Dallas hospital missed chance to contain Ebola

Eighty people may have come in contact with the first diagnosed U.S. Ebola patient before he was hospitalized in Dallas, calling into question why Texas Health Presbyterian clinicians failed to recognize the symptoms when he first sought care and missed a chance to isolate him when he was contagious.

Although hospitals across the country report they were well aware the deadly virus would likely hit the U.S. in September and the patient's sister claims he told a nurse he had just come back from Liberia, clinicians at the Dallas hospital diagnosed him with a low-grade, common viral infection and sent him home with an antibiotic, Vox reports.

But the vital piece of information wasn't communicated to the full team, Mark C. Lester, executive vice president of the healthcare system, told the publication. "As a result, the full import of that information wasn't factored into the clinical decision-making."

The patient--Thomas Eric Duncan--is now in isolation and receiving treatment, and public health workers are tracking and monitoring anyone who had close contact with him, NPR reports.

Although Edward Goodman, hospital epidemiologist at Texas Health Presbyterian, told NPR that his team had a meeting just last week to go over the special checklist sent out by the Centers for Disease Control and Prevention and was well-prepared for a potential Ebola case, the clinicians missed it because the initial symptoms of fever and headache are so similar to other illnesses.

Now that the virus has hit U.S. soil, hospitals are primed to look out for additional cases. Some hospitals have staff ask every patient who shows up at the emergency room about recent travel, regardless of symptoms, according to the NPR report. "We don't want to miss any single case," Ross Wilson, chief medical officer at New York City Health and Hospitals Corp., told NPR. The company's 11 emergency departments get more than 1.2 million visits a year. And for the past few weeks, because of Ebola, Wilson says, staff ask every single person about travel.

Epidemiologist Rossi Hassad, Ph.D, of Mercy College in New York City, told Medpage Today he was troubled that despite heightened awareness about the Ebola virus and enhanced hospital assessment protocols, "a patient with Ebola-related symptoms and a history of travel from Liberia was not readily considered a suspected case of Ebola. This must not be repeated, as it may prove costly."

To learn more
- read the Vox story
- here's the NPR report
- read the MedPage Today story

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