New York City
physician tests positive for Ebola
A New York physician who recently returned from the front lines of the Ebola
epidemic in West Africa has tested positive for the deadly virus, according
to two U.S. government officials. The man, identified as Craig Spencer by
New York City Councilman Mark Levine, is in isolation at Bellevue Hospital
in Manhattan. Spencer, who had been treating Ebola patients in Guinea with
Doctors Without Borders, returned to New York this month.
He becomes just the fourth person diagnosed with Ebola in the United States
-- and the first diagnosed outside of Texas.
The New York City health department, which did not identify Spencer, said in
an earlier statement that he had returned to the United States "within the
past 21 days from one of the three countries currently facing the outbreak
of this virus." On Thursday, the statement said, Spencer "presented a fever
and gastrointestinal symptoms" and was transported from a residence in
Harlem to the hospital in Manhattan.
A federal official said the Centers for Disease Control and Prevention is
readying a team of specialists for epidemiology, infection control and
communications to travel to New York on Thursday night. CDC officials
declined to comment.
The New York lab that conducted the preliminary Ebola test is a part of the
Laboratory Response Network, a group of facilities designed to coordinate
quickly with the CDC in response to public health threats. The CDC has "high
confidence" in the results and is unlikely to repeat the test, the federal
On Sept. 18, Spencer published a photo of himself on Facebook wearing
personal protective equipment. In an accompanying post, he wrote: "Off to
Guinea with Doctors Without Borders (MSF). Please support organizations that
are sending support or personnel to West Africa, and help combat one of the
worst public health and humanitarian disasters in recent history."
A spokesman for Doctors Without Borders confirmed that someone who had
worked with the organization had recently returned to New York from an
Ebola-affected country and notified the organization's office Thursday
morning about developing a fever.
Hours before the positive diagnosis, the city health department's statement
said that a team of disease detectives had already begun "to actively trace
all of the patientâ€™s contacts to identify anyone who may be at potential
"We can safely say it has been a very brief period of time that the patient
exhibited symptoms," New York Mayor Bill de Blasio said at a news conference
Thursday evening. "The patient is in good shape and has gone into a good
deal of detail with our personnel with regard to his actions in the last few
Physicians volunteering with Doctors Without Borders follow strict protocols
as they return from the Ebola zone. They first travel through Europe and are
debriefed in Brussels. Doctors can remain in the field for a maximum of four
to six weeks; upon returning to the United States, they are told to follow
CDC guidelines. Those without any known exposure to Ebola are told to
monitor their health for a 21-day incubation period, according to the
Emergency officials received a call just before noon Thursday for a sick
person in Harlem, a fire department spokesman said. The patient met Ebola
risk criteria, so a special hazardous EMS unit was sent to the apartment
with personnel who were fully covered in personal protective equipment. The
vehicle was immediately decontaminated, said New York City EMS union
president Israel Miranda.
In its statement, the city health department noted that Bellevue Hospital
"is designated for the isolation, identification and treatment of potential
Ebola patients by the City and State." Earlier this month, New York Gov.
Andrew M. Cuomo (D) designated Bellevue as one of eight hospitals in the
state that could care for potential Ebola patients.
According to Spencerâ€™s public LinkedIn
profile, he has worked as a doctor at NewYork-Presbyterian/Columbia
University Medical Center, not far from where he lives, since July 2011.
Visit the Washington Post for the story.
announces $840 million initiative to improve patient care, physician access
to information and lower costs
Health and Human Services Secretary Sylvia M. Burwell today announced an
initiative that will fund successful applicants who work directly with
medical providers to rethink and redesign their practices, moving from
systems driven by quantity of care to ones focused on patientsâ€™ health
outcomes, and coordinated healthcare systems. These applicants could include
group practices, healthcare systems, medical provider associations and
others. This effort will help clinicians develop strategies to share, adapt
and further improve the quality of care they provide, while holding down
costs. Strategies could include:
Giving doctors better access to patient information, such as information on
prescription drug use to help patients take their medications properly;
Expanding the number of ways patients are able communicate with the team of
clinicians taking care of them;
Improving the coordination of patient care by primary care providers,
specialists, and the broader medical community; and
Using electronic health records on a daily basis to examine data on quality
â€śThe administration is partnering with clinicians to find better ways to
deliver care, pay providers and distribute information to improve the
quality of care we receive and spend our nationâ€™s dollars more wisely,â€ť said
Secretary Burwell. â€śWe all have a stake in achieving these goals and
delivering for patients, providers and taxpayers alike.â€ť
Through the Transforming Clinical Practice Initiative, HHS will invest $840
million over the next four years to support 150,000 clinicians. With a
combination of incentives, tools, and information, the initiative will
encourage doctors to team with their peers and others to move from
volume-driven systems to value-based, patient-centered, and coordinated
health care services. Successful applicants will demonstrate the ability to
achieve progress toward measurable goals, such as improving clinical
outcomes, reducing unnecessary testing, achieving cost savings and avoiding
â€śThis model will support and build partnerships with doctors and other
clinicians across the country to provide better care to their patients.
Clinicians want to spend time with their patients, coordinate care, and
improve patient outcomes, and the Centers for Medicare & Medicaid Services
wants to be a collaborative partner helping clinicians achieve those goals
and spread best practices across the nation,â€ť said Patrick Conway, M.D.,
deputy administrator for innovation and quality and CMS chief medical
By participating in the initiative, practices will be able to receive the
technical assistance and peer-level support they need to deliver care in a
patient-centric and efficient manner, which is increasingly being demanded
by healthcare payers and purchasers as part of a transformed care delivery
system. Participating clinicians will thus be better positioned for success
in the healthcare market of the future - one that rewards value and outcomes
rather than volume.
HHS encourages all interested clinicians to
participate in this initiative. For more information on the Transforming
Clinical Practice Initiative visit
Blood of Ebola
survivors tested as short-term treatment option
ANTWERP, Belgium â€“ An international research consortium led by the Institute
of Tropical Medicine in Antwerp (ITM) will assess whether treatment with
antibodies in the blood of Ebola survivors could help infected patients to
fight off the disease. If proven effective, this straightforward
intervention could be scaled up in the short term and provide an urgently
needed treatment option for patients in West Africa.
The researchers will receive â‚¬ 2.9 million of European Union (EU) funding to
evaluate the safety and efficacy of treatment with blood and plasma made
from the blood of recovered Ebola patients. A World Health Organization
(WHO) expert meeting in September recommended convalescent blood therapies
as one of the most promising strategies meriting urgent evaluation as
treatment of Ebola disease. As a result of the current outbreak, there are
also substantial numbers of survivors to prepare Ebola plasma.
ITMâ€™s Johan van Griensven, the projectâ€™s coordinating investigator, said,
â€śBlood and plasma therapy are medical interventions with a long history,
safely used for other infectious diseases. We want to find out whether this
approach works for Ebola, is safe and can be put into practice to reduce the
number of deaths in the present outbreak. Ebola survivors contributing to
curb the epidemic by donating blood could reduce fear of the disease and
improve their acceptance in the communities.â€ť
Blood and plasma from recovered Ebola patients has been used in a limited
number of patients previously. For example, during the 1995 Ebola outbreak
in Kikwit, in the Democratic Republic of the Congo (DRC), seven out of eight
patients receiving convalescent whole blood survived. However, whether this
was due to the transfusions or to other factors is unclear. There is an
urgent need to evaluate this therapy in carefully designed studies according
to the highest ethical and scientific standards.
EU Research, Innovation and Science Commissioner MĂˇire Geoghegan-Quinn said
in the funding announcement that it is urgent to step up medical research on
Ebola and the selected projects â€ťenlist the best academic researchers and
industry to take the fight to this deadly disease.â€ť
The project, which will start in Guinea in
November 2014, is supported and guided by the WHO and the International
Severe Acute Respiratory and Emerging Infection Consortium (ISARIC). The
Wellcome Trust will provide additional support, enabling unparalleled
international collaboration across the public, private and not-for-profit
sectors to tackle the Ebola emergency. Visit
the Institute of Tropical Medicine for more information.
hospitals weigh withholding care to Ebola patients
The Ebola crisis is forcing the American healthcare system to consider the
previously unthinkable: withholding some medical interventions because they
are too dangerous to doctors and nurses and unlikely to help a patient.
U.S. hospitals have over the years come under criticism for undertaking
measures that prolong dying rather than improve patients' quality of life.
But the care of the first Ebola patient diagnosed in the United States, who
received dialysis and intubation and infected two nurses caring for him, is
spurring hospitals and medical associations to develop the first guidelines
for what can reasonably be done and what should be withheld.
Officials from at least three hospital systems said they were considering
whether to withhold individual procedures or leave it up to individual
doctors to determine whether an intervention would be performed. Ethics
experts say they are also fielding more calls from doctors asking what their
professional obligations are to patients if healthcare workers could be at
U.S. health officials meanwhile are trying to establish a network of about
20 hospitals nationwide that would be fully equipped to handle all aspects
of Ebola care.
Their concern is that poorly trained or poorly equipped hospitals that
perform invasive procedures will expose staff to bodily fluids of a patient
when they are most infectious. The U.S. Centers for Disease Control and
Prevention is working with kidney specialists on clinical guidelines for
delivering dialysis to Ebola patients. The recommendations could come as
early as this week.
The possibility of withholding care represents a departure from the "do
everything" philosophy in most American hospitals and a return to a view
that held sway a century ago, when doctors were at greater risk of becoming
infected by treating dying patients.
"This is another example of how this 21st century viral threat has pulled us
back into the 19th century," said medical historian Dr. Howard Markel of the
University of Michigan.
Because the world has almost no experience treating Ebola patients in
state-of-the-art facilities rather than the rudimentary ones in Africa,
there are no reliable data on when someone truly is beyond help, whether
dialysis can make the difference between life and death, or even whether
cardiopulmonary resuscitation (CPR) can be done safely with proper
protective equipment and protocols.
Such procedures "may have diminishing effectiveness as the severity of the
disease increases, but we simply have no data on that," said Dr. G. Kevin
Donovan, director of the bioethics center at Georgetown University.
Donovan said he had received inquiries from fellow physicians about whether
hospitals should draw up lists of procedures that would not be performed on
an Ebola patient. "To have a blanket refusal to offer these procedures is
not ethically acceptable,â€ť he told the doctors.
Nevertheless, discussions about adopting policies to withhold care in Ebola
cases are under way at places like Geisinger Health System, which operates
hospitals in Pennsylvania, and Intermountain Healthcare, which runs
facilities in Utah, according to their spokesmen.
Dr. Nancy Kass, a bioethicist at Johns Hopkins Bloomberg School of Public
Health, said healthcare workers should not hesitate to perform a medically
necessary procedure so long as they have robust personal protective gear.
So far, only two U.S. hospitals have used kidney dialysis: Texas Health
Presbyterian Dallas, which treated Liberian patient Thomas Duncan and where
two nurses became infected, and Emory University Hospital in Atlanta, which
has treated four Ebola patients at its biocontainment unit without any
healthcare workers becoming infected.
Although it is not yet clear how the Dallas nurses became infected, health
officials have questioned both the lack of adequate training in the use of
protective gear and the decision to perform invasive procedures.
The American Society of Nephrology and CDC are now working on new dialysis
guidelines for Ebola patients, whose kidneys often fail. In some cases,
dialysis can help a patient get through the worst of the illness until their
own immune system can fend off the virus.
Nephrologist Dr. Harold Franch said the new guidelines will consider both
whether the procedure is medically necessary and whether the hospital can do
it safely. "Most academic medical centers and many good private tertiary
care hospitals will be able to do this," he said. Yet he thinks many
hospitals may not offer the service, since â€śit takes a lot of money and time
to train people.â€ť
At University of Chicago Medicine, questions
of taking last-ditch measures were discussed early in the hospital's Ebola
planning, said Dr. Emily Landon, a bioethicist and epidemiologist. Landon
views dialysis as a "no brainer" for Ebola patients, and believes the risks
are fairly low to the well-trained nursing staff who have volunteered for
the hospital's isolation ward. But putting in a breathing tube and putting
them on a ventilator is more controversial.
Visit Reuters for the article.
WHO says Ebola
outbreak continues to spread in West Africa
Ebola is racing ahead of efforts to contain its spread, according to the
World Health Organization. There are nearly 10,000 reported cases â€“ a tally
that underestimates the true scope of the epidemic as overwhelmed health
workers fall behind in their record-keeping the WHO says. About half have
Ebola has now reached every district in Sierra Leone and all but one
district in Liberia, with "intense transmission" in these countries' capital
cities, according to the WHO.
Some experts worry that Ebola is poised to spill over the borders to other
African countries, such as Ivory Coast. Of the eight districts in Guinea and
Liberia that border Ivory Coast, all but one have reported Ebola cases. In
August, Ivory Coast closed its borders with Ebola-affected countries and
temporarily suspended flight.
Two of the four parts of Guinea with new Ebola cases this week are near the
border with Ivory Coast, a country of 20 million people, according to the
WHO. With a metro area population of more than 7 million, Ivory Coast's
economic capital, Abidjan, is the second largest city in West Africa, behind
"There is no magic boundary at the border," says Michael Osterholm, director
of the Center for Infectious Disease Research and Policy at the University
of Minnesota. "We shouldn't be surprised if we see cases."
Osterholm notes that farmers often leave home in the fall, as they finish
harvesting their crops, and migrate to other countries looking for work. He
fears that these seasonal migrations could help spread Ebola across Africa.
Experts have blamed Ebola's spread through West Africa on poverty, lack of
education and crumbling public health systems, which were battered during
years of conflict. Although the first Ebola case apparently occurred in
Guinea in December, local health officials didn't realize they were dealing
with an Ebola outbreak until March, when there were already nearly 50 cases.
At a press conference Thursday, WHO officials addressed rumors that Ebola
had been detected in other West African countries.
"At WHO, we hear about many rumors of cases in different countries. Most of
these turn out to be negative," said Keiji Fukuda, the WHO's assistant
director-general for health security and environment, following an emergency
meeting on Ebola.
"Ebola is one of these things that is really hard to cover up," Fukuda said.
"There is reasonable confidence that we are not seeing widespread
transmission into neighboring countries. . . . We think it would be very
difficult to miss."
West Africa today is nowhere close to goals set by the United Nations' to
get the outbreak under control, according to the WHO.
Even with the modest goal of meeting only 70% of the region's needs by Dec.
1, affected countries would need at least 16 more labs, to help medical
staff quickly diagnose patients; 230 more "dead body management teams," to
bury or cremate bodies in ways that doesn't spread Ebola; 4,388 more
hospital beds; and 20,000 contract tracers, to help find and isolate
The WHO is working to prepare Ivory Cost and 14 other countries with borders
or strong travel ties to the Ebola-affected nations. The WHO will stage
simulation drills, for example, and provide other types of technical
Even Doctors Without Borders, which has been on the ground fighting Ebola
since March, has had to suspend taking care of women and children at one of
its hospitals in Sierra Leone, which once admitted more than 10,000 people
per year. The organization's overwhelmed staff can no work maintain
"flawless infection control" in that hospital, putting staff lives at risk.
"It is our intention to resume our activitiesâ€¦as soon as possible, but for
that we need to first put all of our energy in fighting Ebola," said Brice
de le Vingne, director of operations at Doctors Without Borders. "We really
hope that in a few months, we'll be able to focus once again on treating
mothers and children."
Visit USA Today for the article.
sterilization wrap first to receive FDA clearance for all standard
sterilization methods in North America
Kimberly-Clark Health Care, soon to be Halyard Health, announced it is the
first and only manufacturer to receive 510(k) clearance from the U.S. Food
and Drug Administration (FDA) for use of their sterilization wrap portfolio
with all standard sterilization modalities.
The KIMGUARD ONE-STEP and QUICK CHECK family of sterilization wrap is now
the most validated sterilization wrap on the U.S. market, with comprehensive
FDA clearance for use with low temperature Sterrad sterilization systems,
STERIS sterilization systems, pre-vacuum steam, ethylene oxide (EO) and
â€śProviding innovation in sterilization technology has been a longtime
priority at Kimberly-Clark Health Care and we will continue to invest in
innovation as we transition to Halyard Health,â€ť said Lon Taylor, Marketing
Director, Surgical and Infection Prevention, Kimberly-Clark Health Care.
â€śSecuring FDA clearance for use of our market-leading Sterilization Wrap
with each and every sterilization modality supports our ongoing mission to
help clinicians prevent infections and protect patients.â€ť
In November 2014 Kimberly-Clark Health Care
will become Halyard Health, an independent medical technology company
focused on preventing infection, eliminating pain and speeding recovery.
Visit Atlanta Business Chronicle for the article.
still works against staph infections, study finds
An older antibiotic called vancomycin is still effective in treating
dangerous Staphylococcus aureus bloodstream infections, a new study
finds. The findings show that doctors should keep using vancomycin to treat
Staphylococcus aureus infections even though there are several newer
antibiotics available to do the job, University of Nebraska researchers
They analyzed the outcomes of nearly 8,300 cases of Staphylococcus aureus
bloodstream infections in the United States and several other countries. The
overall death rate was 26 percent. The researchers concluded that vancomycin
is still a safe and effective treatment in such cases.
Their findings were published in the Journal of the American Medical
"The study provides strong evidence that
vancomycin remains highly useful," study leader Dr. Andre Kalil, an
infectious diseases specialist and a professor in the internal medicine
department, said in a university news release. "The prevention of a rapid
switch to newer drugs has another great benefit to our patients -- less
unnecessary exposure to these drugs, which will translate into less
development of antibiotic resistance," Kalil said. (HealthDay)
Visit NIH for the report.
You need to wash
your towels more often than you think. Here's why.
We're always on the hunt for ways we can keep our homes germ-free, and we
landed on one particularly nasty vessel of ick: towels. If you're drying
silverware with a kitchen towel, for instance, chances are you're drying it
with germs. A 2014 study from the University of Arizona found that 89
percent of kitchen rags carried coliform bacteria, the stuff found in both
animal and human digestive tracts that's used to measure water
contamination. Twenty-five percent tested positive for E. coli.
A deep dive into the particulars of towel cleaning looked at how often you
should wash the various kinds of towels used on a daily basis? It turns
out you should wash all your towels more often than you probably think. For
bath towels, the experts we spoke with recommend washing after about three
uses to remove millions of dead skin cells and avoid that musty scent.
Kitchen rags should ideally be dipped in diluted bleach between uses,
according to a University of Arizona germ expert. And face towels should
really be replaced after every use if you don't want to reintroduce bacteria
to your pores, says a dermatologist.
Kelly Reynolds, a researcher at the University of Arizonaâ€™s Zuckerman
College of Public Health says you should launder your kitchen towels after
each use. A next-best option though is to dip your towels in a diluted
bleach solution between uses, and let them dry. Reynolds recommends filling
your sink with water and a bit of bleach â€“ two teaspoons per gallon of sink
water will do the trick and prolong the time you're able to use your towels
between washes. At least weekly, launder them in your washing machine (on an
antibacterial or sanitizing cycle, if possible).
That musty smell isn't your imagination -- because bath towels are
extra-thick, they lock in moisture and harbor odors more quickly. When you
wash them, use vinegar in place of fabric softener, says laundry expert Mary
Marlowe Leverette. "Fabric softener residue traps odors," she explains. "The
vinegar strips it away." Leverette recommends running your bath towels
through the washing machine as normal, but with no soap and just one cup of
vinegar. Then, wash again with regular detergent. Mary Gagliardi â€“ aka
Clorox's "Dr. Laundry" expert â€“ says to give them a "second rinse," if your
washer has that option. Dry immediately to prevent mustiness.
Face towels and washcloths
"Dirt and bacteria have a way of getting caught in the fabric on a
washcloth," says Dr. Eric Schweiger, of New York's Schweiger Dermatology.
"When you wash or dry your face with a dirty washcloth, you're reintroducing
that dirt and bacteria back into the skin."
Face towels and wash clothes should be washed after every use. And while
that's the ideal frequency with which you want to wash your face and body
cloths, it's really about how much you use it. If you're only using a towel
to pat your face dry, Schweiger says, it's okay to use it a few times
between washes. But if you're removing makeup, a real-deal laundering is
necessary. He recommends a regular, hot-water wash cycle, using
fragrance-free detergent to avoid irritating your skin.
Visit the Huffington Post for the article.