Wednesday, October 1, 2014

US Ebola Patient's Sister: Brother Told Hospital He Had Been to Liberia



US Ebola Patient's Sister: Brother Told Hospital He Had Been to Liberia
Wednesday, 01 Oct 2014 01:17 PM
The first patient to be diagnosed with Ebola in a U.S. hospital was evaluated initially and turned away, a critical missed opportunity that could result in others being exposed to the deadly virus, infectious disease experts said.

On Wednesday, the patient's sister raised further questions by saying her brother says he told relatives he notified officials the first time he went to the hospital that he was visiting from Liberia, one of the worst-hit African nations by the disease.

Mai Wureh says her brother, Thomas Eric Duncan, went to a Dallas emergency room on Friday and they sent him home with antibiotics. She says he said hospital officials asked for his Social Security number and he said that he didn't have one because he was visiting from Liberia.

Duncan arrived in the U.S. on Sept. 20 to be with relatives in Dallas. He began to develop symptoms last Wednesday and sought care two days later. He was released and returned to the hospital and was admitted Sunday.

On the patient's first visit to Texas Health Presbyterian Hospital in Dallas last Friday, he walked into the hospital presenting "non-specific symptoms" and was sent home with a prescription for antibiotics, Dr. Edward Goodman, an infectious disease specialist at the hospital, told a news conference on Tuesday.

On the second visit two days later, the patient, who has not been identified, arrived by ambulance, potentially putting at risk the emergency responders who transported the patient that Sunday. They have been quarantined but so far have tested negative for the virus.

For months, the U.S. Centers for Disease Control and Prevention (CDC) has been warning American hospitals that Ebola was just a plane ride away. The CDC has urged hospital emergency department staff to ask patients whether they have recently traveled to Liberia, Sierra Leone or Guinea, the three countries hardest hit by the worst Ebola outbreak on record.

At least 3,091 people have died from Ebola since the West African outbreak was first reported in a remote forest region of Guinea in March.

It was only on that second visit on Sunday, however, that the hospital learned that the patient had recently arrived in the United States from Liberia and admitted him to an isolation unit.

Dr. Goodman said the hospital is reviewing what they might have missed on the patient's initial visit. "Our staff is thoroughly trained on infectious disease protocols. We have been meeting literally for weeks in anticipation of such an event," he said.

In the early stages of infection, Ebola resembles many other viral illnesses, causing headache, fever, fatigue, muscle pain and sore throat, which is why health experts stress the need to ask about travel histories.

The two-day lag "is a critical point," said infectious disease expert Dr. Michael Osterholm of the University of Minnesota. "It is going to be very important to go back and look at this and ask basic questions about what happened and could it have been handled differently" so the patient was not in the community and at home for two days while he was contagious.

If he appeared to have Ebola-like symptoms, asking about travel history should have been a tipoff to test for that disease, Osterholm said.

"Once someone hits a healthcare setting, asking about travel history should be a standard question today," he said.

CDC Director Dr. Thomas Frieden said in a news conference that it is possible some people who came in contact with the man could become infected with Ebola, but it probably would only be a handful of people, mostly family members.

Osterholm was also struck by the fact that the man was apparently not a healthcare worker caring for Ebola patients in West Africa, as were five other patients exposed to the disease there and were airlifted back to the United States for treatment.

That raises questions about how the Texas patient contracted the disease.

"In any kind of emergency you wish things could have gone a little bit quicker," said Gerald Parker, vice president for Public Health Preparedness and Response at Texas A&M Health Science Center, referring to the two-day lag between when the patient sought treatment and when he was admitted to the hospital. "But I still give the hospital, state and federal officials high marks in this regard."

Parker said it is not a surprise to anyone in the public health community that the United States has a case of Ebola, "but it underscores that Ebola is a global and national security issue and that we need to double down on our efforts to help West Africa get this outbreak under control."

Epidemiologist Anne Rimoin of the University of California Los Angeles was not overly concerned about the time lag, given the fact that Ebola can only spread through direct contact with the bodily fluids of an infected patient.

"Until someone becomes very, very ill they are not very contagious," said Rimoin, who was flying to the Democratic Republic of Congo on Wednesday to conduct public health research there. The hospital "probably suspected typhoid or malaria, which is far more common."
Liberia
Ellen Johnson Sirleaf is the president of Liberia, and was a guest at George Soros’s 2013 wedding.

Note: Jim Yong Kim was a guest at George Soros’s 2013 wedding, and the director, HIV-AIDS department for the World Health Organization.
Thomas R. Frieden is the U.S. representative nominee for the World Health Organization, the director at the Centers for Disease Control and Prevention (CDC) for the Barack Obama administration, and was the commissioner for the New York City Health Department.
CDC Foundation is a foundation for the Centers for Disease Control and Prevention (CDC).
Bloomberg Family Foundation was a funder for the CDC Foundation.
Elaine L. Chao is a director at the Bloomberg Family Foundation, and a trustee at the New York-Presbyterian Hospital.
John J. Mack is the chairman for the New York-Presbyterian Hospital, a director at the Bloomberg Family Foundation, an advisory board member for Everytown for Gun Safety, and was a benefactor for the Harlem Children's Zone.
Michael R. Bloomberg is the founder for the Bloomberg Family Foundation, the founder of Everytown for Gun Safety, was the New York (NY) mayor, and a benefactor for the Harlem Children's Zone.
Richard S. Fuld Jr. was a benefactor for the Harlem Children's Zone, and is a trustee at the New York-Presbyterian Hospital.
George Soros was a benefactor for the Harlem Children's Zone, married in 2013, a benefactor for the Human Rights Watch, the chairman for the Foundation to Promote Open Society, and his daughter is Andrea Soros.
Foundation to Promote Open Society was a funder for the Harlem Children's Zone, the Human Rights Watch, and the Millennium Promise.
Robin Renee Sanders is a director at the Human Rights Watch, and was the
 U.S. ambassador for the Republic of the Congo.
Amy Robbins Towers is a director at the Human Rights Watch, a board member for the CDC Foundation, an advisory council member for the Acumen Fund, and was a director at the Millennium Promise.
CDC Foundation is a foundation for the Centers for Disease Control and Prevention (CDC).
Andrea Soros is a director at the Acumen Fund, and George Soros’s daughter.

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