Because a preliminary test of a suspected Ebola patient came back negative Monday, federal officials see no need to track the passengers of a commercial bus that the man used to travel from New Jersey to Durham overnight Saturday, said Dr. Megan Davies, North Carolina’s state epidemiologist.
Three people at a Person County home, where relatives took the man after he arrived in Durham, are still being checked for symptoms twice daily – once in person and once by phone – by county health officials and are under a county order to stay inside, Davies said in a telephone news conference Monday afternoon.
That order will end if the patient tests negative again on Wednesday, she said.
The unidentified man told health officials that he had no known exposure to Ebola patients while in Africa, and he said he had not visited health-care facilities there.
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He had flown into Newark, N.J., on Saturday from Liberia, one of the three West African nations where the epidemic of the deadly virus is raging. He rode the bus from Newark to Durham, then was taken to the home in Person County, said Dr. Aldona Wos, the state Secretary of Health and Human Services.
There, the man used a thermometer given to him by border control agents at the Newark airport. He found that his temperature was well above normal, at 101.9 degrees. He then called the federal Centers for Disease Control and Prevention, which alerted North Carolina health officials, who then called Person health officials.
The man was taken to Duke Hospital and arrived about 9:30 p.m. Sunday. About 11:20 p.m., a blood sample from the patient arrived at the state’s new public health lab in Raleigh, and technicians worked into the night, finishing the test about 3:30 a.m., Wos said.
As the threat of Ebola spread from West Africa to the United States, the CDC designated the sophisticated North Carolina lab as one of 18 state and municipal labs in the nation to be used for testing.
The test Sunday night was the first the North Carolina lab had performed for a suspected Ebola case.
Fever is a key symptom of the disease, and is being used to screen travelers from the affected countries. But it’s also a common symptom for a host of other illness. Davies said during the news conference that the man has neither shown further symptoms common to Ebola, nor exhibited a fever since he arrived at Duke.
According to guidelines from the CDC, that negative test result indicates that the patient posed no threat to the other passengers of the bus, or to the EMS workers who transported him to Duke, Wos said.
Even someone who has Ebola isn’t contagious unless they have developed symptoms of the disease. It can only be passed via direct contact with body fluids from someone with symptoms.
The news conference Monday was the third for Wos and other state health officials on the topic of Ebola in less than a week, including one Sunday night at 9:30 to answer basic questions about the suspected case.
Wos has made it a mantra that her office wants to “overeducate” the public to not only promote readiness but to fight the hysteria and many misconceptions about Ebola.
She said that communications on the case between federal, state, local officials and the hospital showed that North Carolina’s preparations for any appearance of the virus, which have been under way since July, have been effective, especially given that it all happened at night and on a Sunday.
“I think the lesson learned is that we’re quite well-prepared,” she said.
Dr. Lisa Pickett, chief medical officer for Duke University Hospital, said in an interview Monday that Duke’s health-care system has been training for months to handle potential cases of the virus and has performed tests to make sure the right screening is being used at every point where a new patient carrying it could appear. Hospital staff who are trained to use the isolation area to care for such patients had conducted a drill Friday for the exact situation that they found themselves in Sunday night.
The hospital has built a list of 30 to 40 members of its staff who have volunteered to handle patients suspected of having Ebola, Pickett said.
About a dozen are working with the patient now, she said. If the later test reveals that he actually has contracted the virus, it will take two or three times as many staff members. But for now Duke is trying to hold down the staffing required, as none of the workers on the case will be allowed to work with other patients while there is still a chance the man has Ebola.
In the event that he does test positive, the caregivers assigned to his case will be quarantined for 21 days themselves when they eventually go off duty.
The next test
The patient will be tested again early Wednesday. If that test also comes back negative and doctors think he doesn’t have any other serious health problem, he will be free to leave the hospital, Davies said.
At that point, he will no longer be considered a patient, and his only obligation will be to check in with public health officials daily for 21 days, the maximum incubation period for Ebola before symptoms appear.