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Health Care, Healthcare, Public Health, Public Policy, Uncategorized

Dallas Nurse Amber Vinson Discharged After Being Declared ‘Ebola-Free’

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Dallas nurse Amber Vinson, the second health care worker to contract Ebola after treating Thomas Eric Duncan at Texas Health Presbyterian Hospital in Dallas, has tested negative for the potentially deadly virus and was discharged from Emory University Hospital in Atlanta Tuesday.

“After a rigorous course of treatment and thorough testing, we have determined that Miss Vinson has recovered from her infection with Ebola virus and that she can return to her family, to the community and to her life without any concerns about transmitting this virus to any other individuals,” Dr. Bruce Ribner, director of Emory University’s serious communicable disease unit, announced today.

Vinson spent two weeks in treatment at Emory’s state-of-the-art isolation ward, one of four such high-level biocontainment patient care units in the country. The hospital has previously treated Ebola patients Kent Brantly and Nancy Writebol — the American aid workers who contracted the virus while caring for Ebola victims in Liberia — and an unnamed American physician who was working for the World Health Organization when he fell ill.

Doctors declared Vinson virus-free on Friday, but she spent four more days recovering in the facility before being discharged. Smiling and looking vibrant, Vinson was greeted by applause as she entered the room for an afternoon press conference before leaving the hospital. “I’m so grateful to be well,” Vinson said in a statement.

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Dallas nurse Amber Vinson hugs members of her health care team at Emory University Hospital, where she declared Ebola-free after two weeks of treatment in a special isolation facility.

“First and foremost, I want to thank God,” she said, adding that God gave her the “hope and strength to fight” Ebola. Vinson also thanked her mother, fiancé and extended family for visiting. “Family played such an important role in my recovery,” she said, “by being there every minute, every day, even though you couldn’t be close.”

She also expressed her gratitude to the health workers who cared for her and stressed the importance of not losing focus on the fight against Ebola in West Africa, where nearly 5,000 people have died from the virus and more than 10,000 have been infected in what the World Health Organization recently described as “the most severe acute public health emergency in modern times.”

“While this is a day for celebration and gratitude I ask that we not lose focus on the thousands of families who continue to labor under the burden of this disease in West Africa,” said Vinson. Before she left, Vinson hugged more than a dozen staff members as they smiled, laughed and wished her a safe trip home to Texas.

Experience with Ebola patients ‘changed the algorithm’ for treatment

Vinson, 29, was diagnosed after taking care of Thomas Eric Duncan, the first Ebola patient diagnosed on U.S. soil, at Texas Health Presbyterian Hospital in Dallas. Dallas nurse Nina Pham, who also worked to treat Duncan, contracted the disease as well but was declared Ebola-free after treatment and was released last week from the National Institutes of Health Clinical Center in Bethesda, Maryland.

Dr. Ribner said Pham and Vinson may have recovered so quickly because they were younger than most Ebola patients, and because they were wearing personal protective equipment when they were treating Duncan, meaning they were exposed to a lesser “viral load” than most patients.

He also noted that a great deal has been learned by Emory’s team after successfully treating four Ebola patients, particularly concerning things such as fluid and electrolyte management. He said the chance to study the virus in a developed nation has also changed some of the “general dogma” and assumptions doctors made when treating the virus at the onset of the West Africa outbreak.

For example, Dr. Ribner noted that the consensus within the medical community had changed with regards to how aggressive care providers can be in treating Ebola patients. The general belief had been that patients who were ill enough to require a ventilator or dialysis were likely to die, and so those treatments were not worthwhile, he said.

“That is certainly not the case,” Dr. Ribner said. “I think we have changed the algorithm for how aggressive we are going to be willing to be in the care of patients with Ebola virus disease.”

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Dr. Bruce Ribner, director of Emory University’s serious communicable disease unit, said the experience of treating four Ebola patients at their hospital has provided a valuable opportunity to fine-tune Ebola treatment in the developed world.

Dr. Ribner also weighed in on the debate over state policies such as those in New York and New Jersey that force medical workers returning after treating Ebola patients in West Africa into a medically unnecessary 21-day quarantine. He said states must do “a very delicate balancing act” as they decide whether to quarantine the returning healthcare workers, but “we must not let fear get in the way.”

“We all recognize that there is a lot of anxiety, and that is understandable,” Dr. Ribner added. “But the American healthcare system has been successfully able to treat patients with the Ebola virus.”

The Centers for Disease Control and Prevention laid out new guidelines Monday calling for voluntary isolation and monitoring of travelers exposed to Ebola, while rejecting the idea of placing asymptomatic people under mandatory quarantines. The updated advice to state and local officials breaks down travelers’ risk level into categories: high risk, some risk, low risk and no risk. Those at highest risk are anyone who’s had direct exposure to an Ebola patient’s body fluids, including health care workers who suffer a needle-stick injury during a patient’s care. Health workers who cared for Ebola patients while wearing proper protective equipment would be considered at “some risk.”

The CDC recommends that people in the highest risk category isolate themselves from others for 21 days — far less stringent than the mandatory quarantines that experts have condemned as “draconian” and “not scientifically based“, warning that the measures could have “unintended consequences” that threaten public health in the U.S. and abroad.

“Let’s not forget the best way to stop this epidemic and protect America is to stop it in Africa,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on Sunday. “[A]nd you can really help stopping it in Africa if we have our people — our heroes, the health care workers — go there and help us to protect America. We need to treat returning people with respect.”




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