Ebola patient Nina Pham, in yellow, is helped out of an ambulance at Dallas Love field for a flight to Maryland, on Oct. 16. (Michael Ainsworth/The Dallas Morning News)
One of the first 48 people who came in contact with the country’s first Ebola patient has been cleared, Dallas Mayor Mike Rawlings said Friday.
The man, who has not been identified, has shown no symptoms of the virus for 21 days and is no longer under quarantine. He came into direct contact with Thomas Eric Duncan, of Liberia, who died last week from the Ebola virus.
Rawlings said the man visited the Ivy Apartments where Duncan was staying. The man’s contact with Duncan came days before Duncan was rushed to a hospital on Sept. 28.
“This was the first contact they could trace,” Rawlings said, adding the man was in the apartment when Duncan was sick and then left.
Rawlings didn’t provide specific dates of the exposure, but Duncan arrived in Dallas on Sept. 20. He first began feeling sick on Sept. 24 and went to the emergency room of Texas Presbyterian Health Hospital late Sept. 25. After being released with antibiotics early on Sept. 26, Duncan returned to the apartment until Sept. 28.
That’s the day an ambulance returned him to the hospital. He died Oct. 8.
Duncan’s girlfriend, Louise Troh, remains under quarantine through Sunday.
Perry calls for air travel restriction
Texas Gov. Rick Perry said Friday morning that he asked President Barack Obama to consider creating a “no-fly” list for the hospital workers in Dallas who cared for the country’s first Ebola patient.
Two nurses have been diagnosed with the deadly virus after they cared for Duncan.
Officials are monitoring 75 other health care workers who may have been exposed to the Ebola virus while Duncan was being treated at the hospital. One of those people is reportedly in quarantine on a cruise ship. One of the nurses who contracted Ebola was allowed to fly from Ohio to Dallas on Monday before she was diagnosed with the virus.
“It’s indefensible that one of Mr. Duncan’s nurses was allowed to fly from Ohio to Dallas after she said she had a low-grade fever,” Perry said.
Officials with the Centers for Disease Control and Prevention told the nurse she was allowed to travel.
Perry said that though he does not have the authority to ban any of the hospital workers who cared for Duncan from traveling, he asked that the president implement a no fly list. He also called for banning travel from African countries most affected by Ebola.
“Air travel is in fact how this disease crosses borders, and it’s certainly how it got to Texas in the first place,” Perry said.
Other politicians have urged the president to restrict travel from West Africa. Seven GOP senators on the Judiciary Committee, including Texans John Cornyn and Ted Cruz, wrote the president on Friday urging him to cut off visas for travelers from Liberia, Sierra Leone and Guinea.
Nearly 6,400 such visas were issues between March 1 and Sept. 26. State Department figures show that from March 1 to Sept. 27, the United States issued 3,135 visas to Liberians, 1,472 for Sierra Leoneans, and 1,791 for Guineans.
“The Ebola epidemic is a national security issue, and a threat to global security,” they wrote, blasting Obama for “seemingly inflexible” resistance to curbing travel from the hot zone. “A travel ban must be put in place to protect our homeland and reduce any spread of the virus.”
This year, about 9,200 confirmed, suspected and probable Ebola cases have been reported, with most cases confined in Guinea, Sierra Leone and Liberai, according to the World Health Organization. Of those cases, about 4,500 people have died.
Gubernatorial candidate Wendy Davis also announced Friday her support for limiting travel from countries ravaged by the disease.
“With two Texans already infected by this terrible disease, we must do everything we can as a state and as a nation to ensure it remains contained and that families stay safe,” Davis said in a written statement. “A commonsense step that should be on the table includes a temporary travel ban for non-U.S. citizens from countries with high infection rates.”
Perry also commented Friday on how Presbyterian and CDC officials have handled the country’s first Ebola case. He said the newness of the disease in the United States likely contributed to some of the failings.
“We must admit along the way we have seen ample opportunity for improvement from the CDC all the way to the hospital,” Perry said. “It’s perhaps understandable that mistakes were made, but it’s also unacceptable.”
Since Duncan was first diagnosed with the virus, a state task force has prepared recommendations for how to improve responses to infectious diseases. Perry called for designated treatment centers with specialized staff and state-of-the-art equipment to care for Ebola patients.
Perry also emphasized the importance of paying attention to facts and not “rumor” regarding how the disease is transmitted. He said that limiting travel of those potentially exposed is reduce panic and ensure the virus is contained.
“The odds of a specific person contracting Ebola are still exceptionally remote,” he said.
Diagnosed nurses
A nurse, who cared for Duncan, is in fair condition Friday morning after she contracted Ebola.
Nina Pham, 26, was moved Thursday to the National Institutes of Health clinic in Bethesda, Md. Texas Health Presbyterian Hospital Dallas had previously listed her condition as good.
Pham and Amber Joy Vinson, 29, both contracted the Ebola virus after Duncan died Oct. 8. Both cared for Duncan before his death.
Vinson was transferred Wednesday to Emory University Hospital in Atlanta. Both hospitals have specialized isolation units.
Pham has remained stable after she was admitted to the NIH clinic late Thursday. Doctors declined to elaborate during a press conference Friday morning on why they listed Pham in fair condition but said they did a full assessment after she arrived.
But they emphasized that she is not deteriorating and they expect her to recover.
“This is a serious infection. She’s getting optimum care. It would not be appropriate to make a prediction on when she will get out. She will get out when she’s well enough and free of virus,” said Dr. Anthony Fauci, director of allergy and infectious diseases at NIH. “We fully intend to have this patient walk out of this possible and we will do everything we can to make that happen.”
Pham has remained in good spirits since she arrived at NIH.
“She’s doing quite well compared to what we were told about how she was doing by the other hospital,” said Dr. Rick Davey, deputy clinical director at NIH.
The doctors repeatedly declined Friday morning to comment on the quality of care Pham received while at Presbyterian in Dallas.
“When we were asked to accept a patient, we accepted the patient,” Fauci said.
Fauci said he is optimistic that the plasma Pham received from Dr. Kent Brantly, who recovered from the Ebola virus, will help improve her condition.
Because there is no specific treatment or cure for Ebola, doctors have to treat the individual symptoms, including vomiting, diarrhea, fever and rash. Pham has been fatigued since she has been in isolation at NIH.
“This is a virus that really wreaks havoc on you… This virus knocks you out,” Fauci said.
But despite the disease, Pham has remained in good spirits, he said.
“She’s a trooper. She’s very brave,” Fauci said.
Other health care workers monitored
State officials have asked Presbyterian workers who cared for the country’s first Ebola patient to limit their public interactions and avoid commercial travel.
Dallas leaders on Thursday declined to declare a local emergency in response to the Ebola virus. They moved to have workers sign agreements saying they will avoid public places and public transportation. The Texas Department of State Health Services sent out a letter detailing the requirements for health care workers who may have been exposed to the disease, as Dallas officials requested.
Dallas County Judge Clay Jenkins’ staff said all the Presbyterian health care workers monitored for their exposure to the Ebola virus have voluntarily signed agreements to avoid public transit and public places.
The health care workers are asked to limit their movements for 21 days after their last exposure to an Ebola patient. Presbyterian officials have said 75 health care workers possibly came into contact with the virus. They have not said how Pham or Vinson possibly contracted the disease.
After news broke that the first nurse was diagnosed with Ebola, several nursing and health care organizations have called for better access to proper personal protective gear for hospital workers.
On Friday, more than 100 specialists in anesthesia and critical care medicine sent a letter to the American Society of Anesthesiology and the American Association of Nurse Anesthetists calling for full-body hazardous materials suits to be dealing with patients with highly infectious diseases like Ebola.
Late Friday the Department of Defense approved Dallas County Health and Human Services to test locally for the Ebola virus.
2 DART employees, UT student monitored
Two Dallas Area Rapid Transit employees have been in contact with someone who was either exposed to or is carrying the Ebola virus, said DART spokesman Morgan Lyons.
One of those employees is a bus driver who was on the Frontier flight from Cleveland to Dallas carrying Vinson, one of the nurses who contracted the virus.
The other employee is not someone who has contact with customers, Lyons said. Both workers are asymptomatic.
The male bus driver went to Cleveland for a family visit. When he returned to Dallas, he went back to work. Lyons said DART is not disclosing the driver’s route, but “we will attempt to contact customers who were on the bus during his shift.”
“When he finished a shift, he got a call from a family members telling him he had been on a plane with Amber Vinson and suggested he call the CDC’s 1-800 number, He did,” Lyons said.
The driver then told his station supervisor what happened, and the driver was told to go home and see his doctor. The bus he was operating was immediately removed from service for cleaning.
“We remain in contact with local, state and federal healthcare and emergency management officials for updated advice. If needed, we will adjust our actions to make sure we’re keeping you and our customers safe,” DART officials said in a written statement released Friday. “We join local, state and federal officials in urging customers to remember their risk of exposure is low and to remain calm.”
University of Texas at Austin officials sent out a notice Friday afternoon to students that a student at the school was on the same Frontier flight as Vinson. The student was not seated near Vinson during the flight from Ohio to Dallas and remains in daily contact with CDC officials.
The student has opted to stay home for observation. Officials said there is likely no health risk to the campus.
“As president and as the parent of a current UT student, I want you to know that the safety of our students, faculty, and staff always comes first. We are working with city, state, and federal officials to monitor the situation and follow best practices,” said UT president Bill Powers in a written statement.
Possible Ebola patient at Baylor
A Baylor University Medical Center at Dallas spokesman said Friday that a patient called ahead and alerted the hospital that she might potentially have Ebola. The patient drove her own car, which is now in quarantine, “out of an abundance of caution,” the spokesman said.
The spokesman said the patient “screened positive” for the virus. That means the person had some symptoms such as a fever and likely either had contact with someone who has Ebola or they have visited West Africa recently.
But, blood tests have not confirmed whether the patient has Ebola. Later Friday a Presbyterian hospital spokesperson said the patient was determined to be low risk and wanted to leave the hospital.
According to Presbyterian, the CDC and the state health department were advised and did not feet it was necessary to have the woman detained.
The patient went into the hospital through a private entrance Thursday and was immediately put in an isolation room, the spokesman said.
Health care workers monitored the patient until the she was later transferred late Thursday to Presbyterian. Though the patient said she was on the Centers for Disease Control and Prevention watch list, when hospital officials called the CDC, the woman was not on the watch list.
The spokesman said, generally, there have been other patients who have screened positive without testing positive.
Hospital owner credit outlook lowered
Also on Friday, Moody’s Investor Service changed the outlook on Texas Health Resources’ debt rating from positive to developing in response to the Ebola crisis at Presbyterian.
“A longer-term disruption in financial performance or significant financial stress, including a permanent reduction in volumes, damage to the brand, or liabilities in excess of insurance may result in negative rating pressure,” a written report released Friday said. “This event is also a material distraction for management and will consume resources that would otherwise be devoted to growing the enterprise. Moody’s analysis will examine patient volume and census trends, malpractice and other insurance levels and updated liquidity information.”
Staff writers James Ragland, Tristan Hallman, Ryan Rusak, Christy Hoppe, Todd Gillman, Robert Wilonsky and Holly Hacker contributed to this report.
Letter to People With Possible Ebola Exposure