If you’re like most of us, when you heard that a healthcare worker in Dallas had been diagnosed with Ebola virus disease, you assumed that the exposure occurred during his first visit to the hospital.<\/p>\n
That is, before<\/em> he was diagnosed with Ebola, and before<\/em> infection precautions had been instituted.<\/p>\n But no, it happened after he was diagnosed, and isolated, and presumably when all the care providers were using infection prevention measures of some sort. The same is true for the second Dallas healthcare worker, and the nurse in Spain, and in none of these cases can a specific breach in precautions be definitively pinpointed as the cause.<\/p>\n Yes, the nurse’s union in Dallas is citing major problems with their protocols<\/a>, and certainly there were issues in Spain as well<\/a>. But regardless of what actually happened, these cases emphatically reinforce that safe care\u00a0for\u00a0Ebola virus disease is a monumental challenge. Which is\u00a0why all of us ID doctors are on high alert for the time when such a case occurs, and why yesterday CDC stated they would send out an expert response team to any hospital that has a confirmed case<\/a> — a decision that makes tons of sense.<\/p>\n I confess the magnitude of this infection control challenge did not fully strike me until last week — this is before the Dallas care providers were diagnosed — when I heard a fascinating, brilliantly clear plenary talk at IDWeek<\/a>\u00a0from Bruce Ribner, the doctor in charge of the Emory team that cared for two Ebola patients.\u00a0If you have half an hour, I cannot recommend this presentation strongly enough.<\/p>\n There’s a shortened text summary here<\/a>\u00a0on the IDWeek website,\u00a0and many of his slides can be downloaded here<\/a>\u00a0(they were used for a national teleconference yesterday).<\/p>\n A remaining\u00a0question — should all Ebola virus disease patients be cared for in designated centers\u00a0only?\u00a0The CDC is actively considering this recommendation, which needless to say has huge ramifications for our healthcare system.<\/p>\n Your thoughts?
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