Spanish nurse reported in as soon as her temp rose; they sent her away. The threshold is TOO HIGH

[magical thyme]

For the 2nd time in a week, a potentially exposed person reported in with mild symptoms and was sent on their way. For the 2nd time, that person was left to walk around for days potentially infecting others.

"She had alerted them to a slight fever on 30 September, said Antonio Alemany from the regional government of Madrid, and checked into a hospital in Alcorcón with a high fever on Sunday. Ebola protocol was immediately activated at the hospital and initial and secondary tests were both positive for the virus."
http://www.theguardian.com/world/2014/oct/06/nurse-spain-tests-positive-ebola

The problem is with the fucking criteria. The temperature threshold is 101.5F -- and it is too effing high.

Duncan's was only 100.1 when the ED doctor followed the criteria and sent him home.

How many symptomatic people are they going to let loose before they figure out that the problem is the guidelines?!?!

[elleng]

1. OH GEEZE!

[haikugal]

2. Unreal...n/t

[Agschmid]

3. Regardless of the temperature...

both of these folks should have been considered high risk. These are both pretty significant failures IMO.

[magical thyme]

4. the point is that the official guidelines that have been sent out use 101.5F as the threshold temp

below that, docs and an infected nurse, are told not to worry yet, even with known Ebola exposure.

[RobertEarl]

5. That's nutz

It's like they are too busy, or something?

Poor lady. The system has failed her.

Who is next?

[eShirl]

11. This needs to change now; ebola is not fcking around. n/t

[grasswire]

6. ...

Health authorities on Monday said that health professionals treating Ebola patients in Spain always followed protocols outlined by the World Health Organisation. The nurse would have entered García Viejo’s room just twice, said Alemany, and would have been wearing protective equipment on both occasions. “We don’t know yet what failed,” said Alemany. “We’re investigating the mechanism of infection.”

[magical thyme]

7. I've been working on my protocol, because the sr techs around me are so lax where I work

I've been increasingly careless over the years.

I cannot believe how many times in one day I found myself unconsciously starting to adjust my glasses or reaching to scratch an itch.

And as soon as you remind yourself keep your hands away from your face, your eyes and nose start itching nonstop.

[Barack_America]

8. 100.1 isn't technically febrile in most hospitals.

[magical thyme]

10. I'm referring to CDC criteria, not what a hospital considers a fever

Duncan's was only 100.1 when he first reported to the ED.

The CDC's criteria say 1. travel to Liberia and 2. temp of 101.5F or higher and 3. one other

Following the 101.5F threshold has now turned 2 infected people loose within a week, delaying their treatment and potentially infecting others.

The criteria are not working.

[ecstatic]

9. Also, if the CDC is wrong about the temperature,

what else are they wrong about? The guidelines are outdated. Period.

[magical thyme]

12. the guidelines are not outdated; they're based on this epidemic for US doctors.

the threshold is too high.

They've made for a couple dozen 1-2 day false alarms with neg tests, but they've released 2 infected people.

[Ex Lurker]

13. If you lower the threshold too much, you get a lot of false postives

body temperature fluctuates throughout the day. According to WebMD, the cutoff point for a fever is 100.4.

[pnwmom]

14. Better a hundred false positives than a real case that is sent back into the population. n/t

[pnwmom]

15. So why should the cutoff for Ebola be almost a full degree higher than that? It shouldn't.

Lots of serious illnesses begin with a lower fever that then rises. This is probably the case with Ebola, too.

[magical thyme]

18. Then fever should not be a criteria for exposed patients.

Because neither of the first 2 cases diagnosed outside of Africa met the threshold criteria.

Or any even slight temperature elevation of exposed patients should at least lead to temporary isolation and evaluation. Jeebus, we have totally non-sick people in our ED all the time, and even do extensive testing if they keep coming back, up to and including a recent spinal tap/CSF for somebody with normal CBC and CMP because of a headache and fever. But we won't isolate and monitor a potential Ebola case?!?!

"El Mundo reported that it was the nurse who asked to be tested for Ebola, having to insist repeatedly on being tested before it was done on Monday."
http://www.theguardian.com/world/2014/oct/07/ebola-crisis-substandard-equipment-nurse-positive-spain

[magical thyme]

20. if these 2 positives were out of 100 other positives that were caught immediately, then maybe

maybe.

But these are the only 2 positives diagnosed outside of Africa, and both were sent away because they didn't meet the threshold criteria.

The criteria isn't working.

[LeftInTX]

16. Grhhh......

I understand the traditional 101.5 F thing, but yeah......

[muriel_volestrangler]

17. There's nothing that says they 'sent her away'; she was on vacation on Sept 30th

The patient, who is married with no children, was on holiday when she began showing symptoms, said Alemany.

The Spanish nurse went on vacation the day after the priest died but checked in Sunday to a public hospital in the working class Madrid suburb of Alcorcon with a fever and was placed in isolation.

https://ca.news.yahoo.com/spanish-nurse-suspected-catching-ebola-hospital-patient-infected-173001840.html

Antonio Alemany, a health official from the regional government of Madrid, told the news conference that the nurse went on vacation a day after Father García Viejo died. She got in touch with a medical center on Sept. 30 after feeling feverish, but had been leading “a normal life” while on vacation, he added, without giving details on her whereabouts during that period.

http://www.nytimes.com/2014/10/07/world/europe/spain-reports-first-case-of-ebola-contracted-outside-west-africa.html?_r=0

The wording used everywhere never says she went into a hospital. It sounds like she phone or emailed, and told them she had a slight fever. She's a nurse; she knew she had helped treat 2 Ebola patients. It was her diagnosis.

[IdaBriggs]

19. I think the "real factor" needs to be exposure/risk.

People's bodies fight/react differently sometimes. My husband's body temperature runs "low" usually, so when he gets a fever of 99.5, for HIM that is high....