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Dallas Hospital Alters Account, Raising Questions on Ebola Case

NEW YORK TIMES          Oct. 3, 2014

DALLAS TEX.      

On Thursday, the hospital, Texas Health Presbyterian Hospital in Dallas, released a statement essentially blaming a flaw in its electronic health records system for its decision to send the patient — Thomas E. Duncan, a Liberian national visiting his girlfriend and relatives in the United States — home the first time he visited its emergency room, Sept. 25. It said there were separate “workflows” for doctors and nurses in the records so the doctors did not receive the information that he had come from Africa.

But on Friday evening, the hospital effectively retracted that portion of its statement, saying that “there was no flaw” in its electronic health records system. The hospital said “the patient’s travel history was documented and available to the full care team in the electronic health record (E.H.R.), including within the physician’s workflow.”

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Germany received second Ebola patient

BBC            October 3, 2014

A hospital in the German city of Frankfurt-on-Main has taken in an Ebola patient after he was flown in during the night under tight security.

He is a Ugandan doctor who worked with Ebola patients in Sierra Leone. After arriving on a medical flight, the man was brought to Frankfurt University Hospital where he was placed in an isolation ward.

It is Germany's second case, with a man undergoing treatment in Hamburg after arriving from West Africa in August.

The Frankfurt hospital said the patient's arrival had gone well.

Hesse Minister of Social Affairs Stefan Gruettner said the patient had been working for an Italian aid organisation in Sierra Leone and had helped Ebola sufferers there before becoming infected himself.

Full Story
http://www.bbc.com/news/world-europe-29473623

Medical staff in protective equipment attend the arrival of the Ebola patient at Frankfurt University Hospital

 

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Ebola Victim's Air Journey shows weak spots in screening.

NEW YORK TIMES              October 3, 2014

MONROVIA, Liberia — The arrival in the United States of a Liberian man infected with the Ebola virus shows how difficult it is to control or restrict the disease from spreading, and how porous current procedures are in a world of globalized air travel.

Liberian officials said on Thursday that they planned to prosecute the passenger, Thomas E. Duncan, for lying on an airport questionnaire about not having contact with a person infected with Ebola before his travel — a pivotal part of the country’s screening process.

Mr. Duncan took three planes as he flew from Monrovia, the Liberian capital, to Dallas last month, connecting in Brussels and Washington.

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Dallas Hospital says software flaw led to initial release of Ebola patent

Update with additional information and text of the hospital statement  (scroll down).

 

5 NBC News Chicago

 Oct 3, 2014 • Updated at 7:53 AM CDT

The Dallas Hospital that sent Ebola patient Thomas Eric Duncan home said a software flaw, and not human error, caused doctors to miss the diagnosis, NBC News is reporting.

The electronic health records (EHR) system that the hospital uses has a separate workflow for physicians and nurses. The travel history of the patient was located in the nursing portion of the workflow within the EHR, but not in the physician's workflow.

“As result of this discovery, Texas Health Dallas has relocated the travel history documentation to a portion of the EHR that is part of both workflows," the hospital said.

Link to story

Source: http://www.nbcbayarea.com/news/national-international/Texas-Hospital-Software-Blame-Ebola-Patients-Misdiagnosis-277988141.html#ixzz3F5cyR89B

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U.S. Efforts to combat Ebola in Africa hampered by local conditions

NEW YORK TIMES                Oct 3, 2014
by Helene cooper

MONROVIA, LIBERIA

Detailed description of the delays and problems the U.S. military is facing in building hospital and other facilities to counter the Ebola epidemic.

Problems include breakdowns in equipment used by local contrators in preparing the sites and need to repair the battered runways of the main Liberian airport.

Read Full Report

http://www.nytimes.com/2014/10/03/us/us-effort-in-liberia-barely-gets-on-the-ground.html?_r=0

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NBC Cameraman stricken with Ebola in Liberia, being flown home

      NBC NEWS            October 2, 2014

An American freelance cameraman working for NBC News in Liberia has tested positive for Ebola and will be flown back to the United States for treatment.

...

The freelancer came down with symptoms on Wednesday, feeling tired and achy. As part of a routine temperature check, he discovered he was running a slight fever. He immediately quarantined himself and sought medical advice. On Thursday morning, the 33 year-old American went to a Medecins Sans Frontieres (MSF) treatment center to be tested for the virus. The positive result came back just under 12 hours later.

The cameraman, who also is a writer, is the fourth American to have contracted Ebola in Liberia. He has been working in Liberia on various projects for the past three years. NBC News is withholding the cameraman’s name at the request of his family.

Full Story

http://www.nbcnews.com/storyline/ebola-virus-outbreak/nbc-news-freelancer-africa-diagnosed-ebola-n217271

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USG expected to announce within days procedures for handling Ebola patents' medical waste

                                                    October 2, 2014

Reuters reports that the U.S.Government expects to settle within days the critical question of how hospitals should handle and dispose of medical waste from Ebola patients.

Experts have warned that conflicting U.S. regulations over how such waste should be transported could make it very difficult for U.S. hospitals to safely care for patients with Ebola, a messy disease that causes diarrhea, vomiting and in some cases, bleeding from the eyes and ears.

Read full story

http://www.reuters.com/article/2014/10/02/us-health-ebola-waste-idUSKCN0HR07T20141002

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WHO Situation Report: Few Signs Ebola is Coming Under Control

WHO: Ebola Response Roadmap Situation Report
1 October 2014  OVERVIEW
The total number of probable, confirmed and suspected cases (see Annex 1) in the current outbreak of Ebola virus disease (EVD) in West Africa reported up to 28 September 2014 is 7178, with 3,338 deaths. Countries affected are Guinea, Liberia, Nigeria, Senegal and Sierra Leone.
Figure 1 shows the total number of confirmed and probable cases in the three high-transmission countries (Guinea, Liberia, and Sierra Leone) reported in each epidemiological week between 30 December 2013 (start of epidemiological week 1) and 28 September 2014 (end of epidemiological week 39). For the second week in a row the total number of reported new cases has fallen. It is clear, however, that EVD cases are under-reported from several key locations. Transmission remains persistent and widespread in Guinea, Liberia and Sierra Leone, with strong evidence of increasing case incidence in several districts. There are few signs yet that the EVD epidemic in West Africa is being brought under control.
Read Full Report (with graphs)http://apps.who.int/iris/bitstream/10665/135600/1/roadmapsitrep_1Oct2014_eng.pdf

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Sierra Leone Situation worsens: Estimated Five New Cases per Hour

SIERRA LEONE SITUATION    TWO ARTICLES  (Scroll down)

THE GUARDIAN             OCT. 2, 2014

 Nowa Paye, 9, is taken to an ambulance after showing signs of the Ebola infection in the village of Freeman Reserve Liberia. Photograph: Jerome Delay/AP

Ebola is spreading at the rate of five new cases an hour in Sierra Leone, according to figures released as world leaders and experts on disease control gathered in London to discuss the outbreak.

The figures from Save the Children showed there were 765 new cases last week in the west African country alone, but only 327 hospital beds to treat infected patients. ...The rate of spread of the deadly virus is projected to double to 10 people an hour in the country before the end of October, Save the Children said.

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Man in U.S. With Ebola Had Been Screened to Fly, but System Is Spotty

NEW YORK TIMES   Oct. 2, 2014

By Matthew J. Wald and Jad Mouawad

As he was preparing to leave Liberia for Dallas two weeks ago, Thomas E. Duncan, the man confirmed to be the first Ebola case in the United States, was checked at the airport for signs of the disease. He was determined to have no fever and allowed to board his flight, American officials say. 

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