DALLAS – The Ebola crisis in the U.S. took another alarming turn Wednesday with word that a second Dallas nurse caught the disease from a patient and flew across the Midwest aboard an airliner the day before she fell ill, even though government guidelines should have kept her off the plane.
Amid growing concern, President Barack Obama canceled a campaign trip to address the outbreak and vowed that his administration would respond in a “much more aggressive way” to Ebola cases in the United States.
Though it was not clear how the nurse contracted the virus, the case represented just the latest instance in which the disease that has ravaged one of the poorest corners of the earth – West Africa – also managed to find weak spots in one of the world’s most advanced medical systems.
The second nurse was identified as 29-year-old Amber Joy Vinson. Medical records provided to The Associated Press by Thomas Eric Duncan’s family showed she inserted catheters, drew blood and dealt with Duncan’s body fluids.
Duncan, who was diagnosed with Ebola after coming to the U.S. from Liberia, died Oct. 8.
Kent State University in Ohio, where three of Vinson’s relatives work, confirmed she was the latest patient.
Even though the nurse did not report having a fever until Tuesday, the day after she returned home, the director of the Centers for Disease Control and Prevention said she should not have boarded a commercial flight.
The nurse also knew before heading home that another nurse, Nina Pham, had been diagnosed with Ebola, and she had a slightly elevated temperature – 99.5 degrees, according to government officials.
While in Cleveland, she was contacted by health officials and told that her health would need to be more closely monitored for Ebola, the CDC said.
Agency spokesman David Daigle said Wednesday evening that Vinson spoke to a CDC official before she boarded a plane back to Dallas, reporting her temperature was below 100.4 degrees and that she had no symptoms. The official, a contact tracer responsible for monitoring Vinson, cleared her to fly.
From now on, CDC Director Tom Frieden said, no one else involved in Duncan’s care will be allowed to travel “other than in a controlled environment.”
He cited guidelines that permit charter flights or travel by car but no public transportation.
On its website, the CDC says all people possibly exposed to Ebola should restrict their travels – including by avoiding commercial flights – for 21 days.
Ebola patients are not considered contagious until they have symptoms.
Frieden said it was unlikely that others on the plane were at risk because the nurse was not vomiting or bleeding.
Even so, the CDC is alerting the 132 passengers who were aboard Frontier Airlines Flight 1143 from Cleveland to Dallas-Fort Worth on Monday “because of the proximity in time between the evening flight and first report of illness the following morning.” Officials are asking passengers to call the health agency so they can be monitored. The nurse flew from Dallas to Cleveland on Friday, Oct. 10.
Kent State said it was asking the workers related to Vinson to stay off campus for 21 days “out of an abundance of caution.”
Her Ebola diagnosis was confirmed Wednesday.
The CDC’s investigation suggests that health-care workers were at highest risk from Sept. 28 to Sept. 30, the three days before Duncan was diagnosed. Both nurses who contracted Ebola worked on those days and had extensive contact with him when he had vomiting and diarrhea, Frieden said.
Medical records indicate that the workers wore protective equipment, including gowns, gloves and face shields during that time. The first mention in the records that they wore hazmat suits was on Sept. 30.
In his most urgent comments on the spread of the disease, Obama also warned that in an age of frequent travel, the disease could spread globally if the world doesn’t respond to the “raging epidemic in West Africa.”
The second nurse was transferred Wednesday to a special bio-containment unit at Emory University Hospital in Atlanta, where other Ebola patients have been treated successfully.
Pham will be monitored in Dallas to determine the best place for her care, Frieden said.
The CDC has acknowledged that the government was not aggressive enough in managing Ebola and containing the virus as it spread from an infected patient to a nurse at a Dallas hospital.
The second case may help health officials determine where the infection-control breach is occurring and make practices safer for health workers everywhere.
For example, if both health workers were involved in drawing Duncan’s blood, placing an intravenous line or suctioning mucus when Duncan was on a breathing machine, that would be recognized as a particularly high-risk activity. It might also reveal which body fluids pose the greatest risk.
At the Dallas apartment complex where the second nurse lives, emergency responders in hazardous-materials suits began decontamination work before dawn Wednesday.
Police guarded the sidewalk and red tape was tied around a tree to keep people out. Notices handed out to neighbors advised of the diagnosis. Officials said she lives alone with no pets.
Ryan Fus, 24, who lives in the same building as the blocked-off apartment, said police knocked on his door before 6 a.m. to notify him and make sure he was all right.
“It’s a little shocking that it’s right near me,” he said.
Dallas city spokeswoman Sana Syed said a hazardous-materials crew cleaned common areas of the complex and that the state was sending a crew to clean the apartment.
In all, public-health officials are monitoring more than 100 people who might have been exposed to Ebola through Duncan – at least 76 of them at the hospital.
Associated Press medical writers Marilynn Marchione and Mike Stobbe and AP reporters Martha Mendoza, Maud Beelman, Matt Sedensky and Alex Sanz in Dallas also contributed to this report.
Ebola spawns fear, anxiety in U.S.
WASHINGTON — Ebola started as a faraway thing, and that was scary enough. Then it jumped to a Dallas hospital, where one man died and two nurses were infected. On Wednesday, Ebola took a different kind of leap — a psychological one — as concerns spiked nationally about how the threat of the virus might interfere with commerce, health and even daily routines.
As authorities disclosed that an infected nurse had taken a flight from Cleveland to Dallas one day before showing symptoms, Ebola moved closer to becoming the next great American panic — an anthrax or SARS for the social media age.
Across the country, workers and travelers took symbolic safety steps, wearing sanitary masks or lathering with hand sanitizer. Airline stocks fell as investors bet on a slowdown in travel due to Ebola concerns. Children living near the Washington area’s Dulles International Airport told a psychologist about their fears of contracting the disease.
Though its dangers are real and terrifying, epidemiologists and other authorities say that, for now, Ebola’s greatest mark could be on the psyche of the country where other health threats are more perilous.
President Barack Obama late Wednesday sought to quell any risk of panic, telling the American people, “The dangers of your contracting Ebola, the dangers of a serious outbreak, are extraordinarily low.”
In Montgomery County, Maryland, meanwhile, health officials have been reminding the public that there were 36,000 deaths in the country during flu season last year.
“I urge individuals to try to keep this in perspective. It (Ebola) is scary, it is worrisome, but in our country, more people will die from the flu than from Ebola,” said Montgomery Health Officer Ulder Tillman earlier this week.
Still, all over the country, Americans expressed deep anxiety about the threat of Ebola. According to a new Washington Post-ABC News poll, two-thirds of Americans are now worried about an Ebola epidemic in the United States, and more than 4 in 10 are “very” or “somewhat worried” that they or a close family member might catch the virus.
Michael Luke-Anthony, who cleans the cabins of airplanes at John F. Kennedy International Airport in New York, said he watches Ebola news daily when he wakes up and has taken to taping his pant and shirt sleeves — a way to prevent skin exposure.
“My fear is, the whole Ebola situation, it can get anywhere,” Luke-Anthony, 22, said. “It got from Liberia to Texas. It’s traveling quick. It could be in one of those planes.”
Last week, 200 airline cabin cleaners refused to report for work at LaGuardia Airport in New York, saying they did not have sufficient protection.
Michael Oberschneider, founder and director of Ashburn Psychological and Psychiatric Services, in Ashburn, Virginia, said that some of his child and teen patients have said they are fearful of visiting Texas or going to Dulles Airport, both of which they view as potential danger spots.
“Many of these kids are bringing up Ebola at the start of the session,” Oberschneider said. “And I’ll ask them, did you talk about it at school? They say, ‘No, no, no. I just saw it on CNN.’ “
Even relative to other diseases, Ebola is positioned to maximize fear. More than half who get sick don’t survive. Some cases come with painful hemorrhaging. Health workers attend to patients — or bodies — in protective gear that brings to mind a nuclear disaster.
Adding to public angst is declining confidence in top disease officials, who have repeatedly asked for calm while also edging away from their initial and most confident pledges that the outbreak would be easily contained in the United States.
“We’ve had a number of chinks in the armor” in stopping the spread, said Eden Wells, a clinical associate professor of epidemiology at the University of Michigan. But, Wells said, “the risk is still low — even for those sitting on the plane” with the health-care worker from Dallas.
So far, the travel industry has appeared particularly vulnerable to the Ebola fears, with airplanes being the most obvious pathway for contagion. Airline stocks have been falling ever since worries about the virus began to spread this summer. Delta, United and Southwest stocks have all tumbled more than 5 percent this month.
Thomas Frieden, director of the Centers for Disease Control and Prevention, said Wednesday that it wasn’t appropriate for the now-infected health-care worker to have flown Monday, a time when she had a low-grade 99.5-degree fever.
Public school systems across the Washington region have increased their monitoring, invariably prudent measures that nevertheless might stir additional anxiety. Those who show up at school health centers in Fairfax County, Virginia and Montgomery County now face questions about their recent travel histories.
John Torre, a Fairfax County schools spokesman, said that his school system has also added a new section to student enrollment forms inquiring about recent travel to and from West Africa, including to countries such as Liberia, Guinea and Sierra Leone where the outbreak has been concentrated.
The enrollment forms now ask if students have traveled to West Africa in the previous 21 days or if a family member has visited there in the previous 40 days.
“I am concerned since I have a 5-year-old son,” said Chris Baker, who works in Annapolis, Maryland for a real estate title company. “I worry about that aspect, being a father.”
In Dallas, perhaps most of all, the concerns feel very real.
Eric Williams, who’s running an independent campaign for Congress, said stores in Dallas are selling out of hand sanitizer.
“My wife and I went to look for some — we had to go to three different stores before we were able to find one bottle of sanitizer,” Williams said. “And that was at the dollar store. They had three bottles left on the shelf.”
The candidate has suggested a citywide “no-contact” policy: no handshakes, no hugs.
Officials say “everything is okay, when not everything is okay,” Williams said. “People are concerned. Are we getting the truth?”
The Dallas hospital that treated Duncan has seen one of the strongest local impacts.
On Wednesday, at Texas Health Presbyterian Hospital Dallas, only three or four children were at an infant and child day-care center. It was a cloudless day, but on a baseball-field size playground outside, there was nobody to be seen; the tricycles, slides and plastic toys — all untouched.
The only sign of life: one crow, sitting on a fence.
