CDC Confirms 2nd U.S. Ebola Case: There Was Breach in Protocol

The Dallas health worker is in isolation and in stable condition

A health care worker at Texas Health Presbyterian Hospital in Dallas who provided care for Thomas Eric Duncan, the Ebola patient who died there earlier this week, has tested positive for the virus, the CDC confirmed Sunday afternoon.

"Today, the Centers for Disease Control and Prevention (CDC) confirmed test results reported late last night by the Texas Department of State Health Services' public health laboratory showing that a healthcare worker at Texas Presbyterian Hospital is positive for Ebola," the CDC said in a news release.

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The positive test is apparently as a result of a “breach of protocol," CDC Director Dr. Tom Frieden said earlier Sunday.

"At some point there was a breach in protocol and that breach in protocol resulted in this infection," Frieden said.

The woman tested positive for Ebola in a preliminary test at the state public health laboratory in Austin. Another test to confirm the diagnosis was conducted by the Centers for Disease Control and Prevention in Atlanta.

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Texas Christian University communications director Lisa Albert released a statement Sunday evening, confirming the Ebola patient graduated from TCU in 2010 with a bachelor's degree in nursing.

"At this point, TCU has no reason to believe this alum has been on campus recently," Albert's statement continued. "We ask everyone to please keep this 2010 alum in your thoughts and prayers during this time."

"The level of her symptoms, and indications from the test itself suggest the level of the virus that she had is low," Frieden said. The female caregiver had extensive contact with Duncan before he died Wednesday from Ebola, he said.

Dallas County Judge Clay Jenkins said Sunday the unidentified health care worker is a "heroic" person who "was proud to provide care to Mr. Duncan." 

The worker is in isolation and in stable condition. Jenkins said her family has requested privacy because they are "going through a great ordeal."

"While this is bad news, this is not news that should bring about panic,"  Jenkins said.

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The state health department said the worker reported a low grade fever Friday night and was isolated at Texas Health Presbyterian Hospital Dallas and the preliminary test result was received late Saturday.

"The entire process from patient's self-monitoring to the admission into isolation took less than 90 minutes," Dr. Daniel Varga with Texas Health Presbyterian Dallas said at a news conference Sunday morning.

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Texas Health Presbyterian Dallas said a close contact of the health care worker has already proactively been put into isolation at the hospital. The 24-bed Intensive Care Unit at the hospital is being used as an isolation unit. Eighteen other people who had lesser degree of contact with the worker were being monitored.

Mayor Mike Rawlings said the health care worker lives in an apartment complex in the 3700 block of Marquita Avenue in Dallas.

Rawlings said Dallas-Fire Rescue crews have cleaned and decontaminated open areas of the complex, and crews were seen later in the day carrying drums of contaminated material from the patient's apartment.

A reverse 911 call went out at 7:15 a.m. Sunday to alert neighbors. Rawlings also said informational materials about the virus were placed on peoples' doors in the area.

Rawlings said there is a pet dog inside the apartment and that they will contact the proper authorities and "have a plan to take care of the pet."

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The car the health care worker drove to the hospital has been decontaminated and secured. Rawlings said everything the new patient touched has been decontaminated to ensure everyone's safety.

Texas Department of State Health Services said "contact tracing" has begun. Health officials interviewed the health care worker and are identifying any other contacts or potential exposures.

Texas Health Presbyterian Dallas said the health care worker was involved in Duncan's care on his second visit to the hospital. Duncan, from Liberia, was the first person diagnosed with Ebola in the U.S. He died from the virus on Oct. 8.

The hospital said the worker followed all CDC protocols in caring for Duncan, including wearing gloves, gown, mask and shield. Frieden said at a later press conference that the worker has not been able to identify a specific breach of protocol that might have led to her being infected.

Health care workers are among the original 48 people identified as having had contact with Duncan before he was admitted on Sept. 28. The original contacts have a week to go on their 21-day monitoring period and will be monitored twice daily, Jenkins said. Nineteen people are in charge of the monitoring, Jenkins said he asked for additional CDC help at midnight and workers had arrived in Dallas. None of the rest of the monitored people have shown symptoms of Ebola.

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Ebola is spread through direct contact with bodily fluids of a sick person or exposure to contaminated objects such as needles. People are not contagious before symptoms such as fever develop.  

"We knew a second case could be a reality, and we've been preparing for this possibility," said Texas health commissioner Dr. David Lakey. "We are broadening our team in Dallas and working with extreme diligence to prevent further spread."

Varga said the emergency department at Texas Health Presbyterian Dallas is on diversion, meaning ambulances will not bring new patients to the ER, but the hospital will continue to care for the patients at the hospital.

Frieden said four things are being done now -- caring for the health care worker, assessing her contacts from the moment she showed symptoms, evaluating other health care workers for exposure, and investigating how it happened to make sure it doesn't happen in the future.

The Dallas Independent School District confirmed the health care worker has no children attending DISD schools, so the district is not affected.

A community prayer vigil has been set for 6 p.m. Monday at Munger Place Church, located at 5200 Bryan Street in Dallas.

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