Monday, October 13, 2014

Wikipedia:2014 United States Ebola virus outbreak

2014 United States Ebola virus outbreak

2014 United States Ebola virus outbreak

From Wikipedia, the free encyclopedia
Cases in the United States
USA-Ebola-outbreak-2014.svg
Map showing location of Ebola patients diagnosed in the U.S. (in red). Does not include people evacuated to the U.S. after contracting Ebola in Africa. Updated: October 6, 2014
Deaths 1
Cases first diagnosed in U.S. 2
Cases evacuated to U.S. from other countries 5[1]
Suspected cases in medical isolation 1[2]
Quarantined people 4[3]
Under observation 10 (via primary contact)[note 1][5]
40 (via secondary contact)[note 2][5]
On September 30, 2014, the first case of Ebola virus disease diagnosed in the United States was confirmed in a 42-year-old Liberian national, Thomas Eric Duncan, who died on October 8.[6][7][8]
Duncan, who had been visiting family in Dallas, Texas, was treated at Texas Health Presbyterian Hospital.[9][10] By October 4, his condition had deteriorated from "serious but stable" to "critical".[11] On October 4, Duncan started receiving the experimental drug brincidofovir, but remained in critical condition.[12][13] On October 8, Duncan died of Ebola virus disease.[14]
A second case was diagnosed on October 11 in a nurse who had provided care to Duncan at the hospital.[15]

History

Articles related to the
Ebola virus epidemic in
West Africa
Ebola virus virion.jpg
Background articles
Overview
Affected nations
Related
Democratic Republic of the Congo outbreak

West Africa

For more details on this topic, see Ebola virus epidemic in West Africa.
Researchers believe that the 2014 Ebola virus epidemic began on December 2, 2013, when a 2-year-old boy in the village of Meliandou, Guéckédou, in Guinea, a country in West Africa, fell ill and died four days later. His sister fell ill next, followed by his mother and grandmother. No cases of Ebola had ever been reported in West Africa and the early cases were diagnosed as diseases more common to the area.[16][17] The first cases in Liberia were reported in late March,[18][19] and by June the first cases in Liberia's capital Monrovia were reported.[20][21][22] The virus then spread to Sierra Leone when 14 mourners at a traditional healer's funeral became infected. It is believed the healer had been to Guinea, possibly to treat the family of the index case. The first case in Freetown, Sierra Leone's capital, was reported in late July.[23][24][25][26] An outbreak was also reported in Nigeria in late July,[27][28] however containment efforts were effective and by late September no further transmission was reported.[29] A single case was reported in Senegal in August; both Nigeria and Senegal will be declared free of Ebola disease following a 42 day waiting period as required by the WHO.[30][31]

First case

On September 15, 2014, the family of Ebola virus disease patient Marhalene Williams were unable to summon an ambulance to transfer Williams to the hospital. Their tenant, Thomas Eric Duncan, helped to transfer Williams by taxi to an Ebola Treatment Ward in Monrovia, Liberia. Duncan rode in the taxi to the treatment ward with Williams, her father, and her brother. The family was turned away due to lack of space and Duncan helped carry Williams from the taxi back into her home, where she died shortly afterwards.[32]
On September 19, 2014, Duncan went to the airport in Monrovia, where according to Liberian officials Duncan lied about his history of contact with the disease on an airport questionnaire before boarding a Brussels Airlines flight to Brussels.[33] In Brussels, Duncan then transferred to a United Airlines trans-Atlantic flight to Washington Dulles and arrived in Dallas, Texas, on September 20.
Duncan began experiencing symptoms on September 24, 2014, and went to the Texas Health Presbyterian Hospital emergency room late in the evening of September 25, 2014. During this visit, his reported symptoms were a 100.1 °F (37.8 °C) fever, abdominal pain for two days, a headache, and decreased urination. He did not report that he had vomiting, diarrhea, or nausea at that time.[34] The ER nurse asked about his travel history and recorded that he had come from Liberia, but according to hospital staff Duncan denied having been around anyone who was sick.[35] [36] Duncan was diagnosed with a "low-grade, common viral disease" and was sent home with a prescription for antibiotics.[37]
Duncan began vomiting on September 28, 2014, and was transported the same day to the same emergency room by ambulance.[38][39] His Ebola diagnosis was confirmed during a CDC news conference on September 30, 2014.[40][41] Duncan’s condition deteriorated over the following days, and on October 4, 2014, while in critical condition, Duncan began receiving the drug brincidofovir, which only received a FDA emergency investigational new drug authorization for Ebola treatment on October 6.[42][43] Duncan was not given the experimental drug ZMapp, which had been used to treat previous cases of Ebola in aid workers and medical staff, because stocks of the drug were depleted at the time of his infection.[44] Duncan failed to recover, and on October 8, 2014, Duncan became the first patient to die within the United States of Ebola virus disease.[45][14]
Up to 80–100 people may have had contact with people who had contact with Duncan after he showed symptoms. Health officials monitored 50 low-risk contacts and 10 high-risk contacts; the 10 high-risk contacts are Duncan's close family members and three ambulance workers who took him to the hospital.[46] Everyone who came into contact with Duncan is being monitored daily to watch for symptoms of the virus.[47]

Second case

On the night of October 10, 2014, a nurse at Texas Health Presbyterian Hospital who had treated Duncan reported a low-grade fever and was placed in isolation. On October 11, the nurse tested positive for Ebola virus.[15][48][49] On October 12, the CDC confirmed the positive test results.[15] Hospital officials said the nurse wore the recommended protective gear when treating Duncan on his second visit to this Dallas hospital, and she had "extensive contact" with him on "multiple occasions". The nurse was in stable condition as of October 12.[15][48][50] Tom Frieden, director of the Centers for Disease Control and Prevention, said that the infection was caused by an unknown breach of protocol.[51][52]

Reaction

"First and foremost, I want the American people to know that our experts, here at the CDC and across our government, agree that the chances of an Ebola outbreak here in the United States are extremely low."
US President Barack Obama, Remarks by the President on the Ebola Outbreak, September 16, 2014.[53]
Liberian authorities said they could prosecute Duncan if he returned because he had filled out a form before flying falsely stating he had not come into contact with an Ebola case.[54] Liberian President Ellen Johnson Sirleaf told the Canadian Broadcasting Corporation she was angry with Duncan for what he had done, especially given how much the United States was doing to help tackle the crisis:
"One of our compatriots didn't take due care, and so, he's gone there and in a way put some Americans in a state of fear, and put them at some risk, and so I feel very saddened by that and very angry with him.…The fact that he knew (he might be a carrier) and he left the country is unpardonable, quite frankly."[55]
The United States federal government told American citizens not to worry about an epidemic of Ebola in the United States, stating that the risk of such an epidemic was very low.[56] On Twitter on September 30, over 50,000 tweets in response to the Ebola case were posted in one hour.[57]
Following Duncan's death, President Obama said the government would develop expanded screening of airline passengers for Ebola, but there would be no travel ban.[58]

Airport screening procedures

The process of screening airplane passengers for fever, as well as the issuance of Ebola questionnaires, is to be implemented at five U.S. airports, which take more than 94% of the passengers from Guinea, Liberia, and Sierra Leone, the three countries that are hit heavily with Ebola. These airports are John F. Kennedy International Airport in Queens, New York; Newark Liberty International Airport in Newark, New Jersey; O'Hare International Airport in Chicago, Illinois; Washington Dulles International Airport in Dulles, Virginia; and Hartsfield–Jackson Atlanta International Airport in Atlanta, Georgia.[59][60][61]
The lackadaisical, and sometimes even complete lack of, screening at other airports in the U.S. for Ebola patients was criticized on October 12 by Dr. Aileen Marty, a doctor for the World Health Organization who had spent the 31 days prior in Nigeria.[62]

Medical evacuations to the U.S.

Map showing countries affected with Ebola
Map, showing countries and U.S. states affected with Ebola in color. Nebraska and Georgia are in blue, and Texas is in orange/lighter red.
As of October 6, 2014, five Americans have been evacuated to the U.S. for treatment after contracting Ebola in West Africa.[63] Kent Brantly, a physician and medical director in Liberia for the aid group Samaritan's Purse, and co-worker Nancy Writebol were infected while working in Monrovia.[64][65][66] Both were flown to the United States at the beginning of August for further treatment in Atlanta's Emory University Hospital.[67] On August 21, Brantly and Writebol recovered and were discharged.[68]
On September 4, a Massachusetts physician, Rick Sacra, was airlifted from Liberia to be treated in Omaha, Nebraska at the Nebraska Medical Center. Working for Serving In Mission (SIM), he is the third U.S. missionary to contract EVD.[69] He believes he probably contracted Ebola while performing a caesarean section on a patient who had not been diagnosed with the disease. While in hospital, Sacra received a blood transfusion from Kent Brantly, who had recently recovered from the disease. On September 25, Sacra was declared Ebola-free and released from the hospital.[70]
On September 9, the fourth U.S. citizen who contracted the Ebola virus arrived at Emory University Hospital in Atlanta for treatment. The identity of the patient, a doctor working for the WHO in Sierra Leone, was not released.[71] He was scheduled to receive a blood or serum transfusion from a British man who had recently recovered from the disease.[72] In addition, on September 21, a CDC employee was flown back to the United States after low risk exposure with a healthcare worker. Currently he shows no symptoms and is being monitored. The CDC announced he poses no risks to his family or the United States.[73] On September 28, a fourth American doctor was admitted to National Institutes of Health hospital.[74]
On October 2, NBC News photojournalist Ashoka Mukpo, covering the outbreak in Liberia, tested positive for Ebola after showing symptoms.[75] Four other members of the NBC team, including Dr. Nancy Snyderman, were being closely monitored for symptoms.[76] Mukpo was evacuated on October 6 to the University of Nebraska Medical Center for treatment in their isolation unit.[63]
Another doctor was evacuated from Sierra Leone after suffering a needle prick injury while treating Ebola patients and developing a fever. He was treated at the National Institutes of Health Clinical Center where he was found not to have Ebola and was released.[77]

Biocontainment units

There are four specialized biocontainment units in the United States: the University of Nebraska Medical Center in Omaha, Nebraska, where Mukpo and Sacra were treated; the U.S. Army Medical Research Institute of Infectious Diseases at Fort Detrick, Maryland; St. Patrick Hospital and Health Sciences Center of Missoula, Montana;[78] and Emory University Hospital in Atlanta, Georgia, where Brantley, Writebol and the unnamed patient had gone after contracting Ebola.[75]

See also

Notes

  1. These people may have had direct contact with Duncan after he started showing symptoms. Includes one homeless man found on October 5, 2014.[4]
  2. These people may have had contact with people who may have had direct contact with Duncan.

References

  1. "Who are the American Ebola patients?", CNN, October 6, 2014
  2. "Ebola ruled out for 2 patients in isolation at D.C.-area hospitals; 1 has malaria", ABC News, October 4, 2014
  3. "Dallas Ebola Family Joins Long History of Quarantines", NBC News, October 4, 2014
  4. "Found: Homeless Man Sought in Ebola Case Being Monitored". NBC News. October 5, 2014. Retrieved October 5, 2014.
  5. "CDC chief warns against restricting entry to the US over Ebola crisis", Fox News, October 4, 2014.
  6. CDC confirms first ever Ebola case in United States, cdc.gov; accessed October 9, 2014.
  7. Thomas Eric Duncan profile, nytimes.com; accessed October 9, 2014.
  8. (French) Ebola: le premier patient à avoir été diagnostiqué hors d’Afrique est mort, Antoine Boyet, Ijsberg Magazine, 8 octobre 2014
  9. http://www.nytimes.com/2014/10/02/us/after-ebola-case-in-dallas-health-officials-seek-those-who-had-contact-with-patient.html?_r=0
  10. "Thomas Eric Duncan: From healthy to Ebola". WYFF4. Retrieved October 3, 2014.
  11. "First US Ebola case Thomas Duncan 'critical'". BBC News. October 4, 2014. Retrieved October 4, 2014.
  12. "Dallas Ebola Patient Receives Experimental Drug". The Huffington Post. October 6, 2014. Retrieved October 7, 2014.
  13. "Chimerix Announces Emergency Investigational New Drug Applications for Brincidofovir Authorized by FDA for Patients With Ebola Virus Disease". Retrieved October 7, 2014.
  14. "Texas Ebola patient dies". CNN. October 8, 2014. Retrieved October 8, 2014.
  15. Fernandez, Manny (October 12, 2014). "Texas Health Worker Tests Positive for Ebola". New York Times. Retrieved October 12, 2014.
  16. Baize, Sylvain; Pannetier, Delphine; Oestereich, Lisa; Rieger, Toni (April 16, 2014). "Emergence of Zaire Ebola Virus Disease in Guinea — Preliminary Report". New England Journal of Medicine. doi:10.1056/NEJMoa1404505.
  17. John Vidal. "Ebola: research team says migrating fruit bats responsible for outbreak". the Guardian. Retrieved September 30, 2014.
  18. "2 of 5 Test Positive for Ebola in Liberia". Liberian Observer. March 31, 2014. Retrieved July 6, 2014.
  19. "Ebola Virus Disease Epidemic in Liberia: Situation Report 11" (PDF). LR: Ministry of Health and Social Welfare. April 13, 2014. Retrieved July 6, 2014.
  20. "Seven die in Monrovia Ebola outbreak". BBC News. June 17, 2014. Retrieved July 28, 2014.
  21. "Ebola Haemorrhagic Fever, West Africa (Situation)". WHO. April 16, 2014. Retrieved April 16, 2014.
  22. "Ebola Haemorrhagic Fever, West Africa (Situation)". WHO. April 27, 2014. Retrieved April 27, 2014.
  23. "Sierra Leone hunts Ebola patient kidnapped in Freetown". BBC News. July 25, 2014. Retrieved July 27, 2014.
  24. "Ebola outbreak: Sierra Leone escaped patient dies". BBC News. July 27, 2014. Retrieved July 27, 2014.
  25. http://www.nytimes.com/2014/08/29/health/ebola-outbreak-in-sierra-leone-is-tied-to-one-funeral.html?_r=0
  26. "WHO - Sierra Leone: a traditional healer and a funeral". Retrieved September 30, 2014.
  27. "Ebola virus disease, West Africa". WHO. July 25, 2014. Retrieved July 27, 2014.
  28. Wesee, Ben P. (August 4, 2014). "I'm ok - Nigerian Ambassador Assures Public". The New Dawn, Monrovia. Retrieved August 7, 2014.
  29. "Nigeria's Optimism Amid Ebola's Threat". September 24, 2014. Retrieved September 25, 2014.
  30. "Worst-ever Ebola outbreak, by the numbers". CBC News. Retrieved September 16, 2014.
  31. "Ebola Response Roadmap Update, September 22, 2014". WHO. September 22, 2014. Retrieved September 22, 2014.
  32. Thomas Eric Duncan timeline, nytimes.com; accessed October 8, 2014.
  33. "Ebola Patient in Dallas Lied on Screening Form, Liberian Airport Official Says", New York Times, October 2, 2014
  34. "Texas Hospital Makes Changes After Ebola Patient Turned Away". NBC News. Retrieved October 10, 2014.
  35. "Scarier Than Ebola: Human Error". BusinessWeek. Retrieved October 3, 2014.
  36. "Liberia, U.S. Hospital Both Say Ebola Patient Lied About Exposure". NPR.org. October 2, 2014. Retrieved October 4, 2014.
  37. "Texas Ebola patient told hospital of travel from West Africa but was released". Washington Post. Retrieved October 3, 2014.
  38. "Electronic-Record Gap Allowed Ebola Patient to Leave Hospital". Bloomberg. Retrieved October 3, 2014.
  39. "Dallas hospital says Ebola patient denied being around sick people". Los Angeles Times. Retrieved October 3, 2014.
  40. "Ebola in the US - Ebola in Dallas - 2014 Ebola Outbreak". 2014 Ebola Outbreak. Retrieved October 3, 2014.
  41. Maggie Fox. "How Did The Ebola Patient Escape for Two Days?". NBC News. Retrieved October 3, 2014.
  42. "Dallas Ebola Patient Receives Experimental Drug". The Huffington Post. October 6, 2014. Retrieved October 7, 2014.
  43. "Chimerix Announces Emergency Investigational New Drug Applications for Brincidofovir Authorized by FDA for Patients With Ebola Virus Disease". Retrieved October 7, 2014.
  44. Boseley, Sarah (October 1, 2014). "First Ebola patient diagnosed in US won't be treated with ZMapp". The Guardian. Retrieved October 5, 2014.
  45. "Texas Ebola Patient Thomas Eric Duncan Has Died". ABC News. Retrieved October 8, 2014.
  46. "10 people at 'high risk' for Ebola as 50 people monitored daily after contact with Dallas Ebola patient". New York Daily News. Retrieved October 3, 2014.
  47. "Hospital: Dallas Ebola patient in critical condition". CNN. October 4, 2014. Retrieved October 5, 2014.
  48. "Ebola: Texas nurse tests positive - CNN.com". CNN. October 12, 2014. Retrieved October 12, 2014.
  49. "CDC Test Confirms Dallas Caregiver Positive for Ebola". NBC News. Retrieved October 12, 2014.
  50. Ebola: Health care worker tests positive at Texas hospital. BBC News October 12, 2014.
  51. "CDC confirms second Ebola case in Texas. Health worker wore ‘full’ protective gear.". Washington Post. Retrieved October 12, 2014.
  52. Marilynn Marchione (12 October 2014). "Key question: How did Dallas worker catch Ebola?". AP.org. Retrieved 12 October 2014. "Training has been ramped up, and the CDC now recommends the hospital minimize the number of people caring for an Ebola patient, perform only procedures essential to support the patient's care, and name a fulltime infection control supervisor while any Ebola patient is being cared for."
  53. Remarks by the President on the Ebola Outbreak. Retrieved 2014-10-12.
  54. "Liberia to Prosecute Man Who Brought Ebola to United States". NBC News. Retrieved October 3, 2014.
  55. "Liberian President criticizes Ebola patient in Dallas - CNN.com". CNN. 2 October 2014. Retrieved October 3, 2014.
  56. September 30, 2014. "White House Urges Calm After First Confirmed U.S. Ebola Case". Time (magazine). Retrieved October 3, 2014.
  57. Yan, Holly (October 1, 2014). "1st Ebola diagnosis in the United States: Should we worry?". CNN. Retrieved October 3, 2014.
  58. Roberta Rampton; Richard Valdmanis (6 October 2014). "U.S. working on new screenings for Ebola but no travel ban". Reuters. Retrieved October 7, 2014.
  59. Sabrina Tavernise; Michael D. Shear (8 October 2014). "U.S. to Begin Ebola Screenings at 5 Airports". The New York Times. Retrieved 12.October 2014. Check date values in: |accessdate= (help)
  60. Zeke J Miller; Alexandra Sifferlin (8 October 2014). "U.S. to Screen Passengers From West Africa for Ebola at 5 Airports". Time. Retrieved 12 October 2014.
  61. Karen Matthews (11. October 2014). "Stepped-up Ebola screening starts at NYC airport". AP.org. Retrieved 12.October 2014. ""Already there are 100 percent of the travelers leaving the three infected countries are being screened on exit. Sometimes multiple times temperatures are checked along that process," Dr. Martin Cetron, director of the Division of Global Migration and Quarantine for the federal Centers of Disease Control and Prevention, said at a briefing at Kennedy. ... The screening will be expanded over the next week to New Jersey's Newark Liberty, Washington Dulles, Chicago O'Hare and Hartsfield-Jackson in Atlanta." Check date values in: |date=, |accessdate= (help)
  62. "W.H.O. doctor warns of future Ebola outbreaks if drastic changes aren't made to check travelers". The Daily Mail. 12 October 2014. Retrieved 12 October 2014. Text " DailyMail on Facebook " ignored (help)
  63. "Journalist With Ebola Being Evaluated at US Hospital", Voice of America, October 6, 2014
  64. "Two Americans Stricken With Deadly Ebola Virus in Liberia". July 28, 2014. Retrieved August 2, 2014.
  65. "Ebola outbreak: U.S. missionary Nancy Writebol leaves Liberia Tuesday". August 4, 2014. Retrieved August 4, 2014.
  66. "Ebola drug likely saved American patients". CNN.com. August 8, 2014. Retrieved August 8, 2014.
  67. Steenhuysen, Julie. "Ebola patient coming to U.S. as aid workers' health worsens". MSN News. Retrieved August 1, 2014.
  68. "American Ebola doc: 'I am thrilled to be alive'". Retrieved August 21, 2014.
  69. "A Third US missionary with Ebola virus leaves Liberia". The Telegraph. September 5, 2014. Retrieved September 5, 2014.
  70. "American Doctor With Ebola Is 'Grateful' Following Release From Hospital". ABC News. September 25, 2014. Retrieved September 25, 2014.
  71. "Ebola patient arrives at Atlanta hospital". WCVB Boston. September 9, 2014. Retrieved September 10, 2014.
  72. "British Ebola survivor flies to United States for blood donation". Reuters. Retrieved September 25, 2014.
  73. "2014 Ebola Outbreak in West Africa-September 25, 2014". CDC. September 25, 2014. Retrieved September 28, 2014.
  74. Maggie Fox. "Possible Ebola Patient Arrives at U.S. NIH Lab". NBC News. Retrieved September 30, 2014.
  75. "US Journalist Believes He Got Ebola While Cleaning Infected Car", ABC News, October 6, 2014
  76. "US cameraman tests positive for Ebola". News24. Retrieved October 3, 2014.
  77. American doctor exposed to Ebola allowed home, AFP, October 7, 2014
  78. Rob Chaney. "St. Patrick Hospital 1 of 4 sites in U.S. ready for Ebola patients". Missoulian.com. Retrieved October 8, 2014.

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