USA and Spain , two numbers separated by thousands of miles but united in the last hours by concerns around two women who have become the two countries first cases of Ebola infection outside Africa : Madrid , Teresa Romero; Dallas , a nurse whose identity remains undisclosed.
How was infected? How have the authorities reacted? How is treating each patient? Questions on two cases with similarities and many others apart.
Contagion
Teresa Romero became the first person infected with Ebola outside Africa. As a nursing assistant, was in contact with the two Spaniards who have died so far the virus victims, religious and missionary Miguel Pajares Manuel García Viejo. Both were taken from African countries where the disease had a very advanced stage and took care of both Teresa. It is believed, however, that the infection occurred in the treatment Viejo Garcia, whom he cleaned up one of his last days and whose room cleaned once had died.
Dallas nurse became infected after attending Thomas Duncan, a Liberian citizen who was the first case diagnosed in the United States and who died last Wednesday.
Human Error
After learning of the contagion of the efforts of the Spanish and American authorities have focused on identifying the source of infection. In both cases it points to human error.
Both in Madrid and Dallas insists that all steps of the security protocol established by the World Health Organization (WHO) to treat patients strictly met infected, so health professionals blame contagion.
In the case of Teresa Romero, spokesman for the Health of PP Congress Ruben Moreno , was the first to point in that direction, the rule existed “relaxation” in the protocol, but in its fulfillment by the auxiliary. “It is obvious that the patient herself has acknowledged that it strictly complied with the protocol,” he said. Depending on the version of the Madrid authorities, Teresa was touching your face with one of the gloves she had been in contact with fluids when Garcia Viejo was peeling the protective suit.
In the United States, director of the Centers for Disease Control (CDC), Thomas Frieden , said in a press conference that “there was a breach of protocol ‘safety and that would have been a ‘inadvertent “failure,” slip “, the culprit of infection. The patient, meanwhile, could not identify any negligence in his performance, which is particularly considered procedures “dialysis and intubation” to be performed on Duncan, to be considered “high risk.”
Insulation
Both Teresa as the American nurse initiated a quarantine period after treating patients with Ebola.
Teresa Doctors diagnosed a simple flu and prescribed paracetamol after the first symptoms of the disease
Manuel García Viejo died on September 25 and, four days later, on 29, the Spanish side began to show the first symptoms of the disease. From this time until his isolated income took six days. Despite posting a few tenths of a fever, or your GP or professionals Hospital La Paz-Carlos III , where they are being treated cases of Ebola in Spain assessed the possibility of contagion 38,6º not reach the protocol established by the Spanish. Therefore, initially diagnosed Teresa’s case as a simple flu and prescribed paracetamol to combat high temperature. It took six long days to make the correct diagnosis. During this period, the auxiliary did not keep the optimum conditions of isolation and continued interacting with others.
In Dallas, only 90 minutes elapsed between the first symptoms of the nurse and your income in total isolation. At that time, you only have a record of a personal contact.
Disinfection
Suspicions of a possible case of Ebola immediately triggered alerts in the United States. Immediately after admission nurse, authorities decontaminated and isolated the specific car that had been taken to hospital and remained in the garage downtown. They also disinfected home and all objects that might have touched so far.
In the Spanish case, even confirmation of the disease did act promptly to authorities. Cleaning jobs in the Hospital Alcorcón began 48 hours after Teresa acudiera with high fever before diagnosis. It was Wednesday and a day later, on Thursday, disinfection equipment began its work at the home of the couple, who until then had been bricked up with drywall, as well as the building where the property is located.
Also, no such precaution was taken to the ambulance the patient moved from her home to the hospital. We used to do a regular ambulance, without the means or the appropriate measures, and continued to use the same vehicle to transport patients for 12 hours.
Protective equipment
The adequacy of protective equipment with which they treated Viejo Miguel Pajares and Garcia has also been questioned from the outset. Practitioners in the Hospital Carlos III denounced even before the positive Teresa Romero, who had neither the material nor the proper training to treat sick Ebola was known. Following the spread of the Madrid side, is still questioning the suit in which he serves is right: limits the time that a professional can work with him for the high temperatures reached inside, have suitable sizes and are not known or explained correctly protocols for them and discard them.
A lot less protection had professionals cleaned and disinfected Hospital Alcorcón and housing of the marriage of Teresa and Javier .
Nothing to do with the sophisticated equipment used in the United States, where those responsible for sanitizing the areas in contact with the sick appear fully dressed in suits isolated and ventilation systems that allow them to work more comfortably and for longer periods of time.
Information
The American authorities did not wait for daylight to alert the neighbors of the infected patient. Dallas police and a member of the CDC were calling every house in middle of the night, to report the status of the nurse and to deliver leaflets about the disease and how they should act. When they could not locate tenants, agents information on the left door of the residence.
In Spain, confusion marked the actions of the authorities in the early hours, almost until now. The images of neighbors who opened doors scarves are proof of the limited information that has been passed in the vicinity of Teresa Romero and the population in general.
political reaction
One of the most criticized aspects in the Spanish case management policy is being made of the crisis. The Health Minister Ana Mato, has only appeared twice: first, in a press conference hours after the spread of Teresa, and the second will be confirmed after the meeting of the Interregional Council of Health . Neither Mato and the Prime Minister, Mariano Rajoy, who has not shown his face in the media to refer to the crisis of Ebola have been clear in his explanations and responses to questions from citizens.
‘should not be so bad to go to the hairdressers’, is one of the pearls of Teresa said the health minister Javier Rodriguez
has been the Executive Vice President, Soraya Saenz de Santamaria, who has been at the forefront of management and five days after the onset of the crisis announced the creation of a Special Committee to address the situation. It was last Friday, after the meeting of Cabinet , when it also announced the launch of a Scientific Committee that would support the former.
In all this time has also highlighted-for evil attitude of Health Minister Madrid Javier Rodriguez , which Teresa Romero accused of “lying” in the days prior to his admission to the hospital. Rodriguez has also left a whole trail of statements are not without controversy and bad taste. “So bad should not have to go to the hairdresser” or “If I have to resign, resign I have no attachment to the post, I am a doctor and have the resolved “life are just some of the ‘pearls’ he said.
Washington have just spent 24 hours from receipt of contagion Dallas nurse and have appeared the CDC Director, Tom Frieden, to give information about the case in particular and disease in general; the mayor of the city, Mike Rawlings , and a spokesman for the Presbyterian Hospital of Texas . In addition, President Barack Obama has issued a statement demanding a rapid investigation of the facts and asking that “the necessary steps are taken to ensure that the health system” implements proper procedures.
Pets
One of the names of the Ebola crisis in Spain is Excalibur, dog Teresa Romero and her husband, Javier Limón. Doubts about the risk of contagion led to animal health authorities to slaughter the animal, creating a social and media frenzy that crossed the border.
The American patient living with a dog at home. As reported by the mayor of Dallas, keep the animal alive because “it is very important for the patient and want you to be safe.” The dog is being monitored by specialist medical teams to treat the disease.
Settings
The same teams are controlling the only person with whom the employee had contact health, whose identity has not transcended.
In Spain, the initial diagnosis of Teresa Romero, who ruled the spread of Ebola, made the assistant continue his normal life: he attended the examination of oppositions, maintained contact with his family and even went a beauty center and hairdresser. Everyone in those days had contact with the woman are being closely watched since last Monday to monitor the possible occurrence of symptoms of the disease.
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