A second nurse in Dallas has tested positive for Ebola Wednesday morning, according to the Centers for Disease Control and Prevention. Amber Joy Vinson had traveled on a plane from Cleveland to Dallas the day before reporting her symptoms and officials are now tracking down all the passengers on her flight.
The news comes three days after officials announced the first-ever Ebola transmission in the United States involving Nina Pham, a 26-year-old nurse who cared for the Liberian patient who died from Ebola in Dallas. Pham is in isolation and remains in good condition.
The second nurse, 29-year-old Vinson, also became infected while caring for Thomas Eric Duncan at Texas Health Presbyterian. On Monday October 13, she traveled on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth, the CDC said. On Tuesday, she reported a fever and was put into isolation at the hospital. The CDC said, "Because of the proximity in time between the evening flight and first report of illness the following morning, CDC is reaching out to passengers [on the flight]."
According to the CDC, Vinson had a temperature of 99.5 at the time of her flight, which means she wouldn't have been very contagious. Still, the agency is asking the 132 passengers on the flight to call 1 800-CDC INFO (1 800 232-4636).
Vinson is being transferred from Texas to Atlanta's Emory Hospital, where the first American Ebola patient Kent Brantly was cared for successfully.
Vinson reportedly lived alone, and three of her contacts are being followed up with. Dallas officials were already decontaminating her apartment Wednesday morning and distributing fliers about Ebola throughout the neighborhood.
"As we have said before, because of our ongoing investigation, it is not unexpected that there would be additional exposures," the CDC warned in a statement.
It's not yet clear how Vinson became infected with the virus, though the CDC's director Tom Friden said both Vinson and Pham cared for Duncan before he was diagnosed during his "highest risk days." They both had "extensive contact with his bodily fluid" when he was vomiting and experiencing diarrhea.
A series of missteps in Dallas
Duncan, the first person to be diagnosed with Ebola in the United States, died at at Texas Health Presbyterian on October 8. He tested positive for the virus over a week after arriving in Dallas from Liberia, one of countries hardest hit by the epidemic.
A hospital misstep in failing to diagnose Duncan at an early stage might have affected his outcome, but it has also affected the lives of everyone with whom he came into contact.
Officials are still following up with 48 people who had some kind of exposure to Duncan or his family prior to Duncan's diagnosis. So far, none of them have fallen ill, and they've passed the eight to ten day period when they would be most likely to show symptoms.
The CDC has been monitoring one of Pham's contacts and 50 people who had exposure to Duncan after his diagnosis on September 28, during his hospital stay.
The investigation will also involve the 132 passengers who shared Vinson's Cleveland-Dallas flight.
The CDC still says it can contain any US outbreak
Vinson's case raises questions about how Ebola-exposed health workers movements will be tracked and how they will be prevented from flying while potentially infectious.
CDC director Tom Frieden said, "Because at that point [when she traveled on a plane] she was in a group of individuals known to have exposure to Ebola, she should not have traveled on a commercial airline. The CDC guidance in this setting outlines the need for what is called controlled movement."
"It is certainly possible that someone who had contact with [Duncan]... could develop Ebola in the coming weeks," Frieden said previously. Still, he added: "I have no doubt we will stop this in its tracks in the US. I also have no doubt as long as this continues in Africa, we need to be on guard."
That said, the failure to screen and diagnose Duncan on his first visit to hospital — and news that he transmitted Ebola to two health workers — has raised public concern about Ebola, in particular, among health-care workers and hospital staff who might come into contact with Ebola patients in their clinics.
To address those concerns, yesterday the CDC announced precautions that it would be taking in Dallas and in hospitals across the country. They include:
- Sending an additional team to Dallas, including experts who successfully controlled outbreaks of Ebola in Africa in the past two decades, including in health-care settings.
- Making improvements to processes and procedures at the Dallas hospital to reduce risk to health care personnel.
- Having a site manager in place and at the Dallas hospital 24/7 as long as Ebola patients are receiving care, to oversee the putting on and taking off of personal protective gear and the care given in the isolation unit.
- Establishing a dedicated CDC response team that could be on the ground within a few hours at any hospital with a confirmed patient with Ebola.
- Providing more opportunities for healthcare providers to receive additional training and to get their questions answered from CDC experts.
This is part of a wider effort to protect Americans from Ebola. As a precautionary measure, the Department of Homeland Security announced last week that they would begin screening flight passengers coming in from West Africa for signs of infection, starting with five American airports.
For now, though, the major concern is stopping the outbreak at its source. Ebola is currently concentrated in West Africa, in Liberia, Guinea and Sierra Leone. There, more than 8,000 people have gotten the virus, and more than 4,000 have died.
Transmission from patients to health workers has been an all-too-common feature of this outbreak. More than 230 health workers have died while caring for the sick in this epidemic — an unprecedented number, according to the World Health Organization.