A healthcare worker in Texas has been diagnosed with Ebola, the first known transmission of the deadly virus in the US. The nurse was involved in the care of Thomas Duncan, a man who arrived in Dallas from Liberia before showing symptoms of the disease. A hospital official said the healthcare worker was “following full CDC precautions,” including a mask, gloves, gown, and face shield while caring for Duncan when he arrived at Texas Health Presbyterian Hospital’s emergency room on September 28th.

At a press conference in Atlanta this morning, CDC director Tom Frieden said that “clearly, there was a breach in protocol,” adding that the agency will “undertake a thorough investigation to understand how this may have happened.” The patient has been identified as a nurse who had “extensive contact” with Thomas Duncan, though she was not included on a list of 48 people who were under monitoring by the CDC following Duncan’s original diagnosis. The agency, Frieden explained, had ruled out health care workers who came in contact with the patient after September 28th, when he was placed into isolation.

In extended remarks, Frieden added, “It is certainly very concerning, and it tells us that there is a need to enhance the training and protocols and to make sure that the protocols are followed. The protocols work. We have decades of experience caring for patients with Ebola, but we know that even a single lapse or breach … can result in infection.” The CDC has performed its own tests to confirm that the nurse indeed has Ebola.

It is unclear how the disease spread considering the precautions that were taken. Daniel Varga, chief clinical officer of Texas Health Resources, which runs the hospital, said “We’re very concerned.” It’s possible that the worker contracted the disease while removing the suit — a nursing assistant in Spain who tested positive for the virus last week after caring for an Ebola patient there suggested she got the disease from her protective gear. Her case is the first transmission of the disease outside of Africa.
It is not news that should bring about panic.”

The worker in Texas had been under voluntary self monitoring after coming in contact with Duncan, though she was not labeled a “high risk,” Varga told reporters. Self-monitoring includes taking one’s temperature twice daily. After reporting a fever on Friday, the nurse was immediately admitted to an isolation room at the hospital, and an Ebola test came in positive on Saturday night. Hazmat crews were then deployed to decontaminate the area where the worker lives, and officials began the process of tracking down anyone who had been in contact with the person.

Varga noted that “The system of monitoring, quarantine and isolation was established to protect those who cared for Mr Duncan as well as the community at large by identifying any potential Ebola cases as early as possible and getting those individuals into treatment immediately.”

That system worked as planned here. Dallas County Judge Clay Jenkins said, “We expected that it was possible that a second person could contract the virus. Contingency plans were put into place … which will make our jobs in monitoring and containment much easier in this case than in the last one.” He added, “while this is obviously bad news, it is not news that should bring about panic.”

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