[We will update this post throughout the day.] The Centers for Disease Control and Prevention confirmed Sunday afternoon that the health care worker at Texas Health Presbyterian Hospital in Dallas has tested positive for the Ebola virus. It is the first known case of Ebola being contracted in the U.S.
Meanwhile, early Sunday evening, crews started decontaminating the health care worker's apartment in the M streets.
7:54 p.m.: Texas Health Presbyterian once again diverting emergency room patients
At 7:21 p.m., Texas Health Presbyterian Hospital sent out a statement saying it was opening its emergency room once again to patients. For several hours on Sunday, it was sending ambulances to other hospitals. “The Texas Health Presbyterian Hospital Dallas emergency department is no longer on EMS divert,” the statement says. “The department is appropriately staffed, and ambulances may begin bringing patients in for care immediately.”
Then, less than 30 minutes later, at 7:48 p.m., Presbyterian officials sent out an updated statement, saying the emergency department is back on "EMS divert status."
3:15 p.m.: Obama asks CDC to quickly investigate protocol breach at Presbyterian
The White House says President Barack Obama has asked the Centers for Disease Control and Prevention to move as quickly as possible in investigating the apparent breach of infection control procedures at Texas Health Presbyterian Hospital in Dallas.
The hospital had treated a Liberian man with the virus before he died on Wednesday. A health care worker who treated the man has tested positive for Ebola.
Obama also is having federal authorities take more steps to make sure hospitals and health care providers are ready to follow the proper procedures in dealing with an Ebola patient.
Obama received an update about the latest developments on Ebola from his health secretary and his assistant for homeland security.
2:45 p.m.: After news of second Ebola case, city officials respond quickly in patient's neighborhood
KERA's Lauren Silverman visited the neighborhood where the second Ebola patient lives. She filed this report and offers this recap of what's happened so far today:
The usual sounds of dogs barking and baby strollers in the M Streets neighborhood of Dallas were silenced Sunday morning by helicopters circling overhead.
Below, cameras zoomed in on a small, 1930s brick apartment building with two large live oaks out front. A yellow hazardous waste barrel sat in the front lawn.
Mary Jud and her husband live around the corner from the building. They got a 7:30 a.m. phone call from the city saying there was someone who had tested positive for Ebola.
Rather than be upset about the early morning call, Jud was grateful.
“It made me feel very comfortable and very safe that the city is taking care of its neighbors,” Jud said.
The 5700 block of Marquita is just four miles south of the Vickery Meadow apartment complex where Thomas Eric Duncan first showed symptoms of Ebola.
This time around, the city responded fast. At a Sunday morning press conference at Presbyterian, Dallas Mayor Mike Rawlings said since the city got the news at midnight, there was a rush to make sure residents feel safe.
“The Dallas Fire and Rescue Hazmat team has cleaned up the common areas and decontaminated any of the open areas of the apartment complex,” Rawlings said. “We have knocked on every door in that block and talked to every single person that came to the door.”
A Hazmat team has also decontaminated the car the patient drove in, as well as the hospital parking lot and handrails that could have been infected. The inside of the health care worker’s apartment will also be cleaned.
It took five days for Dallas County to decontaminate the apartment where Duncan, the first Ebola patient, was staying. That delay was widely criticized. Nearly 50 people who were in contact with Duncan are still being monitored for any signs of Ebola. Now, Dallas County Commissioner Clay Jenkins says there will be extra monitoring for the 18 hospital workers who cared for Duncan.
Texas Health Resources chief clinical officer Dan Varga said the woman sick with Ebola is believed to have had contact with only one person after she showed symptoms. That’s good news, Jenkins said. Ebola is only spread by the bodily fluids of someone with symptoms.
“You cannot contact Ebola by walking by people in the street or by being around contacts that are not symptomatic,” Jenkins said. “So while this is obviously bad news, it is not news that should bring about panic.”
The CDC and health officials will have to monitor the sick woman’s contacts for three weeks – that’s how long Ebola can remain infectious.
11:10 a.m.: CDC says Dallas health care worker tested positive Ebola due to hospital protocol breach
A health care worker has tested positive for the Ebola virus because of a breach in protocol at the Dallas hospital where she was helping treat an Ebola patient, the director of Centers for Disease Control and Prevention said this morning.
That breach could affect other hospital workers who treated the Ebola patient, officials say.
“At some point there was a breach in protocol and that breach in protocol resulted in this infection,” Dr. Tom Frieden said. “It’s deeply concerning that this infection occurred.”
Federal and state health officials are examining what happened at Texas Health Presbyterian Hospital, where Thomas Duncan was treated for Ebola. He died on Wednesday.
On Friday, the health care worker reported a low-grade fever. She was quickly placed in isolation at Presbyterian.
Federal officials will focus on Presbyterian using kidney dialysis and a ventilator to treat Duncan -- those are considered high-risk procedures, Frieden said. He said he was unaware of any prior Ebola patient who has undergone intubation or dialysis.
"The two areas where we will be looking particularly closely is the performance of kidney dialysis and respiratory intubation," Frieden said this morning. "Both of those procedures may spread contaminated materials and are considered high-risk procedures. They were undertaken … as a desperate measure to try to save his life. In taking off respiratory protective equipment, we identified this as a major potential area for risk."
Meanwhile, health officials continue to monitor 48 people who had contact with Duncan until he arrived at the hospital on Sept. 28. None were showing Ebola symptoms as of Sunday morning.
The Presbyterian health care worker was not among the 48 contacts.
Dr. David Lakey, the Texas health commissioner, said Sunday that despite the second case in Dallas, officials will be able to stop the spread of Ebola.
"We have to be very careful," he said. "We need to closely look at the practice, the infection control practices as they are occurring to be meticulous, to be sure there are no breaches. Is it frustrating or disappointing? Of course it is. ... Do I doubt that we're going to stop this spread here in this one hospital? No. I firmly believe we will stop it."
11:05 a.m.: The scene at the apartment complex where the health care worker lives
The woman who tested positive for Ebola lives in the 5700 block of Marquita Avenue, near Greenville Avenue, in East Dallas. This is a picture of the back alley leading to her apartment, provided to KERA by Brandon Babayans, a neighbor.
Dallas Mayor Mike Rawlings visited the neighborhood today to talk with residents. Police have been patrolling the neighborhood. Letters have been given to residents to inform them about Ebola. City officials say Dallas hazmat crews have decontaminated open areas at the apartment complex.
One neighbor told KERA's Lauren Silverman: "We got a call from the city of Dallas at 7:30; it made me feel very safe that the city is taking care of us."
10 a.m.: Watch the CDC press conference
The CDC held a news conference earlier today -- here's video from The Washington Post:
Original post: Hospital worker was wearing full protective gear when treating Ebola patient
A health care worker at Texas Health Presbyterian Hospital in Dallas has tested positive for Ebola, the state health department says.
The worker provided care to Thomas Duncan, the first patient in the United States to be diagnosed with Ebola, during his second visit to the hospital. Duncan died on Wednesday morning.
The worker was in full protective gear -- including a gown, gloves, mask and shield -- while caring for Duncan, said Dr. Daniel Varga, chief clinical officer with Texas Health Resources.
Varga did not identify the worker and says the family of the worker has "requested total privacy."
Meanwhile, a top federal health official said the health care worker's Ebola diagnosis shows there was a clear breach of safety protocol and all those who treated Duncan are now considered to be potentially exposed.
Dr. Tom Frieden, head of the Centers for Disease Control and Prevention, told CBS' "Face the Nation" that among the things CDC will investigate is how the workers took off that gear - because removing it incorrectly can lead to a contamination.
"I think the fact that we don't know of a breach in protocol is concerning, because clearly there was a breach in protocol." Frieden said. "We have the ability to prevent the spread of Ebola by caring safely for patients ... We'll conduct a full investigation of what happens before health workers go in, what happens when they're there, and what happens in the taking out, taking off their protective equipment because infections only occur when there's a breach in protocol."
The worker reported a l0w-grade fever Friday night. Within 90 minutes, the worker was in an isolation ward at Presbyterian. A preliminary blood test on the caregiver showed positive for Ebola late Saturday night.
The preliminary test was done in Austin; the federal Centers for Disease Control will do further testing today.
The patient is stable, the hospital says.
Presbyterian says the health care worker had been under a self-monitoring regimen prescribed by the Centers for Disease Control and Prevention.
The health care worker was taking his or her temperature twice each day – on Friday night, the caregiver notified the hospital that he or she was on the way to the hospital. The caregiver was immediately placed into isolation.
A close contact has been placed in isolation as a proactive measure, hospital officials say.
All Presbyterian workers are following CDC-prescribed precautions when they interact with Ebola patients, Varga said.
“We’re very concerned,” Varga said. “We’re still confident that the precautions that we have in place will protect our health care workers.”
Texas Health Resources is tracking 18 employees who came into contact with Duncan.
Mayor Mike Rawlings says city officials were alerted at midnight to news of the health care worker being placed in isolation. Dallas-Fire Rescue hazmat teams have decontaminated open areas at an apartment complex in the 5700 block of Marquita Avenue in East Dallas where the health care worker lives. The complex is near the intersection of Marquita and Greenville Avenue. Neighbors have been notified. Police are present.
Hazmat teams have also decontaminated the patient’s car at Presbyterian, as well as railings and other items the patient might have touched on the way into the hospital.
“We … have been working throughout the morning to make sure the citizens of Dallas are safe when they wake up,” Rawlings said at the Sunday morning press conference. “I believe I can say they are.”
Varga at Presbyterian says the hospital’s emergency department has been placed “on diversion” due to staff capacity issues. Ambulances are being sent to other hospitals for now.
"While we are on diversion we are also using this time to further expand the margin of safety by triple-checking our full compliance with updated CDC guidelines," Presbyterian said in a statement. "We are also continuing to monitor all staff who had some relation to Mr. Duncan’s care even if they are not assumed to be at significant risk of infection."
Epidemiologists from the Centers for Disease Control and Prevention are in Dallas, but Dallas County Judge Clay Jenkins has requested additional workers to help.
— Shawn Williams (@ShawnPDPD) October 12, 2014
— Sana Syed (@dallaspiosana) October 12, 2014
How Ebola spreads
From The Associated Press: "Ebola spreads 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. The World Health Organization says blood, feces and vomit are the most infectious fluids, while the virus is found in saliva mostly once patients are severely ill and the whole live virus has never been culled from sweat."
“You cannot contract Ebola from walking by people in the street or being around contacts who are not symptomatic,” Dallas County Judge Clay Jenkins said Sunday morning. “While this is obviously bad news, it’s not news that should bring about panic.”
The CDC has produced this infographic about Ebola in the United States:
Statement from Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention released this statement Sunday.
Texas Reports Positive Test for Ebola in a Health Care Worker
CDC doing confirmation testing today
A healthcare worker at Texas Presbyterian Hospital who provided care for the index patient has tested positive for Ebola according to preliminary tests by the Texas Department of State Health Services’ laboratory. The patient was isolated after the initial report of a fever and remains so now. Confirmation testing at the Centers for Disease Control and Prevention’s laboratory is being done today.
On Friday October 10, a healthcare worker at Texas Presbyterian Hospital who provided care for the index patient reported a low grade fever and was referred for testing. The health care worker had been self-monitoring for fever and symptoms.
The hospital and patient were notified of the preliminary positive result. In addition, CDC has interviewed the patient to identify any contacts or potential exposures in the community.
This is understandably disturbing news for the patient, the patient’s family and colleagues and the greater Dallas community. The CDC and the Texas Department of State Health Services remain confident that wider spread in the community can be prevented with proper public health measures including ongoing contact tracing, health monitoring among those known to have been in contact with the index patient and immediate isolations if symptoms develop.
Ebola is spread through direct contact with bodily fluids of a sick person or exposure to objects such as needles that have been contaminated. The illness has an average 8-10 day incubation period (although it could be from 2 to 21 days) so CDC recommends monitoring exposed people for symptoms a complete 21 days. People are not contagious during the incubation period, meaning before symptoms such as fever develop.
CDC tests results will be shared when confirmatory tests are done, following appropriate patient notification.
Press release from Texas Department of State Health Services
Here is the full news release from the Texas Department of State Health Services:
A health care worker at Texas Health Presbyterian Hospital who provided care for the Ebola patient hospitalized there has tested positive for Ebola in a preliminary test at the state public health laboratory in Austin. Confirmatory testing will be conducted by the Centers for Disease Control and Prevention in Atlanta.
The health care worker reported a low grade fever Friday night and was isolated and referred for testing. The preliminary test result was received late Saturday.
"We knew a second case could be a reality, and we've been preparing for this possibility," said Dr. David Lakey, commissioner of the Texas Department of State Health Services. "We are broadening our team in Dallas and working with extreme diligence to prevent further spread."
Health officials have interviewed the patient and are identifying any contacts or potential exposures. People who had contact with the health care worker after symptoms emerged will be monitored based on the nature of their interactions and the potential they were exposed to the virus.
Ebola is spread through direct contact with bodily fluids of a sick person or exposure to contaminated objects such as needles. People are not contagious before symptoms such as fever develop.
Press release from Texas Health Presbyterian
Texas Health Presbyterian sent this statement to media Sunday morning:
Late Saturday evening, a preliminary blood test on a care-giver at Texas Health Presbyterian Hospital Dallas showed positive for Ebola. The healthcare worker had been under the self-monitoring regimen prescribed by the CDC, based on involvement in caring for patient Thomas Eric Duncan during his inpatient care that started on September 28.
Individuals being monitored are required to take their temperature twice daily. As a result of that procedure, the care-giver notified the hospital of imminent arrival and was immediately admitted to the hospital in isolation. The entire process, from the patient’s self-monitoring to the admission into isolation, took less than 90 minutes. The patient’s condition is stable. A close contact has also been proactively placed in isolation. The care-giver and the family have requested total privacy, so we can’t discuss any further details of the situation.
We have known that further cases of Ebola are a possibility among those who were in contact with Mr. Duncan before he passed away last week. The system of monitoring, quarantine and isolation was established to protect those who cared for Mr. Duncan as well as the community at large by identifying any potential ebola cases as early as possible and getting those individuals into treatment immediately.
Finally, we have put the ED on “diversion” until further notice because of limitations in staffed capacity -- meaning ambulances are not currently bringing patients to our emergency department. While we are on diversion we are also using this time to further expand the margin of safety by triple-checking our full compliance with updated CDC guidelines. We are also continuing to monitor all staff who had some relation to Mr. Duncan’s care even if they are not assumed to be at significant risk of infection.
All of these steps are being taken so the public and our own employees can have complete confidence in the safety and integrity of our facilities and the care we provide.
More about Thomas Eric Duncan
Thomas Eric Duncan, the first person diagnosed with Ebola in the U.S., died Wednesday in Dallas. Duncan, 42, grew up next to a leper colony in Liberia and fled years of war before later returning to his country to find it ravaged by the disease that ultimately took his life.
Duncan arrived in Dallas in late September, realizing a long-held ambition to join relatives. He came to attend the high-school graduation of his son, who was born in a refugee camp in Ivory Coast and was brought to the U.S. as a toddler when the boy's mother successfully applied for resettlement.
The trip was the culmination of decades of effort, friends and family members said. But when Duncan arrived in Dallas, though he showed no symptoms, he had already been exposed to Ebola. His neighbors in Liberia believe Duncan become infected when he helped a pregnant neighbor who later died from it. It was unclear if he knew about her diagnosis before traveling.
Duncan had arrived at a friend's Vickery Meadow apartment on Sept. 20 - less than a week after helping his sick neighbor.
He first went to Presbyterian on Sept. 25 complaining of illness, but the hospital sent him home. He returned to Presbyterian on Sept. 28 via ambulance -- he was sent into the hospital's isolation ward, where he remained until he died.
For the nine days before he was taken to a hospital in an ambulance, Duncan shared the Vickery Meadow apartment with several people.
The Associated Press contributed to this report.
Ebola in Dallas: A Timeline
Here's a look at some of the main events over the past several days. Hover over the right-hand side of the timeline to advance it.