DALLAS — 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.”
In Texas, medical records showed that a 26-year-old nurse who contracted Ebola while caring for a dying Liberian man repeatedly visited his room from the day he was placed in intensive care until the day before he died.
Nurse Nina Pham was among about 70 hospital staffers who were involved in Thomas Eric Duncan’s care after he was hospitalized, according to the records. They drew his blood, put tubes down his throat and wiped up his diarrhea. They analyzed his urine and wiped saliva from his lips, even after he had lost consciousness.
Pham and other health care workers at Texas Health Presbyterian Hospital wore protective gear, including gowns, gloves, masks and face shields — and sometimes full-body suits — when caring for Duncan, but Pham became the first person to contract the disease within the United States.
Her family told Dallas television station WFAA on Monday that she was the health care worker with Ebola. A rector at her family’s church, Hung Le, said Pham’s mother told him Pham has the virus.
The Texas Christian University nursing school graduate was monitoring her own temperature and went to the hospital Friday night when she discovered she had a low fever. She was in isolation and in stable condition, health officials said.
Public health authorities have since intensified their monitoring of other Dallas hospital workers who cared for Duncan.
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.
Pham’s name appears frequently throughout the hundreds of pages of records provided to The Associated Press by Duncan’s family. They show she was in his room Oct. 7, the day before he died.
Her notes describe nurses going in and out of Duncan’s room wearing protective gear to treat him and to mop the floor with bleach.
She also notes how she and other nurses were ensuring Duncan’s “privacy and comfort,” and providing “emotional support.”
Frieden has said a breach of protocol led to the nurse’s infection, but officials are not sure what went wrong. Pham has not been able to point to any specific breach.
The CDC is now 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. 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 with Duncan before he 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 Pham 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.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told ABC’s “Good Morning America” that federal health authorities should consider requiring that Ebola patients be sent only to highly specialized “containment” hospitals.
Duncan, who arrived in the U.S. from Liberia on 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.
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.
Elsewhere:
• Officials said Pham’s King Charles Spaniel has been taken from her Dallas apartment and will be cared for at an undisclosed location.
• 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.
• A Louisiana waste disposal site says it won’t accept the ashes generated when a Texas Ebola victim’s belongings from his apartment were incinerated, and a judge has signed an order temporarily blocking the disposal in the state.
• Hospital and family members say the American journalist being treated for Ebola in Nebraska is showing signs of improvement. Dr. Mitchell Levy said his son, 33-year-old Ashoka Mukpo, has been improving in recent days and currently has no symptoms.
