Fears of the Ebola virus have deepened with word that a second US nurse caught the disease from a patient and flew across the Midwest aboard an airliner the day before she was diagnosed.
President Barack Obama cancelled a campaign trip to address the outbreak.
It’s not clear how the nurse contracted the virus, though the second case among health workers pointed to lapses beyond how one individual may have donned and removed protective clothing.
Authorities declined to say what type of care the nurse provided to Thomas Eric Duncan, who was diagnosed with Ebola after coming to the US from Liberia. He died on October 8.
Even though the nurse did not report having a fever until Tuesday, the day after she returned home, she should not have boarded a commercial airliner after learning that another nurse, Nina Pham, had been diagnosed with Ebola, government officials said today.
CDC Director Tom Frieden said no one else involved in Duncan’s care will be allowed to travel “other than in a controlled environment”.
Infected Ebola patients are not considered contagious until they have symptoms. Dr Frieden said it was unlikely that other passengers or airline crew members were at risk because the nurse did not have any vomiting or bleeding.
Even so, the CDC is alerting the 132 passengers aboard the Frontier Airlines Flight 1143 from Cleveland to Dallas-Fort Worth on Monday “because of the proximity in time between the evening flight and first report of illness the following morning.”
Officials are asking them to call the health agency so they can be monitored. The woman flew from Dallas to Cleveland on October 10.
The nurse reported a fever on Tuesday and was in isolation within 90 minutes, Dallas County Judge Clay Jenkins said.
“We are looking at every element of our personal protection equipment and infection control in the hospital,” said Dr Daniel Varga, chief clinical officer for Texas Health Resources, which operates Texas Health Presbyterian Hospital Dallas.
In Washington, the White House said Mr Obama’s trip to New Jersey and Connecticut would be postponed to a later date. The president was to meet with top officials who are co-ordinating the government’s response to Ebola.
His decision to nix the trip – just a few hours before Air Force One was scheduled to depart – reflected the urgency of the situation amid escalating concerns about the disease.
The second nurse will be transferred to a special bio-containment unit at Emory University Hospital in Atlanta, where other Ebola patients have been successfully treated, Dr Frieden said. Ms Pham will be monitored in Dallas to determine the best place for her care.
The CDC has acknowledged that the government was not aggressive enough in managing Ebola and containing the virus as it spread from an infected patient to a nurse at a Dallas hospital.
“We could’ve sent a more robust hospital infection control team and been more hands-on with the hospital from day one about exactly how this should be managed,” he said on Tuesday.
The second case may help health officials determine where the infection-control breach is occurring and make practices safer for health workers everywhere.
For example, if both health workers were involved in drawing Mr Duncan’s blood, placing an intravenous line or suctioning mucus when he was on a breathing machine, that would be recognised as a particularly high-risk activity. It might also reveal which body fluids pose the greatest risk.
Dr Frieden outlined new steps this week designed to stop the spread of the disease, including the creation of an Ebola response team, increased training for health care workers nationwide and changes at the Texas hospital to minimise the risk of more infections.
The new case lends support to nurses’ claims this week that they have inadequate training and in some cases, protective gear, to take care of Ebola patients.
“They’re not prepared” for what they are being asked to do, said RoseAnn DeMoro, executive director of National Nurses United, a union with 185,000 members.
Based on statements from nurses it did not identify, the union described how Mr Duncan was left in an open area of the emergency room for hours. It said staff treated him for days without the correct protective gear, that hazardous waste was allowed to pile up to the ceiling and safety protocols constantly changed.