Dallas Ebola infection/incubation timeline 10.16.14

[morningfog]

Days since Duncan showed symptoms (Sept. 24)......22 days.


Days since Duncan was isolated (Sept. 28).....18 days -- 48 people are being observed in this group, including his family and the first responders. No one from this group has shown any symptoms of infection.


Days since Duncan's death (Oct. 8)......8 days -- 76 people provided care to Duncan before his death. As of today, two nurses, Nina Pham and Amber Vinson, have shown symptoms and infection has been confirmed. Pham was in his room often, from the day of his admission until the day before he died, which is when he would have been the most infectious and his bodily fluids contain the highest viral load. Vinson was in his room during the three days prior to the hospital wearing hazmat suits. It is unclear when her last contact with Duncan was.


Days since Pham showed symptoms (Oct. 10).....6 days -- One person is being observed as having direct contact with Pham after she showed symptoms.

Days since Vinson showed symptoms (Oct. 14)......2 days -- Vinson flew on a commercial flight (with some 100 other passengers) from Cleveland to Dallas with a temperature of 99.4 degrees. She was quarantined and will be transferred to Emory.

______________________________________________________


The class of people exposed to Duncan pre-isolation have not shown symptoms and likely will not. The incubation period of this strain is 7-10 days in most people who become infected. In three days the 21 day incubation period will expire.

Both Pham and Vinson were isolated when they had no symptoms other than a low-grade fever. Their viral load was low and it is unlikely they infected anyone prior to isolation.

The 74 other people in the same class/timeline as Pham and Vinson are now in the critical period. If more were infected, they will most likely show symptoms in the next 1-4 days, with just over two weeks to go until the 21 days.

Of course, the clock has just started (and will restart) for those treating Pham and Vinson. Pham has been upgraded to "good condition" following treatment and a blood transfusion from Dr. Brantly. VInson is to be transferred to Emory for treatment.

[vanlassie]

1. Thank you for your clarity.

[morningfog]

2. Vinson listed in stable condition. Monitoring not even ncesseay for remaining 75 health workers.

http://abc13.com/health/will-there-be-another-texas-case-of-ebola/352769/

Authorities told Eyewitness News 75 people remain at risk of contracting the virus after treating Thomas Eric Duncan. Duncan died from the virus last week.

Texas Health offered any one of the at-risk employees a room in the hospital. For the next few weeks, each must monitor themselves for Ebola symptoms. Hospital leaders stressed this is not medically necessary. They're acting out of precaution

.

[morningfog]

3. It's believed that Pham and Vinson were infected from the 28th to the 30th, 50 others entered room.

CDC officials believe workers at Texas Health Presbyterian Dallas faced the greatest danger of infection after the Liberian man who eventually died at the hospital, Thomas Eric Duncan, was first admitted on Sept. 28 but before lab tests confirmed an Ebola diagnosis three days later. “Our investigations increasingly suggest that the first several days before the patient was diagnosed appear to be the highest risk period,” CDC Director Tom Frieden said Wednesday in a media briefing. The two nurses who became infected had “extensive contact” with the patient during that three-day period, while he was vomiting and had diarrhea.

Duncan was isolated at that time and the hospital says nurses followed CDC guidelines. But the recommendations were changing, and the union representing nurses has said protocols were missing or inadequate. “When the CDC issued updates, as they did with leg covers, we followed their guidelines,” the hospital said in an e-mail today. The hospital didn’t initially have Tyvek isolation suits, and some in the first batch that arrived were too big for the nurses. “It is possible that nurses used tape to cinch the suits for a better fit,” according to the hospital’s statement.
Story: A Texas College Rejects Nigerians Over Ebola Concerns

There’s a lot we don’t know but this much is clear: In the first days that Duncan was hospitalized, hospital workers had never before seen Ebola. That alone raises the risk that they were inadvertently exposed to a virus that, by all accounts, requires meticulous procedures to prevent seriously ill patients from infecting caregivers.

It takes as long as 21 days between when someone is infected with Ebola and when they develop symptoms. If other workers contracted the virus from Duncan between Sept. 28 and Sept. 30, the window in which they’d get sick closes around Oct. 21. The CDC is “planning for other eventualities in case we get additional cases in the coming days,” Frieden said.

The agency is monitoring about 50 hospital workers who entered Duncan’s room during his treatment. That includes the the entire time he was hospitalized, not just the first three days before Ebola was confirmed. There are another 48 people Duncan had contact with before he was admitted. None have so far shown signs of illness, according to the CDC. The 21-day incubation period will close for them this weekend. Other people who had direct contact with the stricken health-care workers are also being monitored.

http://www.businessweek.com/articles/2014-10-16/ebola-what-the-next-week-will-tell-us-about-americas-risk

[morningfog]

4. Pham flown to NIH in Maryland. Vinson flown to Emory. No new infections reproted as yet.

All good things.

It is good that it seems (at least for now) any Ebola patient will be treated in one of four isolation units who actually know how to do it and have done it well.

Other good facts:

No additional health care worker of the 74 have reported any symptoms.
None of Duncan's 48 pre-isolation contacts have reported symptoms.
There is only one person who had direct contact with Pham after her fever.

[morningfog]

5. 19 days with no signs of infections in Duncan's pre-isolation

group of 48.

No new infections from Duncan's health care provider today. Very good thing. 9 days since his death, we are in that critical time for symptoms to appear.

[KMOD]

6. One Duncan contact has been cleared

and released from quarantine.

http://thescoopblog.dallasnews.com/2014/10/hospital-workers-who-cared-for-countrys-first-ebola-patient-asked-to-limit-movement.html/

slowly but surely, we're getting there.

[morningfog]

7. Very good news.

We are in a very fluid moment right now. As the days pass and the numbers being monitored are cleared (even if some more health workers are added in the interim) everyone will begin to calm down. Hopefully the infected number will not grow at all anymore.

[Yo_Mama]

8. Thank you for continuing these factual and informative posts.

I am so glad we don't have news of another case to post in response. You have no idea how glad I am!!

[morningfog]

9. Thanks for the thanks.

It helps me to follow to story with details and timelines. A DU OP is a good place for me to keep track of data and facts, whether anyone else ever looks at them or not, lol.

[KMOD]

11. It's very much appreciated, morning fog :)

on Monday, all Duncan initial contacts, including Louis Troh and her family, will be free to get on with their lives.

http://www.bigcountryhomepage.com/story/d/story/duncans-family-to-leave-quarantine/18661/B8sJVTOPnkmKlLX8KeYyKg

Edited to add:

My heart breaks for Louis Troh and her family. I can't imagine losing a loved one and not being able to grieve with others. When I had heard that Louis fell to the floor in grief upon learning of Thomas Eric Duncan's death, and that no one could console her, that broke my heart.

[uppityperson]

10. Thank you for putting this together, it clearly shows who all and what all

You are the best, thank you very much.

[GusBob]

12. good synopsis thanks. how many false alarms have there been?

Such as the deputies who visited the apartment. I think there have been others across the country

Some prisoner in our local jail claimed he was exposed but it proved to be false