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Oct 27, 2014 2:01 AM

Questions about the care of Dallas Ebola patient

The Associated Press

DALLAS (AP) Of the nine people who have been treated for Ebola in the United States, only one has died.

Family members of Thomas Eric Duncan, who was diagnosed with the virus in Dallas after arriving from Liberia, say he did not get all the help they wanted before he died Oct. 8. They now question why his care was different in some ways than that of other patients treated in the U.S.

Here are some of the questions raised about his care and answers from health officials.

Q: How quickly was Duncan diagnosed?

A: Duncan was misdiagnosed with a sinus infection after first arriving at Texas Health Presbyterian Hospital Dallas on Sept. 25. He returned in far worse shape on Sept. 28, when a doctor quickly flagged Duncan as a possible Ebola victim. But the misdiagnosis meant Duncan did not get care for Ebola as quickly as possible.

Q: Did Duncan get a blood transfusion from an Ebola survivor?

A: No. The Dallas hospital couldn't find a survivor with a matching blood type for Duncan. As a result, Duncan could not get a transfusion of blood plasma containing antibodies from an Ebola survivor. That tactic has been used as an experimental treatment.

Q: How about experimental drugs?

A: Duncan received an experimental antiviral drug called brincidofovir six days after doctors first suspected he had Ebola, according to his medical records. American video journalist Ashoka Mukpo received the same drug and recovered. Other patients have been treated with ZMapp and TKM-Ebola, which are the only antivirals proven to protect nonhuman primates from Ebola, according to Dr. Thomas Geisbert, an Ebola expert at the University of Texas Medical Branch in Galveston. A manufacturer has run out of ZMapp doses, though limited doses of TKM-Ebola are available.

Q: Would using other drugs or treatments have made a difference?

A: Experts disagree, but they acknowledge it's hard to know anything for certain because so little data is available.

Q: Why wasn't Duncan moved to a hospital specially equipped to treat highly infectious diseases like Ebola?

A: Duncan's relatives say they wanted him sent to Emory University Hospital in Atlanta, which has a special isolation unit and had experience treating Ebola patients. It's not clear who made the decision to keep Duncan at the Dallas hospital. His records don't mention a move. A spokeswoman for the Texas Department of State Health Services said the decision not to move Duncan came from Presbyterian Hospital and the U.S. Centers for Disease Control. Hospital spokesman Wendell Watson said the hospital raised the possibility with the CDC of transferring Mr. Duncan to another hospital such as Emory. But CDC felt that would be unnecessary, Watson said. CDC spokesman Thomas Skinner said the decision to treat Duncan in Dallas was made by the hospital, doctors and the patient.


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