The Madrid hospital where the nurse got Ebola was specially chosen and prepared to handle Ebola.

[pnwmom]

And the nurse who got it only had 2 contacts with her patient.

http://www.nytimes.com/2014/10/07/world/europe/spain-reports-first-case-of-ebola-contracted-outside-west-africa.html

The Carlos III hospital was specially selected and prepared to treat another Spanish priest who had been working in Africa and was the first European to be repatriated after being infected with Ebola. The priest, August Miguel Pajares, died on Aug. 12, five days after entering the special unit of the hospital.

Ms. Mato, the health minister, would not discuss how a staff member could have contracted Ebola while working in a hospital specially equipped to handle such a dangerous virus. “We are trying to determine whether all the health safety protocols have been followed,” she said.

Ms. Mato urged people to remain calm, adding that “all the possible measures” were being taken to guarantee public health safety.

Antonio Alemany, a health official from the regional government of Madrid, told the news conference that the nurse went on vacation a day after Father García Viejo died. She contacted a medical center on Sept. 30, after feeling feverish, but had been leading “a normal life” while on vacation, he added, without giving details about her whereabouts during that period.

SNIP


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

A nurse in Spain has become the first person to contract Ebola outside of West Africa in the latest epidemic, authorities said on Monday.

The woman, who was described as a "sanitary tech," last month treated a priest in Madrid who later died of Ebola after contracting the virus while doing missionary work in Sierra Leone.

The elderly priest, Manuel Garcia Viejo, was treated in Madrid's Carlos III hospital, where he had been in quarantine since his return from Africa. He died on Sept. 25. The nurse entered the priest's room twice: Once to treat him and once upon his death, to recover his belongings, officials said. She began showing signs of illness on Sept. 30 and sought treatment, they said.

SNIP

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.

[Avalux]

1. It's certainly puzzling...

Ebola is a very messy disease in its end stage; the missionary died, so we know he was not in control of his body fluids, and they were probably everywhere. People had to take care of his body around that time, and then clean up. The article states the nurse was in contact with the missionary's body after he died. Very messy.

[JimDandy]

2. And both of their patients died too.

Not a good track record for them, so far. This track record may be what is in store for us if they can't get a handle on what happened there in order to prevent it here.

It certainly is looking like it is hard to NOT get Ebola, if your exposure is to a dead infected body or someone in the very end stages of the disease when their body is chock full of the virus.

(eta-there was nothing in the post but the title and link when I first replied.)

[magical thyme]

43. their patients were both very old and probably very advanced disease state

since they died very quickly after arrival. The 2nd one died I think within 3 days of being shipped in, so probably was not saveable.

But I do question their preparedness based on other things. I just don't think they respect women as professionals there, and this is what that leads to.

[Bluenorthwest]

3. What exactly is a sanitary tech and what treatment would such a tech provide?

nt

[pnwmom]

4. The second article says:

"The nurse entered the priest's room twice: Once to treat him and once upon his death, to recover his belongings, officials said."

[Bluenorthwest]

7. I read that. I asked what sort of treatment a sanitary tech would provide because that detail is

important and they refer to her as a sanitary tech, a term I am not familiar with.

[pnwmom]

8. Why is the label more important than what she actually did?

Although obviously that wasn't clear from what the hospital said.

[Bluenorthwest]

9. It is not more important, I also asked what she actually did. The 'label' or job title, becomes the

only clue to the sort of 'treatment' actually provided. Which we do not know. Important as it is.

[dixiegrrrrl]

10. Exactly,,,

she has been described as a nurse and as a sanitary clerk interchangeably, but nurse duties usually do not include disposing of infected room sheets and etc.
Well, at least not in US. I believe. Maybe different in Spain.

[PADemD]

11. Here's a job description for HEALTH CARE SANITARY TECHNICIAN

http://oatels.doleta.gov/images%20a-i/HEALTHCA602.pdf

[riverwalker]

17. So no direct patient contact?

like environmental services in US?
Is that link from a Spanish hospital?

[PADemD]

25. No, not Spanish site. Found the description on line through a job title search.

[riverwalker]

36. sounds like a nursing assistant in US

from the press conference in Spain:

•The infected woman was not a nurse but a "auxiliar de enfermeria", a nursing assistant. She worked in both cases under WHO and the European center for the control of infectious diseases.
•The infection event is still under investigation; she went twice into the patient's room: once to assist him and then after the former patient died. No accidental contact was reported.

[morningfog]

39. "to assist him" sounds like contact.

[MohRokTah]

5. Most likely, she broke protocol. eom

[pnwmom]

6. Most likely, the protocol is much, much harder to follow than people think.

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=5629124

[kestrel91316]

12. There's no room for error with Ebola. it only takes a single virus particle to infect and kill.

[LisaL]

13. And they follow protocol so well in Dallas.

A whole bunch of sheriff's deputies went into Duncan's apartment without any protective gear.
People washed his puke off the pavement. No protective gear again.
It would be a miracle if it didn't spread, not the other way around.

[MohRokTah]

14. Not really

Exchange of bodily fluids is required.beyes, nose, mouth or an open wound.

[LisaL]

15. Not really?

How did this nurse get it? She was in the hospital wearing protective gear.
Please explain this since you seem to know so much.

[MohRokTah]

16. She failed to follow protocols and got fluid in her eyes, nose, mouth, or open wound. eom

[pnwmom]

19. No one knows that she deliberately failed to follow protocols. Even her hospital is saying

they don't know what happened.

It could be that the protocols are so complicated they're almost impossible to follow perfectly.

[MohRokTah]

24. Nobody said she deliberately failed to follow protocols. That she failed to follow protocols...

is a fact as evidenced by her infection.

And no, they are not all that complicated, but one misstep and you open yourself up to infection.

[pnwmom]

26. Or maybe she followed the protocol perfectly and there was a tiny hole in her glove

or other flaw in her protective wear.

And you might not think the protocols are complicated, but many medical personnel do.

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=5629923

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=5629124

[woolldog]

49. Lisa don't you love all the Ebola experts on here.

I mean, if it were so cut and dry as to how you can catch or not catch Ebola this nurse would have never gotten infected. People are getting infected even when they do follow the latest protocols. So maybe we don't know as much as we think we know.

[TBF]

18. Open wound on your hand while

wiping up bodily fluids. Pinprick hole in the glove ... I can see how this would happen.

I've been reading extensively on this as I am an immune compromised person (chronic illness). I don't worry about catching it in the air or anything like that. But there are going to have to be very strict procedures on working with patients and clean up of facilities.

One thing I read is about recommendations for simple things like hand-washing and alcohol-based sanitizing agents (apparently alcohol-based cleaners kill this virus).

At this point I think the best we can do is learn as much as possible as the pharma companies work to develop treatments/potential vaccines.

[cwydro]

29. What about the NBC cameraman?

He says he had no direct contact with anyone.

The whole thing is puzzling.

[LisaL]

31. He washed a car in which somebody died from Ebola.

[MohRokTah]

32. He did have direct contact with somebody's bodily fluids.

He may not know when or where, but he did.

Touch a place where infected fluids exist, then rub your eyes. That's an infection vector.

The average person touches their face somewhere between 3000 and 4000 times per day, and there are four locations on everybody's face that can become an infection vector.

[magical thyme]

44. he had splashback while helping to disinfect the car

or a chair. I read he said he remembered getting a tiny splash in his face while helping disinfect something ( I remembered it as chair, but may have misread or misremembered that).

[Barack_America]

20. Given most people are symptomatic 8-10 days from infection,

The math would suggest she became infected while treating the priest, having begun showing symptoms 5 days after his death (when she collected his things).

From what I've seen, it looks like the biggest risk is when ungowning. The gowns are so loose, there are bound to be crevices that escape the sanitizer. Take off your gloves before your gown...boom. Plus, the special types of masks they're wearing are awful to wear, and have to be fit-tested before you know they'll work. Adjust/remove your mask first...boom.

I've scrubbed into surgeries many, many times. When I try to visualize gowning and ungowning for an Ebola patient, it's almost paralyzing.

[pnwmom]

21. This is what I'm afraid of. It's not that people are deliberately being lax on the precautions,

it's just that it's so hard to follow them perfectly.

[Barack_America]

22. Gowning and ungowning should be witnessed.

[pnwmom]

23. That would help. I wonder if that's standard. n/t

[ecstatic]

27. Perhaps ebola is no longer as "difficult" to catch as researchers

keep insisting. Maybe catching it required direct contact 2 decades ago, but that might not be the case now. It's troubling to hear all the blame that is thrown around as one trained medical professional after another comes down with the disease. Maybe the doctors and nurses are doing everything right. How can they fully protect themselves if the guidelines they're getting are wrong/outdated.

[MohRokTah]

34. The structure of Ebola simply does not allow for that sort of a mutation.

Anything is possible, that is a highly unlikely mutations. It's far more likely the virus would mutate to being shed while the infected person is still asymptomatic, making the infection vectors happen earlier.

[cwydro]

28. We still don't know how the cameraman got it either.

He's certainly not medical personnel of any sort.

[LisaL]

30. He thinks he got it when he washed an infected car.

[XemaSab]

37. Which was washed how long after the person died?

"Direct contact with bodily fluids" isn't "I touched something 24 hours later that an infected person had touched."

[LisaL]

41. But fluids on surfaces can stay infected with a virus, and it's not clear for how long.

I didn't see it reported on how long ago the person died in the car before he washed it.

[pnwmom]

48. I found this.

http://www.msdsonline.com/resources/msds-resources/free-safety-data-sheet-index/ebola-virus.aspx

SURVIVAL OUTSIDE HOST: The virus can survive in liquid or dried material for a number of days (23). Infectivity is found to be stable at room temperature or at 4°C for several days, and indefinitely stable at -70°C (6, 20). Infectivity can be preserved by lyophilisation. 


[pnwmom]

47. The virus can remain alive on surfaces at room temperature for days.

http://www.msdsonline.com/resources/msds-resources/free-safety-data-sheet-index/ebola-virus.aspx

SURVIVAL OUTSIDE HOST: The virus can survive in liquid or dried material for a number of days (23). Infectivity is found to be stable at room temperature or at 4°C for several days, and indefinitely stable at -70°C (6, 20). Infectivity can be preserved by lyophilisation. 


[cwydro]

38. Washed a CAR?

Really?

Darn, where does that leave the gut washing vomit off the sidewalk in Dallas?

This is just crazy, ya know?

[LisaL]

40. Coming to a hospital near you? Or me?

[kestrel91316]

42. Possibly. If the vomit was not bone dry when he started spraying it,

he could have been exposed to viable virus.

[riverwalker]

33. they used "extreme" precautions

http://elpais.com/elpais/2014/10/06/ciencia/1412611515_352524.html

The patient was admitted in the morning with a high fever. So the hospital activated the protocol before a possible case of Ebola and is isolated in the emergency room. A total of 60 health professionals who have had contact with the affected are under surveillance, according to a spokesman for the Union of Nursing.
She is a woman of 44, married and childless, of Galician origin but has been in the Carlos III over 15 years, according to other health center that consulted by this newspaper. These other colleagues who, as the affected, have been working in shifts to care of the missionaries, have expressed surprise at the spread as protective measures were "extreme". Health protection wearing two coveralls two pairs of gloves and goggles when treated patients.

[pnwmom]

35. Well, that's discouraging. n/t

[Yo_Mama]

45. Yeah, but it's probably in the downstream chain of decontamination.

Not directly when handling the patient. Clearly that's why they are now going to check all the other health care workers. If there was a flaw once, it may be systemic and have potentially exposed more than one worker.

One thing, this will cause every center to review all their procedures and training very, very carefully. Pure hell to be the canary in the Ebola mine, though.

[Yo_Mama]

46. That article says she had fever beginning on the 30th???

Not good.

Previamente, el pasado día 30, había alertado al servicio de riesgos laborales del hospital de que tenía fiebre.

Why did it take so long to test her?