Ebola study says a dozen more were hospitalized during Dallas outbreak than was revealed

Ebola Virus

Ebola Virus

More people than the public knew were hospitalized for possible Ebola exposure during Dallas’ outbreak, a new study says.

Last fall, only two people were known to be hospitalized here after potentially contracting the often-fatal disease from a Liberian traveler. They were the nurses who tested positive.

At the time, it was not revealed that an additional dozen people, nine of them health care workers, came down with Ebola-like symptoms while being monitored for possible exposure. The report said they developed fevers, headaches, abdominal pain, nausea, vomiting or diarrhea.

Without fanfare, the patients were hospitalized for one to five days and released after testing negative for Ebola. Their average stay was 2.5 days.

Some patients might not have reported their symptoms if they thought the media would find out and stigmatize their families, said Dr. Wendy Chung, chief epidemiologist at Dallas County Health and Human Services and the study’s lead investigator.

“Our patients appreciated the sensitivity to their privacy,” she said. “It would be detrimental to society if fear prevented exposed persons from reporting developing illness.”

The study analyzed the massive effort that identified 179 local people who had contact with the disease and, therefore, needed to be monitored daily for symptoms.

Dallas County Judge Clay Jenkins, who served as spokesman during the Ebola response effort, said not all those hospitalized were considered likely to develop Ebola.

“We had maybe three we were on pins and needles about,” he recalled. “The rest were the result of following the protocols that needed to be followed.”

The facts surrounding Dallas’ Ebola outbreak are well-known: Thomas Eric Duncan was diagnosed with the disease on Sept. 30 after traveling to Dallas from Liberia, where the disease was spreading. Two of his nurses became infected while they cared for him at Texas Health Presbyterian Hospital Dallas.

Duncan died Oct. 8. The nurses, Nina Pham and Amber Vinson, were treated at specialty hospitals outside Dallas. Both survived.

The study, released Tuesday in the prestigious Annals of Internal Medicine, described a complicated monitoring effort after Duncan’s Ebola diagnosis, the nation’s first. Each person exposed to him or either of the nurses when they were infectious had to be monitored for 21 days, Ebola’s incubation period. Most stayed at home.

The contact-tracing effort was of a scale and intensity that “were unprecedented in the United States for any acute communicable disease,” the study concluded. Patients had their temperatures taken daily while being monitored for other symptoms.

“This is different from other situations, such as MERS, measles, mumps, where contacts are typically asked to self-monitor for symptoms,” Chung said.

The monitoring effort was made public during the outbreak, but the additional hospitalizations were not.

Chung and her colleagues wrote an earlier report on the Ebola surveillance effort, which described how the government, various local agencies and nonprofit groups scrambled to provide for the basic needs of people placed in isolation. That report, published in December by the Centers for Disease Control and Prevention, listed the housing, transportation, food and clothing needs of those stuck at home.

The new study analyzed the type of contact each person had with the three Ebola patients. Health care workers were considered “high risk” if they had skin-to-skin contact with an Ebola patient as well as exposure to blood or bodily fluids.

Household contact with an Ebola patient posed “some risk,” as did being within 3 feet of an Ebola patient in a hospital room for longer than 15 minutes while not wearing protective gear.

“Least risk” was defined as contact with equipment or lab specimens from an Ebola patient’s room, but outside contaminated areas.

“Community exposure” included those who had shared a bed, residence or “brief hug” with any of the three Ebola patients. It also included their primary caregivers or anyone who had cleaned a bathroom used by an Ebola patient or washed their clothing.

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Dan Mullin is an active writer and editor for the Pluto Daily who covered the 2014 Ebola Outbreak. Mullin attended the Wake Forest School of Medicine before leaving to pursue his lifelong science goal of allowing humans to live forever via a computer/brain transfer.