Wednesday, 29 October 2014

Ebola nurse on defensive gets call from Obam

ATLANTA (AP) — A nurse who fueled Ebola fears by flying to Cleveland after being infected by her dying patient was released Tuesday from a hospital isolation unit, where doctors defended her as a courageous front-line caregiver.

Another nurse, held for days in a medical tent in New Jersey after volunteering in West Africa, was in an undisclosed location in Maine, objecting to quarantine rules as overly restrictive.

While world leaders appeal for more doctors and nurses on the front lines of the Ebola epidemic, health care workers in the United States are finding themselves on the defensive.

Lawyers now represent both Amber Vinson, who contracted the virus while caring for a Liberian visitor to Texas, and Kaci Hickox, who is challenging the mandatory quarantines some states are imposing on anyone who came into contact with Ebola victims.

The virus is still spreading faster than the response, killing nearly half of the more than 10,000 people it has infected in West Africa.

World Bank President Jim Yong Kim said Tuesday that at least 5,000 more health workers are urgently needed in Liberia, Sierra Leone and Guinea. U.N. Secretary-General Ban Ki-moon, traveling with him in Africa, said mandatory quarantines for health care workers, Ebola-related travel restrictions and border closings are not the answer.

The Pentagon announced Tuesday that the Joint Chiefs of Staff recommended to Defense Secretary Chuck Hagel that he require all U.S. troops returning from Ebola-fighting missions in West Africa to be kept in supervised isolation for 21 days. Balancing that and similar quarantines announced by several state governors, President Barack Obama said the Ebola response needs to be "based on science."

"We've got to make sure that those workers who are willing and able and dedicated to go over there in a really tough job, that they're applauded, thanked and supported. That should be our priority. And we can make sure that when they come back they are being monitored in a prudent fashion," Obama said after calling Vinson from the White House.

Vinson's trip home to join her bridesmaids for wedding preparations was one of several moves by doctors and nurses that could have exposed others in the United States. In Ohio alone, 163 people were still being monitored Tuesday because of contact or potential contact with Vinson in a bridal shop and on the airplanes she used. Vinson arrived in Dallas on Tuesday evening, after tests showed she is now free of the virus.

New Jersey Gov. Chris Christie said voluntary stay-at-home measures were obviously insufficient, since even doctors and nurses had moved around in public before getting sick. He was among the first to announce mandatory 21-day quarantines for anyone who had contact with possibly infected people.

Vinson, 29, was infected while caring for Thomas Eric Duncan, who died at Texas Health Presbyterian Hospital Dallas on Oct. 8. She inserted catheters, drew blood, and dealt with Duncan's body fluids, all while wearing protective gear.

Dr. Bruce Ribner, an infectious disease expert who oversaw Vinson's recovery at Emory University Hospital, said her doctors in Atlanta don't know how she got infected in Dallas. He released no details about her treatment and wouldn't say whether certain drugs are proving more effective. "The honest answer is we're not exactly sure," he said.

But Emory University Hospital spokeswoman Holly Korschun later confirmed that Vinson received blood plasma from Ebola survivor Kent Brantly, and said Ebola survivor Nancy Writebol also donated her plasma, but it wasn't ultimately needed.

Ebola is only contagious when people who carry the virus get sick, and Vinson didn't show symptoms before flying to Ohio on Oct. 10. She reported her temperature to the Centers for Disease Control and Prevention, as required, on Oct. 13, and was cleared to fly back to Dallas. The next day, she developed a temperature, and on Oct. 15, she tested positive for Ebola.

Another nurse, Nina Pham, also was infected by Duncan, and was released Oct. 24 from the National Institutes of Health.

Vinson didn't take any questions at Emory. Instead she read a statement thanking God, her relatives and her doctors, appealed for privacy as she returns home to Texas, and asked "that we not lose focus on the thousands of families who labor under the burden of this disease in West Africa."

Hickox, the Doctors Without Borders volunteer, was staying meanwhile in an "undisclosed location," said Steve Hyman, one of her lawyers. Maine health officials announced she will be quarantined at home for 21 days after the last possible exposure to the disease, following the state's health protocols.

But Hyman said he expected her to remain in seclusion for the "next day or so" while he discusses her situation with Maine health officials. Hyman said the state should follow the Centers for Disease Control and Prevention guidelines, which require only monitoring, not quarantine, for health care workers who show no symptoms after treating Ebola patients.

"She's a very good person who did very good work and deserves to be honored, not detained, for it," he said.

Culled from Associated Press. Contributors include Associated Press writers Elias Meseret in Addis Ababa, Ethiopia; Jeff Martin in Atlanta; Robert F. Bukaty in Fort Kent, Maine; and David Sharp in Portland, Maine.

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