Photograph by Jaime R. Carrero, Reuters

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A member of a hazmat team disinfects the entrance to the apartment of an infected health care worker in Dallas.

Photograph by Jaime R. Carrero, Reuters

Ebola Outbreak in United States Sees Another Diagnosis, Another Big Snafu

A newly diagnosed nurse flew on a commercial airliner on Monday.

DALLAS—The Ebola crisis in the United States escalated Wednesday, as a second nurse here was diagnosed with the disease, concerns rose over whether more health care workers at a Dallas hospital might be infected, and President Obama faced increasing questions about whether the U.S. government is doing enough to ensure Americans' safety.

Amber Joy Vinson, 29, became the second nurse who treated Ebola patient Thomas Eric Duncan to contract the illness, raising questions about whether federal officials and the hospital had done enough to protect health care workers from the potentially lethal virus. Vinson flew on a commercial airliner from Cleveland to Dallas Monday night, though she was running a slight fever and had apparently been told by public health authorities to avoid public means of transportation such as air travel.

People with Ebola are contagious only when symptomatic and get more contagious the sicker they become, so it's unlikely that Vinson was particularly contagious on Monday night. But all her fellow passengers on that flight will be notified that they were potentially exposed to Ebola. It is not clear whether they will be asked to monitor their temperatures twice daily for 21 days—the duration of the virus's incubation period—and limit their future travel.

In a sign of the mounting concern, President Obama canceled a campaign trip to meet with his cabinet on Ebola, while the White House press secretary took questions about whether Obama still had confidence that Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, can adequately lead the nation's response to the crisis.

In light of the new revelations, some conservative commentators and Republican Congressman Peter Sessions, who represents Dallas, have begun calling for Frieden's resignation.

Vinson's trip is at least the third major snafu since Duncan, a Liberian, started feeling ill on September 25 during a visit with his fiancee, and went to a nearby emergency room in Dallas. Duncan was sent home four hours later with antibiotics—which are useless against a viral infection. He was rushed back to Texas Presbyterian Hospital on Sunday, September 28, by ambulance.

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A woman looks out her window toward the nearby residence of an infected health care worker.

Forty-eight people who came into contact with Duncan while he was feeling ill and before his hospitalization were put on 21-day watch after his diagnosis and monitored for signs of fever. None have come down with the illness, and they will be declared disease-free on Sunday when all risk of infection is considered over.

But it became clear this week that dozens of people who cared for Duncan at Texas Presbyterian—who were thought to have been protected by gowns, masks, and gloves—may have been exposed to the virus. Frieden said in a Wednesday conference call that he believes any exposure occurred before Duncan's diagnosis of Ebola was confirmed on Tuesday, September 30—and hence before the CDC's involvement in his care began.

"The first several days before the patient was diagnosed appear to be the highest risk period," Frieden said. Both Vinson and nurse Nina Pham, who was diagnosed with Ebola on Sunday, treated Duncan during that time.

Approximately 50 health care workers were involved in Duncan's care or had potential contact with his bodily fluids during that time, Frieden said. They are being monitored, he said, and more may end up being diagnosed.

Vinson notified authorities on Tuesday morning that her temperature had topped 100 degrees. It was already climbing, Frieden said, and above 99 on Monday night when she flew back to Dallas from Cleveland, where she reportedly went to plan her upcoming wedding with her family.

Pham, another of Duncan's nurses, who was diagnosed with Ebola on Sunday, is listed in "good" condition at Texas Presbyterian.

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U.S. Army soldiers from the 101st Airborne Division, which is being deployed to West Africa to help fight Ebola, train at Fort Campbell in Kentucky.

More than 8,900 people in Liberia, Sierra Leone, and Guinea have been diagnosed with Ebola in recent months, and the virus has been directly blamed for nearly 5,000 deaths. Those estimates are believed to be low, and World Health Organization officials said Tuesday that approximately 70 percent of those infected die.

In the United States, the chance of survival appears to be much higher, thanks to sophisticated medical care and experimental treatments.

Three missionary workers have been treated and cured of the disease in recent months, and two more patients are recovering well in American hospitals. Duncan is the only person to have died of Ebola in the United States.

Patients in the U.S. have been hydrated with intravenous fluids, their electrolytes have been kept in balance, and other symptoms, such as heart irregularities, are aggressively treated—none of which is possible in West Africa, where many of the Ebola clinics lack reliable electricity and running water.

Vinson, the latest patient, was being transported Wednesday afternoon to Emory University Hospital in Atlanta, which has treated three previous patients.

Frieden said in a news conference Tuesday that he thinks every hospital in the United States should have the capacity and training to properly isolate and diagnose a patient with Ebola. But he conceded that medical centers with previous experience—such as Emory and the Nebraska Medical Center—were probably best suited to care for Ebola patients safely, without passing on the infection to health care workers.

Frieden and his boss, Health and Human Services Secretary Sylvia M. Burwell, both said Wednesday that they have been boosting hospital and staff training in light of new cases of Ebola.

Nurses, particularly the union National Nurses United, have complained that they feel inadequately prepared to deal with an Ebola patient at their hospitals.

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The dog of infected nurse Nina Pham is being held by Dallas Animal Services.

In Dallas, residents generally blame the federal government for the mistakes that have been made, and defend their local hospital—one of the largest in the region.

Jerry White, who lives near Vinson and was walking home midday Wednesday, said federal officials should stop trying to push the blame on local ones.

White, who went to Texas Presbyterian for an appointment Wednesday, said he wasn't scared at the hospital or on the train to and from the facility, and saw nothing unusual except the rows of satellite TV trucks in both places.

"It was just like it was any other day." White said he feels sorry for the two nurses, who "might have been my kids."