On the same day that Doctors Without Borders/Médecins Sans Frontières (MSF) physician in Guinea, Dr. Craig Spencer was laboratory confirmed positive for Ebola Virus Disease (EVD) in New York City, the organization he volunteered for published their protocols for staff returning from Ebola-affected countries.
MSF says specific guidelines and protocols for staff members returning from Ebola assignments have been in place since March, in the earliest days of the West Africa outbreak.
Out of more than 700 expatriate staff deployed so far to West Africa, no MSF staff person has developed confirmed Ebola symptoms after returning to their home country, until Dr. Spencer.
While some MSF staff members have been exposed in the field, those exposures were detected and the staff members were immediately isolated and treated. Two international staff members have been medically evacuated. They have fully recovered.
Here are some details of the protocol:
MSF pre-identifies health facilities in the United States that can assist and manage the care of our staff members in the event they develop symptoms after their return home. This pre-identification practice is carried out in coordination with the US Centers for Disease Control (CDC) and departments of health at state and local levels.
Upon returning to the United States, each MSF staff member goes through a thorough debriefing process, during which they are informed of our guidelines.
The guidelines include the following instructions:
1. Check temperature two times per day
2. Finish regular course of malaria prophylaxis (malaria symptoms can mimic Ebola symptoms)
3. Be aware of relevant symptoms, such as fever
4. Stay within four hours of a hospital with isolation facilities
5. Immediately contact the MSF-USA office if any relevant symptoms develop
These guidelines are consistent with those provided by the CDC to people returning from one of the Ebola-affected countries in West Africa. MSF is also implementing new federal guidelines outlining reporting requirements for people returning from Ebola affected countries.
Spencer becomes the 9th patient to be treated for Ebola virus on US soil. The first eight are as follows:
1. 33-year-old Samaritan’s Purse physician, Dr. Kent Brantly was the first Ebola patient to be treated in the United States. Brantly was infected with Ebola in Liberia and transported to Emory University Hospital on Aug. 2. Dr. Brantly was discharged on Aug. 21.
2. SIM USA missionary worker, Mrs Nancy Writebol, was transported to Emory University Hospital on Aug. 5 for treatment. She worked alongside Dr Brantly in Liberia. Mrs Writebol was discharged from the hospital on Aug. 19.
3. 51-year-old SIM USA physician, Dr. Rick Sacra arrived at the Nebraska Medical Center for Ebola treatment on Sept. 5 after contracting Ebola in Liberia. He was released on Sept. 25 after testing negative for the virus.
4. The fourth EVD case in the US was the unnamed WHO physician (Patient X) who arrived at Emory on Sept. 9 and was discharged on Oct. 19. He contracted the viral disease in Sierra Leone.
5. Liberian national, Thomas Eric Duncan, was admitted to Texas Health Presbyterian Hospital of Dallas on Sept. 28. He was confirmed positive for EVD on Sept. 30, the first person to test positive for the virus in the US. Unfortunately, on Oct. 8, Mr Duncan succumbed to the lethal virus becoming the first Ebola fatality on US soil.
6. NBC freelance cameraman, 33-year-old Ashoka Mukpo, contracted EVD in Liberia when on assignment with NBC News Chief Medical Editor and Correspondent Dr. Nancy Snyderman. Mr. Mukpo arrived at Nebraska Medical Center on Oct. 6 for treatment. He was released from the hospital on Oct. 22.
7. Four days after the death of Thomas Duncan, 26-year-old Texas Health Presbyterian Hospital of Dallas nurse, Nina Pham, tested positive for EVD, becoming the first person to contract Ebola in the United States. She contracted EVD while treating Mr. Duncan. Ms Pham is currently being treated at the National Institutes of Health in Bethesda.
8. On Oct. 15, a second Texas Health Presbyterian Hospital of Dallas nurse, 29-year-old Amber Vinson, tested positive for Ebola, the second secondary case of EVD due to treating Mr. Duncan. Ms. Vinson is currently being treated at Emory University Hospital.