Nurse in Madrid tests positive for ebola

[cali]

The Spanish nurse is the first person in the current outbreak known to have contracted Ebola outside Africa.

She was a member of the team that treated Spanish priest Manuel Garcia Viejo, who died of the virus on 25 September.

Some 3,400 people have died in the outbreak - mostly in West Africa.

The priest died in the hospital Carlos III de Madrid after catching Ebola in Sierra Leone.

<snip>

http://www.bbc.com/news/world-europe-29514920

[mainer]

1. Wow. This happened in a modern hospital, with precautions.

And they already knew the patient had Ebola.

[cali]

2. yes, that was my thought too.

I'm still unclear as to how easy/difficult it is to contract.

[Cali_Democrat]

11. You're unclear, but it's actually quite clear how someone could contract Ebola

http://www.cdc.gov/vhf/ebola/transmission/index.html

Perhaps you should familiarize yourself with this information.

[cali]

15. I have read it.

However, people are not all the same. duh. couldn't figure that out? that figures. Individual immune systems vary. and quite a few experts,including the microbiologist who discovered and named ebola, believe it is mutating.

http://www.neonnettle.com/news/1185--ebola-is-mutating-says-professor-peter-piot

[Cali_Democrat]

16. You still appear to be unclear about how one could contract Ebola

You also appear to be unclear about viruses themselves and how they survive.

Regardless of the individual, the only way someone can contract Ebola is through direct contact. People are not all the same? Of course people aren't the same, but the only way for ANYBODY to get Ebola is through direct contact with the body fluids of someone infected or objects infected with the virus...such as a syringe.

Not everyone who comes into contact with the virus will be infected, but the only way for anybody to get the virus is through direct contact.

You probably need to educate yourself a little more on this subject before you panic.

The Flat Earth Society would like us to panic and run around like chickens with our heads cut off.

Me?

I prefer the scientific approach.

[pnwmom]

33. This hospital was specially chosen and prepared to handle Ebola.

And they say it is unclear how this nurse could have contracted Ebola, given all the precautions.

[Scootaloo]

76. Human or chance error.

[Yo_Mama]

14. Well, the CDC lists someone in the room (three feet) for a prolonged period without PPE

as at risk, so maybe that's how.

It's clear that direct contact isn''t necessary when the patient is acutely infectious.

It could also have been from transference - for example, in taking off the PPE, in Africa they are first dousing the person with chlorine, so the person doesn't become infected by stripping off their infected protective wear. It could also have been from PPE people leaving the vicinity and going to another area where they disrobed who touched knobs/doors etc on the way and then another person who was not all garbed up touched those surfaces. Then there is dealing with the disposal/handling of the discarded PPE. There have to be multiple layers of isolation in order for this all to work perfectly.

However they knew the patient was coming days before, and they should have been totally prepared, so this is going to be a shock to everyone, CDC included. The western medical community will be awaiting the outcome of the investigation with some anxiety.

It's very very hard to have total sterilization in acute care settings. I am not sure that the "modern" western hospitals are going to do that much better than some of the hospitals in Africa, which are in many cases well set up.

Sorry someone snarked at you for expressing the reasonable and obvious thought.

Btw, I just came from a medical clinic, and this news was not making anyone any happier. We have had several people coming in the past week wanting testing because of what they believed was possible exposure, and we've had multiple calls in the last two weeks from families who have relatives who just arrived from Africa who wanted their relatives tested. None of which is possible, btw. The CDC case criteria exclude it, and Ebola testing is done only specialized labs. We are referring them to hospitals because they should be tested, but I don't think any of them are going to be tested.

This situation is not under control at all. Anyone who can get out of Africa who believes that they are at risk is heading straight for the US. Sooner or later, one of them will be infected. Sooner or later, one of them will not evidence clinical infection, but be shedding virus. There are always carriers.

Btw, of the ones who came in last, one was a professor of medicine, and one was a top pharmaceutical exec. So the "hysteria" is more prevalent among the highly qualified and knowledgeable than among those who watch Fox News. A crowd-think is forming on DU, but it's not a well-informed crowd-think.

[pnwmom]

25. It's hard to believe that the staff who first met the Ebola patient inside the "bubble,"

the staff who were outfitted from head to toe in protective gear, didn't continue to use every precaution they could think of. So, yes, this is scary.

Also, the fact that the nurse had only had 2 contacts with the patient. http://www.democraticunderground.com/10025628900

Thanks for the information about the testing. It's outrageous that people who have been in Africa recently and VOLUNTEER for testing can't be tested.

[uppityperson]

31. Your link says she had earlier treated another priest with ebola but outside incubation period.

http://www.nbcnews.com/storyline/ebola-virus-outbreak/spanish-nurse-first-person-contract-ebola-outside-africa-n219581

Health authorities said the nurse earlier had also helped treat another priest, Miguel Pajares, 75, who had been working in Liberia when he was afflicted with Ebola. He was airlifted back to Spain on Aug. 7 and died five days later.

"We are working to verify the exact source of contact to see if all strict protocols were followed," Spanish Health Minister Ana Mato said at a news conference on Monday.

Thirty health-care workers who came into contact with the nurse will now be under observation for 21 days, Spanish health officials said. They are also working to compile a list of people the unnamed nurse may have interacted with outside of the hospital.

Edited as I misread the month as Sept, not Aug.

[pnwmom]

35. Yes, outside the incubation period. So she must have gotten it from one of her two contacts

with the second priest.

[uppityperson]

38. I misread the other's month so edited. It will be interesting to see what they trace back

for her at work and at play. I wish her the best, good health.

[dixiegrrrrl]

3. Yeah.....kinda makes one...pause....for a moment, ya know? n/t

[uppityperson]

4. :( Once again a caregiver. :(

[Sopkoviak]

5. I'm withholding judgement and speculation until we know

If the nurse is black and uninsured because,

Well you know.

[cali]

6. nope. don't know. don't know what your inane snark has to do with this story. fail.

[etherealtruth]

7. No, I don't know ....?

Spain has an effective universal health care program....?

[Cali_Democrat]

13. My post angered conservatives.

Spain has universal health care like every western country, except for America.

[840high]

62. No - I don't know.

[Avalux]

8. "She started to feel ill last week when she was on holiday."

Which means, all those who may have been in contact with her while on holiday (where?), will need to be identified and monitored.

I'm wanting to know how she became infected.

[morningfog]

17. And why didn't she immediately report when she felt ill?

She had been treating an Ebola patient and then feels ill?

Or did she report?

[magical thyme]

68. she did, her only symptom was a slightly elevated temp. she checked in immediately and apparently

they sent her on her way.

The problem is their criteria. The threshold temp of 101.5F is way too effing high. Duncan's was only 100.1, which didn't meet the guidelines and is why he was released.

Unfortunately I think because too many people were quick to blame the doctor without looking more closely, we have a repeat. In the US, calls to the CDC have spiked dramatically in the last week. From 100 suspicious and only a dozen isolated and tested, to some 800 calls.

[Aerows]

18. My question

Where was she, where did she go, and she has been wandering around for a week not feeling well???

[dixiegrrrrl]

47. And therein lies the huge problem with Ebola

Not only does it take massive numbers of people to treat patient groups,
it takes massive numbers to track down all the "contacts" every time someone is infected.

Kinda spooky when you think of 6 degrees of contact principle. Ripples in a pond of contacts.

[etherealtruth]

9. Mistakes and breeches happen ... but, one would think (hope) ....

...that a multi layered system of precautions would be in place.

This is certainly disconcerting .... never-the -less hoping this woman receives the very best care, recovers with no further spread of the disease.

[mainer]

10. Up till now, I've been sanguine about it. Now a little worried.

She was on holiday when she felt ill. Who knows how many people she may have infected -- at the hotel, at restaurants, at the hospital when she checked herself in. If it was a resort area, then there would have been travelers there, who would subsequently head to their respective cities...

[deutsey]

12. I'm trying to reserve judgment

but this new development is unsettling.

[Aerows]

19. And for nearly a week

Who knows how many people she has come in contact with and like you say, they will head off to their own respective cities, only to get sick, and possibly wander around for a week thinking they have a travel bug, infecting people as they go ...

[morningfog]

20. It's not clear how long she was feeling ill,

and she only has a fever. Hopefully, she went in early enough so as to not infect anyone.

[Avalux]

21. Keep in mind though - people get infected from contact with body fluids.

We have no idea if 'feeling ill' means she was vomiting, or sweating, or had diarrhea, that others may have been exposed to....

[morningfog]

23. Only a fever according to reports.

That is a positive.

[Avalux]

24. That is very good news.

If that was her only symptom, then others weren't at risk, unless she was exchanging body fluids.

It's interesting to me....to consider the extent of exposure that causes infection. If a person is infected with a small 'dose' of the virus, it might take awhile for the viral load to get to a level where symptoms occur (up to 21 days). But if a person is infected with a large 'dose' (as in semen/sexual or blood contact), symptoms would occur much sooner.

[Aerows]

34. "High Fever"

is a tip off that it wasn't just that day.

A low grade fever is the initial stage, high-grade fever comes as your immune system works overtime against itself with Ebola.

[suffragette]

67. Deutschewelle is reporting she felt ill for "several days" before she went to a hospital.

http://www.dw.de/spanish-nurse-first-to-contract-ebola-outside-africa/a-17979617

The 40-year-old nurse checked into hospital in the Madrid suburb of Alcorcon on Sunday, despite having started to feel ill several days earlier.



Pretty much confirms what you have been thinking about the fever.

[Aerows]

71. Thanks for that

Appears she wandered.

[pnwmom]

22. After only having 2 contacts with an Ebola patient.

How are these health care personnel, who are all taking recommended precautions, getting exposed to the disease?

http://www.democraticunderground.com/10025628900

[Avalux]

26. Well, we don't know they're taking the necessary precautions.

They're supposed to, but all it takes is one mistake...perhaps a soiled bed sheet not disposed of properly....vomit not cleaned up properly...

[pnwmom]

28. It's hard to believe that the staff that met the missionary when he was in his "bubble,"

the staff that were suited up from head to toe, decided to later dispense with the precautions. And they have said they didn't.

Also, the nurse only had 2 contacts with the patient. It clearly takes very little exposure to become infected with this virus.

[kestrel91316]

27. Horrifying breach of recommendations. She has low risk exposure, presumably,

having worked on ebola patients. So when she got that fever, why was she not IMMEDIATELY isolated???

Now they have to scramble to find everyone she had any contact with over the past week.

Jesus wept.

[Avalux]

29. Because she was on holiday....last week.

That just boggles my mind.

[Aerows]

36. Came in with High Fever

Low grade spread and immune system response as it begins to turn against itself is a symptom. HIGH fever, means it is a lot more present in bodily fluids. I'm just going by the reports. She was "feeling ill" but maybe a low grade fever, when it spiked, she went to the hospital.

[yawnmaster]

85. caregivers are actually among the high risk group. eom

[riversedge]

30. "first person in the current outbreak known to have contracted Ebola outside Africa"

And so it starts.

[jeff47]

37. OMG!!! INCINERATE AFRICA NOW!!! AND SPAIN!!!!!

STOP ALL GLOBAL TRAVEL!!!!!! IT'S JUST LIKE THE BLACK DEATH!!!!!!!



Guess what? People make mistakes. Even in hospitals. Only takes one slip for the people treating the ill to catch ebola.

[Rex]

41. .

[Aerows]

44. Read what you just wrote.

"Only takes one slip for the people treating the ill to catch ebola"

It appears that way. I don't work in health care, so I'm not worried. My spouse doesn't work in health care so I'm not worried. My family members that work in health care couldn't possibly be infected. Nobody I know could possibly be infected because no mistakes will be made by the hospital or lab that MY family members work at.

[jeff47]

50. Stop panicking, and think through your scenario.

A medical professional makes a mistake and gets infected. What happens? Exactly what happens here.

The people treating ebola patients are themselves monitored, and when they start showing symptoms, they go into quarantine too.

She got a fever. That's it. So she couldn't have spread it. She was not a fountain of blood and bile infecting everyone in Spain. Despite all the panic in this and lots of other threads.

[Aerows]

54. You are so sweet.

You always show up every single time anyone questions the government and their handling of any situation.

And this is spreading of misinformation, let me inform you of a few things.

She tested POSITIVE. TWICE. She only came into the hospital after running a HIGH fever, not a low grade one, which means it is taking over her body. More transmissible.

"It's going to be alright, and anyone saying anything different is a cuckoo" tends to be your narrative. That's fine. I have a much more curious mind than yours, and I hope others have curious minds, too. You can't shut down every conversation that makes a government agency look bad just because you want people to shut up, be quiet and stop asking questions.

Not on the internet, so get used to it.

[DisgustipatedinCA]

66. Excellent post, and probably long overdue.

I'm a huge believer in science. I'm also a huge believer in human fallibility. That doesn't leave us in a very good place as regards Ebola.

[Aerows]

72. I'm hanging in there.

this isn't political, but a bunch of people want to make it so.

I don't. It needs to be dealt like as what it is - a global health emergency.

[jeff47]

69. And you're still panicking.

You always show up every single time anyone questions the government and their handling of any situation

And you always show up insisting science is always wrong. Such as here.

She only came into the hospital after running a HIGH fever, not a low grade one, which means it is taking over her body. More transmissible.

And if you'd stop panicking for a minute, you'd pause to remember how ebola is transmitted. She has a fever. That's it. She's not bleeding. She's not vomiting. She's not fucking everyone she comes across. The virus doesn't appear in sweat or spit until later in the disease.

In other words, she still could not infect large masses of people. Yet you are insisting that this is horrible because she could have infected large masses of people.

I have a much more curious mind than yours

No, you utterly reject evidence that you don't like over anything that reinforces your preconceptions. Then you disappear when you're shown to be utterly wrong.

You claim that makes you more curious, because you're just exploring other options. What that actually means is you're demanding people respond to your impossible theory instead of what can actually happen.

What if Ebola was caused by thermisol? Let's spend weeks pushing any story we find claiming a cover-up to help big business sell mercury-based preservatives!

[Aerows]

75. Are you frightened? n/t

[distantearlywarning]

63. Nobody is panicking.

It's worth thinking through and talking about these things, and thinking through and talking about is not the same thing as "panic" or "hysteria". Stop trying to police discussions.

[jeff47]

70. No, it really isn't.

It's worth thinking through and talking about these things

Only when you understand the disease well enough to have a useful discussion.

What if ebola is transmitted by sunspots? What if ebola travels backwards in time from a post-apocalyptic future? We should think through and talk about those possibilities.

Alternatively, we could keep in mind what is already known about the virus and stop thinking about and talking through things we know are not true.

[Aerows]

74. It is *EXACTLY* an attempt at policing discussions

That is the first indication of grasping at straws and desperation.

[Aerows]

78. Thank you

the last think we need is policing discussions, particularly with those that don't have their facts straight.

Screaming on DU that no one has been infected except ... a nurse in Spain.

May God bless the victims and Spain.

[Jamastiene]

39. I hate Ebola.

It is sad that it exists in the first place, but even sadder to see it spreading all over the globe like this. I hate that disease. Stephen King could not have invented a disease that was scarier and nastier.

[yawnmaster]

58. the drama regarding it is sure spreading, but the disease isn't. eom

[morningfog]

65. Uh, the disease has been spreading for months.

[kestrel91316]

79. Uh, yes it is. Tell the folks in West Africa it isn't and then get back to us.

If you aren't in a million little pieces by then.

[yawnmaster]

82. I'm sorry, my context was in this country. Sorry for the clarification. eom

[kestrel91316]

87. No problem. But give it time. We ain't so special.

[yawnmaster]

88. I disagree. We are special. we have the education and the infrastructure...where we should spend..

dollars is to also make Africa special like us.
That is where the key to fighting this resides.

It will take education - the foundation of the epidemiological infrastructure.

[glowing]

40. It may be worse that she was on holiday when this occurred.

When you are at home, you pretty much fend for yourself. When on holiday, restaurant staff who takes away dirty dishes and silverware are in immediate contact, as well as the dishwashers in the back... And those wait staff have contact with many, many more people in any given day. AND, then there is the hotel staff; more specifically, the cleaning staff going from room to room cleaning toilets, changing sheets, cleaning off sink tops.... And it's not as if these are the types of job positions that are paying top dollar, no matter what country. They are less likely to run to the Dr for a tiny sniffle.

And if she's on Holiday, is she with anyone? Is she having sexual contacts with other people? And then they too have other partners down the road? It is she married and has a husband and children in close proximity to her? And those children are attending school and the husband other work functions?

It really is a bit disconcerting to know she was with the patient 2 times, probably suited up since they were treating this patient, and still got Ebola. Maybe it wasn't from the Enola patient they were treating with all the precautions; perhaps another ill patient came in and they were unaware he/ she had Ebola, and they were given antibiotics and sent back out of the hospital. Oh, and before going on holiday, how many patients in the hospital with a weakened immune system did she come into contact with, other staff members, and general public visiting with patients.

This does have the potential of becoming bigger by the day. And this is a fairly contained viral infection... Just imagine a viral strain that can be passed thru the air? It seems we've been lucky as a world to contain disease and viral outbreaks that used to wipe out so many people. But viruses change and mutate pretty rapidly as far as evolution standards go. Should we all panic? No! Should we be demanding a better plan of dealing with these types of infectious diseases here. Our health care is disjointed and not everyone has insurance, so the first reaction for hospitals is to release the patient, rather than test for a virus from Africa.

[Aerows]

42. She didn't get admitted

until she already had a high fever. That means that she had a lot more viral content in her body if the WHO and CDC are to believed. Thus, could infect a lot more people.

[Rex]

43. So does this mean she was infected while on vacation?

For a decease that isn't traditionally very easy to catch, she sure did seem to get it easily. I hope she can be treated and cured.

[Aerows]

45. She said she wasn't feeling well

and didn't go in until AFTER she had a high fever. Not just the low grade one.

Our resident "don't be alarmed, our government has everything under control" folks are showing up, so that leads me to believe that we need to be a little less gullible toward what is being said. Not to the point of paranoia, no, but it's time for some questions to be asked, some funds to be dedicated, and for those that desire burying our heads in the sand to STFU and let intelligent people have a conversation.

[Rex]

46. I wonder too if they are actually scared, truly frightened

and so the only way they know how to decrease some of that fear - is to act silly stupid about it, "THE END IS NEAR SERIES!" so that makes them feel better. Like it is NOT really happening and they can make fun of it at a distance.

People cope with stress in different ways. I have no compunction to panic (nor have I seen anyone on DU panic), so the 'town criers' seem to be humming to hear themselves imo. I am, however, worried...and I want to talk about this topic like rational adults do.

Worry is healthy, a good human response to a worsening crisis.

[kestrel91316]

48. I have thought that Friedman's calm, deliberate reassurances seemed a bit forced this

weekend. I think he's scared.

[distantearlywarning]

64. I agree.

I think it's whistling past the graveyard. But denial and "ostriching" isn't any more helpful than is panic/hysteria.

It's not only fine, but a really good thing to have some discussion about this situation. For example, maybe if the nurse in Dallas had had a few more conversations with other people about Ebola and where it originated and the symptoms, etc, s/he would have alerted a doctor to his condition instead of sending him home with antibiotics. I read that Duncan's girlfriends' daughter was highly informed about the risks and possibilities and as a result insisted on calling 911 and warned the paramedics when they came. Too bad others who came in contact with him weren't as well-informed and willing to take action instead of pretending like everything would be fine. A little knowledge goes a long way.

Right now, I'm not worried about getting Ebola at all. But neither am I on board with the posters who just want everyone to stop talking about it.

[jeff47]

52. No, fever does not spread ebola.

She would have to be vomiting or bleeding. Or having sex with someone.

[Aerows]

53. Sigh.

Fever is a SYMPTOM of the presence of the virus in ones system and thus the ability to be contagious. Via blood, semen, urine, bleeding and yes, SWEAT.

If you wish to spread misinformation, take it up with the CDC. I'm quoting exactly their literature on it. Sweat. Saliva. Sputum.

If you have better information than the WHO and CDC, then I suggest you head to Madrid post-haste because they need you.

[Drayden]

57. So the NBC camera man was bled on or vomited on?

Or was he bumping uglies with ebola patients?

[yawnmaster]

59. He thinks it may have been from body fluids (blood likely since ebola patients leak) in a car...

in which a person had died.
so essentially it was probably blood or vomit.

[Drayden]

60. Blood is pretty darn visible.

Not to mention has a distinct odor and feel. I highly doubt he sat in a puddle of blood. Much more likely to have been sweat. Sweat from, ya know, fever.

[yawnmaster]

61. he was spraying water and trying to clean the inside of the car. actually it was quite likely blood

the person was dead in the car. That means they had been leaking blood from pretty much all possible ways.

this is what gives ebola such a high drama R number.

[rainbow4321]

81. Anyone see the pic of Dallas apt sidewalk being power washed?

Duncan reportedly threw up outside as he was being taken to the ambulance. FOUR days later the news got video and pics of a guy dressed in shirt and jeans, NO protective gear, power washing that sidewalk. While passerbys stood and watched.

These people may be fucked.

[yawnmaster]

83. those people may. but an epidemic it doesn't start. eom

[Aerows]

77. Which makes that assertion ridiculous

if people are getting it through hazmat suits, we need to evaluate the situation with some different ideas than "We think it is the size of a bread box, smaller than a mouse trap and longer than 10 hours."

[kestrel91316]

80. What an ignoramus. Fever indicates the patient has become contagious.

Per CDC guidelines.

You know, that evidence-based science-y stuff?

[Drayden]

49. This is what confuses me

By all accounts this hospital and nurse took many precautions to protect from ebola transmission and she still caught it, yet the family of Mr. Duncan lived with him for days in a small, crowded apt and with his soiled linen for days longer still, and to date (10+ days later) no else that was around him or in that apartment had fallen ill.

[LisaL]

51. Incubation period is up to 21 days.

[Drayden]

55. While that is true,

It is my understanding that is a maximum timeline made with an abundance of caution and the vast majority that will go on to get infected start exhibiting symptoms within 7-10 days of exposure virtually all within 2 weeks. I think the family members and healthcare workers and EMS team that had the most direst exposure to Mr Duncan can be optimistic they have passed the most critical timeframe and still don't have symptoms. I am hopeful no one else will fall sick, but wish we understood more the mechanism of transmission, why some in space suits taking universal precautions, and some with very minimal exposure (the NBC camera man for example) have caught it and others with no protection and much more exposure have not.

[Aerows]

56. Hard to tell

It seems to depend on how much viral material affects the person to infect them.

[yawnmaster]

84. mainly because fomites have not been shown to transmit. If they do then it is at a low frequency...

from the CDC:
"In the only study to assess contamination of the patient care environment during an outbreak, virus was not detected in any of 33 samples collected from sites that were not visibly bloody. However, virus was detected on a blood-stained glove and bloody intravenous insertion site.3 There is no epidemiologic evidence of Ebolavirus transmission via either the environment or fomites that could become contaminated during patient care (e.g., bed rails, door knobs, laundry)." Aug. 14, 2014

from;
http://www.cdc.gov/vhf/ebola/hcp/environmental-infection-control-in-hospitals.html

[Drayden]

86. I read today they plan on euthanizing

then incinerating the nurse's dog Is there even any evidence a dog could spread this disease? Apparently the nurse and her husband are against this being done to their dog. Can you imagine being helpless and trapped in a hospital and sick and knowing this will be done to your pet dog, which many view as a family member? This seems like exaggerated true panic, unlike the harmless speculation done here.

[Aerows]

73. Any updates? n/t