U.S Ebola Patient: Family Quarantined

Courtesy Medpage Today by Michael Smith

The family of the Dallas Ebola patient has been quarantined so they can be monitored twice a day for symptoms of the virus, according to a Texas health official.

The so-called "control order" was issued in order to ensure the family members would be available for the monitoring, according to David Lakey, MD, the commissioner of the Texas Department of State Health Services.

They're among about 100 people being assessed for possible exposure to the patient, identified as Thomas Eric Duncan, while he was symptomatic, Lakey told reporters in a joint telebriefing between the CDC and Texas officials.

But Lakey and other Texas officials didn't explain why the quarantine order was needed, except to say they were concerned that the family might not be properly monitored -- with temperatures taken twice daily -- without it.

In a later news conference, Dallas County Judge Clay Lewis Jenkins, the country's chief executive, said he and other officials had information that suggested the order was "appropriate ... for the safety of the family and the safety of the public."

But he said he would not be disclosing the information.

Earlier, Lakey said food and groceries were being delivered to the family and a cleaning organization would be brought in to decontaminate the apartment and safely to remove soiled sheets, laundry, and other potentially contaminated items.

At the moment, he said, the family members have no symptoms and pose no risk to others.

Lakey also said the man was sent home with antibiotics after his first appearance at Texas Health Presbyterian Hospital even though he had told a nurse that he had been in Liberia. "Unfortunately, connections weren't made between the travel history and symptoms," he said.

He said the case is a "lesson for all of us ... across the U.S., people don't take the travel history as seriously as they need to."

CDC Director Tom Frieden, MD, said the lapse is "a teachable moment."

The officials gave no details of Duncan's condition, except to say that it is serious. Frieden added that the use of experimental therapies is "being discussed" and decisions will rest with the treating physician and the patient.

Several of the American Ebola patients airlifted from West Africa for treatment in the U.S. were given investigational therapies, but it remains unclear what effect they had.

The "bottom line," Frieden said, is that "we remain confident that we can contain any spread of Ebola within the United States."

He said some of the people in Dallas who were in close contact with Duncan might have been infected, but systems are being put in place so that those infections won't spread.

That requires "meticulous and rigorous" work to assess possible contacts and identify those who are at risk and need to be monitored for 21 days, Frieden said. CDC experts, as well as state and local officials, are doing that work now, he said.

Indeed, "the risk of an ongoing or uncontained outbreak in the U.S. is highly unlikely within our public health and medical infrastructure," commented Steven Lawrence, MD, of Washington University School of Medicine in St. Louis.

And the infection is unlikely to spread within the hospital where Duncan is being cared for, he told MedPage Today in an email: "We know how to contain it ... the infection prevention methods are effective when used properly."