Ebola Is Diagnosed in Texas, First Case Found in the U.S.
By DENISE GRADY

A man who took a commercial flight from Liberia that landed in Dallas on Sept. 20 has been found to have the Ebola virus, the Centers for Disease Control and Prevention reported on Tuesday. He is the first traveler to have brought the virus to the United States on a passenger plane and the first in whom Ebola has been diagnosed outside of Africa in the current outbreak.

As the disease has swept across West Africa, many health experts said it would be only a matter of time before it reached the United States. Hospitals and health departments around the country have been preparing for it, and a number of false alarms have occurred. But this time, the case is real.

The man, who was visiting relatives in the United States, was not ill during the flight, health officials said at a news conference Tuesday evening. Indeed, he was screened before he boarded the flight and had no fever. Because Ebola is not contagious until symptoms develop, there is “zero chance” that the patient infected anyone else on the flight, said Dr. Thomas R. Frieden, director of the disease centers. Ebola is spread only by direct contact with body fluids from someone who is ill.

A team from the C.D.C. is being dispatched to Dallas to help trace any contacts who may have been infected, including family members, health care workers and others with whom the patient spent time in Dallas. Health officials in Texas said they had already begun that process. Dr. Frieden said the family and community contacts were few, no more than a handful. But he said it was possible that family members who were with the man while he was ill would turn out to be infected.

Contact tracing involves identifying people who might have been exposed to the patient during the time he was infectious, and then monitoring them for symptoms every day for 21 days — the full incubation period of the disease. Most people develop symptoms within eight to 10 days of being exposed. Anyone who starts running a fever or having symptoms is then isolated and tested for Ebola. If the test is positive, that person is kept in isolation and treated, and his or her contacts are then traced for 21 days. The process is repeated until there are no new cases.

Describing these methods as “tried and true,” Dr. Frieden said, “I have no doubt that we’ll stop this in its tracks in the U.S.”

Dr. Frieden declined to disclose flight information or to say whether the patient is an American citizen. He said the man was not a health worker, and officials had no idea how he had become infected.

The man did not get sick until about Sept. 24, several days after he arrived. He is being treated at Texas Health Presbyterian Hospital in Dallas, and is critically ill, Dr. Frieden said. He said there was no reason to move the patient to another hospital, noting that any hospital in the United States capable of isolating patients for other infectious diseases could safely handle an Ebola case. Doctors and the patient’s family are discussing whether to try experimental treatments, Dr. Frieden said.

The hospital’s epidemiologist, Dr. Edward Goodman, said: “We have had a plan in place for some time now for a patient presenting with possible Ebola. Ironically, we had a meeting the week before of all the stakeholders who might be involved. We were well prepared to care for this patient.”

Feeling ill, the man first sought medical help on Friday, and was treated and sent home. Ebola was not recognized. Officials did not say where that initial visit took place. Dr. Frieden said the early symptoms of Ebola, like fever and nausea, can easily be mistaken for other illnesses. But he added that public health experts have for months been urging doctors and nurses to take a travel history on anyone who shows up with such symptoms and to be on the alert for Ebola in anyone who has been to Guinea, Liberia or Sierra Leone.

With worsening symptoms, the man sought care again on Sunday, and was then admitted to the hospital in Dallas and placed in isolation. Blood samples arrived at the disease centers on Tuesday, and tested positive for Ebola. A state lab in Texas also tested samples, and got positive results.

Dr. Frieden briefed President Obama by telephone on Tuesday afternoon about the case, explaining what the White House described as the “stringent isolation protocols” being used to treat the patient and efforts to trace the patient’s contacts to mitigate the risk of the virus spreading.

Dr. Frieden told the president that the C.D.C. had been prepared for an Ebola case in the United States, according to an account of the call distributed by the White House, “and that we have the infrastructure in place to respond safely and effectively.”

The Obama administration was working to prevent a public panic over the case, using social media to describe how Ebola can — and cannot — be transmitted.

“You cannot get Ebola through the air, water or food in the U.S.,” the White House said on Tuesday night in a posting on its official Twitter account. “Ebola can only spread from contact with the blood or body fluids of a person or animal who is sick with or has died from the disease.”

Another official Twitter posting said, “America has the best doctors and public health infrastructure in the world, and we are prepared to respond to Ebola.”

伊波拉入侵美！歐巴馬急商對策

緊急追蹤空窗期接觸對象

美國疾病防治中心（CDC）30日證實，美國國內出現首起確診的伊波拉病例，這也是在非洲外診斷出的第一起伊波拉病例，目前該病患正在德州的健康長老醫院接受隔離治療。

美國總統歐巴馬30日也和疾病防治中心主任佛萊登開會，研議「迫切的隔離方案」以避免疫情擴散。

白宮表示，歐巴馬和佛萊登「商討嚴格隔離方案，除了讓病患接受治療，同時也持續追蹤病患接觸對象，降低出現更多病例的風險」。

佛萊登指出，該名男性病患上個月20日自賴比瑞亞回到美國，24日開始出現伊波拉症狀，26日就醫，目前病情嚴重。不過佛萊登並沒有透露該名病患在賴比瑞亞進行什麼活動，以及他是如何接觸到病毒。

同班機乘客 感染機會不高

疾病防治中心同時派遣一支流行病學家前往德州，著手追蹤該病患從回國到住院治療期間接觸過的所有對象。佛萊登說：「我們絕對會做更多。」該病患在疾病潛伏期時沒有接觸太多人，只有家人和一些社區成員，佛萊登說當時和該名病患搭同班機回美國的乘客染病的機會不大。

CDC：疫情不會擴散全國

為了避免大眾恐慌，佛萊登同時在記者會上說：「伊波拉是很嚴重的病，即使有完善的照護仍有極高的致死率。不過美國有精良、過去證明成功發揮療效的公衛經驗來防治伊波拉，我有信心我們可以控制這起病例，不會讓伊波拉擴散全美。」

美國國內目前有幾名伊波拉病患，但都是在西非受到感染，送回美國治療。

伊波拉是病毒感染的出血熱，初期症狀包括突然出現高燒、倦怠、肌肉痠痛、頭痛與咽喉痛等，容易被誤診為瘧疾、傷寒或腦膜炎。

另外，美國首富比爾蓋茲29日接受網站訪問時，公開讚揚美國對伊波拉疫情的處理方式，包括快速又有效地運送大批物資，以及醫療人員進出非洲疫區。蓋茲並宣布，他的「比爾暨梅琳達蓋茲基金會」將捐贈5000萬美元，幫助對抗西非地區的伊波拉疫情。

原文參照：
http://www.nytimes.com/2014/10/01/health/airline-passenger-with-ebola-is-under-treatment-in-dallas.html

Video：C.D.C. Announces First Ebola Case
Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention, said the infected individual came to the United States from Liberia.
http://nyti.ms/1rEyvLc

2014-10-01．聯合晚報．A6．國際焦點．編譯徐偉真