From Guinea, a country of 11 million people, the Ebola Virus Disease has spread to four other West African nations—Senegal, Liberia, Nigeria and Sierra Leaone — killing more than 3,000 people in a matter of days. The latest destination for this near-genocide is Dallas, a small city in Texas, United States, where the first person diagnosed in the country has been quarantined alongside 80 other possible contacts.
The trip made by Thomas Eric Duncan, a former chauffeur, from Liberia to the United States on September 20 has now raised controversies on how far the virus can travel and may force countries to rethink the flight restriction policy against countries where the disease has been endemic.
Until September 17 when President Barrack Obama sent 3,000 troops to help with the transportation of medical equipments, the US been sitting on the sidelines.
Speaking at the US Centre for Disease Control, Atlanta, Obama announced a comprehensive plan, which involves the construction of 17 treatment centres with 100 bed facilities each. Some 500 health care workers will also be trained weekly.
“Faced with this outbreak, the world is looking to us, the United States, and it is a responsibility that we embrace. We are prepared to take leadership on this, to provide the type of capabilities that only America has and mobilize our resources in ways that only America can do,’’ Obama had said.
However, Duncan’s trip to the US has thrown up several issues. First is the inability of officials at the Texas Health Presbyterian Hospital to isolate Duncan on September 26, the day he first reported to the hospital.
Reacting to the development, a Consultant Gynecologist, Dr. Rotimi Akinola expressed hope that the situation would be brought under control soon. He however, remarked that the failure to isolate Duncan on his first visit to the hospital shows a natural weakness in any human system.
“There is no human system anywhere in the world that is above mistake. But they have an effective contract tracing mechanism and better record keeping. I am sure that system will rise to the occasion,’’ he enthused.
Texas hospital explains
A nurse at the Texas hospital was said to have asked Duncan about his recent travels while he was in the emergency room, and the patient was said to have told the nurse that he had been in Africa.
Executive Vice President of Texas Health Resources, Dr. Mark Lester confirmed this but that the information was not “fully communicated” to the medical team.
The man underwent basic blood tests, but not an Ebola screening, and was sent home with antibiotics, said Dr. Edward Goodman with Texas Health Presbyterian Hospital.
Three days later, the man returned to the facility, where it was determined that he probably had Ebola. He was then isolated.
“The hospital followed all suggested CDC protocols at that time. Texas Health Presbyterian Hospital Dallas’ staff is thoroughly trained in infection control procedures and protocols,” the hospital said Wednesday.
The Centres for Disease Control and Prevention, which has helped to lead the international response to Ebola, advises that all medical facilities should ask patients with symptoms consistent with Ebola for their travel history.
Duncan’s travel history “was not acted upon in an appropriate way,” said Dr. Sanjay Gupta, CNN’s Chief Medical Correspondent.
“A nurse did ask the question and he did respond that he was in Liberia and that wasn’t transmitted to people who were in charge of his care,” Gupta said. “There’s no excuse for this.”
A U.S. official told CNN senior medical correspondent Elizabeth Cohen that the situation was clearly “a screw-up.” A patient who shows up to a hospital with a fever and a history of travel to Liberia should be treated as an infection risk, the official said.
Asked repeatedly by Gupta whether the patient should have been tested for Ebola during his first visit to the hospital, CDC Director Dr. Thomas Frieden said officials were still looking at details about how the case was handled.
“We know that in busy emergency departments all over the country, people may not ask travel histories. I don’t know if that was done here,” Frieden said. “But we need to make sure that it is done going forward.”
Duncan is a 42-year-old Liberian national, according to his friend. This is Duncan’s first trip to the US, where he was visiting family and friends.
The close associate, who does not want to be identified because of the sensitivity of the case, contacted the CDC with concerns that the hospital was not moving quickly enough after Duncan’s second hospital visit.
The associate said Duncan is “all right” now, but is in pain and hasn’t eaten in a week.
He is in serious condition, the hospital told CNN. Neither the hospital nor government officials have identified Duncan by name.
Tracing contacts
A CDC team is in Dallas helping to find anyone Duncan may have come in contact with, Frieden said.
Once those people are identified, they will be monitored for 21 days — taking their temperatures twice a day — in cooperation with local and state health officials, Frieden said.
Some school-age children have been in contact with the Ebola patient, but the students haven’t exhibited symptoms of the deadly virus, authorities said.
Five students at four different schools came into contact with the man, Dallas Superintendent Mike Miles said.
The children are being monitored at home, and the schools they attended remain open, he said.
Paramedics who transported the patient to the hospital have been isolated, Rawlings’ chief of staff said. They have not shown symptoms of the disease so far, Frieden said.
The ambulance used to carry the patient was still in use for two days after the transport, city of Dallas spokeswoman Sana Syed said.
But she emphasised that the paramedics decontaminated the ambulance, as they do after every transport, according to national standards.
Pupils stay at home
Worries over Ebola kept some Dallas schoolchildren home Thursday after school officials identified five students who might have come into contact with the first person in the US to be diagnosed with the virus.
The Dallas Independent School District was still gathering morning attendance figures from four campuses where the affected students were in class earlier this week, spokesman Andre Riley said. Those students have shown no symptoms and are being monitored at home, where they are expected to remain for three weeks.
But there are already signs of parents taking no chances.
Yah Zuo left L.L. Hotchkiss Elementary on Thursday morning with her two children, including a six-year-old daughter. Zuo hoped to enrol her elsewhere.
Zuo is of Liberian origin and said she knows the family of Duncan.
“In situations like this, you cannot stay friends. You have to protect the ones you love,” ,” Zuo said.
She added, “This virus is not something you play with.”
It was not exactly clear how Duncan knew the students, but his sister said he had been visiting with family, including two nephews.
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