U.S. Ebola Patient’s Family Confined

     DALLAS (CN) – Relatives of a patient with the first confirmed domestic case of Ebola have been ordered into isolation in their apartment under armed guards, and the Dallas hospital treating him is under fire for releasing him on his first visit to the emergency room.
     Thomas Eric Duncan traveled from his home in Liberia on Sept. 20 and became ill in Dallas on Sept. 24 while visiting relatives, the Centers for Disease Control and Prevention said .
     Duncan sought treatment at Texas Health Presbyterian Hospital Dallas on Sept. 26. He was admitted to the hospital two days later after developing symptoms consistent with the infectious disease. He has remained in isolation since and remains in serious condition, the hospital said Thursday.
     Dallas County officials are leading the response, in close consultation with the CDC and the Texas Department of State Health Services, among other agencies.
     Dallas County confined Duncan’s immediate family to a north Dallas apartment on Wednesday evening, according to Dallas County Commissioner Clay Jenkins.
     “The actions that we took, while unusual, were appropriate,” Jenkins said at a news conference Thursday. “We are there for the safety of the family and the safety of the public.”
     Jenkins declined to elaborate on what specific information triggered the confinement orders.
     Several days worth of food have been delivered and a contractor is scheduled to decontaminate the apartment, he added.
     “I recognize there are competing interests in their rights and freedom and the overarching public concern,” Jenkins said.
     Four close family members of Duncan are subject to the confinement order “out of an abundance of caution,” DSHS officials confirmed.
     “The orders were hand-delivered to the family members Wednesday evening by local health officials,” DSHS said in a statement.
     “The orders legally require the family to stay at home and not have any visitors without approval from the local or state health department until at least Oct. 19. The order is in place until the incubation period has passed and the family is no longer at risk of having the disease.”
     Public health experts have cast a wide net in the investigation, with “100 potential or possible contacts” with Duncan being monitored for symptoms, according to the DSHS.
     While severe and often fatal, Ebola is difficult to transmit. It requires direct contact with blood, bodily fluids or contaminated needles. It is not spread through casual contact or through the air.
     The virus is not contagious before symptoms appear, which include sudden fever, fatigue and headaches. The incubation period, between exposure and symptoms, can be from two to 21 days.
     The hospital has faced a wave of criticism about why Duncan’s travel history did not set off red flags that would have prevented his release during his first visit.
     The hospital said that while protocols were followed by the doctor and nurses, it has identified a “flaw” in the way physician and nurse portions of its electronic health records interacted in this case.
     “The documentation of the travel history was located in the nursing workflow portion of the EHR, and was designed to provide a high reliability nursing process to allow for the administration of influenza vaccine under a physician-delegated standing order,” hospital officials said in a statement Thursday. “As designed, the travel history would not automatically appear in the physician’s standard workflow
     Also Thursday, Liberian officials announced that Duncan would face criminal charges for allegedly lying when questioned for airport screening.
     Duncan answered “no” on a questionnaire asking whether he had cared for an Ebola patient or touched the body of someone who died in an area affected by Ebola, The Associated Press reported.
     Duncan had helped carry an ill and pregnant neighbor into a taxi and her death was believed to be related to her pregnancy, the AP reported.
     It is unknown whether Duncan knew of the woman’s cause of death when he left for Dallas.
     Hospitals officials said that during questioning on his first visit, Duncan said he not been around anyone who was ill.
     Eric Weeks, Duncan’s nephew, was so concerned about his uncle’s release that he personally contacted the CDC for help.
     “I called CDC to get some actions taken, because I was concerned for his life and he wasn’t getting the appropriate care,” Weeks told NBC News. “I feared other people might also get infected if he wasn’t taken care of, and so I called them to ask them why is it a patient that might be suspected of this disease was not getting appropriate care?”
     Weeks said he hopes “nobody else got infected because of a mistake that was made.”
     Also Thursday, NBC News said that an American cameraman working in Liberia had contracted Ebola, and will be flown back to the United States for treatment.

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