A mild fever was the first sign that the nurse in Dallas was infected in Ebola. She started feeling ill last Friday. It was alarming but not a surprise. The nurse, 26-year old Nina Pham, knew she was at risk because she’d helped treat Thomas Eric Duncan, the Liberian man who was the first person diagnosed with the dreaded disease in the United States.

Pham became the first – and so far only – person infected by Duncan. In the wake of her infection, U.S. health officials have pledged to review how future Ebola cases are handled.

Additional Images Although some experts say the Ebola virus doesn’t spread easily, health-care workers are well advised to go to extremes to protect themselves. The recent illness of a nurse in Texas who treated Thomas Eric Duncan has been blamed on a breach of safety protocol. The Associated Press developments Nurse upbeat about recovery The Dallas nurse who became the first person to contract Ebola on American soil said Tuesday that she is doing well as her hospital expressed optimism about her recovery. Texas Health Presbyterian Hospital Dallas released a statement on Nina Pham’s behalf. The comments were her first since she became infected with Ebola while caring for a man from Liberia who later died of the disease. “I’m doing well and want to thank everyone for their kind wishes and prayers,” Pham said. Pham was among about 70 staff members who cared for Thomas Eric Duncan. Creature comforts for dog Officials say the year-old King Charles Spaniel belonging to Pham has been given comfortable bedding, toys and other items to entertain him while he stays at a decommissioned naval air base in Dallas. City spokeswoman Sana Syed said that Bentley is staying in the former residence of the executive officer at the decommissioned Hensley Field, which is owned by the city. Bentley is being monitored because some fear that dogs can harbor the virus. There was an uproar in Spain after Madrid authorities euthanized a dog belonging to a nursing assistant sickened by Ebola. U.N. agency warns of worse to come The World Health Organization warned that death rates from the Ebola virus could skyrocket to 10,000 new cases a week. In Geneva, Assistant Director-General, Bruce Aylward said that by December, he envisions 5,000 to 10,000 Ebola cases per week in Guinea, Liberia, and Sierra Leone, the West African countries hardest hit by the outbreak. As of Tuesday, Aylward said, there had been 8,914 Ebola cases and 4,447 deaths from the virus, which began ravaging the region in March. Aylward cautioned against assuming that the outbreak has slowed down. “Quite frankly, it’s too early to say,” Aylward said. “People may draw the wrong conclusion that this is coming under control.” Facebook founder aids CDC Facebook founder Mark Zuckerberg and his wife, Priscilla Chan, are donating $25 million to the U.S. Centers for Disease Control’s nonprofit arm to help fight Ebola. The grant is for the CDC’s Ebola response in the three West African countries most affected – Guinea, Liberia and Sierra Leone – and “anywhere in the world where Ebola poses a threat to health,” according to an e-mailed statement from the CDC Foundation. – From news service reports

But the case is also noteworthy for another, potentially positive reason: Nearly 50 people were exposed to Ebola before the nurse, and none of them has been diagnosed with the disease.

This group of neighbors, family members and first responders is being watched carefully by health authorities. They had some degree of close contact with Duncan during the four-day period when he was contagious – from when he started showing Ebola symptoms on Sept. 24 to when the hospital finally admitted him on Sept. 28. They didn’t take any Ebola-specific precautions. They didn’t know he was infected. Some stayed in the same apartment as Duncan as his condition worsened. Yet, so far, they have not gotten sick. And their 21-day Ebola incubation period started before Pham’s.

ROOM FOR REASSURANCE

“That the casually exposed are not getting sick, it’s reassuring,” said Julie Fischer, an associate research professor of health policy at George Washington University. “What we’ve seen so far, it’s not surprising and it’s not shocking.”

That’s a good thing. This entire harrowing episode is playing out as health authorities predicted. Ebola is acting as portrayed in medical textbooks, based on nearly 40 years of research. Experts said the disease is hard to catch, that an infected person is not contagious until symptoms appear and that Ebola is spread by close contact with bodily fluids such as blood, sweat and saliva.

No evidence points to anything else.

“Ebola is not a terribly infectious disease,” said Joel Selanikio, a former U.S. Centers for Disease Control and Prevention (CDC) epidemiologist. “It’s quite difficult to get.”

The fear behind Ebola is massive. But the virus does not appear to be any more virulent than in previous outbreaks, experts say. Doomsday predictions of Ebola mutating and becoming airborne like the flu have not played out. The “airborne” discussion has frustrated many scientists, such as Heather Lander, who holds a doctorate in experimental pathology and worked in high-security labs with Ebola. It led her to start a blog called Pathogen Perspectives, which delves into the myths and realities of the disease.

“We know how this is spread,” said Lander of Galveston, Texas, and those paths have not changed. “So far, what we’re seeing absolutely reaffirms what we were expecting to see.”

‘BREACH IN PROTOCOL’

Pham, the nurse at Texas Health Presbyterian Hospital, was infected despite taking every precaution. But she also cared for Duncan during a hospital stay that included dialysis and time on a ventilator. As the disease progressed, Duncan became increasingly contagious. The viral load grew. Invasive medical procedures are known to increase the hazards to health care workers.

“These are high-risk procedures,” Fischer said.

CDC director Tom Frieden said Sunday that a “breach in protocol resulted in this infection,” a comment met by criticism because it sounded like he was blaming Pham. But some health officials saw Frieden’s comment as a way of tamping down fear about a novel infection route.

“This is not an unknown, inexplicable action by the virus,” Fischer said.

Even taking every precaution, things can go wrong. And the margin of error with Ebola is small.

All of this confidence, however, is built on the expectation that the virus continues to act like its historical self.

Pham now faces a fight against the disease. Other hospital workers will need to monitor themselves for symptoms of Ebola until at least Oct. 29, 21 days after Duncan died.

But that window of worry is closing for the group of nearly 50 people who had contact with Duncan before he was admitted to the hospital on Sept. 28. Their 21 days are up Oct. 19, less than a week away.

Considering that the bulk of infections appear in the first 10 to 12 days after exposure, that could be reassuring.

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