<p>^^^Not particularly surprising. There will probably be several people infected in association with this person. Fortunately in Dallas, we don’t bury our own dead, we don’t barricade CDC workers from our community so that we can handle it ourselves, we take it very seriously and are willing to do what is recommended to nip it in the bud.</p>
<p>I asked my wife (a doctor) about this, and she said that in a busy urban ER, they may not have known that the patient was Liberian at all, especially if he didn’t have insurance (which I assume he didn’t) and thus may not have shown any ID. They probably see a lot of sick people who look a lot like him.</p>
<p>There’s a news conference going on right now. Paraphrasing - A nurse asked the pertinent travel from Liberia question but regretfully the information was not communicated to the entire clinical care team. In other words, somebody messed up.</p>
<p>Too bad we can’t stamp an entry date on people that fades after 21 days. Maybe in invisible ink like for a concert.</p>
<p>^^^Of course they do. He presented exactly the way hundreds of patients a week do. The problem as I see it is that the CDC has sent all hospitals missives recommending that they ask about recent travel (and it should be asked in any case as early ebola can also present like malaria) in their ERs. I’m sure thousands of ERs didn’t ask that question that day and this hospital was the unlucky one. However, that’s really not an excuse if that is actually what happened.</p>
<p>I say wherever he resided while in dallas needs to be quarantined. If they are continuing daily routines such as going to school, work, etc then the risk is still there. </p>
<p>AP - school superintendent says they are monitoring 5 kids at home who were in contact with the patient</p>
<p><a href=“http://hosted.ap.org/dynamic/stories/U/US_EBOLA_CHILDREN_MONITORED?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2014-10-01-13-20-13”>http://hosted.ap.org/dynamic/stories/U/US_EBOLA_CHILDREN_MONITORED?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2014-10-01-13-20-13</a></p>
<p>I feel a bit bad about posting this much information, but it’s from a local TV station’s site. (Please tell me if I should delete.)</p>
<p><a href=“http://www.wfaa.com/story/news/health/2014/10/01/thompson-dallas-county-ebola-patient-cases/16524303/”>http://www.wfaa.com/story/news/health/2014/10/01/thompson-dallas-county-ebola-patient-cases/16524303/</a></p>
<p>The family reported that the patient did say that he was in an area affected by the Ebola outbreak</p>
<p>
</p>
<p>
</a></p>
<p>The last few paragraphs of the article linked by @missypie worry me. If the hospital is so sophisticated and they were so ready then why didn’t his symptoms combined with place of origin raise more red flags? Every person who comes into contact with patients or reviews charts also has to be “sophisticated”</p>
<p>Why did they give him antibiotics? “I’ve been in Liberia and I don’t feel well.” “Oh here, try this and come back in two weeks if you’re not better.” ???</p>
<p>So far I have not heard a good reason why the information provided by the patient was not communicated to the whole team. What does that even mean? They said she checked off that question and response on the questionnaire. That tells me that “the team” is not reading the triage nurses’ assessments. Additionally, this seems like information that I, as a triage nurse, would want to make sure had been received and duly noted. As soon as the patient admitted to having recently been in Liberia, he should have been put in isolation, given his symptoms. </p>
<p>I know it’s easy to quarterback, and as a nurse, I’m usually sympathetic to those in the medical profession, particularly those in busy urban ERs, but this was a big fail. It’s not scapegoating the ER staff to state categorically that if this information is true, they screwed this up royally.</p>
<p>At first I thought the country of origin was just mentioned in the context of not having a SSN…I could see where the billing-type folks would need training on connecting not having a SSN because a person is from X country with “tell someone.” But it sounds like it was a medical professional that he told. </p>
<p>I am very sympathetic to those who are overworked in all kinds of jobs. For years I have taken comfort in the fact that no wonder what kind of mistake I make at my job, no one dies. I could be sued, bankrupted, lose my license, etc etc but no one would ever die due to my act or neglect. There are so many people who can’t say that. </p>
<p>Cross posted with you, Nrdsb4. Thanks for providing your point of view as nurse.</p>
<p><a href=“Top doc: 'Several people were exposed,' more will be infected by Dallas Ebola case | Washington Examiner”>http://washingtonexaminer.com/top-doc-several-people-were-exposed...more-will-be-infected-by-dallas-ebola-case/article/2554213</a></p>
<p>Professor of medicine at Georgetown recommends that travel between the infected countries and the U. S. be ‘limited’.</p>
<p>
</p>
<p>Why to? Seems to me the only problem is from. If someone decides they want to go on vacation to Liberia I don’t see the need to stop them, I just don’t want them coming back with Ebola. </p>
<p>From the main Ebola infected countries (not talking about if one case shows up in Canada), it doesn’t seem unreasonable to have a quarantine protocol before getting on a plane to the US. These aren’t major trading partners with the US, we can tolerate whatever limiting of trade there is because of this quarantine. </p>
<p>From the Mayor:</p>
<p>
</p>
<p>Not the Mayor’s best moment (Does diversity = scary disease, Mr. Mayor?) I’m pretty sure our Liberian community would prefer to be highlighted for positive achievements.</p>
<p>^^^^If you limit the number of people allowed to travel there, you have less people to quarantine when they return, that’s why it makes sense to limit travel both to and from.</p>
<p>Obviously anyone WE SEND to the area to help stop the spread of the disease deserves whatever measures are required to take care of them in the event they are ill and in keeping them comfortable when they are quarantined prior to return.</p>
<p>Wasn’t there a headline last month that we’re sending 3000 soldiers to Africa to “fight” Ebola?
Still wondering about the risks of that decision.</p>
<p>
</p>
<p>I can’t say I’m educated on the logistical challenges of quarantining in Liberia, but really, how hard could it be? I don’t think we’re going to have thousands flocking to Liberia regardless if there’s some enforced limit or not. </p>