Ebola Blog: Dallas Hospital Says It Gave Ebola Patient Experimental Drug As Quickly As It Could | KERA News

Ebola Blog: Dallas Hospital Says It Gave Ebola Patient Experimental Drug As Quickly As It Could

Oct 9, 2014

The experimental drug Brincidofovir was administered to the Dallas Ebola patient as soon as it possibly could, Texas Health Presbyterian officials said Thursday afternoon.

The patient, Thomas Eric Duncan, died Wednesday morning after an 11-day hospital stay.

Mr. Duncan’s physicians treated him with the most appropriate and available medical interventions, including the investigative antiviral drug Brincidofovir,” the hospital says. “After consulting with experts across the country, the CDC, and the FDA, the investigative drug was administered as soon as his physicians determined that his condition warranted it, and as soon as it could be obtained.”

Duncan was the first Ebola patient to receive the drug, Presbyterian officials said.

Another experimental drug, ZMapp, was not administered to Duncan because it was not available. It hasn’t been available since August. ZMapp was given to two American missionary workers who contracted Ebola in Liberia – Dr. Kent Brantly, a Fort Worth-trained doctor, and Nancy Writebol. Brantly and Writebol have since recovered from Ebola after being treated at an Atlanta hospital.

In addition, Presbyterian officials say Duncan did not receive the same type of serum transfusion as the Ebola patient being treated in Nebraska because his blood type was not compatible with the serum donors.

Brantly gave serum to the Nebraska patient, Ashoka Mukpo, a freelance NBC cameraman diagnosed with Ebola while working in Liberia.

Presbyterian says a team of more than 50 workers cared for Duncan “in a professional and compassionate manner.” A 24-bed intensive care unit was used to take care of Duncan. The treatment area remains sealed and is being decontaminated, hospital officials said in a statement.

It’s been widely reported that Duncan first visited Presbyterian on Sept. 25, feeling ill. Emergency room workers sent him home with antibiotics.

“Our care team provided Mr. Duncan with the same high level of attention and care that would be given any patient, regardless of nationality or ability to pay for care,” the statement says. “In this case that included a four-hour evaluation and numerous tests. We have a long history of treating a multicultural community in this area.”

On Sept. 28, Duncan returned to Presbyterian, this time in an ambulance.

On Saturday, Duncan’s condition changed from serious to critical. By Wednesday morning, his condition had deteriorated. His heart stopped.

Duncan had earlier expressed his wishes to his attending doctor that the care team not perform chest compressions or defibrillation to prolong his life.

5:35 p.m. Dallas County deputy released from hospital

The Dallas County deputy who had been involved in the Dallas Ebola investigation and was brought to Texas Health Presbyterian Hospital after feeling ill has been released from the hospital, Presbyterian officials announced. Earlier in the afternoon, state health officials announced he had tested negative for Ebola.

3:09 p.m.: Dallas County deputy tests negative for Ebola, state health department says

The man who had been involved in the Dallas Ebola investigation and was brought to Texas Health Presbyterian Hospital after feeling ill has tested negative for Ebola.

Shortly before 3 p.m., the Texas Department of State Health Services released a short statement: "The Texas Department of State Health Services has completed testing of the specimen submitted today by Texas Health Presbyterian Hospital Dallas. The result is negative for Ebola.

12:35 p.m. Dallas County deputy involved in Ebola investigation who fell ill is in good condition

The man who had been involved in the Dallas Ebola investigation and was brought to Texas Health Presbyterian Hospital after feeling ill is in good condition, officials say.

He has had no fever, no vomiting and no diarrhea, Presbyterian officials said.

“His current condition is not consistent with an early-stage Ebola diagnois,” the hospital said in a statement.

The hospital’s standard lab testing results are all within normal ranges for the patient, Michael West Monnig.

Monnig is a Dallas County sheriff’s deputy who walked into the apartment where the Dallas Ebola patient, Thomas Duncan, had stayed before he got sick and was sent to Presbyterian. Monnig had no direct contact with Duncan; instead he was in the apartment with Duncan’s relatives.

Duncan died Wednesday morning.

On Wednesday afternoon, Monnig showed up at an urgent care clinic, showing some, but not all, symptoms of Ebola. He was transported via ambulance to Presbyterian. Officials have stressed since Wednesday that Monnig doesn’t seem to have Ebola.

Texas health officials say Ebola test results are expected late this afternoon.

"The Ebola patient had already been hospitalized so the deputy did not have direct contact with him," according to a statement from the Texas Department of State Health Services. "All known cases of Ebola have occurred through direct contact with blood or other bodily fluids or exposure to contaminated objects, such as needles."

Dr. David Lakey, Texas health commissioner, said in a statement that "the risk is extremely low" and that officials "want to err on the side of caution."

The statement continues: "The state approved the test for Ebola after consulting with doctors at Presbyterian and the U.S. Centers for Disease Control and Prevention. This will be the third person tested for Ebola at the state public health laboratory in Austin. The first was the Dallas patient who tested positive, and the second was a patient from the Houston area who was negative. The Austin lab is one of only 13 in the nation that can test for Ebola."

11:30 a.m. Ebola's impact on Dallas tourism? Not much

We've heard anecdotal reports that people are staying away from Dallas due to the news of the diagnosis of the Ebola patient. But the Dallas Convention and Visitors Bureau tells NPR's Jeff Brady that the Ebola news isn't scaring people away from Big D.

"Medical professionals at the local, county, and federal level have made it clear that the public at large is not at risk and have done an impressive job of reassuring the public by articulating and imparting important facts," DCVB spokesman Frank Librio told Jeff.  "We have received two requests for information to date from organizations scheduled to visit Dallas -- and the CVB is providing the latest information available from the City and County officials.  The groups were not concerned or cancelling their meetings, an indication that people are paying attention to the medical facts. Those groups were Design Build (in market now) and Dallas Area Paralegal Association (meeting starts tomorrow) We have not received any calls from tourists to my knowledge." 

Dallas Mayor Mike Rawlings noted earlier this week that despite Ebola being in the news, attendance was strong at two big events last weekend -- the State Fair of Texas and the Dallas Cowboys game in Arlington.

10 a.m.: Death of Ebola patient renews questions about his medical care

The death of the Dallas Ebola patient, the first diagnosed in the United States, has renewed questions about his medical care.

It’s also led many to wonder whether Thomas Eric Duncan's life could have been extended or saved if the Dallas hospital where he first sought help had taken him in sooner.

Duncan died in Dallas on Wednesday, a little more than a week after his illness exposed gaps in the nation's defenses against the disease and set off a scramble to track down anyone exposed to him.

The 42-year-old Liberian man had been kept in isolation since Sept. 28 at Texas Health Presbyterian Hospital, where a fevered Duncan first showed up a couple of days earlier and told the staff he had been in West Africa. Doctors initially sent him home. He returned via ambulance after his condition worsened.

Dr. Phil Smith is the director of the biocontainment center at the Nebraska Medical Center, where an NBC News freelance cameraman is being treated for Ebola. He said getting early treatment is key to survival.

When a patient reaches the point of needing dialysis and respiratory help, as Duncan did this week, there may be little doctors can do.

"At that point, any kind of intervention, whether it is an antiviral drug or convalescent plasma, is less likely to work," said Smith, an infectious disease specialist.

Duncan carried the deadly virus with him from his home in Liberia, though he showed no symptoms when he left for the United States. He arrived in Dallas on Sept. 20 and fell ill several days later.

Thomas Eric Duncan, 42, was the first Ebola patient diagnosed in the United States. He traveled from Liberia to Dallas in late September before he got sick. He was sent to Texas Health Presbyterian Hospital in Dallas.
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Of the six Ebola patients treated so far in the U.S., Duncan was the only one not cared for in one of the special hospital units set up to deal with highly dangerous germs. That's because health officials knew the others had Ebola at the time they decided where the patients should go, whereas Duncan sought care at Texas Health Presbyterian hospital on his own.

Health officials also have said that any hospital with isolation capabilities can treat Ebola patients, but Duncan's death is sure to renew attention on the hospital's response.

There is no way to know whether any specific treatment or step might have saved Duncan's life. At the time of his death, he was taking an experimental antiviral drug.

He died "despite maximal interventions," said Dr. Tom Frieden, director of the Centers for Disease Control and Prevention. "The earlier someone is diagnosed, the more likely they will be to survive."

Pastor George Mason of Wilshire Baptist Church in Dallas was present when county officials told Louise Troh, the woman Duncan had been staying with, of his death.

"She expressed all the what-ifs," including whether the initial delay in admitting Duncan made a difference, Mason said.

9:35 a.m.: Gov. Perry visiting Army troops before they head to West Africa to contain Ebola

Gov. Rick Perry is visiting Army troops before they deploy to West Africa to support U.S. efforts to contain and eradicate Ebola.

Perry is coming to the sprawling Army installation at Fort Hood on Thursday to address the soldiers before they leave. He isn't seeking re-election in November but is seriously considering a second run for the White House in 2016.

Perry has formed a 17-member task force of top state medical, military, emergency-response and public education officials to better prepare Texas for Ebola and other infectious diseases. He says the medical response system is working and Texans shouldn't panic. 

Thomas Duncan, a 42-year-old Liberian man, died Wednesday at a Dallas hospital after becoming the first patient to develop Ebola in the United Sates.

The Associated Press contributed to this report.

A timeline of main Ebola events

Here's a look at some of the main Ebola news developments over the past several days. Hover over the right-hand side of the timeline to advance it.