DALLAS — The second Dallas nurse diagnosed with Ebola shouldn't have traveled on a commercial flight due to her exposure to the virus prior to her diagnosis, said Tom Frieden, director of the Centers for Disease Control and Prevention.
But the CDC has now confirmed that it gave Amber Vinson permission to return to Dallas by air after making a trip to Ohio.
Vinson, 29, was identified by a family member as the nurse diagnosed with the virus. Like 26-year-old Nina Pham, who was diagnosed before her, Vinson was among those who had frequent contact with Duncan during his treatment at Texas Health Presbyterian Hospital Dallas.
Frieden called the first days of Duncan's diagnosis and isolation at the hospital the highest risk moments. He pinpointed those days between September 28 through September 30.
"These two health care workers both worked on those days and both had extensive contact with the patient when the patient had extensive production of bodily fluids because of vomiting and diarrhea," he said.
Officials say Vinson was a passenger on Frontier Airlines Flight 1143, which flew from Cleveland, Ohio to Dallas-Fort Worth International Airport on Monday — the day before she was admitted into the hospital. At a news conference in Cleveland, officials said Vinson made the trip north to prepare for her upcoming wedding and visit with her mother.
However, because of her exposure to the virus, Vinson shouldn't have traveled on the commercial flight, the CDC director said on Wednesday. Frieden revealed the nurse registered a low-grade fever of 99.5 degrees before she boarded the plane.
It was later confirmed that the CDC gave Vinson permission to get on the plane because she was showing no other symptoms of the virus, and her temperature didn't reach the threshold of 100.4 degrees.
"She wasn't bleeding or vomiting," Frieden said. "The level of risk around her would be extremely low, but because of the extra margin of safety, we will be contacting [all those who were on the flight]."
The CDC announced during a teleconference Wednesday afternoon that Vinson was stable would be moved to a critical care facility at Emory University Hospital in Atlanta.
An ambulance left Texas Health Presbyterian Hospital on Wednesday afternoon to take Vinson to a waiting medical evacuation jet at Dallas Love Field.
"She's a fine young lady, educated," said Martha Shuler, whose son was previously married to Vinson. "She's a good girl."
The 80-year-old woman was the family member who identified Vinson as the third person to be diagnosed within the United States and the second to have contracted the disease in the country.
Shuler said her son was very upset to hear that Vinson had contracted Ebola. She said that even though they were divorced, Vinson and her son had remained in contact.
She said her son spoke to Vinson's mother after the diagnosis.
Lory Harris has known Vinson since childhood. Her daughter grew up with Vinson and they attended the same church. She said Vinson's mom told her several months ago that she was engaged to be married.
"All I know is she's a sweetheart," Harris said. "That's how I remember Amber, as sweetheart."
Frieden said they have identified three contacts close to Vinson who will now join others under health monitoring.
As a precaution, the CDC is contacting all 132 passengers on that flight, which landed around 8:16 p.m.. They have asked passengers to call 1-800-CDC-INFO.
Frontier Airlines says the plane stayed at D/FW Airport overnight, and has since been cleaned. It traveled to Cleveland on Tuesday and was cleaned again. The airline says Vinson traveled to Ohio from North Texas on Flight 1142 on Oct. 10.
"The safety and security of our customers and employees is our primary concern. Frontier will continue to work closely with CDC and other governmental agencies to ensure proper protocols and procedures are being followed," the airline said in a press release.
Wednesday morning, Mayor Mike Rawlings confirmed that Vinson lives alone without pets at The Green in the Village Apartments, in the 6000 block of Village Bend near Skillman, just north of Lovers Lane.
Police and Dallas Fire-Rescue teams were at the complex early Wednesday, cleaning common areas and knocking on doors, communicating with neighbors. Reverse 911 calls were sent out at 6:15 a.m. to people who live in the area.
"We rallied together and we decided that we needed to move quickly like we did Sunday morning," Mayor Rawlings said.
He added that the state has hired a company to come in Wednesday afternoon and clean Vinson's apartment and car.
Like Pham, Vinson had also been involved in caring for Thomas Eric Duncan, the Liberian man who died of Ebola one week ago at Presbyterian. More than 70 hospital employees had been involved in that effort and are still being monitored.
Officials said Vinson reported a fever on Tuesday and was immediately isolated at the hospital in the morning. The Ebola diagnosis was made late Tuesday by testing at a state laboratory in Austin. A separate test was being administered by the Centers for Disease Control and Prevention in Atlanta and was expected to confirm the Texas test.
During Wednesday's news conference, Frieden said health officials continue to investigate ways to improve the safe treatment of Ebola patients. Frieden said when CDC workers first arrived to Texas Health Presbyterian that health care employers were using a variety of protective gear and in different ways.
"We noted that some health care workers were putting on three to four layers of protective equipment in the belied that this would be more protective," he said. "... These are good, dedicated people who are worried about themselves and their families. They were trying to protect themselves better. But, in fact, by putting on more layers of gloves or other protective clothing, it becomes much harder to put them on; it becomes much harder to take them off."
- LINK: Fast facts about Ebola
As for the condition of the first nurse diagnosed with Ebola, Presbyterian Hospital said Tuesday that Pham's condition has improved to "good." Her dog, who had been moved to an undisclosed location, is also doing well.
Health care officials had signaled that additional cases of Ebola were to be expected in the wake of Thomas Duncan's death, and Dallas County Health and Human Services director Zachary Thompson reiterated that position in an interview on News 8 Daybreak Wednesday.
"I've got to remind Dallas County residents: Let's not get into the fear factor and panic," he said. "It should be contained within the health care workers, and hopefully we don't see any more cases, but don't be surprised."
Mayor Rawlings said during a press conference that he hopes to minimize rumors and maximize facts.
"The only way we are going to beat this is person by person, moment by moment, detail by detail," he said.
He added that city leaders are not fearful and that there is hope if we do what is right and take care.
"It may get worse before it gets better, but it will get better," he said.
The CDC issued a reminder Wednesday that the Ebola virus is known only to spread via direct contact with the bodily fluids of an infected person, or exposure to objects like needles that have been contaminated. The illness has an average 8-10 day incubation period, although it can range from 2 to 21 days.
People are not contagious during the incubation period before symptoms appear.
- LINK: Complete Ebola coverage
Dallas County Judge Clay Jenkins said Wednesday that the 48 people who had contact with Thomas Eric Duncan outside the hospital are still healthy without symptoms of Ebola. Their incubation period for being monitored for symptoms ends on Sunday.
While Thompson said Wednesday that Dallas should consider isolating health care workers before symptoms of Ebola show up, Jenkins disagreed.
"This is not gonna be a situation where we're gonna put protective orders on 75 health care workers. The system right now is working," he said.
The workers are being provided another place to stay, away from their families, while they are in the incubation period.
Executive President of Texas Health Resources Dr. Daniel Varga said Wednesday that the hospital has an isolation unit set up which can handle up to three patients. A new area has also been opened to screen patients for Ebola.
"No one wants to get this right more than our hospital," Varga said.
Texas Governor Rick Perry released the following statement on Wednesday upon the news of Vinson's diagnosis.
"The diagnosis of a second health care worker in Dallas reaffirms what a formidable foe this virus is.
I am in daily contact with Dr. Brett Giroir and Dr. David Lakey and earlier today spoke with White House Chief of Staff Denis McDonough and HHS Secretary Sylvia Mathews Burwell to ensure state and federal management of this issue is tightly coordinated.
This is the first time that our nation has had to deal with a threat such as this. Everyone working on this challenge – from the medical professionals at the bedside to the public health officials addressing containment of the infection – is working to end the threat posed by this disease. These individuals are keeping the health and safety of Texans and the needs of the patients as their most critical tasks. Every relevant agency at the local, state and national levels is working to support these individuals.
I have great faith that we will succeed in this important mission; once we have put it behind us we will be the stronger for it and more prepared to meet the kinds of challenges that we as Americans are uniquely prepared to face."
Gov. Perry's Task Force on Infection Disease Preparedness and Response will meet on Wednesday to discuss improving Texas' response and treatment of Ebola.