CHICAGO - Health authorities in the United States are advising the nation’s hospitals to re-evaluate their approach in providing care to Ebola patients.
Speaking Monday in Atlanta, Georgia, U.S. Director Tom Frieden urged hospitals to watch for patients with fever or symptoms of Ebola who have traveled from the three worst-affected West African nations - Liberia, Sierra Leone and Guinea - in the past 21 days.
Frieden also said authorities are investigating how a nurse in Dallas became the first person to contract the disease within the United States. He blamed an unknown "breach of protocol" for the infection of the woman, who treated a Liberian man who was the first person to die of Ebola in the United States.
Family members identified the nurse as 26-year-old Nina Pham.
The CDC is monitoring 48 hospital workers who treated or were in contact with that man when he was very sick.
President Barack Obama on Friday met with senior members of his administration for an update on what the White House called the "apparent breach in infection control protocols" at the Dallas hospital. He said that the investigation should occur quickly and that lessons learned from it should be disseminated to health care workers nationwide.
Also Monday, Obama spoke with U.N. Secretary General Ban Ki-moon, saying the international community must redouble its resolve and decisively address the Ebola crisis.
In addition, the president spoke with his French counterpart, Francois Hollande. The White House said the two leaders agreed that more needs to be done to set up Ebola treatment facilities in the affected African countries.
Frieden made the declaration on Sunday at a news conference and called for an investigation into how the unidentified nurse became infected while caring for Liberian national Thomas Eric Duncan, the first Ebola patient diagnosed in the United States. Duncan died last week at Texas Health Presbyterian Hospital.
Healthcare and infection control experts said that hospital staff need to be coached through the stages of treating an Ebola patient, making sure they have the right safety equipment and know how to use it properly to prevent infection.
It was not immediately clear whether the Texas hospital prepared its staff with simulation drills before admitting Duncan, but a recent survey of nurses nationwide suggests few have been briefed on Ebola preparations. Officials at the hospital did not respond to requests for comment.
Some experts also question the CDC's assertion that any U.S. hospital should be prepared to treat an Ebola patient as the outbreak ravaging West Africa begins to spread globally. Given the level of training required to do the job safely, U.S. health authorities should consider designating a hospital in each region as the go-to facility for Ebola, they said.
“You don't scapegoat and blame when you have a disease outbreak,” said Bonnie Castillo, a registered nurse and a disaster relief expert at , which serves as both a union and a professional association for U.S. nurses. “We have a system failure. That is what we have to correct.”
More than 4,000 people have died in the worst Ebola outbreak on record that began in West Africa in March.
In recent months, the CDC has published detailed guidelines on how to handle various aspects of Ebola, from lab specimens and infectious waste to the proper use of protective equipment.
How that information gets communicated to frontline workers, however, varies widely, Castillo said.
In many cases, hospitals “post something on a bulletin board referring workers and nurses to the CDC guidelines. That is not how you drill and practice and become expert,” she said.
CDC spokesman Tom Skinner said the agency is still investigating the case of the Dallas nurse, but stressed that “meticulous adherence to protocols” is critical in handling Ebola. “One slight slip can result in someone becoming infected.”
Skinner said the CDC is going to step up its education and training efforts on how to triage and handle patients, and may consider designating specific hospitals in each region as an Ebola treatment facility.
“We've been doing a lot over the past few months, but clearly there is more to do,” he said. “The notion of possibly transporting patients diagnosed with Ebola to these hospitals is not something that is out of the question and is something we may look into.”
Dr. Gavin Macgregor-Skinner, an expert on public health preparedness at Pennsylvania State University, also disagreed with the talk of a breach of protocol, saying it just puts the onus on the nurse.