We answered readers’ questions about the second Ebola patient in Dallas — a nurse at Texas Health Presbyterian Hospital — during a Twitter chat Sunday. Here are edited excerpts:
How could a nurse wearing protective equipment have contracted the virus?
There could have been a breach in protocol such that a health care worker had a tear in their gloves that they didn’t see. They may have forgotten to put on a key piece of the protective gear, such as a face mask.
CDC officials indicate that the dialysis and intubation of the first Ebola patient could have posed risks for health care workers. Why?
Dialysis is a treatment for patients whose kidneys are not working as well as they should. The dialysis machine takes over the job of the kidneys and filters the blood. Because such a large volume of blood is going through the dialysis machine, and because the blood of Ebola patients can contain a lot of the virus, this procedure can potentially put health care workers at risk of infection.
Dr. Philip Smith, medical director of the University of Nebraska Medical Center’s Biocontainment Patient Care Unit, said that with dialysis, “there’s always the opportunity for blood splatters to occur.”
Ebola patients can quickly become sick, and that means they might need help breathing. When that happens, doctors put a tube down their throat in a process called intubation.
As that tube is passed down the patient’s throat, another health care worker uses a thin, straw-like tube attached to a kind of vacuum to suction away secretions such as saliva and sputum. Both the process of inserting the tube and performing suction can generate lots of droplets. Although the blood and feces of Ebola patients contain the most virus, saliva and sputum could also contain Ebola and pose a threat to health care workers.
What are the differences between local hospitals and special treatment centers in Nebraska and Atlanta?
Biocontainment units like those at the Nebraska Medical Center and at Emory University Hospital in Atlanta were designed for the isolation and treatment of patients with the most lethal and contagious illnesses. That includes diseases that are airborne and even diseases caused by exposure to radiation. One of the key differences is that staff there receive intensive training on how to wear and take off personal protective equipment. A second difference is that the units were built with the on-site capability to safely sterilize and incinerate any medical waste generated from caring for an Ebola patient.
If the nurse’s dog was infected, could the dog infect other animals and people?
There is no evidence of dog-to-human transmission of Ebola. But there is one CDC study that shows dogs can become infected with Ebola without showing any signs of the illness. The study also found that dogs can excrete the virus. That led the researchers to believe that humans could potentially contract the virus from dogs.
What are the health care workers required to wear when they treat the Ebola patient?
The CDC guidelines for U.S. health care workers specify that they should wear a surgical gown, gloves, eye protection and a face mask when caring for patients with Ebola. They also say that in “certain conditions, (e.g., copious amounts of blood, other body fluids, vomit, or feces present in the environment),” health care workers should wear two pairs of gloves, disposable shoe covers and leg coverings.
Some other frequently asked questions about Ebola.
What are the symptoms of Ebola?
Ebola can cause fever, headache, diarrhea, vomiting, muscle aches and rash two to 21 days after infection. These symptoms closely mirror symptoms of other diseases such as malaria and typhoid, so it’s important to see your doctor if you have recently traveled to West Africa and return home with these symptoms.
When is Ebola contagious?
Only when someone is showing symptoms, which can start with vague symptoms including a fever, flu-like body aches and abdominal pain, and then vomiting and diarrhea.
How does Ebola spread?
Through close contact with a symptomatic person’s bodily fluids, such as blood, sweat, vomit, feces, urine, saliva or semen. Those fluids must have an entry point, like a cut or scrape or someone touching the nose, mouth or eyes with contaminated hands, or being splashed. That’s why health care workers wear protective gloves and other equipment.
The Associated Press contributed to this report. Dr. Seema Yasmin, a former epidemiologist with the CDC, is a physician and a professor at the University of Texas at Dallas.