On seemingly opposite ends of the globe two new cases of Ebola have been confirmed by respective health authorities. The Ministry of Health in Mali has confirmed the infection of a 2 year old who traveled from Guinea while New York has confirmed that a Doctor who recently returned from Guinea has tested positive for the virus.
Mali is the sixth country in West Africa to be affected by the largest recorded outbreak. It is understood that the 2 year old girl was placed in isolation along with all direct contacts on the the 23rd of October 2014. The Ministry of Health released a statement confirming the importation after a suspected case was identified at Fousseyni Daou Kayes Hospital. It is strongly suspected that at least one of the girls parents has died from Ebola recently.
In the USA a suspected case appeared at Bellevue Hospital when Dr Craig Spencer was admitted with symptoms. Significant concern has been raised about the time line for this infection after it emerged that Dr Craig Spencer may have been symptomatic while using the subway and taxi cabs. Research suggests that Ebola can survive without a host for several days. CDC officials have been dispatched to assist with the case and contact tracing has begun.
The World Health Organization and the United Nations raised concerns about the risk of case importation for Mali and Côte d’ Voire in recent weeks after reports began to emerge that the outbreak was continuing to spread in Guinea, Sierra Leone and Liberia. The confirmation of a case in Mali reaffirms the statements from officials and experts in recent weeks. The outbreak must be contained in the West Africa “Hot Zone”.
A second health care worker has reportedly been isolated at the Texas Health Presbyterian Hospital in Dallas. Initial testing has been positive for Ebola and the samples will be verified with the CDC in the coming hours. A press release from the Texas Department of State Health Services confirms that the worker developed a mild fever on Tuesday.
Texas state officials have confirmed that the health care worker was involved in the care of Thomas Eric Duncan. The CDC has been vocally concerned about the infection risk for health care workers in the USA. In the worst affected West African countries as many as 400 health care workers have been classified as suspected or confirmed cases in the last year.
The Nigerian outbreak generated at least 19 cases from a single index patient most of which have been health care workers. The first health care worker infected in the USA has been reported as doing well after receiving a plasma donation from the blood of Ebola survivor Doctor Kent Brantly. Blood transfusions are only possible where there is a plasma match but provide increased survival rates by transferring antibodies to the receiver.
A scathing report in the LA Times earlier in the week pointed to a significant lack of infection controls in the hospital raising concerns that several additional cases are on the horizon. The report suggested that nurses and doctors were not sufficiently trained and may have lacked appropriate equipment.
The CDC was criticized by the general public when it blamed the first health care worker infection on “protocol breach” with many outspoken responses pointing the finger of blame towards the CDC for a lack of action and proper training. The slow CDC response to the first case and apparent lack of preparedness have been broadly criticized.
A health care worker has tested positive for Ebola according to Texas Health Presbyterian Hospital where Thomas Duncan the first American Ebola case was treated. Blood samples have been sent to the CDC for final confirmation. According to reports the nurse showed symptoms of a fever on Friday evening with the initial test results received late Saturday.
No detail or information has been provided as yet however speculation is rife that this is likely one of the health care workers that came into contact with Duncan on his first visit to the hospital when he was sent home. There is a low probability that an infection would have occurred once the hospital knew they were dealing with Ebola. Health care workers have been infected at an alarming frequency throughout the Ebola outbreak.
Contact tracing has already begun following a patient interview by health officials and monitoring off any suspected contacts generated from this case will likely begin immediately. The patient was admitted and isolated shortly after exhibiting the initial symptoms which should minimize the potential time the virus has to spread.
False positive tests are a possibility and the case will only be confirmed as official once the CDC confirms them with a second test result.
UPDATE: The worker treated Duncan on his second visit to the hospital and was following all guideline precautions including PPE.
UPDATE: President Obama has requested an urgent investigation into the case.
UPDATE: The CDC has confirmed the test results officially
Details have begun to emerge surrounding the first confirmed case of Ebola in Europe. The nurse who contracted the virus during treatment of a repatriated priest in Madrid was confirmed as the first case in Spain yesterday. The Spanish Health Ministry announced the diagnosis during a Press Conference.
- 30 Contacts which are mostly Health Care workers have been identified
- The nurse monitored her temperature twice a day
- A mild fever developed on the 30th of September
- Protective gear was worn but may not have been level 4 appropriate
- Her suit was inspected before and after treating the patient
- She attended to the patient on two occasions
- The hospital has isolated her but is not confirmed as containment capable
- The nurse could have been contagious for 5 days before isolation
- She is not in the same hospital where she treated the Ebola patient
- Some reports claim that she is a nursing assistant not a full nurse
- Contact tracing has begun
- The nurse will be moved to “La Paz-Carlos III”
- A second suspected case is likely but not officially confirmed
Spectators from around the world have voiced their concern at the transmission of Ebola to a trained Health Care worker in a European country. Western hospitals are claimed to be some of the best in the world and it is difficult to imagine that the correct precautions were not taken. Human error and potential misunderstandings around the transmission of the EVD may have played a part.
The repatriation of Ebola patients has been a controversial topic around the world. Many people are deeply conflicted by the conundrum of bringing a citizen back to their home when they’ve become infected while treating Ebola in the affected West African Countries.
A Nurse in Spain has become infected with Ebola. She was one of the nurses who cared for a repatriated priest who had been transferred to a hospital in Madrid and later died from the disease. Unlike the case of Thomas Eric Duncan where the infection came from Liberia, this infection happened on European soil making it the first confirmed transfer of Ebola outside the West African Region. The news comes as somewhat of a surprise given that the first diagnosed case outside of Africa in the US generated roughly 100 contacts. Many expected that the first transfer would have been related to Duncan. Media houses reported initial testing showed the nurse as positive which is expected to be confirmed by the Health Ministry later today.
The high rate of infection among Health Care workers has alarmed many people around the world and will certainty further increase fears that the virus will continue to spread uncontrollably. An emergency meeting of Health Ministry Advisers is currently underway and a Press Conference is expected later in the day.
Early symptoms of Ebola mimic the flu and may begin as soon as 2 days after infection. Typically symptoms become visible 2 weeks after contact with virus and progress rapidly from the 7th day onward. Ebola is only infectious once you are showing symptoms. Spain and Officials of the European Union are likely to track the nurse’s movements and keep an eye on all workers she came in contact with. High risk suspected patients are likely to be quarantined for a period of 21 days after which it is assumed you don’t Ebola if you have not shown symptoms.
The Priest passed away on the 25th of September placing the infection within the expected incubation period.
UPDATE: The Spanish Health Minister, Ana Mato has confirmed the case and says 30 contacts will be monitored.