Worker who cared for Thomas Eric Duncan flew on US flight from Cleveland the day before she reported Ebola symptoms • Live blog: Wednesday’s developments in Ebola outbreak

A second healthcare worker who treated Thomas Eric Duncan, the first patient in the US to be diagnosed with Ebola, has tested positive for the virus, escalating the challenge for officials battling to contain it in Texas.



The worker, a nurse at Texas Health Presbyterian hospital in Dallas, was immediately isolated after reporting a fever on Tuesday. Officials on Wednesday said that more cases were a possibility.

The second infection calls into question the Dallas hospital’s ability to protect staff treating Ebola patients, and raises concerns about the quality of the initial response to Duncan’s diagnosis by state and federal agencies. The US Centers for Disease Control and Prevention (CDC) admitted before the latest announcement that it should have sent a bigger team to Dallas in the wake of Duncan’s diagnosis.

“It may get worse before it gets better,” said Dallas mayor Mike Rawlings at a press briefing on Wednesday morning.

The CDC said it was working to confirm Texas’s preliminary diagnosis of the new patient.

“An additional healthcare worker testing positive for Ebola is a serious concern, and the CDC has already taken active steps to minimise the risk to healthcare workers and the patient,” it said.

The CDC also said on Wednesday that the new patient had flown on Frontier Airlines flight 1143 from Cleveland, Ohio, to Dallas on 13 October, the day before she reported Ebola symptoms. The flight was the last one of the evening, and the plane was cleaned in Dallas according to normal procedures, which the airline said meets CDC guidelines, before being used again the next day.

The airline crew said the patient exhibited no symptoms during the flight; however, the CDC is asking all 132 passengers from it to contact the agency.

Officials had warned several times since the first nurse was diagnosed that there was a possibility more infections could follow. “Health officials have interviewed the latest patient to quickly identify any contacts or potential exposures, and those people will be monitored,” the state department of health said.

Of the 77-person team that cared for Duncan, two nurses have so far tested positive for Ebola. Public health officials are still monitoring the other 75 who may have had contact with Duncan or his blood.

In addition, officials are also monitoring 48 people who had or may have had direct contact with Duncan before he was admitted to an isolation unit on 28 September. The group has nearly reached the end of the disease’s 21-day incubation period - most people exposed to the disease develop symptoms after eight to 10 days. Thomas Frieden, the director of the CDC, said on Tuesday it would be “unusual” for these contacts, all of whom are asymptomatic, to develop Ebola at this point.

The Dallas mayor said the city’s fire and rescue department has begun decontaminating common areas of the new patient’s apartment and outside the building, and has informed neighbors of the diagnosis. The new patient lives alone and has no pets, Rawlings said. Tenants living



“The only way that we are going to beat this is person by person, moment by moment, detail by detail,” Rawlings said. “We want to deal with facts, not fear ... It may get worse before it gets better, but it will get better,” he added.

A nurse, 26-year-old Nina Pham, was the first person to have been infected with Ebola in the US, and was diagnosed this weekend. She had cared for Duncan during much of his 11 days as a patient at Texas Health Presbyterian hospital in Dallas. He died in an isolation ward on 8 October.



The hospital said on Tuesday that Pham was in good condition.

On Tuesday, the CDC said it was establishing a rapid-response team to help hospitals “hands on, within hours” whenever there was a confirmed case of Ebola.



Frieden conceded for the first time on Tuesday that the agency should have been more hands-on with the hospital, and sent a larger team of to help after Duncan tested positive.

“I wish we had put a team like this on the ground the day the patient, the first patient, was diagnosed. That might have prevented this infection,” Frieden said, referring to Pham, at a press conference on Tuesday.

“It’s scary and getting it right is really important because the stakes are so high,” he added.

Frieden said Tuesday that investigators have yet to identify the apparent breach in protocol that led to Pham’s contracting the virus. Experts say healthcare workers are at the highest risk of infection when they remove the protective gear after leaving the quarantine room. If the garments are not taken off in a careful and deliberate fashion, there is a risk the contaminants on the gear could transfer to the worker’s skin.

On Tuesday, the nation’s largest nurses union, National Nurses United, released a scathing statement, which it said was written by Texas Health Presbyterian nurses, accusing the hospital of being unprepared to treat Duncan. The statement described “confusion and frequently changing policies and protocols” and said the hospital did not provide the proper protective gear and repeatedly changed its protocols for his treatment.

Frieden has come under pressure over the response to Ebola, but White House spokesman Josh Earnest said President Obama was confident of Frieden’s ability to lead the public health effort.

At least 4,447 people have died in west Africa in the worst ever outbreak of the virus, which can cause fever, bleeding, vomiting and diarrhoea, and spreads through contact with body fluids, but cases in the US and Europe have been limited so far.



Obama was due to hold a video conference on Wednesday with British, French, German and Italian leaders to discuss Ebola and other international issues, the White House said.

Prospects for a quick end to the contagion fell as the World Health Organisation predicted that the three worst-hit countries in west Africa – Liberia, Sierra Leone and Guinea – could produce as many as 10,000 new cases a week by early December.