Friday, October 03, 2014

U.S. Defends Ebola Response, About 50 Under Observation
Healthcare workers respond to Ebola case in Dallas.
6:13pm EDT
By Jon Herskovitz

DALLAS/WASHINGTON (Reuters) - U.S. officials broadly defended the response to the country's first case of Ebola, although one acknowledged that while the government was confident of containing the virus, it had been "rocky" in Dallas.

Health officials in Dallas charged with checking the spread of Ebola have narrowed their focus to about 50 people who had direct or indirect contact with an infected Liberian visitor, including 10 at high risk who are being checked twice daily for symptoms.

In Washington, officials were asked at a news conference why the visitor, Thomas Eric Duncan, was able to get past screening in his journey from Liberia and then be sent home after telling a Dallas hospital about his travel history.

“There were things that did not go the way they should have in Dallas, but there were a lot of things that went right and are going right," Dr. Anthony S. Fauci, a director at the National Institutes of Health, told reporters at the White House.

“So, although certainly it was rocky" in terms of how people perceived the response, "the reason I said there wouldn’t be an outbreak is because of what is going on right now.”

Fauci and other officials repeatedly said the U.S. healthcare infrastructure was strong enough to prevent the virus from spreading. The case has put authorities and the public on alert over concerns that the worst epidemic of Ebola on record could spread from West Africa.

The World Health Organization on Friday updated its death toll to at least 3,439 out of 7,492 suspected, probable and confirmed cases. The epidemic has hit hardest in impoverished Liberia, Sierra Leone and Guinea.

A cleanup crew was decontaminating the Dallas apartment where Duncan had been staying before he was admitted to the hospital five days ago and where he remained in serious condition on Friday.

Four people close to Duncan who were quarantined in the apartment in a northeastern section of the city "will be moved to another location soon," Dallas County Fire Marshal Robert De Los Santos told reporters. Earlier, the county said it was safe for them to remain there during the cleanup.

The handling of the Dallas case in the early stages of Duncan's illness has raised questions about how prepared local and national health officials were to handle that case and whether people were unnecessarily exposed.

Dr. David Lakey, commissioner of the Texas Department of State Health Services, said at a news conference that out of 100 people who needed to be reached, "There's now approximately 50 individuals we feel we need to follow on a daily basis."

"Most of those individuals are at low risk. There are about 10 individuals who are at higher risk. We continue to watch those individuals closely."

The observations include fever checks at least twice daily. Ebola, which can cause fever, vomiting and diarrhea, spreads through contact with bodily fluids such as blood or saliva.
Sheets and other items used by the man in the apartment have been sealed in plastic bags, but questions have been raised about the delay in sanitizing it.

Senior Obama administration officials were scheduled to hold a news conference on Ebola on Friday afternoon, while the Pentagon said it could increase the number of military personnel being sent to West Africa to help with the outbreak there.

A crew from the Cleaning Guys, a hazardous materials cleanup company, arrived at the apartment building around 11:30 a.m. CDT (12.30 p.m. EDT) to start the work, which officials said would take about three hours. Along with the cleanup crew, three fire and rescue vehicles also arrived at the apartment complex.

The cleanup crew, garbed in yellow hazardous material suits and masks, was inside the apartment and packing the soiled sheets, Duncan's luggage and other personal items into blue barrels, the fire marshal said. The mattress was being cut into pieces to fit into the barrels.

Another Dallas County official said the cleaners would take the containers to a secure location.

Duncan was being treated at Texas Health Presbyterian Hospital. Officials said a disposal vendor was in place to remove any potentially contaminated materials from the hospital.

U.S. health officials say they are confident that they can prevent the spread of the Ebola virus in the United States.

BEING CHECKED FOR EBOLA SYMPTOMS

Since Duncan's diagnosis, people have visited hospitals in a few states and were checked for Ebola symptoms. On Friday, Howard University Hospital in Washington said it admitted and isolated a patient with possible symptoms who had recently traveled from Nigeria "in an abundance of caution."

The CDC says outbreaks in Nigeria and Senegal appear to have been contained.

As part of the U.S. effort to help contain the spread of Ebola, the Pentagon on Friday said the number of military personnel that could be deployed to West Africa could reach nearly 4,000, more than earlier estimates of about 3,000.

"It may not go that high," said the Pentagon's chief spokesman, Rear Admiral John Kirby.

In Congress, U.S. House Appropriations Committee Chairman Hal Rogers, a Republican, and ranking Democrat Nita Lowey set an Oct. 17 deadline for the Obama administration to provide details of its plan to deal with the outbreak, including how each agency is contributing and monthly costs.

Louisiana Governor Bobby Jindal, a Republican, became the latest public official to call on the U.S. government to shut down flights from Ebola-stricken countries.

The critical issue of how hospitals in the United States should handle and dispose of medical waste from Ebola patients is being addressed, the government said. The U.S. Department of Transportation said it expected to release new guidelines later on Friday that would allow Texas hospitals to dispose safely of Ebola-infected medical wastes.

Most U.S. hospitals are not equipped with incinerators or large sterilizers called autoclaves that could accommodate the large amounts of soiled linens, contaminated syringes and virus-spattered protective gear generated by the care of an Ebola patient, said Dr. Jeffrey Duchin, chair of the Infectious Diseases Society of America's Public Health Committee.

NBC News said on Thursday that one of its freelance cameramen, Ashoka Mukpo, 33, had contracted Ebola in Liberia, the fifth American to be diagnosed after being infected in West Africa. NBC said he had quarantined himself after feeling ill and discovering he had a fever.

The Nebraska Medical Center in Omaha said in a statement that an Ebola patient was scheduled to arrive for treatment on Monday morning. The statement did not identify the patient, who would be the second to be treated there. The first was Dr. Richard Sacra, who was discharged on Sept. 25. He contracted the disease while treating people in West Africa.

NBC has said the entire reporting crew would return to the United States on a private plane and remain under quarantine for 21 days, the maximum incubation period for Ebola.

(Reporting by Bill Trott and Eric Beech in Washington, Julie Steenhuysen in Chicago, Colleen Jenkins in Winston-Salem, North Carolina, Lisa Maria Garza and Marice Richter in Dallas; Writing by Jim Loney and Grant McCool; Editing by Lisa Von Ahn and Jonathan Oatis)

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