A federal health official said Sunday there was "clearly" a breach in protocol that led to the infection of a Dallas healthcare worker with Ebola in what is thought to be the first U.S. transmission of the deadly virus.
"We're deeply concerned about this new development," Dr. Thomas Frieden, head of the Federal Centers for Disease Control and Prevention, said in an interview on CBS' "Face the Nation."
"I think the fact that we don't know of a breach in protocol is concerning, because clearly there was a breach in protocol. We have the ability to prevent the spread of Ebola by caring safely for patients."
In a separate CDC briefing, Frieden said the worker was self monitoring and when she developed symptoms she was promptly isolated.
"The level of her symptoms and indications from the test itself suggest that the level of virus she had was low," Frieden said.
Officials at the Texas Department of State Health Services said "preliminary" test results late Saturday confirmed the presence of the virus in a healthcare worker at Texas Health Presbyterian Hospital, where a Liberian patient, Thomas E. Duncan, died last week.
"We knew a second case could be a reality, and we've been preparing for this possibility," David Lakey, state health department commissioner, said in a statement.
"We are broadening our team in Dallas and working with extreme diligence to prevent further spread," he said.
Frieden said the CDC is in the process of identifying the health worker's contacts and conducting a full investigation of procedures at the Texas hospital to determine how the transmission occurred.
He said all healthcare workers who cared for Duncan are now being treated as if they had been potentially exposed.
"Infections only occur when there's a breach in protocol," Frieden said. "We know from many years of experience that it's possible to care for [patients] with Ebola without risk to healthcare workers, but we also know that it's hard, that even a single breach can result in contamination, and one of the areas that we look at closely are things like, how you take off the gear that might be affected or contaminated."
Frieden said the healthcare worker had extensive contact with Duncan in the days leading up to his death. Additional tests to confirm the infection of the healthcare worker are expected to be completed Sunday by the CDC, Friden said.
"Unfortunately, it is possible in the coming days that we will see additional cases of Ebola. This is because the healthcare workers who cared for this individual may have had a breach of the same nature of the individual who appears now to have a preliminary positive test," Frieden said.
He said CDC investigators will be looking at "the interventions that were done to try desperately to keep the index patient alive," a reference to Duncan's care. This included dialysis and intubation.
Dallas County Judge Clay Jenkins said that the second infection was something for which Texas health officials were prepared.
"That healthcare worker is a heroic person who helped provide care to Mr. Duncan," Jenkins told reporters Sunday.
"We expected that it was possible that a second person could contract the virus. Contingency plans were put into place, and the hospital will discuss the way that the healthcare worker followed those contingency plans, which will make our jobs in monitoring and containment much easier in this case than in the last one," Jenkins said.
The healthcare worker identified in the latest case reported a low-grade fever Friday night and was immediately isolated and referred for testing, officials said.
The preliminary test result was confirmed late Saturday.
Health officials said they are now in the process of identifying those who may have had contact with the healthcare worker, and those people will be monitored depending on how much exposure they may have had.
Authorities provided no information about the identity of the new patient except to say it was a healthcare worker who had provided care for Duncan, 42, who was admitted three days after initially seeking help for symptoms on Sept. 25.
Dr. David Varga of the Texas Health Resource said the worker was in full protective gear when providing care to Duncan during his second visit to Texas Health Presbyterian Hospital. Varga did not identify the worker and said the family of the worker has "requested total privacy."
Duncan was the first patient diagnosed in the U.S. with the often-fatal hemorrhagic fever, which has killed more than 4,000 people in western Africa.
He apparently contracted the disease in Liberia before traveling to Dallas. Neighbors in the Liberian capital of Monrovia said Duncan had helped a neighbor try to reach a hospital when she showed symptoms of what later turned out to be Ebola.
The neighbor died, and Duncan flew to the U.S. to join his fiancée and other relatives. He developed a 103-degree fever shortly after arriving and was initially sent home with antibiotics, then admitted when his condition worsened.
He died Wednesday.
Sunday's announcement marks a deadly new milestone — the first case of Ebola transmitted in the U.S.
It is significant that it involved a healthcare worker, because U.S. public health authorities have long said they have been expecting the appearance of Ebola and are confident that they are prepared to prevent its further spread.
Hospital officials have said Duncan was treated by more than 50 people in a secure, 24-bed intensive care unit.
Authorities have been closely monitoring all of those who had contact with Duncan before he was placed in isolation, especially a high-risk group of 10 which includes his fiancée and three relatives.
Three paramedics who treated Duncan have also been under observation.
Copyright © 2014, Los Angeles Times9:32 a.m.: This story was updated with information from the CDC and Texas health officials
6:05 a.m.: This story was updated with information from Dr. Varga.
4:22 a.m.: This story was updated with background on Duncan.
This story was first posted at 3:35 a.m.
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