Sunday, October 5, 2014, 1:00 p.m. ET
\n \nOPERATOR: Welcome, and thank you all for standing by. I\u2019d like to remind the participants that their lines have been placed on a listen-only mode until today\u2019s question and answer session of today\u2019s conference. At that time, if you have question, press star 1 followed by one on your touchtone phone. Today\u2019s conference is being recorded. If anyone has objections, please disconnect at this time. I\u2019ll be turning your call over to your first speaker today, Dr. Barbara Reynolds. Thank you ma\u2019am, you may begin.
\nBARBARA REYNOLDS: Good afternoon, you\u2019re joining CDC\u2019s daily update on the Ebola response. I\u2019m Barbara Reynolds, the CDC\u2019s director of public affairs. Today you\u2019ll be hearing from three speakers and then we\u2019ll take questions. Our first speaker is CDC director, Dr. Tom Frieden. Dr, Frieden?
\nTOM FRIEDEN: Hello everyone, it is exactly one week, since the first patient with Ebola in this country was diagnosed in Dallas, Texas and it\u2019s a good time to look back on what has happened in that week, and to say well all of the things that have happened, and where we are, and where we are likely to be going. The patient was diagnosed on Tuesday. Within about two hours, we announced that. That evening we had staff on the ground helping the terrific staff in Dallas, Texas to respond to this case. And we have no doubt that we will stop it in its tracks in Texas. It\u2019s worth stepping back and saying how Ebola spreads. Ebola only spreads by direct contact with someone who\u2019s sick or with their body fluids. So the core of control is identifying everyone who might have had contact with them and making sure they\u2019re monitored for 21 days and if they develop symptoms to immediately isolate them to break the chain of transmission. Today I would like to spend a minute talking about what\u2019s happening in Dallas, and then turn to my colleagues there, then about what\u2019s happening in the U.S. more broadly and finally where we are with the epidemic in West Africa. In terms of Dallas, the work of the state and local departments with CDC assistance has been terrific. They have been able to assess all 114 individuals who might possibly have had contact. They were able to rule out that 66 did not have contact. They identified ten who appeared to have had contact with the individual when he might possibly have been infectious. Of those ten, seven are health care workers and three are family or community contacts. In addition, there are about 38 other people in whom we could not rule out that they had contact. So all of those 48 people will be tracked for 21 days to determine whether they have fever and if any developed fever, they will be immediately isolated, tested and if they have Ebola, given appropriate care and determine whether there were any additional contacts to their case. That\u2019s how we have stopped every outbreak in Ebola in the world until this one in West Africa. That\u2019s how we stopped it in Lagos, Nigeria and how we will stop it in Texas. Going on to the U.S. situation, we have seen a lot of understandable concern. Because of the deadly nature of Ebola and we\u2019re really hoping for the recovery of the patient in Dallas, we understand that his situation has taken a turn for the worse. We know that Ebola is a very serious disease and we\u2019re hoping for his recovery. But because it\u2019s such a deadly disease, people are scared. And it\u2019s normal to be scared, in fact for the health care workers who are caring for people with Ebola, we want them to be scared. We want them to have a healthy respect of the risk for any lapse in infection control procedure. We want them to channel that fear into being incredibly meticulous about infection control. Many people have pointed out that initially the individual was not diagnosed and we have done at CDC and will be doing a lot more in the coming days and weeks to inform and empower, not just doctors, but nurses, health care professionals of all time, anybody who has been in Sierra Leone or Liberia in the last several days, that if that happens, we rapidly isolate them, assess them and if indicated, test for Ebola. CDC has already done \u2014 reached hundreds of thousands of health care professionals with alerts, information, materials, tools, webinars at least once a week and we will ramp that up with medical associations, groups of doctors, nurses and others, making sure that this issue of Ebola remains tops \u2014 we have seen the level of interest increase. In fact we were getting about 50 calls or e-mails per day before the initial patient was diagnosed here. Now it\u2019s up to 800 calls or e-mails per day. We also understand the level of concern. We also understand that people would like to do everything possible to keep Ebola out of the U.S. and we agree with that 100 percent. Our top priority at the CDC is to protect Americans from threats. We work 24/7 to do that. In this case we are doing it by many different ways, and one of them is to stop the outbreak at its source, in Africa. There\u2019s a good possible that someone will travel, infect someone else, come into this country or another country, and have a case of Ebola. As long as Ebola is continuing in Africa\u2013an outbreak anywhere is potentially a threat everywhere. But that doesn\u2019t mean we can\u2019t do anything. One of the things we do is to make sure that everyone leaving those countries is intensively screened with their temp being taken, questions being asked and being observed to see if they appear to be ill. That screening has removed 77 people who would have boarded planes to leave the country and didn\u2019t because of the training that the CDC staff helped those countries implement. They need the airlines to keep flying, otherwise they won\u2019t be able to keep their societies moving and we won\u2019t be able to stop the outbreak there. In addition of course, we work with health care workers around the country so there\u2019s rapid identification of cases and of course we\u2019re now looking at the issue of entry screening. And we\u2019re looking at all possibilities, there have been suggestions from people in congress, from the public, from the media, we\u2019ll look at those and see what works to protect Americans and to make sure that whatever we do doesn\u2019t unintentionally actually increase our risk. If we make it harder to fight the outbreak in West Africa, we actually increase our own risk. So those are the criteria that we\u2019re using, working across the U.S. government, there are many agencies focused on this and will be committed to doing whatever we can to further increase the safety of Americans. Getting finally to issue of what\u2019s happening in West Africa today, the situation remains very fluid. It\u2019s striking when I speak to the CDC leaders, who are there, and we have sent u now 135 of our top disease detectives, and they\u2019re working down to the county and district levels in each one of the countries. One of the things that\u2019s quite striking is the diversity of the experience. This isn\u2019t just West Africa, its three individual countries, each individual country has its own pattern of disease spread. There\u2019s some districts that haven\u2019t had a case of Ebola, with some, it\u2019s just a handful of cases in each of their districts. We\u2019re looking at each of the 62 districts across each of these three countries to see what can be done to comb down this forest fire, to put out the sparks where it\u2019s spread to some places and place where is it\u2019s got a huge problem to isolate as many people as rapidly as possible. We have seen real progress in the response over the past one to two weeks, the department of defense being on the ground has made a big difference. They\u2019re already moving out and helping with operations. We have also seen USAID effectively increase support for families who want to respectfully and safely \u2014 so while we\u2019re still not ahead of it, we\u2019re certainly getting further along than we were before. I\u2019m looking forward to briefing president Obama on the situation in west Africa tomorrow and to further ensuring that the president\u2019s direction that we move rapidly to do as much as we can to stop this is what we\u2019re doing not only at CDC, not only across the U.S. government, but globally, because we\u2019re seeing a tremendous global coalition committed to doing this. So that\u2019s a built about where we are in Dallas and the U.S. and globally. And before I turn it over to my colleagues in Texas, just to highlight, one thing that happened that didn\u2019t get much notice in this past week, because it happened to be on Tuesday, the day that we announced the diagnosis. We published a report on what happened in Nigeria when they had a single case and they didn\u2019t do any infection control, they ended up with 19 secondary cases, additional cases, but because of a rapid public health response, effectively tracking nearly 900 contacts, it appears that they have been able to stop the outbreak in Nigeria. Though we can\u2019t give the all clear yet, it does look like the outbreak is over there. I\u2019m confident that wherever we apply the fundamental principles of infection control in public health, we can stop Ebola.
\nBARABARA REYNOLDS: Thank you, Dr. Frieden. Next speaker is Dr. David Lakey, who\u2019s the commissioner of the Texas department of state health services. Dr. Lakey.
\nDAVID LAKEY: Well, good afternoon, this is David Lakey, the commissioner of health for the state of Texas. And I would like to thank Dr. Frieden for the support of the CDC as we\u2019re working on this effort right now. It\u2019s one effort and one team. I want to start off by saying that my thoughts and prayers and our thoughts and prayers with the patient right now, but also with the family as they\u2019re going through this event and the contacts that are identified that obviously have concern about what\u2019s going on with them right now and with the hospital workers who are caring for this ill patient right now. In fact we\u2019re doing our work in partnership with the CDC and our global health department here in the state of Texas. A lot of very important hard work is taking place here in Texas, in Dallas to ensure that the people of Dallas are safe. The good news is that we have had no more cases and no one has reported any symptoms and we\u2019re happy about that and we\u2019re reassured but still very cautious in making sure we continue to care for individuals, monitor the situation in the way it needs to be done. Our function here is to monitor every contact and every possible contact and we have identified all the contacts and our priority in public health is to continue tracking those individuals. We want to make sure that we are closely monitoring them and what\u2019s what we are focused on. Also as we are monitoring individuals, as we identify needs that they may have, we\u2019re working through our command structure to make sure those issues are addressed. Making sure if food issues are identified, that \u2014 that those issues are resolved. We have also, the neighbors, they have had concerns and we have tried to provide health educators in the community to help address those issues. Our focus is to make sure that you are informed of what\u2019s going on and understand how the public health system works and what the risks may be. The public health systems works to prevent and contain these risks, and I know it\u2019s been noted several times, but obviously a lot of people are listening right now, I want to re-empathize, that Ebola is not spread by the air, and people are not contagious unless they have symptoms. This can\u2019t be stated enough and I think it needs to be reassuring to the individuals who are listening today. There are hospitals across the stay Texas and the nation that on the look youth for any additional cases. We want hospitals to be on high alert and to identify individual who is have a travel history to the areas that are affected and that come in with any symptoms that could be associated with Ebola and that these \u2014 we\u2019re going to call on us, and that\u2019s exactly how we want the simple to woman, as they\u2019re identified, as a concern that they can get the testing that needs to be done. So we\u2019re all on high alert right now and that\u2019s where we believe it should b we continue to plan for contingencies, we\u2019re making plans so that we\u2019re prepared as we need to be to address those issues. And again Dr. Frieden, I want to thank you for the partnership between the CDC and the state of Texas as we work together to assure the safety of the people in Dallas. Thank you.
\nBARBARA REYNOLDS: Our final speaker is Dallas county judge Clay Lewis Jenkins, Judge Jenkins?
\nCLAY LEWIS JENKINS: Good morning and happy Sunday to everyone on the call. I want to start off by thanking all of the people who are currently being monitored and their families. I realize that when you\u2019re being monitored, even with a low risk for Ebola, it is a very unsettling and frankly terrifying process to worry about. And I am praying for all of you and many others are as well. This morning, I had the opportunity to participate in half of a mass and it was a mass by the bishop of the Archdiocese of Dallas for the Catholic Church where 1.2 million Catholics are under his leadership and the sermon was on Ebola and remaining calm and showing compassion and our duties to our fellow man. I know that is a message that is being preached throughout synagogues, churches and mosques in the Dallas county area and so I want to thank the faith community for stepping up, for the faith leader who found the home for Louise and the three young men, and for all the faith leaders who have stepped up as you always do in times of crisis. I want the public to remember, we had the same sort of concerns and some people had the same types of panic when we had the west nile virus outbreak in 2012. I\u2019m speaking to you from our EOC here in Dallas county, sitting directly next to me is David Lakey of the state of Texas, our state public health commissioner, and highest authority on the public health, and Dave Daigle from the CDC, these are the two men that they have embedded at the Dallas county offices when we stopped the west nile virus in 2012 and we will contain this Ebola situation as well. We are \u2014 as the news reports have come out, I\u2019ll answer the first question ahead of time, we are working to find a low risk individual who has been identified as a contact. We have our Dallas county sheriff\u2019s department and Dallas police department teams on the ground now and they have been there since last night, we are working to locate the individual and get him to a comfortable, compassionate place where we can monitor him and care for his every need during the full monitoring period. I want to assure you this person has not committed a crime, they are a low risk individual, and I emphasize low risk individual, and we are doing this as a precautionary measure. Again, I want to thank everyone, the staff of homeland security and emergency management and Dallas county health and human services as well as my executive staff for all of their hours and hours of work on very little sleep. And the individual was seen yesterday, the low risk individual I just spoke of was seen yesterday, was monitored and is an asymptomatic low exposure individual. Remember what we talked about, for those of you who are not medical reporters, asymptomatic people, have zero chance of contracting the Ebola virus from a symptomatic individual. We just need to locate this individual and need your help in letting them know they\u2019re not in trouble. We want to move them to a comfortable and compassionate place and care for their every need while we monitor them throughout the monitoring period. And with that, I\u2019ll turn it over for questions.
\nBARBARA REYNOLDS: Thank you judge Jenkins, we\u2019re now going to open the room for questions and by phone through the operator. Thank you.
\nOPERATOR: And again, Parties on the phone, if you would like to ask a question, star 1 and record your name before you start talking.
\nSTEVE GEHLELCH: Steve with WSB, Can you talk about this patient in Dallas soon to take a turn for the worse, are they getting the same treatment those patients we saw here in Atlanta and Nebraska that seemed to get better? Is there some different treatment or is there some reason why they haven\u2019t taken to this treatment?
\nTOM FRIEDEN: Ebola is a very serious infection and unfortunately can be fatal in many people who get the infection. Some patients received an experimental treatment known as z-mapp. That is three specific antibodies, but there are a very small number of doses in the world, and I understand it\u2019s all gone. It takes a long time to make more of that medicine, so it\u2019s not going to be available any time soon. There\u2019s a second experimental medicine, both of these medicines, we don\u2019t know if they work or not, but they are two experimental medicines that may be promising. And the second could be somewhat dangerous to use, it could make the patient sicker in the interim and the family would have that choice, if they wanted to, they would have access to it.
\nMICHELE MARILL: Thank you, Dr. Frieden. Michele from Hospital Employee Health Newsletter, I have two questions; the first one has to do with protections for health care workers. The CDC guidance currently is that health care workers wear a safe mask. There are some experts in respiratory protection who have argued that the precautionary principle says that in the absence of absolute certainty that higher levels of protection should be used, and certainly other patients in the U.S. who had Ebola were treated in high containment settings. In your recommendations, what are health care workers using in terms of respiratory protection?
\nTOM FRIEDEN: The key with Ebola is to make sure that the barrier and other precautions are trickily followed. Where we have seen lapses in infection control in Africa, that resulted in spread, it\u2019s because of a problem of either putting on or taking off the protective equipment. That can be an area of risk, if you take it off and don\u2019t do it carefully, you might contaminate yourself by mistake. It\u2019s very clear from everything we have seen in Africa, from everything we have seen over the last 40 years with this virus, that the spread is nowhere near as contagious as something like flu or measles or TB or even the common cold, that catching it requires direct contact. And there\u2019s an interesting clue here, over the past decade, though we have not had until now any patients with Ebola in the U.S. we have had five patients in the U.S. who have had other hemorrhagic fevers from other entire rouses. Marburg is very similar to Ebola. None of those five patients were initially diagnosed. None of them were cared for with any special precautions beyond what we generally do and there were no secondary infections in any of those cases. In fact for the women who had Marburg, she underwent surgery before she knew she had the Marburg infection. If hospitals want fob \u2014 want to have additional safeguards, that\u2019s entirely up to them, but we have, for many years in fact, decades cared for patients in Africa with these conditions and not had infections as long as the infection control procedures are strictly followed. It\u2019s not a question of being highly infectious; it\u2019s a question of making sure that the precautions that are taken are strictly and meticulously adhered to.
\nMICHELLE MARIL: I just had a second question. With regard to you mentioned seven health care workers are among those being monitored, when the patient first appeared at the hospital, routine blood work was taken. Did your net include the people in the laboratory who were handing those blood specimens?
\nTOM FRIEDEN: We have looked at all potential exposures within the hospital context. We\u2019ll go to the phone for the first question.
\nOPERATOR: Our first question comes from Elizabeth Cohen with CNN
\nELIZABETH COHEN: Hi, Dr. Frieden and everybody else, thank you for having this press conference. The Dallas patient, is he receiving any other medicine besides the \u2014
\nTOM FRIEDEN: I actually didn\u2019t hear the specifics of your question, is he receiving what, you asked?
\nELIZABETH COHEN: Ebola anything other than supportive care?
\nTOM FRIEDEN: As far as we understand, experimental medicine is not being used, as I mentioned earlier, the medication you mentioned can be quite difficult for patients to take and can worsen their conditions. So it\u2019s up to their treating physicians, himself, his family as to what treatment to take, supportive care, managing fluids, supporting the patient\u2019s vital functions, these are all critical issues to be addressed. Next question on the phone?
\nOPERATOR: The next question comes from Donna Young with Scripp news.
\nDONNA YOUNG: Thank you for taking my call. I have a question about the difference between why you\u2019ve got the physician that was exposed in Sierra Leone monitored or treated at the NIH as opposed to the Duncan family and friends why they were kept under guard in an apartment complex now moved to a private home, why are they not being monitored in a medical facility when you\u2019ve got another person being monitored at the national institutes of health clinical center. And when will \u2014 the status of the patient at the NIH, and has he actually been tested for Ebola?
\nTOM FRIEDEN: For any individual questions you would have to consult the treating facility and they would consult the family and that\u2019s who would make available any situation. The situation in NIH is a clinical research center where clinical research is done and you would have to refer any questions to them. In terms of the contacts in Texas I\u2019ll turn it over to Dr. Laky, the concern for anyone who has had contact, they\u2019re not a risk to others. The only thing we need to ensure is that their temperature is among monitored and if they\u2019re found to be positive, then appropriately cared for. The authorities in Texas determined that the only way to ensure that for certain individuals that temperature gets monitored daily is to take the actions they took.
\nDAVID LAKEY: Thanks Tom, I think that\u2019s correct. We put in a control order to ensure that we could protect the public\u2019s health and safety and monitor these individuals and do everything we can to monitor it very compassionately and care for their needs. We feel very comfortable where the individuals are at this time, honestly there were challenges in getting them entered into that location, but things are going well with them now and we again have individuals that are working with them daily, monitoring them, taking their temperature, and we feel very comfortable that they\u2019re in a safe environment at this time. You\u2019ve been working directly with them and transported them to the house, anything you would like to add to that?
\nCLAY LEWIS JENKINS: Sure, if you are in the hospital and that were your family, you would want them to be in the kind of place that we have this family in. Their medical monitoring is excellent and we\u2019re doing everything that needs to be done that could be done in a hospital, it\u2019s just consists essentially of checking their temperature and their vitals twice a day. And without getting into the specifics of the children \u2014 the individuals, we got a young man who\u2019s enjoying playing basketball now and he can\u2019t be doing that in the hospital. Even though the science on this is clear, Ebola was discovered in 1976, and the officials that are working together with us, hand in hand, on the team, are the same experts who have been working on it everywhere it\u2019s reared its head in the last, whatever it\u2019s been 40 years, even though that\u2019s true, if i put this family in a hospital, there are going to be people that are afraid to go to the hospital. I need your citizens to know that Presbyterian and every other hospital in Dallas County is safe and if you need medical care, you need to go to the hospital. Frankly I\u2019m more concerned about bad outcomes if we overcrowd emergency rooms with panic or people stop using Presbyterian, which is a great hospital, than I am about statistically the chance of this disease spreading. So that was the thought process in moving them to a location away from other individuals that is more restful and appropriate place for young people.
\nTOM FRIEDEN: Thank you. Next question on the phone?
\nOPERATOR: Our next questions comes from Ana Campoy with Wall Street Journal, your line is open.
\nANA CAMPOY: Yes, hi. I was wondering if you can tell us more about this individual that you\u2019re looking for, is he or she one of the 50 that you were monitoring. And what kind of contact did he or she have with Mr. Duncan? And have you had other people that have gone missing like him in the past few days?
\nTOM FRIEDEN: So I will outline the overall and then turn to Dr. Lakey. The individual who\u2019s being sought now was monitored yesterday, so he hasn\u2019t missed a day of monitoring. Even though he has gone missing, I\u2019m sure the authorities in Texas can find him again. The nature of his contact is considered low risk. He if you will recall, identified two groups, one a group of 10 who definitely appears to have had contact. It may not have been substantial contact, but it was contact. And there was a group of 8 who might have had contact. For the ten who did, all of them have been monitored each day since they were identified, none of them have symptoms, none of them have fever. And I do want to highlight, even though we have described that as a higher or deft contact. This is. Like a needle stick, this is someone who may have touched the patient. Not a very high risk, but deft contact. But this individual was not in that group of ten who had definitely contact. Dr. Lakey?
\nDAVID LAKEY: I just want to echo your comments there, this is a low contact individual, if it had been identified that he was seen yesterday and did not have any fever yesterday, but that we believe that we need to again work to make sure we work to locate him, to make sure he is continued to be monitored compassionately. As has been noted, he\u2019s homeless. We\u2019re working very hard to address that issue so we have a controlled environment to monitor him and that\u2019s the work that\u2019s taking place right now to ensure that his every need is met during this time that we\u2019re monitoring him. If he\u2019s listening right now, we want to make sure that we address his needs and monitor him compassionately.
\nCLAY LEWIS JENKINS: Let me add something to that, if he\u2019s listening to this, I\u2019m the one that took his family in my personal car to where they were right now, it\u2019s a great place. We would like to find a great place to among for you as well. You have my word that your every need will be taken care of during that monitoring period, we need your help in letting \u2014 coming to us or going to an officer and letting them know who you are, and they will contact me and I\u2019ll come to you and we\u2019ll work out your every need. Thank you.
\nTOM FRIEDEN: We have another question in the room.
\nJOHNNY CLARK: Dr. Frieden, Johnny Clark with Associated Press. You mentioned in your opening statement that unfortunately the patient in Texas has take an turn for the worse, can you give us any details of the complications he\u2019s experiencing?
\nTOM FRIEDEN: I would have to refer you to the hospital, we know that Ebola is a deadly disease and can affect many parts of the body so it can be very challenging to support the vital functions while the patient\u2019s natural immune system is trying to fight it off. Next question on the phone?
\nOPERATOR: Next question comes from Rob Stein with NPR.
\nROB STEIN: Thanks for taking my question. Just a follow-up on the person you\u2019re trying to locate. Can you tell us what u you\u2019re trying to do to locate this person other than this public appeal?
\nTOM FRIEDEN: I think it\u2019s a question about how to locate the person who hasn\u2019t been located.
\nCLAY LEWIS JENKINS: This is judge Jenkins, I\u2019ll take that, I guess we\u2019re the boots on the ground in locating him. We have law enforcement and other first responder agency going to places, we\u2019re using the same sort of data points that we use to find anyone that we\u2019re looking for and we\u2019re making that top tier effort to locate this individual. I want to stress again, not because he\u2019s committed any kind of crime or is in any kind of trouble whatsoever. It\u2019s that we have a great place for him to stay and we\u2019re going to attend to his every need and we need the individual to help us by coming forward and being a hero for his community by letting us help him.
\nTOM FRIEDEN: Thank you, next question on the phone.
\nOPERATOR: Next question comes from Marc Santora with New York Times.
\nMARC SANTORA: Hi, thank you. I was just hoping you might be able to give us a little bit of detail on what happened at Newark airport yesterday, how were you so quickly able to rule out Ebola and are your \u2013 (audio faded)
\nTOM FRIEDEN: Once that patient\u2019s detailed history and clinical examination was done, it became clear that the symptoms that that individual had were not consistent with Ebola, they were consistent with another \u2014 as i said yes, we do expect there will be more concerns, more rumors, more possible cases, what we\u2019ll do is make sure we respond rapidly in each such case, if someone has traveled to one of the three countries that continues to have spread of Ebola and has symptoms consistent with Ebola\u2013in this case, the symptoms were not consistent with Ebola and he was better and went on his way. Next question?
\nOPERATOR: Next question is Eben Brown with Fox News, your line is now open.
\u2014\u2013
TOM FRIEDEN: we\u2019ll go to the next question.
OPERATOR: Next question comes from Lisa Schrinngs with CIDRAP
\nLISA SCHRINNGS: Hi, thanks for being available today, just kind of a quick housekeeping question for myself and other journalists, the week ahead, i know you have a briefing with president Obama tomorrow, to the best of your knowledge today, are there any congressional hearings or other big meetings for people to kind of keep an eye on? Thanks so much.
\nTOM FRIEDEN: We\u2019ll take it one day at a time and we\u2019ll see what gets scheduled when, we look forward to work collaboratively and are really encouraged by the interesting commitment and support we have gotten from everybody in Washington. People understand that we\u2019re all in this together, that there are clear things that we have got to do, it\u2019s hard, it\u2019s going to be a long, hard road but that working together we can stop Ebola, we can stop it here and we can control it in Africa. Next question in the room?
\nREPORTER: Dr. Frieden, now that we are a week out and you\u2019re looking back, is there anything you can learn from really the experience, not only at the airport, but in the hospital, the screening process, generically, as we look at other airports, other cities, other hospitals, other health care facilities when it\u2019s really based on the forthcomingness of that person and their travel history when they\u2019re not forthcoming?
\nTOM FRIEDEN: It\u2019s clear that we need to increase the confidence of the U.S. system and the probability of finding out about travel histories. We learn from the west, we recognize that we can\u2019t always be perfect, and we learned from that experience to say what can be better next time? So we\u2019re intensively informing everyone in the health care system who could have contact with someone who\u2019s coming in to think about Ebola and keep it top of mind. We obviously had some challenges over the past week dealing with medical waste, as it happened, we thought that issue had been resolved the previous week, and before this patient was diagnosed, it was a glitch in removal of medical waste, that\u2019s now been resolved. Every time we have a new situation, we learn from it, we say what can we do differently and better next time?
\nOPERATOR: Next question comes from Sean Sullivan with Washington Post.
\nSEAN SULLIVAN: Thank you for taking my question, I wanted to ask whether the doctors who are treating the patient for Ebola in Dallas are considering giving him any blood transfusions from any of the survivors, anybody who\u2019s been treated successfully, either Dr. Brantley or anybody else.
\nTOM FRIEDEN: you would have to refer that to the hospital, unless Dr. Lakey you have any comment?
\nDAVID LAKEY: I don\u2019t have any comment.
\nTOM FRIEDEN: Next question
\nOPERATOR: Next question comes from Denver Nicks with Time Magazine
\nDENVER NICKS: Hi, thanks for taking a moment. I just wanted to clarify, the fellow that you\u2019re looking for, the low risk potential contact, does he know that you\u2019re looking for him? Have you been in touch with him before?
\nTOM FRIEDEN: David or Clay?
\nDAVID LAKEY: I\u2019ll start out and the answer is, yes he does. We were able to bring him in yesterday and again monitor him. Check his temperature, evaluate him, and told him to stay there and that we needed to follow him and he left and that\u2019s why we have sort of escalated this to make sure that, again, we are able to closely monitor him. Judge?
\nCLAY LEWIS JENKINS: I think that answered the question, unless you get a follow-up.
\nTOM FRIEDEN: Okay, next question on the phone?
\nOPERATOR: Next question comes from Caroline Chen with Bloomberg News; go ahead your line is open.
\nCAROLINE CHEN: Hi, thanks for taking my call. I was wondering if you could clarify what happened at the hospital in Duncan first walked in because they previously sent out a message that there was a problem with the electronic health care record system. Then there was a new statement sent out saying there was no problem with the electronic health care system.
\nTOM FRIEDEN: Dr. Lakey would you like to address that?
\nDAVID LAKEY: Dr. Frieden, I think the hospital is the entity that needs to answer that question about what occurred in the hospital on that date.
\nCAROLINE CHEN: They have not \u2014 they said that they are not going to give any further explanation at this time so we do have two separate statements that are conflicting at this time.
\nTOM FRIEDEN: What I can say is that the care of patients is complex and you have to recognize that lots of people come into emergency departments every day, that\u2019s why we have provided checklists and algorithms, that\u2019s why we\u2019re working with the emergency department, physician and nursing groups to ensure that we\u2019re doing whatever we can so that whenever anyone comes in there is travel history taken and if there are symptoms consistent with Ebola, they\u2019re taken seriously and treated. Two more questions on the phone and one in the room. Next question on the phone?
\nOPERATOR: Next question comes from Leigh Ann Winick with CBS News, go ahead your line is open.
\nLEIGH ANN WINICK: Thank you Dr. Frieden. Could you elaborate on your comment earlier about not eliminating travel from these countries and how that you would eexacerbate these people \u2014 or is it that we won\u2019t be allowing health care workers in?
\nTOM FRIEDEN: There\u2019s a series of things that have to happen to control the outbreak. It could spread to other countries in Africa and be an ongoing risk that we would have to deal with for months or for years. It\u2019s really important that we stop the outbreak. And to do that, we need regular travel; we need countries not completely isolated from the world. I understand there are calls to cut off all flights. For people to \u2014 when I was in Liberia, the health keeping force from the African union was coming, they have already sent dozens of workers, they want to send dozens more, and they\u2019re very helpful. But their response was delayed about a week because Senegal stop between Senegal and the West African countries. That probably increased the risk that Senegal will have imported cases in the future so. We are totally committed as our number one priority to protecting Americans. We have to ensure that whatever we do doesn\u2019t inadvertently increase that risks by making it harder to stop the outbreak in Africa. Next question?
\nOPERATOR: Next question comes from Amanda Chen with Huffington Post, go ahead, your line is open.
\nAMANDA CHEN: Hi, thanks so much for taking my questions. I had two, the first one I just wanted to clarify the time that you consider high risk, you said that\u2019s three relatives or community members and seven were health care workers. But from my understanding before relatives of Duncan are quarantined, wouldn\u2019t it be four relatives? Can you clarify those numbers? And do symptoms have to set in before you\u2019re able to test for Ebola, because I\u2019m wondering why these high risk individuals aren\u2019t tested right now so you would just know.
\nTOM FRIEDEN: So you can\u2019t spread Ebola unless you have symptoms and you can\u2019t test for it accurately, the test will be negative until there are symptoms. In fact when Ebola first comes on, the amount of virus that someone excretes or sheds is very low. So initially, a test might even be negative for someone with an initial fever. As someone gets sicker and sicker, they get more and more infectious because there\u2019s more and more virus in their body. In terms of the household and community contacts, what we have identified is people who either did have definite touch or contact with the individual who is may have had that contact. And you can figure out from the numbers we have given that not all of those who were identified as having been in the household definitely had contact. And I think we end with the question in the room.
\nREPORTER: I had a question about the seven health care workers, the high risk, are they being quarantined in the same fashion? Are they being required to stay in their home? What other, you know was there law enforcement presence and what about their interaction with their family members and so forth?
\nTOM FRIEDEN: It\u2019s really important to emphasize here that the only thing we need to ensure with contact is that their temp is measured every day. And the only reason Texas took the step that they did with those four individuals is that they could not ensure that they could be monitored every day. In terms of the health care workers, it\u2019s really up to the hospital what to do and how to do that. Dr. Lakey, do you want to comment on that? Or I can add some detail if you would like.
\nDAVID LAKEY: I can add a little detail. The individuals obviously have been contacted, they\u2019re being monitored, there\u2019s no problems there, the hospital has allowed them to stay home with pay, so they\u2019re not interacting with any patients, but there\u2019s no problem, we have had no difficulty in monitoring them in their current situation. Thank you.
\nTOM FRIEDEN: Thank you, Judge Jenkins, do you have any final word before we close this press availability?
\nCLAY LEWIS JENKINS: I guess in closing, I would say thank you to the members of the media who are helping to get out the accurate information about how this disease is spread and what people should be concerned about and what they should not be concerned about. It\u2019s very important that we follow the science and don\u2019t overreact in that situation and your work on that is helping tremendously thank you.
\nTOM FRIEDEN: Thank you, Dr. Lakey anything you want to add?
\nDAVID LAKEY: I want to thank you the CDC, for our partnership on this, i want to thank the media, it\u2019s very important that we get accurate information out related to the real risks and what are not risks so your partnership in this is important. And again, to the family members in the contact, our thoughts and prayer are with you as we work through this current situation. Thank you.
\nTOM FRIEDEN: Thank you both very much and thanks also to the team in Texas that\u2019s doing such a terrific job here. The bottom line is that we\u2019re stopping Ebola in its tracks in Dallas. We\u2019re working throughout the U.S. to increase the level of tracking for any possible cases so that if other patients come in, they can be promptly isolated. And we\u2019re continuing to surge the response in Africa to drop Ebola at the source so that we don\u2019t have to deal with it in the coming years. Thank you all so much for covering this.
\nCLAY LEWIS JENKINS: Tom, one thing that we forgot to say or I\u2019m not sure that we said, if you all are still on. Please let everyone that\u2019s being monitored know that our faith community here across ideologies and seconds, our faith community here is make the day a day of prayer for you in their houses of worship. If you\u2019re being monitored, you\u2019re in the thoughts and prayers of tens of thousands if not hundreds of thousands of people today.
\nTOM FRIEDEN: Thank you very much.
\nBARBARA REYNOLDS: Thank you, This concludes today\u2019s briefing on the Ebola first case diagnosing. For reporters who have additional questions, they\u2019re welcome to call CDC at 404-639-3286. Thank you.
\nOPERATOR: Thank you, again, that concludes today\u2019s conference. You may disconnect at this time.
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