CDC Updating Ebola Protocols After Nurse Contracts Virus in Dallas

On Monday, CDC Director Tom Frieden announced the agency is reviewing and updating its protocols for containing Ebola, the New York Times reports. The announcement came after a nurse who treated the first patient to be diagnosed with the disease in the U.S. contracted the virus (Fernandez et al, New York Times, 10/13).

Background

The nurse was on the team at Texas Health Presbyterian Hospital that treated Thomas Eric Duncan, a Liberian national who died last week after spending 10 days at the hospital battling Ebola. The nurse wore protective gear while caring for the patient and was considered to be at low risk for infection (McKay et al, Wall Street Journal, 10/13). According to Frieden, the nurse had "extensive contacts with" Duncan on "multiple occasions."

Daniel Varga, chief clinical officer for Texas Health Resources, said the nurse had been monitoring her temperature twice daily. On Friday night, she was isolated within 90 minutes of reporting a low-grade fever, according to Varga. Tests conducted on Saturday and Sunday found that she had contracted Ebola. The nurse is in stable condition in an isolation ward (Phillip et al, "Post Nation," Washington Post, 10/12). According to Reuters, the nurse, identified as Nina Pham, has received a blood transfusion from a person who survived Ebola (Garza/Wade, Reuters, 10/13).

Top health officials said the infection likely was a result of a breach in protocol. National Institute of Allergy and Infectious Diseases Director Anthony Fauci said there was "an inadvertent, innocent breach of the protocol of taking care of a patient within the personal protective equipment," adding, "That extremely rarely happens" (Hughes/Reinhard, "Washington Wire," Wall Street Journal, 10/12).

However, Chuck Idelson, a spokesperson for the California Nurses Association, criticized the hospital for placing the blame on the infected nurse. Idelson said nurses have experienced a "wave of outrage" and are urging officials to implement a "buddy system," in which a second nurse or caregiver closely watches a health care provider as they put on or take off protective clothing and equipment (Rauber, "BizTalk," San Francisco Business Times, 10/13).

The Texas Nurses Association also said it is wrong for health officials to blame a breech in protocol on Pham, adding, "The facts are not known about how the nurse in Dallas was exposed," and "[i]t is incorrect to assume that the nurse failed to follow protocols" (Reuters, 10/13).

CDC Reviewing Protocol

Frieden on Monday said, "We have to rethink the way we address Ebola infection control, because even a single infection is unacceptable." He noted that CDC already has begun monitoring staff caring for the nurse to ensure there are no breaches in current protocol. CDC also is considering additional steps to make sure the disease does not spread. One possibility Frieden mentioned is spraying health care workers down with cleaning chemicals that kill Ebola before they are permitted to step outside of isolation units. He said, "There are a series of things that are already implemented in the past 24 hours," adding, "If this one individual was infected, and we don't know how within the isolation unit, then it is possible that other individuals could have been infected as well."

In response to that possibility, a team of CDC staff in Dallas worked to identify a "large group" of health care workers who could also have been at risk of contracting the disease from Duncan. According to the Times, the number of people being monitored for symptoms of the disease has increased from about 48 to more than 100. So far, none of the individuals have reported experiencing symptoms of the virus.

According to CDC spokesperson Abbigail Tumpey, any new protocols will first be tested at the Dallas facility. Those that are determined to be effective will be incorporated into CDC guidance on Ebola next week. CDC will notify providers of the updated protocols via news flash updates and email alerts (New York Times, 10/13).

Obama Urges World Leaders To Increase Ebola Efforts

In related news, President Obama on Monday told top U.S. national security and public health officials to learn from the Texas incident and use the lessons to bolster the country's Ebola response, the AP/San Francisco Chronicle reports.

During a meeting with HHS Secretary Sylvia Mathews Burwell, Frieden, homeland security and counterterrorism aide Lisa Monaco and National Security Adviser Susan Rice, Obama called for the investigation into the breach that led to the Pham's infection to happen quickly, so the U.S. can be better informed on how to contain the virus.

Obama also continued to urge global leaders to increase their efforts to help combat Ebola in West Africa. During a call with United Nations Secretary-General Ban Ki-moon, White House officials said Obama "stressed the need for all U.N. member states to ... provide the personnel, equipment and supplies required to stop the epidemic at its source and halt the devastating impact of this crisis on the affected countries and their citizens."

In addition, Obama during a call with French President Francois Hollande discussed the need for treatment centers in the affected regions and ways to help prevent the spread of Ebola to other countries. In a statement, French officials said Hollande and Obama also talked about the possibility of beginning screening programs for travelers from the affected areas (Kuhnhenn, AP/San Francisco Chronicle, 10/13).

Campaigns Focus on Ebola

Meanwhile, political campaigns throughout the country have begun to use the Ebola issue as advertising fodder, the Wall Street Journal reports.

According to the Journal, Republicans have accused the Obama administration of not adequately responding to the outbreak, while Sen. John McCain (R-Ariz.) has called for the administration to appoint an Ebola czar. In addition, some Republicans have continued calls to implement a travel ban on West Africa.

Meanwhile, some Democrats are blaming GOP-supported budget cuts for Ebola's spread. For example, a recent online advertisement from The Agenda Project highlights "in a really clear and stark way the result of the Republican governing philosophy," according to group founder Erica Payne. The ad eventually will expand to television stations in Kansas, Kentucky, North Carolina and South Dakota.

In addition, an online ad posted Monday by the Democratic Congressional Campaign Committee claims that Republicans cut funding that would have gone toward Ebola prevention (Reinhard/Armour, Wall Street Journal, 10/13).

Further, NIH Director Francis Collins in an interview with the Huffington Post on Friday said that $5 billion in funding cuts to the agency over more than a decade's time has affected the development of Ebola vaccinations. He said, "Frankly, if we had not gone through our 10-year slide in research support, we probably would have had a vaccine in time for this that would've gone through clinical trials and would have been ready" (Hicks, "Federal Eye," Washington Post, 10/13).

Inhofe Releases Hold on $700M for Military's Ebola Mission

Also in related news, Sen. James Inhofe (R-Okla.) on Friday released his hold on $700 million in funding for the U.S. military to help combat Ebola in West Africa, CQ Roll Call reports (Scully, CQ Roll Call, 10/10).

Inhofe on Thursday delayed the funding increase over questions about protecting military personnel and the mission's future. A spokesperson for the senator had said Inhofe was waiting for additional information from the Department of Defense on safety precautions and the effort's long-term scope, which Inhofe said should eventually be taken over by other agencies and not-for-profit groups (California Healthline, 10/10).

In a statement on Friday, Inhofe said that the Pentagon provided specifics on plans to help protect military troops deployed to West Africa. However, Inhofe added that he would likely not support more "last-minute funding requests" for military resources in the area. He said, "Significant cuts to the defense budget have eroded the readiness and capabilities of our military, and I cannot support the indefinite commitment of our troops to this mission" (CQ Roll Call, 10/10).