CDC: Nurse shouldn't have flown

(CNN) -- The day before she went to the hospital with Ebola symptoms, Amber Vinson was flying halfway across the country on a commercial jet with 132 other people.

CDC Director Dr. Tom Frieden said she never should have stepped foot on the flight, but another federal official told CNN that no one at the agency stopped her.

Before flying from Cleveland to Dallas on Monday, Vinson called the Centers for Disease Control and Prevention to report an elevated temperature of 99.5 Fahrenheit and informed the agency that she was getting on a plane, the official said. She wasn't told not to board the aircraft, the official said.

After authorities announced the 29-year-old nurse had been diagnosed with Ebola on Wednesday, they were quick to say guidelines weren't followed when she took the commercial flight.

Dallas Mayor Mike Rawlings said he wasn't sure how it happened.

"She was being monitored here in Dallas," he told CNN's "The Situation Room."

"And if she was being monitored correctly, I think she should have never gotten on that flight."

Frieden said she shouldn't have flown because she helped care for Ebola patient Thomas Eric Duncan, and because another health worker who cared for Duncan had already been diagnosed with the virus.

"The CDC guidance in this setting outlines the need for what is called controlled movement. That can include a charter plane, a car, but it does not include public transport," Frieden said. "We will from this moment forward ensure that no other individual who is being monitored for exposure undergoes travel in any way other than controlled movement."

CDC guidelines warn airport screeners that travelers returning from West Africa with a temperature of 100.4 Fahrenheit and higher could be showing Ebola symptoms.

Frieden said Wednesday that Vinson's slightly elevated temperature was another sign she shouldn't have boarded the aircraft.

Vinson didn't show any symptoms when she got on a flight Frontier Airlines flight from Cleveland to Dallas on Monday, the airline said.

Frieden said there's an "extremely low" risk to anyone else on that plane, but the CDC is reaching out to everyone on the flight as part of "extra margins of safety."

Vinson was transferred Wednesday night from the Dallas hospital to Emory University Hospital in Atlanta, which has successfully treated two other patients. It is now treating a third: a male health care worker who was infected in Sierra Leone.

Vinson is "ill but clinically stable," Frieden said.

The first Dallas health care worker diagnosed with Ebola, Nina Pham, remains in good condition, officials said. It has not been determined whether she will be transferred to another facility.

Both Dallas health workers had "extensive contact" with Duncan on September 28-30, when he had "extensive production of body fluids" such as vomit and diarrhea, Frieden told reporters in a conference call.

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Health care workers who had been exposed to Duncan were undergoing self-monitoring. Moving forward, the CDC will ensure that no one else in such a situation travels outside of a closed environment, he said.

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Vinson flew from Dallas-Fort Worth to Cleveland on October 10, Frontier Airlines said. On October 13, she headed home.

That's the flight health officials are concerned about, though they stress that the risk of exposure to passengers who were on the plane with Vinson is low, since she did not yet show symptoms. The Ebola virus is not contagious before symptoms set in.

"Because of the proximity in time between the evening flight and first report of illness the following morning, CDC is reaching out to passengers who flew on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth Oct. 13," the CDC said in a statement. The flight landed Monday at 8:16 p.m. CT.

The woman "exhibited no symptoms or sign of illness while on Flight 1143, according to the crew," Frontier Airlines said in a statement.

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The October 13 flight was cleaned thoroughly after it landed, "per our normal procedures which is consistent with CDC guidelines," the airline said. After the airline was informed of the Ebola patient, the plane was removed from service.

After going through decontamination, the plane was going back into service on Wednesday, Ricky Smith, Cleveland's Director of Port Control, said at a news conference. Both the CDC and the airline were comfortable that it was safe to resume operations, he said.

 

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In a sign of growing concerns about Ebola, President Barack Obama canceled trips to New Jersey and Connecticut on Wednesday to convene a meeting at the White House of Cabinet agencies coordinating the government's response to the outbreak.

Hospital denies 'institutional problem'

Vinson, who lives alone, is in isolation at Texas Health Presbyterian Hospital.

The news that she contracted Ebola cast further doubt on the hospital's ability to handle the virus and protect employees.

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It's the same hospital that initially sent Duncan home, even though he had a fever and had traveled from West Africa. By the time he returned to the hospital, his symptoms had worsened. He died while being treated by medical staff, including the two women who have contracted the disease.

"I don't think we have a systematic institutional problem," Dr. Daniel Varga, chief clinical officer of Texas Health Resources, told reporters, facing questions about the hospital's actions.

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Medical staff "may have done some things differently with the benefit of what we know today," he said, adding, "no one wants to get this right more than our hospital."

People in the Vinson's office building were informed when officials went door to door, and also through early morning reverse 911 calls, officials said.

The health care worker had no pets, authorities said.

Official: Duncan should have been moved

An official close to the situation says that in hindsight, Duncan should have been transferred immediately to either Emory University Hospital in Atlanta or Nebraska Medical Center in Omaha.

Those hospitals are among only four in the country that have biocontainment units and have been preparing for years to treat a highly infectious disease like Ebola.

"If we knew then what we know now about this hospital's ability to safely care for these patients, then we would have transferred him to Emory or Nebraska," the official told CNN senior medical correspondent Elizabeth Cohen.

"I think there are hospitals that are more than ready, but I think there are some that are not."

埃博拉病毒的患者立馬就商用飛機; 為什麼沒有人阻止她？
由凱瑟琳·E. Shoichet，喬希列弗和冬青燕，美國有線電視新聞網
2014年10月16日 - 更新0116 GMT（0916 HKT）
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疾控中心：護士不應該飛
新聞提要
新：聯邦官員：疾病預防控制中心沒有告訴文森不上飛機
新產品：琥珀文森到達埃默里大學醫院
衛生官員要採訪132名乘客飛抵誰在飛機上與她
達拉斯市長：“有沒有辦法，她應該已經上飛機”
（CNN） -她到埃博拉症狀住院的前一天，琥珀文森乘飛機 中途 全國各地的商業噴氣機與132其他人。
疾病預防控制中心主任湯姆·弗里登博士說，她根本就不應該涉足的飛行，但另一個聯邦官員告訴CNN說，沒有人在該機構阻止了她。
在從克里夫蘭到達拉斯在週一飛，文森稱美國疾病控制和預防報告一個高溫99.5華氏溫度和告知，她已經在飛機上的機構，該負責人表示。她沒有被告知不能登機，該負責人表示。
之後，當局宣布29歲的護士被診斷出患有埃博拉週三，他們很快地說指引並沒有跟隨，當她拿著商業飛行。
達拉斯市市長邁克·羅林斯說，他不知道是怎麼發生的。
“她在這裡被達拉斯監控，”他告訴美國有線電視新聞網的“形勢室”。
“如果她是被監視正確，我想她應該從來沒有得到的那個航班。”
弗里登說，她應該不會飛，因為她幫助照顧埃博拉患者托馬斯·埃里克·鄧肯，因為其他衛生工作者誰照顧鄧肯已經被確診為病毒。
“在此設置的疾病預防控制中心的指導概述了需要什麼叫做受控運動，這可以包括包機，一輛汽車，但不包括公共交通，”弗里登說。“我們將從這一刻向前確保誰是被監視暴露任何其他個人旅行經歷以任何方式比控制運動等。”
CDC指南警告機場安檢員在旅客從西非帶回了100.4華氏溫度和更高的可顯示埃博拉病毒的症狀。
弗里登週三表示，文森的稍高的溫度是另一個跡象，她不應該登上飛機。
文森並沒有表現出任何症狀，當她從克里夫蘭到達拉斯星期一的班機邊疆航空公司的航班，航空公司說。
弗里登說，有一個“非常低”的風險給任何人上飛機，但疾控中心已深入到每個人的飛行，作為一部分“安全額外的利潤。”
文森轉移週三晚上 從達拉斯醫院埃默里大學醫院在亞特蘭大，已成功治療的另外兩個病人。它現在處理第三：男性醫護人員誰被感染的塞拉利昂。
文森是“病，但臨床上穩定，”弗里登說。
第達拉斯醫護人員確診為埃博拉病毒，尼娜範，保持良好的狀態，官員說。它尚未確定她是否將被轉移到另一個設備。
無論是達拉斯衛生工作者曾與鄧肯“廣泛接觸”9月28-30日，當他“豐富的生產體液”，如嘔吐，腹瀉，弗里登告訴記者，在一次電話會議。
由於埃博拉應航空旅行限制？
醫護人員誰曾接觸過鄧肯正在經歷自我監測。展望未來，疾病預防控制中心將確保沒有人在這樣的情況下傳播的一個封閉的環境之外，他說。
疾病預防控制中心要採訪的乘客
文森從達拉斯 - 沃斯堡飛往克里夫蘭10月10日，邊疆航空公司說。10月13日，她頭球破門。
這是飛行的衛生官員擔心，儘管他們強調，暴露的風險，乘客誰是與文森飛機是低的，因為她並沒有表現出症狀。埃博拉病毒是不會傳染之前設定的症狀。
“因為在晚上的航班和疾病的第一份報告的第二天早上之間的時間接近，疾病預防控制中心正在深入到乘客誰飛到邊疆航空公司航班1143克里夫蘭到達拉斯/沃斯堡10月13日，”疾病預防控制中心在一份聲明中說： 。該航班降落週一下午8點16分的CT。
女人“沒有表現出症狀或疾病的跡象，而在飛行1143，據劇組工作人員，”邊疆航空公司在一份聲明中說。
你在前線戰鬥的埃博拉？
10月13日航班被清洗後徹底降落，“根據我們的正常程序，這與疾病預防控制中心的指導方針相一致，”航空公司說。之後，該航空公司獲悉埃博拉病人，飛機是從服務中刪除。
在經歷去污，飛機正要回服務於週三，瑞奇·史密斯，端口控制的克里夫蘭騎士隊的主任，在新聞發布會上說。無論是疾病預防控制中心和航空公司很舒適，它是安全的恢復運營，他說。
古普塔適合在埃博拉病毒防護裝備 市長：'關注'關於埃博拉蔓延 了解埃博拉協議 導演：護士的感染“不可接受”
約埃博拉日益關注的跡象，美國總統奧巴馬取消了週三前往新澤西州和康涅狄格州召開一次會議在白宮內閣機構協調政府應對疫情。
醫院否認“制度問題”
文森，誰獨自生活，是孤立的，在得克薩斯州衛生長老會醫院。
她染上埃博拉病毒的消息對醫院的處理能力的病毒和保護員工進一步懷疑。
完全覆蓋埃博拉
這是同一家醫院，最初送鄧肯的家，即使他有發燒和西非曾前往。當他回到醫院的時候，他的症狀已經惡化。他死了，而醫務人員正在接受治療，其中包括誰而染病的兩個女人。
“我不認為我們有一個系統性的體制問題，”丹尼爾·瓦爾加博士，得克薩斯州衛生資源的主要臨床人員告訴記者，面臨著對醫院的行為問題。
里克·佩里頭到歐洲，儘管埃博拉病毒情況
醫務人員“可能與我們今天所知道的利益做一些不同的事情，”他補充說，“沒有人希望得到這個權利超過了我們醫院。”
在文森的辦公樓的人被告知，當官員挨家挨戶，並通過清晨反向911電話，官員說。
在醫護人員沒有寵物，當局說。
官方：鄧肯應該被移動
一名官員接近的情況說，在事後，鄧肯應該被立即傳送到任何埃默里大學醫院在亞特蘭大和內布拉斯加州醫學中心的奧馬哈。
這些醫院都只有四個具有生物控制單元，並已準備多年治療一種傳染性很強的疾病如埃博拉病毒的國家之一。
“如果我們知道我們現在那麼了解安全地照顧這些患者在這家醫院的能力，那麼我們就會把他轉到埃默里或內布拉斯加州，”該官員告訴美國有線電視新聞網資深醫藥記者伊麗莎白·科恩。
“我認為有醫院是多準備，但我覺得有一些則不是。”