A Dallas nurse became the first person to contract Ebola within the United States, prompting local, state and federal officials to scramble Sunday to solve the mystery of how she became infected despite wearing protective gear.
The news further stoked fears of health care workers across the country, many of whom have grown increasingly anxious about having to handle Ebola cases.
The confirmation Sunday of the second Ebola case in Dallas — four days after the death of the first patient, a Liberian national who arrived in this country in September — opened a new and more frightening chapter in the unfolding public health drama.
Although the new Ebola patient was not publicly identified, officials said that she was a nurse who had helped treat the Liberian national, Thomas Eric Duncan, at a Dallas hospital and that she may have violated safety protocols.
It was the first confirmed instance of Ebola being transmitted in this country.
Officials expanded the pool of people they had been monitoring, because the nurse had not been among the 48 health care workers, relatives of Duncan and others whom they were evaluating daily.
“We don’t know what occurred in the care of (Duncan), but at some point, it was a breach in protocol and that breach in protocol resulted in this infection,” Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, said Sunday. “If this individual was exposed, which they were, it is possible that other individuals were exposed.”
The CDC recommended that health officials look more closely at the protective gear that nurses, doctors and hospital assistants use when treating Ebola patients.
It also, for the first time, was considering the idea that patients with the virus should be transferred to hospitals with special containment units and experience in treating the disease. The Dallas hospital at the center of the two Ebola cases — Texas Health Presbyterian Hospital — was facing renewed scrutiny over whether it had properly trained its workers.
“The care of Ebola patients can be done safely, but it’s hard to do it safely,” Frieden said. “Even a single, inadvertent innocent slip can result in contamination.”
The stricken nurse reported a low-grade fever overnight Friday, officials said. It appeared that she drove herself to the emergency room of Presbyterian Hospital, where she worked, and was quickly put in isolation, the officials said.
She had extensive contact with Duncan after his admission to the hospital on Sept. 28, Frieden said.
The woman was in stable condition Sunday. Daniel Varga, chief clinical officer of Texas Health Resources, which oversees Presbyterian Hospital, said Sunday that the worker had worn protective gear when coming in contact with Duncan.
“This individual was following full CDC precautions,” Varga said, adding, “Gown, glove, mask and shield.” Asked how concerned he was that the worker tested positive despite the precautions, he replied, “We’re very concerned.”
Despite Varga’s reassurances about CDC precautions having been followed, Frieden said it appeared the woman had breached safety protocol at the hospital, possibly when removing the protective gear.
Speaking on the CBS program “Face the Nation,” Frieden said, “We’re deeply concerned about this new development.”
The CDC has said that for health workers in the United States, gloves, gowns, masks and face shields or goggles would be protection enough. But many health workers across the country, seeing images of people in Africa completely encased in full-body, hazardous-material suits, have requested similar protection.
“A lot of us are starting to get worried,” said Debra Buccellato, an emergency room nurse in Santa Rosa, Calif. “I’m a single mom, so if I got sick there’d be a huge void.”
Buccellato said she planned to start wearing a face mask for her entire shift.
Although there have been other patients with Ebola treated in the United States in recent weeks, the Dallas nurse is only the second person — after Duncan — whose condition was diagnosed in the United States. All of the other patients received a diagnosis while working in West Africa near Ebola victims.
In Dallas on Sunday, officials were urging residents to remain calm.
“You cannot contract Ebola other than from the bodily fluids of a symptomatic Ebola victim,” said County Judge Clay Jenkins, Dallas County’s chief executive, who himself has had close contact with those who lived with Duncan. “You cannot contract Ebola by walking by people on the street or by being around contacts who are not symptomatic.”
City officials moved swiftly to clean and decontaminate many of the places where the nurse had been, including her apartment.
The woman’s dog won’t be destroyed, according to the city’s mayor, who drew a line at killing the pet to help stem the outbreak.
Unlike Excalibur — the dog owned by a Spanish nursing assistant infected with Ebola and which was euthanized last week — the canine in Dallas will be sent to a new location to await its owner’s recovery, Mayor Mike Rawlings said.
McClatchy Newspapers and Bloomberg contributed to this report.
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