Patient with Ebola-like symptoms evaluated at Yale-New Haven

Updated 2:40 p.m.

It remained unclear Thursday afternoon whether the Yale graduate student with Ebola-like symptoms at Yale-New Haven Hospital had the virus, but a hospital official said the patient was in good condition with a low-grade fever and had improved since being hospitalized.

Gov. Dannel P. Malloy said results from a preliminary Ebola test were expected to be available by 4 p.m. If the sample tests positive, a second test would be required. A negative result on the first test would indicate that the patient doesn’t have the virus, he said.

The patient returned to the U.S. from Liberia Saturday. Dr. Thomas Balcezak, Yale-New Haven’s chief medical officer, said the patient was being monitored by a primary care provider in the community, and had notified the provider after developing a fever.

The patient was taken to the hospital’s emergency department and then admitted to a room with negative pressure, designed for infection control. Hospital officials said the patient is in isolation and being monitored by a clinical team, and that Yale-New Haven is working with local, state and federal health officials.

During a press conference Thursday afternoon, New Haven Mayor Toni Harp said that although officials are taking precautions, the patient might not have Ebola.

“This is just a suspected case,” she said. “We don’t believe, in really thinking it through, that it will actually turn out to be an Ebola case.”

Harp said people with symptoms have been calling, but that unless someone has traveled to Sierra Leone, Guinea or Liberia, where the outbreak is concentrated, a person is more likely to have flu.

Yale University President Peter Salovey described the patient as a doctoral student who recently returned from a research mission to Liberia. “The hospitalization decision was made out of an abundance of caution,” he wrote in a letter to the Yale community.

Salovey wrote that doctoral students who were in Liberia reported that they were not in contact with Ebola patients or caregivers and followed travel and hygiene precautions.

During the press conference, Yale School of Medicine Dean Dr. Robert Alpern said that the students were not expecting to have contact with Ebola patients, but that they were in contact with one person who developed Ebola. That person wasn’t symptomatic when interacting with the students, Alpern said.

Balcezak said the state Department of Public Health and local officials are working to ensure that people who were in contact with the patient are being appropriately monitored. When pressed about whether the patient was married or had children, Balcezak declined to say, and said the health department was addressing potential contacts.

The hospital was trying to minimize the number of staff caring for the patient, Balcezak said. Two attending physicians with training in critical care and internal medicine will provide care around the clock, he said. The care team will also include two nurses at all times — one to care for the patient, and one to ensure that the other nurse is putting on and removing protective equipment appropriately.

Hospital President and CEO Richard D’Aquila praised the staff and said the hospital has been preparing for a potential Ebola patient for weeks.

“Everything went just the way we planned last night,” said Dr. Louise Dembry, an infectious disease specialist and hospital epidemiologist at Yale-New Haven.

In a statement released earlier Thursday, the hospital said any patient who comes with Ebola symptoms will be isolated from other patients and cared for in a special isolation room, with staff wearing protective gear, including masks, face shields, gloves and protective gowns or suits. The hospital said it “employs protection measures even greater than those recommended by the CDC.

The state Department of Public Health is “ensuring that all necessary protocols are in place to ensure the patient receives proper care and that hospital patients and the public are protected,” spokesman William Gerrish said Thursday.

Last week, Malloy declared a state of emergency to give Public Health Commissioner Dr. Jewel Mullen the authority to quarantine and isolate people she “reasonably believes” have been exposed to the virus. At the time, officials said the declaration was made as a precaution, not because there was reason to believe anyone in the state had Ebola virus. Without the declaration, the authority to isolate or quarantine would have rested with each local public health director.

Malloy said Mullen had executed the order in response to the potential Ebola case at Yale-New Haven.

The governor said Thursday that he was directing every hospital in the state to conduct a drill to ensure that procedures and emergency medical services are prepared. Malloy also formally convened a “unified command team” to coordinate resources, personnel and communications related to the virus, and to ensure that front line personnel at health care facilities and first responders have received necessary training.

Some hospital officials have wondered whether it would make sense to have specially designated hospitals care for any patients in the state found to have Ebola.

Asked about it last week, State Epidemiologist Dr. Matthew Cartter said it’s important that all hospitals be prepared for someone to walk in with Ebola-like symptoms and to isolate the patient and provide treatment for at least a short time.

He said officials could potentially consider having specific hospitals handle more long-term care, although he said there are challenges to that too. “It’s really difficult to ask a single hospital to be ‘the Ebola hospital,’” he said.

Symptoms of Ebola include a fever greater than 101.5 degrees, severe headache, muscle pain, weakness, diarrhea, vomiting, abdominal pain and unexplained bruising or bleeding. Symptoms can appear between 2 and 21 days after exposure to the virus, but occur on average between 8 to 10 days after exposure, according to the CDC.

The virus spreads through direct contact with blood or body fluids including urine, saliva, sweat, feces, vomit, breast milk and semen, according to the CDC.

As of Oct. 12, there had been 8,997 cases of Ebola worldwide during this outbreak, and 4,493 deaths. All but 24 of the cases occurred in Guinea, Liberia and Sierra Leone.

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