How Not To Handle An Ebola Patient

Barbie Latza Nadeau remarks on how Spain bungled the case of Teresa Romero Ramos, the nurse who contracted Ebola, noting that “now Europe is grappling with its worst fear—the threat of an Ebola outbreak. And even the authorities can’t argue it won’t happen”:

That Romero was allowed to mingle in public after reporting a fever when she was within the known incubation period for the virus is unacceptable.  But what makes Romero’s case particularly troubling is that Spanish health authorities and the hospital where she worked appear complicit in not immediately isolating her. … According to Spanish press reports quoting the Spanish nurses’ union, Romero called Carlos III hospital several times between September 30 and October 2 when her fever finally hit the 38.6 threshold.  Still, it took until October 6 when she had become so deathly ill she was begging for an Ebola test before anyone at the hospital where she worked reportedly reacted.

Then, rather than immediately isolating her and rushing her to the special ward used to treat the previous Ebola patients, they told her to go to the nearby emergency room at Alcorcón, where press reports say she sat in the public waiting room for several hours absent of any protective gear. “I think I have ebola,” she reportedly told anyone who would listen.  But no one took notice until her first test came back positive. By then, dripping with fevered sweat, she would have been inarguably contagious.

And now the Spanish government wants to euthanize her dog – but not if the Internet can help it:

Excalibur, a 12-year-old rescue with soulful brown eyes, was left at home by the nurse’s husband, Javier Limón, as he checked into a quarantine unit. Before leaving, he left the dog water and 33 pounds of food — enough to last it through any observation period — while spreading pleas to help the dog on social media. “The dog is fine. He has the whole house to himself, with the open terrace so he can do his business,” he told Spanish paper El Mundo. “Are they going to put me to sleep, too?” The pleas were heard. A petition to spare the dog received more than 190,000 signatures within a day. …

Excalibur was fine and at home as of Tuesday night in Madrid. The hashtag #SalvemosaExcalibur is trending locally on Twitter.

Jazz Shaw relays some research that helps explain the concerns over Excalibur:

The coverage on CNN this morning clearly missed something (as did I) in terms of transmission through dogs. A reader notes that a study was already done on this and some dogs can, in fact, be infected.

Naina Bajekal has more:

The researchers concluded that “dogs could be a potential source of human Ebola outbreaks and of virus spread during human outbreaks,” but they did not test their hypothesis that human infection could occur through licking, biting or grooming. Instead, the study assumed dogs would transmit the infection in the same way as other animals observed in experiments; those animals excreted viral particles (in saliva, urine, feces) for a short period before the virus was cleared. David Moore, an expert in infectious diseases from the London School of Hygiene and Tropical Medicine, said that since no dogs showed symptoms of the Ebola virus “there is absolutely no evidence to support a role for dogs in transmission.”

By the way, like the Spanish nurse, the case of Thomas Eric Duncan, who today became the first person to die of the disease in the US, was hardly handled in the best way:

[He] started developing symptoms of the disease once he arrived in the US. He went to a Dallas emergency room and told a nurse that he had recently been in West Africa — a region that has been ravaged by an unprecedented Ebola epidemic — but that information was not “fully communicated” to the rest of his medical team. Duncan was diagnosed with a minor infection and sent away from the hospital. He returned days later via ambulance, when his symptoms had worsened considerably.