Top Line

Wednesday, 1 October 2014

Ebola patient surfaces in USA

A man infected with Ebola was allowed to leave a Dallas hospital last week because the results of a screening weren't shared with his health care team, which concluded he had a common virus and discharged him, hospital officials said Wednesday. While health experts agree that the USA is not at risk for a large Ebola epidemic like the one affecting West Africa, some doctors are concerned that the infected patient was sent home from the hospital without treatment the first time he sought care. The Ebola patient, now in intensive care at Texas Health Presbyterian Hospital in Dallas, arrived in the USA on Sept. 20 without symptoms and sought care Sept. 26. He was sent home, only to return to the hospital two days later and be admitted. The Associated Press has identified the patient as Thomas Eric Duncan, noting that he was identified by his sister, Mai Wureh. As the disease progresses, patients also can develop heavy vomiting and diarrhea, and more advanced cases can cause people to vomit blood and suffer severe abdominal pain. At a news conference Wednesday, hospital officials said a triage nurse performed the recommended screening — asking about his symptoms and his travel history — but her report wasn't communicated to the rest of his health care team. Duncan is now in serious but stable condition, according to hospital officials. Mark Lester, executive vice president at Texas Health Resources, said the patient "volunteered that he had been to Africa in response to the nurse operating the checklist and asking that question." That information "wasn't present" as the man's health care team made its decision about whether to admit or release him, Lester said. Hospital officials said there was no risk to other patients in the emergency room. Ebola can be spread only through contact with bodily fluids, such as blood and vomit. The man had fever and abdominal pain but wasn't vomiting, said Edward Goodman, the hospital epidemiologist. Health officials are monitoring a "handful" of people with whom the Ebola patient had contact before he was hospitalized, said Thomas Frieden, director of the Centers for Disease Control and Prevention, on Tuesday. Those people include five school-aged children in Texas. The children are being monitored at home, Texas Gov. Rick Perry said Wednesday at the press conference. "Let me assure you, these children have been identified and are being monitored," Perry said. For weeks, Frieden has told the public that American hospitals are ready for Ebola patients and that emergency room staffers are being urged to check not only a patient's symptoms but also to ask about recent travel. The American College of Emergency Physicians is sending out an alert to all of its members Wednesday to remind them of this protocol.