It’s been 5 days since a 42-year old Liberian man became the first patient to be diagnosed with Ebola in the United States, and the main message that health officials stress daily is this: take the travel history and communicate it with your staff.
The travel history for Ebola is very specific and currently is limited to Guinea, Liberia, Sierra Leone, and Nigeria.
“We’ve produced checklists and flowcharts and we encourage hospitals to use them,” said Dr. Thomas Frieden, director of Centers for Disease Control and Prevention, in a news conference Oct. 4.
Public health officials have so far assessed 114 individuals in Texas who may have had contact with the patient, Thomas Eric Duncan. They have ruled out about half of them, and are now monitoring 50 individuals, 9 of whom had definite contact with Mr. Duncan.
Among the 9 are 4 individuals who were in the same apartment as Mr. Duncan. On Friday, they were moved to an undisclosed location provided by a member of their faith community, Texas officials said.
All 50 individuals will be monitored for 21 days since the day they potentially came in contact with Mr. Duncan after he became ill and infectious. No one has reported a fever so far. Mr. Duncan remains in serious condition.
Dr. Frieden said that tracing those who may have had contact with Mr. Duncan, monitoring them, and isolating them if they become symptomatic are the core of public health practice and that’s “why we’re confident that we’ll stop this in its tracks in Texas.”
Questions, however, remain as to why Mr. Duncan was initially sent home from his first visit to Texas Health Presbyterian Hospital’s emergency department.
Hospital officials added to the confusion late on Oct. 3, when they retracted an earlier statement, which had pointed to a flaw in the electronic health records as the culprit.
In a clarification, officials said, “As a standard part of the nursing process, the patient’s travel history was documented and available to the full care team in the electronic health record (EHR), including within the physician’s workflow. There was no flaw in the EHR in the way the physician and nursing portions interacted related to this event.”
Officials didn’t provide an explanation for the change in the hospital’s statement and said that the broader point is communicating the travel history with all staff.
CDC has received more than 100 Ebola-related inquiries so far and all the specimen have been negative except for Mr. Duncan’s case.
“We expect more rumors about possible cases, but until there’s a positive result, they are just rumors and concerns,” Dr. Frieden said. More than a dozen laboratories around the nation are equipped to conduct high quality testing for Ebola. The test takes a few hours, but with the added shipping time, the process can take up to 24 hours.
Meanwhile, trained CDC staff are screening individuals who are boarding planes from the affected countries and so far 77 people have been prevented from boarding the plane although it’s not clear if they had Ebola.
There are also quarantine stations at all major U.S. airport, but no suspected Ebola cases have been referred to them so far, Dr. Frieden said.
“We’re all connected,” he said. “And we’re not going to get to zero risk until we can control the outbreak in Africa. It’s going to be a long, hard road.”
nmiller@frontlinemedcom.com
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