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U.S. to issue new Ebola care guidelines, watch lists to shrink

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[October 20, 2014]  By Erwin Seba
 
 GALVESTON Texas (Reuters) - The United States will issue strict new guidelines telling American health workers to cover their skin and hair when dealing with Ebola patients, a top health official said on Sunday, while some of the dozens of people being watched for possible exposure to the virus are expected to be cleared.

In Texas, a lab worker who spent much of a Caribbean holiday cruise in isolation tested negative for the deadly virus and left the Carnival Magic liner with other passengers after it docked at Galveston early on Sunday morning.

The new guidelines for healthcare workers and the precautions taken for the cruise passenger reflected widespread anxiety over Ebola in the United States, including calls from some lawmakers for a travel ban on West Africa.

The worst outbreak on record of the virus has killed more than 4,500 people, mostly in Liberia, Sierra Leone and Guinea.

Liberian President Ellen Johnson Sirleaf urged stronger international action to control the epidemic, saying on Sunday the disease was unleashing an economic catastrophe that will leave a "lost generation" of young West Africans.

Belgium announced on Sunday it would screen people arriving at its largest airport from West Africa for signs of fever. In Spain, the government said Teresa Romero, the nurse who contracted Ebola while caring for two infected priests, appeared to be free of the disease.

 



The new guidelines being developed by the U.S. Centers for Disease Control and Prevention would increase protection for medical workers caring for Ebola patients. The new measures were prompted by anxiety after two nurses were infected with the virus, which is spread by contact with bodily fluids of sick people and so makes health workers especially vulnerable.

Health workers would be told to cover hair and skin completely, said Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases. The old guidelines, modeled after World Health Organization protocols, said workers should wear masks but "did have some exposure of the skin," he said.

In addition to the new protocols, the U.S. military plans to create an emergency response team of infectious disease doctors, nurses and trainers to help in the event of an Ebola crisis in the United States. The team would not be deployed in West Africa or elsewhere overseas.

END OF MONITORING

The first person to be diagnosed with the disease in the United States was Thomas Eric Duncan, a Liberian who fell ill while visiting Dallas last month. He died on Oct. 8, and two nurses who treated him were infected. This triggered a lengthy watch list of people who had had possible contact with them.

At midnight, 48 people who might have been in contact with Duncan will no longer require monitoring for signs of the virus, health officials say.

On Monday, more were expected to end 21 days of monitoring, the incubation period for the virus.

They would include Duncan's fiance, Louise Troh, her 13-year-old son and two other people who have been in mandatory quarantine at an undisclosed location in Dallas.

"We are so happy this is coming to an end, and we are so grateful that none of us has shown any sign of illness," Troh said in a statement on Sunday. She said she was still grieving for Duncan, who was the father of another son.

"We continue to mourn his loss and grieve the circumstances that led to his death, just at the time we thought we were facing a happy future together."

There are still 75 health workers in Dallas who have isolated themselves and are being monitored.

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'SCARY'

The lab worker who was being monitored aboard the Carnival Magic worked at Texas Health Presbyterian Hospital, where Duncan was treated. The ship arrived at Galveston after a weeklong cruise that included being denied docking by Belize and Mexico because of the presence of the woman on board.

"It was scary. It was really very worrying," said passenger Regina Sargent of Dallas.

The lab worker, who has not been named, did not have contact with Duncan but was under observation as she might have come into contact with test samples from him.

She voluntarily isolated herself in her cabin and her blood sample was flown by helicopter for testing. "The lab testing done was negative," said Coast Guard Lieutenant Sam Danus.

Officials in Dallas, where nurses Nina Pham and Amber Vinson were infected, have urged residents to stay calm. "This is a critical weekend," Clay Jenkins, Dallas County's top official, said in an interview on ABC's "This Week." If there are no new patients, he said, Dallas is "going to be statistically less likely" to see new cases.

A series of Ebola scares has rattled the United States since Duncan was diagnosed. Americans' faith in the medical system and in its disease prevention ability was jolted by early missteps in his case.

In a public letter on Saturday night, Texas Health Resources Chief Executive Barclay Berdan acknowledged that Texas Health Presbyterian, where Duncan first went, made mistakes, including initially not diagnosing Ebola.

Berdan said aggressive actions since then ensured that the hospital was a safe place, and that outside experts would be consulted to determine how the two nurses became infected.

Vinson is being treated at Atlanta's Emory University Hospital, while Pham is being treated at the National Institutes of Health outside Washington.
 


Fauci said he had a long conversation with Pham on Saturday.

“She's in good spirits,” Fauci told "Fox News Sunday." Asked whether she would recover, he said, "I'm feeling good about the fact that she's progressing very well."

(Additional reporting by Richard Cowan, Sarah N. Lynch, Phil Stewart and Marina Lopes in Washington, Anna Driver and Jon Herskovitz in Texas and Foo Yun Chee in Brussels; Writing by Frances Kerry and Jim Loney; Editing by Crispian Balmer and Eric Walsh)

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