Physician in New York Tests Positive for Ebola

October 23, 2014

( UPDATED October 24, 2014 ) A New York City physician who recently treated patients with Ebola in Guinea as a member of Doctors Without Borders has tested positive for the virus, New York City Mayor Bill de Blasio announced last night.

The 33-year-old physician, identified by Reuters as Craig Spencer, MD, is the fourth person to be diagnosed with Ebola in the United States. He is a fellow in international emergency medicine at New York Presbyterian/Columbia University Medical Center.

Dr Spencer had returned to New York from Guinea on October 17. He was rushed to an isolation ward at Bellevue Hospital from his apartment in Manhattan yesterday after he reported having a fever and gastrointestinal symptoms, according to New York City officials. Bellevue Hospital is one of eight state hospitals designated to treat patients with suspected or confirmed cases of Ebola.

In a statement released yesterday, New York Presbyterian/Columbia University Medical Center called Dr Spencer "a dedicated humanitarian...who went to an area of medical crisis to help a desperately underserved population."

The statement noted that he had not worked at the hospital since his return from Africa.

The Centers for Disease Control and Prevention (CDC) has dispatched three members of its Ebola response team to Bellevue Hospital to offer guidance in infection control and other aspects of patient care. They are joining CDC staffers already in New York City, who were recently evaluating Bellevue Hospital and other local facilities for their Ebola readiness. The agency said in a statement that "it found the facility to be well prepared to care for a patient with Ebola."

Without naming Dr Spencer, the CDC said that the nation's latest Ebola patient, on arrival at John F. Kennedy International Airport on October 17, underwent "enhanced screening" for all travelers from Guinea, Liberia, and Sierra Leone, the epicenter of Africa's Ebola outbreak. "He went through multiple layers of screening and did not have a fever or other symptoms of illness," the agency said.

The New York City Department of Health and Mental Hygiene has placed Dr Spencer's girlfriend and two other friends under a mandatory 21-day quarantine, said department commissioner Mary Bassett, MD, MPH, in a news conference today. Department staff will visit them every day to take their temperature. Each individual also must take their own temperature once a day and report that to the department.

"They are all well at this time," said Dr Bassett at the news conference, which also featured de Blasio, who said, "we have the situation under control."

Dr Bassett said Dr Spencer was not symptomatic before he was hospitalized yesterday. He reported having a normal temperature the night before, on October 22, when he went bowling in Brooklyn. The low-grade fever of 100.3 degrees that he reported on the morning of October 23 was the very first during his 21-day incubation period, she said.

Infected individuals spread the virus only when they are symptomatic and others have direct contact with their bodily fluids.

Dr Spencer Followed Doctors Without Borders Protocols

In response to New York City's first Ebola case, Rep. Tim Murphy (R-PA), who chairs the oversight and investigations subcommittee of the House Energy and Commerce Committee, has reiterated his call to quarantine for 21 days all healthcare workers returning to the United States from Liberia, Guinea, or Sierra Leone after treating patients with Ebola there.

Quarantine, however, is not part of the travel protocols prescribed by Doctors Without Borders and followed by Dr Spencer, the group said in a news release Friday. He engaged in self-monitoring during the 21-day incubation period for the disease, which required him to check his temperature two times a day, stay within 4 hours of a hospital with isolation facilities, and finish a course of malaria prophylaxis. The guidelines discourage returning staffers from going back to work for 21 days, but otherwise do not limit their activities.

"As long as a returned staff member does not experience any symptoms, normal life can proceed," the group stated. "Self-quarantine is neither warranted nor recommended when a person is not displaying Ebola-like symptoms."

When Dr Spencer experienced a fever on Thursday, he reported it immediately to the organization, which then contacted the city's public health department. "He did not leave his apartment until paramedics transported him safely to Bellevue Hospital in Manhattan, and he posed no public health threat prior to developing symptoms," the group said.

"Extremely strict procedures are in place for staff dispatched to Ebola-affected countries before, during, and after assignments," said Sophie Delaunay, executive director of Doctors Without Borders. "Despite the strict protocols, risk cannot be completely eliminated."

Doctors Without Borders noted that since March, three international staff and 21 locally employed staff in the three Ebola hot-zone countries have contracted the virus, mostly outside the group's medical facilities, and 13 have died. Dr Spencer is the first of more than 700 expatriate staff who have worked in West Africa to develop "confirmed Ebola symptoms" after returning to their home country.


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