Patient is Positive for Ebola in Dallas; Not a US Citizen

Update* CDC says patient wasn’t contagious on plane and they WON’T release flight information**

The Centers for Disease Control and Prevention has confirmed the first case of Ebola in a critically ill patient diagnosed in a U.S. hospital, officials announced Tuesday.

The patient — who has been isolated since his symptoms were recognized — is an unnamed man in intensive care at Texas Health Presbyterian Hospital in Dallas.

Hospital workers noted his case because of his symptoms and recent travel history. It is not known if he has infected others, although CDC officials say his contacts are being traced.

The man left Liberia Sept. 19 and arrived in the USA the next day, but had no symptoms when leaving Africa or arriving here, said Thomas Frieden, CDC director. The patient became sick Sept. 24 and he sought care two days later. He was admitted to the hospital Sept. 28. Frieden did not reveal the man’s nationality, but said he came to the USA to visit relatives.

Frieden said there is no danger of the sort of widespread outbreak seen in West Africa.

“I have no doubt that we will control this case of Ebola, so that it does not spread widely in this country,” Frieden said Tuesday. “It is certainly possible that someone who has contact with this patient could develop Ebola. But there is no doubt in my mind that we will stop it here.”

Ebola patients are only contagious once they begin showing symptoms, such as fever, diarrhea and vomiting, Frieden said.

Someone with these symptoms could infect healthcare workers, such as working in an emergency room. However, the virus is only spread through contact with bodily fluids, such as blood or vomit, says Brett Giroir, CEO at Texas A&M Health Science Center, an intensive care specialist.

Ebola does not spread through the air, like measles or the flu, said David Lakey, commissioner of the Texas Department of State Health Services.

Because the man was not sick while on the plane or in the airport, Frieden said he’s not worried that others on his flight will become sick. He said that health officials are following only a “handful” of contacts, including a few family members and friends. “I have no doubt that we will stop this in its tracks,” Frieden said. But as long as the epidemic is spreading out of control in West Africa, “we have to be on our guard.”

Infectious disease experts agreed with Frieden that Ebola is unlikely to spread very far in the USA, however, because of stringent infection control measures in place at American hospitals.

“There is no cause for concern,” says Peter Hotez, dean of the National School of Tropical Medicine and professor at Baylor College of Medicine in Houston. “The Ebola virus is not easily transmitted from person to person, and we have an outstanding infrastructure in place both to contain the virus and trace contacts. There will not be an Ebola epidemic in the United States.”

Giroir noted that other Ebola patients who have been airlifted from West Africa to American hospitals have done well, at least partly because of the good intensive care provided.

“We need to take this extremely serious and with extraordinary care, but Ebola be able to be controlled with appropriate isolation and public health measures, Giroir says. The Dallas hospital is “an extraorindarily fine hospital with very capable physicians and staff.”

Standard public health measures for Ebola include asking patients when they first fell ill and for the names of everyone with whom they’ve been in contact since then. Officials then contact all of those people and monitor anyone at risk for 21 days, to see if they develop symptoms of Ebola, Frieden said.

Patients who aren’t sick by that point aren’t considered at risk for Ebola. Patients who develop fevers are isolated immediately and given treatment, Frieden said.

Those time-consuming but low-tech methods were used to contain the Ebola outbreak in Nigeria. The CDC reported today that the Ebola outbreak in Nigeria appears to be over, with 20 confirmed or probable cases and eight deaths. An Ebola outbreak in Senegal also has been successfully confined to one patient, who traveled to that country from Guinea, but who didn’t infect anyone else in Senegal.

Ebola has infected 6,553 people and has killed 3,083 in the three countries hit hardest by the epidemic — Guinea, Sierra Leone and Liberia — the World Health Organization says. The number of cases has been doubling every three weeks, and the CDC estimates that the disease could affect up to 1.4 million people by January if it’s not quickly put under control.

Three Americans have survived Ebola after getting intensive care in specialized biocontainment units in the USA.

Physician Kent Brantly and missionary Nancy Writebol were treated and released from Emory University Hospital, while physician Richard Sacra was treated and discharged from Nebraska Medical Center in Omaha. Writebol and Sacra were serving in Monrovia, Liberia with missionary group SIM USA, while Brantly worked with missionary group Samaritan’s Purse.

All three received experimental therapies, because there are no approved vaccines or treatments for Ebola.

Brantly and Writebol got the experimental drug ZMapp, which contains man-made antibodies against Ebola. Supplies of that drug — which was early in the development process when the Ebola epidemic broke out — are now exhausted.

Sacra received a drug called TKM-Ebola, which blocks the virus’ ability to replicate. In addition, Brantly received a blood donation from an Ebola survivor while he was in Liberia. Brantly then donated blood to Sacra.

Doctors say they don’t know whether any of these experimental treatments were responsible for curing patients, or if the Americans survived because of excellent “supportive care” to prevent dehydration and other dangerous complications.

About 70% of Ebola patients in this outbreak have died, according to the World Health Organization.

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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.