One of the posters over on the PANDEMIC FLU INFORMATION FORUM summarized the CDC news conference.
See below:
Ebola is a serious disease. It is only spread by direct contact with someone who is sick with the virus.
An individual traveling
19th Sept. Arrived 20th. Had no symptoms when departing Liberia or while arriving. 4-5 days later around the 24th developed symptoms. On the 26th initially sought care. On Sunday the 28th was admitted to a hospital in TX and placed in isolation.
Tested positive for Ebola. State of TX found same results. PCR test.
Next steps:
1. To care for the patient. The most effective care possible as safely as possible.
2. We identify all people who may have had contact with the patient while he could have been infectious. It does not spread from someone who doesn’t have fever and other symptoms.
Once those contacts are all identified they are all monitored for 21 days to see if they develop fever.
Bottom line here is that I have no doubt that we will control this importation, this case, of Ebola so that it does not spread widely in this country. It is certainly possible that someone who had contact with this individual, a family member or other individual, could develop Ebola in the coming weeks. But there is no doubt in my mind that we will stop it here.
We currently do not know how this individual became infected. They undoubtedly had close contact with someone who was sick with Ebola or who had died from it.
[The patient has not revealed where, how, from who, they believe they became infected??]
In West Africa we are surging the response.
Dr. Lakey, TX State Health Svcs.:
Our lab in Austin has a specially trained team to handle specimens like this. At 9:00 this morning we received the sample. PCR was definitely positive for Ebola Zaire. We got the result back at 1:22 this afternoon.
I want to reiterate that we have no other suspect cases in the state of TX at this time but we are closely monitoring the situation and we are ready to assist in any way that is needed.
Dr. Edward Goodman, the hospital epidemiologist, Presby. Hospital, Dallas:
Want to correct one statement. Ebola is not transmitted by the air. It is not an airborne infection. We are a large community hospital with a robust infection control system.
We have had a plan in place for some time now in the event of a patient presenting with Ebola. Ironic enough, in the week before we had a meeting of all the stakeholders that might be involved in the care of such a patient. We are well prepared to deal with such a crisis.
Zachary Thompson, Dallas County H&HS Director:
Dallas County H&HS will proceed with the followup according to CDC guidelines. Will continue to work hard to protect the health and welfare of our citizens.
Questions:
Frieden: CDC has a group of epidemiologist en route. Contact tracing.
Fox5: He started showing symptoms, went to a hospital, was released & sent home.
Frieden: The initial symptoms of Ebola are non-specific.
Dr. Goodman: Nothing more to say.
Question: Was this person involved in fighting the Ebola epidemic? Did they travel on a commercial aircraft?
Frieden: From the information that we have now, it does not appear the individual was involved in the response to Ebola. That’s something we will investigate more.
In terms of the airline flight I really do want to emphasize the focus here over the next period needs to be the patient. We want to give any assistance we can to the patient who we understand is critically ill at this point. And then identifying contacts in the community: family members, or others, any possible contacts through the healthcare setting, and then tracking those contacts. In terms of the flight, I understand that people are curious about that and wonder about it but Ebola doesn’t spread before someone gets sick. He didn’t get sick until four days after he got off the airplane. {Assuming he was honest about that self-reported timeline...} We do not believe that there was any risk to anyone who was on the flight at that time. He left on the 19th and arrived on the 20th.
WABE: How likely is this to continue to be a concern - people who aren’t showing symptoms then but do later?
Frieden: As long as there continue to be cases in West Africa the reality is that patients travel, individuals travel and that appears to have happened in this case. Individuals may travel before they have any symptoms.
ABC: Can you tell us where he was and do you know why he was in those countries?
Frieden: Patient confidentiality.
NBC News: Will patient remain in TX or be transferred to Emory, etc.?
Frieden: One of the things we really want to emphasize is that any hospital that can do isolation can do isolation for Ebola.
Mirian Falco: Can you tell us more about how sick the patient is…how many contacts you are trying to reach?
Frieden: Dr. Goodman, info you can share?
Goodman: Patient privacy - we are unable to share any information about the patient or his symptoms at this time.
He is ill. He is under intensive care. He is being seen by highly trained experts. The health dept. is helping us track any family members who might have been exposed.
[Note they keep emphasizing the tracking of “family members” only.]
Betsy McKay: What was this individual doing, just staying at home? Only family members potentially exposed? Are we talking about a handful who have been exposed?
Frieden: A handful, along with two or three other community members. Our approach is to cast the net widely.
This is a tried and true protocol. This is what we do at CDC globally for Ebola cases.
Nigeria case investigation. That individual was not cared for with infection control. Even with 19 secondary cases they appear to have been able to stop the outbreak.
As long as the outbreak continues in Africa we need to be on our guard.
Lauren Neergard: An American or a visitor? Has health dept reached contacts; has contact tracing begun?
Frieden: The individual was here to visit family who live in this country. The further details are to be identified in the coming days. We are just beginning contact tracing today.
Maggie Fox: You have been clear that people don’t spread this virus unless they are showing symptoms. What steps are you taking to reassure people who might have flown on plane, etc.
Frieden: People can call CDC with questions. Small number with that concern about flight.
[Soooo minimizing the flight aspect…]
This is the stuff of CDC nightmares.
By Kelly Gilblom and Robert Langreth Sep 30, 2014 7:48 PM ET
http://www.bloomberg.com/news/2014-09-30/first-ebola-case-is-diagnosed-in-the-u-s-cdc-reports.html
[snip]
After the patient sought medical care on Sept. 26 and was sent home with antibiotics, he returned in an ambulance to Texas Health Presbyterian two days later and was admitted, said Edward Goodman, an epidemiologist at the hospital. The ambulance workers and other health-care professionals who treated him are being monitored for symptoms, Goodman said.
The CDC and Texas doctors are discussing the use of possible experimental treatments, Frieden said, though no decision has been made.
Obama Briefed
President Barack Obama was briefed today about the patient by Frieden, the White House said in a statement. They discussed the patient’s treatment and what was being done to trace the people the man might have contacted.
U.S. authorities didn’t disclose what flights or airlines the patient took from Liberia. No airlines serve Africa from Dallas/Fort Worth International Airport, the main domestic and foreign gateway to North Texas, and none of the major U.S. carriers with overseas networks — American Airlines Group Inc., United Continental Holdings Inc. and Delta Air Lines Inc. — flies to Liberia. Delta dropped operations last month in Monrovia, the country’s capital.
That left open the possibility the traveler arrived in the U.S. from somewhere else in Africa or via a connection in Europe, and may have stopped elsewhere on a domestic flight before reaching Dallas.
[snip]
Why the big rush? /sarcasm
Oct 26. Zero goes (how?) To hospital, given antibiotics, sent home.
Oct 28. Zero picked up (where?) By EMT
Oct 30. Zero in Intensive care EVD lab verified
Total published history 4 days. From mild flu? Diagnosis ti IC with clear EVD symptoms
What’s wrong with this picture? The apparent speed of EVD as described IMO makes me suspect that Zero’s symptomss are very like Patrick Sawyers’, who managed to get around for a good while undetected and unsuspected. I suspect Zero was symptomatic before he left Africa.
Zero completed the trip Sawyer attempted. Got to be one hell of a contact chain with branches who knows where. TSA/HS should be scouring flight manifests for connecting flights as well as having USA entry info.
The CDC is lying about the small number of contacts...or equivocating if travel was direct by private jet from Europe.
“Next steps:
...
2. We identify all people who may have had contact with the patient while he could have been infectious. It does not spread from someone who doesn’t have fever and other symptoms.
Once those contacts are all identified they are all monitored for 21 days to see if they develop fever.”
Isn’t it possible that by the time those contacts are identified, and if they at that time have symptoms, they themselves could have infected many others? One way, simply by touching a surface and then others touching that same surface?