be a way to contain the virus if it reaches the UK.
3
Cancelling all flights from west Africa would stop the spread of Ebola
ASSOCIATED PRESS
This actually has pretty serious implications. British Airways suspended its four-times-weekly flights to Liberia and Sierra Leone until the end of March, the only direct flight to the region from the UK. In practice, anyone can just change planes somewhere else and get to Britain from Europe, north Africa, or the Middle East. And aid agencies say that flight cancellations are hampering efforts to get the disease under control, they rely on commercial flights to get to the infected regions. Liberia's information minister, Lewis Brown, told the Telegraph this week that BA was putting more people in danger. "We need as many airlines coming in to this region as possible, because the cost of bringing in supplies and aid workers is becoming prohibitive," he told the Telegraph. "There just aren't enough seats on the planes. I can understand BA's initial reaction back in August, but they must remember this is a global fight now, not just a west African one, and we can't just be shut out." Christopher Stokes, director of MSF in Brussels, agreed: “Airlines have shut down many flights and the unintended consequence has been to slow and hamper the relief effort, paradoxically increasing the risk of this epidemic spreading across countries in west Africa first, then potentially elsewhere. We have to stop Ebola at source and this means we have to be able to go there.”
4
Temperature screening at airports is an effective way to stop those who have the disease from travelling
ASSOCIATED PRESS
The screening process is pretty porous, especially when individuals want to subvert it. Wake up on the morning of your flight, feel a bit hot, and you definitely don't want to be sent to an isolation booth for days and have to miss your flight. Take an ibuprofen and you can lower your temperature enough to get past the scanners. And if you suspect you have Ebola, you might be desperate to leave, seeing how much better the treatment success has been in western nations. And experts have warned that you cannot expect people to be honest about who they have had contact with. Thomas Eric Duncan, the Ebola victim who died in Texas, told officials he had not been in contact with anyone with the disease, but had in fact visited someone in the late stages of the virus, though he said he believed it was malaria. The extra screening that the US implemented since his death probably wouldn't have singled out Duncan when he arrived from hard-hit Liberia last month, because he had no symptoms while travelling.
5
Border staff should stop people coming in to the country who are at risk
LEON NEAL via Getty Images
They're not doctors, and it's a monumental task to train 23,500 people who work for the UK Border Agency how to correctly diagnose a complex disease, and spot it in the millions of people who come through British transport hubs. Public Health England has provided UK Border Force with advice on the assessment of an unwell patient on entry to UK, but they can't be expected to check everyone.
6
Screening at British airports should be implemented to stop unwell people coming in from affected areas
ASSOCIATED PRESS
As mentioned before, the UK, especially London, is a major transport hub. Unlike the US, most of those coming from west Africa will have crossed through Europe, so infected people could be coming from practically anywhere, not just flights directly from those countries. This would require the UK to screen every returning traveller, as people could return to the UK from an affected country through any port of entry. This would be huge numbers of low risk people, at vast, vast expense.
7
Ebola doesn't have a cure
John Moore via Getty Images
There are several cures currently being tested for Ebola. They include the ZMapp vaccine which was administered to British sufferer William Pooley and two other Americans who caught the disease in west Africa and they all recovered. Supplies of the drug have now run dry, and it has not been through clinical trials to prove its effectiveness. Mapp Biopharmaceutical, the company that makes ZMapp, says the drug's supplies are exhausted and that it takes months to make even a small batch. But an Ebola cure is very much on the horizon, and would have come sooner had it been seen as any kind of priority for drug companies before it started reaching the western world.
8
Ebola is a death sentence
ASSOCIATED PRESS
It is true that certain strains of Ebola have had a death rate of 90%. However, with this particular epidemic the stats are more positive, a death rate of around 60%. Those who have decent, strong immune systems, are able to access intravenous fluids and scrupulous health care are far more likely to survive, which is why the survival rate of westerners who contract the disease is far better. Experts have suggested that, rather than waste money on pointless airport screenings, funds could be used to improve infrastructure in the affected nations to help halt the spread of the disease at source.
9
Ebola turns you into a zombie
Renee Keith via Getty Images
Just, no.
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