Can wall in Ebola, CDC asserts

Lawmakers at special hearing push W. Africa travel ban

WASHINGTON — In the face of skepticism in Congress, health officials tried to assure the nation Thursday that they can head off an Ebola outbreak in the U.S. despite mistakes that let the deadly virus spread to two nurses and cleared one of them to fly.

Meanwhile, in Texas and Ohio, some schools were closed as a precaution Thurs- day after officials learned that faculty members and students had flown on the same plane as Ebola patient Amber Vinson.

The revelation that one of the hospital nurses who treated Thomas Eric Duncan, who died from Ebola in Dallas, was allowed on a commercial airline the day before she was diagnosed raised new alarms about the U.S. response to the Ebola outbreak in West Africa. Some lawmakers pressed for a ban on travel to the U.S. from the region — a course President Barack Obama has resisted.

The worldwide Ebola death toll is expected to climb above 4,500 in Africa this week, with all but a few of those deaths in Liberia, Sierra Leone and Guinea, the

World Health Organization said. In Sierra Leone, the government announced the virus had infected two people in the last region of the country that had been free of the disease.

Called to Capitol Hill for special hearing Thursday, U.S. health officials emphasized the importance of stopping the virus in West Africa to protect Americans and the rest of the world from its spread.

“You’re right, it needs to be solved in Africa. But until it is, we should not be allowing these folks in, period,” replied Rep. Fred Upton, R-Mich. He called for a ban on the 100 to 150 people who fly into the U.S. each week from the three nations at the heart of the outbreak. “People’s lives are at stake, and the response so far has been unacceptable,” said Upton, chairman of the Energy and Commerce Committee.

Obama on Thursday authorized a call-up of and National Guard and Reserve troops in case they are needed to deal with the Ebola issue. His executive order would allow more forces than the up-to-4,000 already planned to be sent to West Africa, and for longer periods of time.

He also said it may be appropriate to appoint an additional person to lead the anti-Ebola effort in the U.S.

The president met into the evening with top aides and health officials at the White House, saying afterward that he had no “philosophical objection” to imposing a travel ban on West Africa but that he had been told by health and security experts that it would be less effective than measures already in place — and perhaps would be counterproductive.

He said a ban could result in people trying to hide where they were coming from, increasing the chances they could slip through without screening.

Obama spokesman Josh Earnest said earlier that the chances for a widespread outbreak in the U.S. remain “exceedingly low,” despite shortcomings in the government’s initial responses. Health officials said the same.

Dr. Tom Frieden, the director of the Centers for Disease Control and Prevention, told lawmakers Thursday that investigators still don’t know how two nurses caught Ebola while caring for Duncan, a Liberian who died at Texas Health Presbyterian Hospital in Dallas. Duncan was the first person diagnosed with Ebola in the United States after the West African outbreak began in March.

To protect other medical workers while the investigation continues, Frieden said, the CDC is focusing on improving safety procedures.

He said one of the sick nurses, Nina Pham, was moved Thursday from the Texas hospital to a specialized federal facility in Maryland. Vinson has been transferred to an Atlanta hospital that has one of only four bio-containment units in the U.S.

In the hearing on Capitol Hill, the chairman of a House committee cited “demonstrated failures” in the government’s response. Rep. Tim Murphy of Pennsylvania said the “trust and credibility of the administration and government are waning as the American public loses confidence each day.” Frieden testified that despite the latest setbacks, “we remain confident that our public health and health care systems can prevent an Ebola outbreak here.”

In his prepared testimony, the Texas hospital’s chief clinical officer, Dr. Daniel Varga, admitted that the facility had made mistakes in Duncan’s initial treatment, and he apologized for that. “We did not correctly diagnose his symptoms as those of Ebola,” Varga said. “We are deeply sorry.” Duncan was initially sent home from the emergency room with antibiotics for his high fever, despite saying he’d traveled from Liberia.

In Europe, Spain’s government is wrestling with treatment questions, too. The condition of a nursing assistant infected at a Madrid hospital appeared to be improving, but a person who came in contact with her before she was hospitalized developed a fever and was being tested Thursday.

That second person is not a health care worker, a Spanish Health Ministry spokesman said.

To this point, only hospital workers — the Madrid nursing assistant and the two nurses in Dallas — are known to have contracted Ebola outside West Africa during the outbreak.

SCHOOLS SHUT

Elsewhere in the U.S., customs and health officials at airports in Chicago, Atlanta, suburban Washington and Newark, N.J., began taking the temperatures of passengers from the three hardest-hit West African countries Thursday. The screenings, using notouch thermometers, started Saturday at New York’s Kennedy International Airport.

With hospitals and airports on heightened alert, Frieden said the CDC is receiving hundreds of requests for help in ruling out Ebola in travelers. So far 12 cases merited testing, he said. On Thursday officials ruled out Ebola in the cases of a Yale graduate student in Connecticut and four people on a flight in West Virginia.

Frieden said investigators are trying to figure out how the two Dallas nurses caught the virus from Duncan. In the meantime, he said, their cases show a need to strengthen the infection-control procedures that “allowed for exposure to the virus.” Frieden said Vinson never should have been allowed to fly on a commercial jetliner because she had been exposed to the virus while caring for the first Ebola patient, Duncan.

Still, a CDC official cleared Vinson to board Frontier Airlines Flight 1143 from Cleveland to the Dallas area. Her reported temperature — 99.5 degrees — was below a threshold set by the agency, spokesman David Daigle said.

Ebola patients are not considered contagious until they have symptoms. After that, the disease is transmitted only through direct contact with an infected person’s bodily fluids, the CDC has said.

Vinson was diagnosed with Ebola a day after the flight, news that sent airline stocks falling over fears it could dissuade people from flying.

In Akron, Ohio, officials dismissed students at the Resnik Community Learning Center at midday because of Ebola fears and said it would remain closed until Monday. In a letter to parents, Superintendent David James said “a parent at the school had spent time with Ebola patient Amber Vinson when she visited the area this past weekend.” James said the student at the school had not meet with Vinson but that the parent and the student were being isolated.

In central Texas, the superintendent of the Belton Independent School District, south of Waco, said students at two schools had been on the same flight as Vinson on Monday. Susan Kincannon said in a statement that officials decided to shut those schools and a third so they could be cleaned.

Though state and local health officials cleared the children to return to school, their parents decided to keep them home for 21 days, the maximum incubation period of the virus.

The Eagle Mountain-Saginaw Independent School District in Fort Worth did not close any schools, but it announced that one family would be isolated for three weeks because a member of the household had flown to Dallas on Flight 1143. The person who was aboard the plane works at the Naval Air Station Joint Reserve Base Fort Worth, and officials said the decision to isolate the family was made in consultation with the military.

In Solon, a Cleveland suburb of about 23,000, two schools were closed Thursday because a district employee returned to Ohio “on a different flight, but perhaps the same aircraft, as the Texas nurse with Ebola,” the district said in an email to parents.

Frontier Airlines said Thursday that it has taken the aircraft Vinson flew on out of service to undergo a fourth cleaning, including replacement of seat covers, carpeting and air filters. Health care specialists expressed skepticism about the school closings Thursday. “It’s not a rational decision,” said Dr. Andrew Pavia, chief of pediatric infectious diseases at the University of Utah. “And it’s harmful, in that it’s going to further spread misunderstanding and irrational fear.”

Dr. Paul Offit, the chief of infectious diseases at the Children’s Hospital of Philadelphia, likened the response to the early days of the AIDS epidemic “when people were afraid to walk into a grocery store and pick up a piece of fruit because they didn’t know who’d touched it.”

“This isn’t flu or smallpox,” Offit said. “It’s not spread by droplet transmission. As long as nobody kissed the person on the plane, they’re safe.”

FLIGHTS TO AFRICA CUT

In West Africa on Thursday, officials announced two Ebola cases in the previous unaffected Koinadugu district in Sierra Leone’s far north, which had taken aggressive measures to keep the virus out.

Ebola is rampant in the rest of the country, with 425 new cases in the past week and a health care system that is struggling to deal with the disease. The World Health Organization said there have been more than 3,000 infections in Sierra Leone with nearly 1,200 deaths.

Koinadugu had survived infection free for so long in part because it cut itself off from infected areas, but the affected countries have asked other countries to maintain ties and help them fight the disease.

Information for this article was contributed by Jim Kuhnhenn, Emily Schmall, Nomaan Merchant, Connie Cass, Calvin Woodward, James Stengle, Clarence Roy-Macaulay, Paul Schemm, Boubacar Diallo, Elias Meseret, David Pitt, Edith M. Lederer and staff members of The Associated Press; by Manny Fernande, Jack Healy, David Montgomery, Donald McNeil, Jad Mouawad, Patrick McGeehan Alison Leigh Cowan, Monica Disare and Alan Blinder of The New York Times; and by Noam M. Levey, Kurtis Lee and Lauren Raab of the Tribune Washington Bureau.