nurse

President William Powers Jr. announced in a University-wide email Monday afternoon that the monitoring period for a UT student who was on the same flight as a nurse diagnosed with Ebola ended Monday.

According to Powers, the student did not display any symptoms of Ebola during the 21-day quarantine. 

“Local health officials report that the student never showed any symptoms of Ebola and does not pose a risk to the campus community. This student has resumed classes and activities on campus,” Powers said in the email. 

The Austin/Travis County Health and Human Services Department said in a statement the monitoring period for the student, who was considered a low-risk contact, ended at 5 p.m. Monday. 

According to the statement, health officials followed Centers for Disease Control and Prevention guidelines and monitored the student with daily temperature checks. The student stayed home from class at his/her personal residence during the quarantine, Powers said.  

“The UT student … has been monitored by [Austin/Travis County Health and Human Services Department] staff twice daily for temperature readings for 21 days, which is consistent with the Centers for Disease Control and Prevention (CDC) guidelines,” the statement said. “Staff continues to monitor three other contacts that came from or travelled to one of three African countries impacted by the virus. All are considered low risk and all are complying.”

The student originally went into a self-imposed isolation on Oct. 13 after being onboard the same flight as Dallas nurse Amber Vinson. Vinson was officially diagnosed with Ebola two days after the flight and was declared free of the virus on Oct. 28.

Powers also reminded students about the University’s international travel guidelines, which will remain in effect while Ebola is still a global concern. 

“Under these guidelines, all international travelers, faculty, staff and students on official university business must register with the group, International SOS,” Powers said in his email. “Any official travel to Liberia, Sierra Leone and Guinea must be approved by university officials. Upon return, any travelers to those countries must be prepared to work with local health officials to undergo screenings and other possible restrictions.”

Amber Vinson, one of two Dallas nurses infected with Ebola, is free of the virus, according to Bruce Ribner, a doctor at Emory University Hospital.

Vinson was originally diagnosed with Ebola at Texas Health Presbyterian Hospital Dallas about two weeks ago. Vinson was one of the nurses caring for Thomas Duncan, the first person in the U.S. to be diagnosed with the virus. Health officials transferred Vinson to Emory University Hospital in Atlanta for treatment and released her from the hospital Tuesday afternoon.

At a press conference Tuesday, Ribner said Vinson has completely recovered from the virus.

“We have determined that Ms. Vinson has recovered from her infection with Ebola virus and that she can return to her family, to the community and to her life without any concern about transmitting this virus to another individual,” Ribner said.

Vinson is one of two Dallas nurses who was diagnosed with Ebola after caring for Duncan. The other nurse, Nina Pham, was also declared Ebola-free last Friday.

Ribner said he was not sure why Vinson and Pham recovered relatively quickly from the virus. 

David Lakey, commissioner of the Texas Department of State Health Services, released a statement Tuesday confirming that Vinson was cleared of the virus.

“We are so pleased that [Vinson] has been declared free of Ebola,” the statement said. “Through excellent health care and her own courage, she beat the disease. Based on the clinical and lab findings, people are not at risk of getting the disease from her, and she has been completely cleared. We wish her the best as she transitions back to a normal life, and we welcome her back home to Texas.”

Before being diagnosed with the virus, Vinson boarded Frontier Airlines flight 1143 from Cleveland to Dallas. On Oct. 17, the University announced a UT student was also onboard the flight and will not return to campus until Monday.

A second health care worker has tested positive for Ebola, the Texas Department of State Health Services said Wednesday. The nurse is the third person to be diagnosed with the Ebola virus in the U.S.

At a press conference Wednesday, Dallas County Judge Clay Jenkins said the nurse reported a fever on Tuesday and has been placed in isolation at Texas Health Presbyterian Hospital in Dallas, along with Nina Pham, another nurse who tested positive for the virus on Sunday. Both nurses were involved in the care of Thomas Eric Duncan, who died from Ebola last week.

CDC director Tom Frieden said the new patient will be transferred to Emory hospital in Atlanta.

Jenkins said Texas Presbyterian Hospital is preparing for more cases of Ebola. 

"We are preparing contingencies for more, and that is a very real possibility,”  Jenkins said.

Daniel Varga, chief clinical officer for Texas Health Presbyterian Hospital, said the nurses contracted the virus after being exposed to Duncan, even though they were wearing protective equipment. 

“There was an exposure somewhere, sometime in the treatment of Mr. Duncan," Varga said. “Let’s be clear: We’re a hospital that may have done some things different with the benefit of what we know today. But make no mistake, no one wants to get this right more than our hospital."

The CDC and Frontier Airlines have confirmed in a statement that the new patient took a flight from Dallas-Fort Worth to Cleveland on Oct. 10 and returned to Dallas-Fort Worth on Monday evening, the day before she reported symptoms. The CDC is monitoring passengers who flew on the flight, even though the health care worker exhibited no signs or symptoms of illness while on the plane. 

Frieden said the new patient should not have traveled on a commercial airline, and that workers having contact with an Ebola patient will not be allowed to travel. 

The CDC also said it has sent a team to the hospital in Dallas to oversee infection control and monitor its use of protective equipment.

A health care worker in Dallas has tested positive for the Ebola virus, officials from the Centers for Disease Control and Prevention announced Sunday. This is the second known case of the virus in the U.S., and, if the preliminary results are confirmed, it will be the first time the virus has been transmitted between humans in the U.S.

In a press conference Sunday, CDC Director Tom Frieden said the health care worker is a female nurse at Texas Health Presbyterian Hospital. According to Frieden, the nurse had provided care and had “extensive contact” with Thomas Duncan, who died last week and was the first person diagnosed with Ebola in the U.S.

Frieden said officials are examining the case to try and figure out what caused the nurse to contract the virus, since she was in full protective gear when caring for Duncan. 

“We don’t know what occurred in the care of the index patient, the original patient in Dallas, but, at some point, there was a breach in protocol, and that breach in protocol resulted in this infection,” Frieden said. 

Officials plan to examine kidney dialysis and respiratory intubation, which were both performed on Duncan, as procedures in which the virus might have spread.

According to a press release from the Texas Department of State Health Services, the nurse developed symptoms Friday, and a blood sample was tested for Ebola in a lab in Austin. 

“The individual was self-monitoring, and, immediately on developing symptoms, as appropriate, she contacted the health care system, and, when she came in, she was promptly isolated,” Frieden said. 

The press release stated health officials have interviewed the patient and have identified only one possible contact that could have been exposed to the virus. 

David Lakey, commissioner of the Texas Department of State Health Services, said the department has been ramping up control measures to prepare for further possible transmission of the virus. 

“We knew a second case could be a reality, and we’ve been preparing for this possibility,” Lakey said. “We are broadening our team in Dallas and working with extreme diligence to prevent further spread.”

Frieden said the CDC plans to focus on four things related to the second Ebola case — caring for the worker, assessing her possible contacts from when she developed symptoms, evaluating other possible exposures to the virus, and launching an investigation to find out how the breach in protocol happened. 

Frieden said the CDC has sent additional staff to Texas and plans to implement increased training of health care workers at Texas hospitals, limit the number of workers and procedures related to Ebola patients and examine procedures used for personal protective equipment.  

“What we do to stop Ebola is to break the links of transmission,” Frieden said. “We do that by making sure every person with Ebola is promptly diagnosed, that they’re promptly isolated, that we identify their contacts, and that we actively monitor their contacts every day for 21 days.”

The 48 people who have possibly come into contact with the virus are still being monitored, officials said.

The Jonas Center for Nursing and Veterans Healthcare has awarded UT with a $20,000 grant that will be awarded to two doctoral nursing students, which the University will match dollar for dollar.

America has a shortage of nurse faculty, primary care and researchers, according to a report released in 2010 by the National Institute of Medicine on the current and future state of nursing in America. Anticipating this shortage, the institute has recommended that the number of nurses with a doctorate double by 2020.

Growing population rates, especially in older age ranges, have led to the heightened demand in nursing faculty in America, said Alexa Stuifbergen, dean of the nursing school. According to Stuifbergen, because of better care for severe health problems, more people are surviving injuries that would have previously resulted in death.

“I think the greatest challenge that [nursing] will face is a shortage of highly-educated nurses that can serve both as nurse educators and nurse leaders in practice,” Stuifbergen said. “As our population is aging, the need for health care is increasing as well.”

The current faculty that is teaching nursing students is retiring, adding to the shortage, said nursing school spokeswoman Kathryn Wiley.

“It’s because a lot of people are retiring at the average age of about 67, that need to be replaced and,” Wiley said.

The Jonas Scholars Program is important because going to school along with supporting a family and working causes problems for many students interested in pursuing graduate-level nursing, said Linda Yoder, a mentor for doctoral student Eduardo Chavez, last year’s scholarship recipient.

“When you have a family, it’s expensive to go to school and pay to maintain a life,” Yoder said. “If people are working, you’re looking at people going part time and [earning a doctorate degree] in six to seven years.”

The Jonas Scholars Program chose Chavez for the scholarship last year because of the research he is doing for his doctoral dissertation on the leadership of bedside nurses, Yoder said.

According to Yoder, in order to solve the many issues that affect the delivery of care, there needs to be more research done by nursing students who choose to further their education. Honors undergraduate nursing students have opportunities to work with current doctoral students who are researching patient and health care industry problems.

“[Undergraduates] ask a lot of good questions,” Yoder said. “Our honors students have a great time working with faculty doing research... A couple of our students wrote papers last year that got published.”

Motivation for many of the doctoral students lies in doing research to improve nursing, Yoder said.

“I think what motivates people to get a Ph.D is they’re passionate about nursing, but they’re also passionate about contributing to the knowledge and science behind nursing, and you do that with research,” Yoder said.

Maria Hernandez stands behind a fence as she waits for information about her relative outside the morgue in Tegucigalpa, Honduras on Thursday.

Photo Credit: The Associated Press

COMAYAGUA, Honduras — Six guards, 800-plus prisoners in 10 cellblocks, one set of keys. The numbers added up to disaster when fire tore through a prison and 355 people died, many yet to even be charged with a crime, much less convicted.

The deadliest prison blaze in a century has exposed just how deep government dysfunction and confusion go in Honduras, a small Central American country with the world’s highest murder rate.

Prisoners’ scorched bodies were being brought to the capital of Tegucigalpa on Thursday for identification, a process authorities said could take weeks. Dozens of family members gathered outside the morgue wearing surgical masks against the strong smell of death as police called out the names of the few less-charred victims who had been identified.

Most relatives said they didn’t believe the authorities’ account that a prisoner set a mattress on fire late Tuesday after threatening to burn down Comayagua prison, located 55 miles north of Tegucigalpa.

They also faulted prison officials for failing to get help inside quickly as flames engulfed the facility. Hundreds of screaming men burned and suffocated inside their locked cells as rescuers desperately searched for keys.

“Those who lock up the prisoners are in charge of their welfare. Why couldn’t they open the doors?” said a weeping Manuela Alvardo, whose 34-year-old son died. He was to have been released in May after serving a murder sentence.

“It couldn’t have been a mattress fire. This guy wasn’t alone. He was in a crowded cell. The other prisoners wouldn’t have allowed that to happen. They would have put out the fire.”

From the time firefighters received a call at 10:59 p.m., the rescue was marred by human error and conditions inside the prison that led to catastrophe.

Only six guards were on duty, four in towers overlooking the prison and two in the facility itself, said Fidel Tejeda, who was assigned to a tower that night. One of the guards posted inside held all the keys to the prison doors, he said.

Tejeda said he fired two shots as a warning when he first saw flames about 10:50 p.m., but he said prison rules prevented him from leaving his post to help evacuate the 852 prisoners.

“It would be a criminal act,” Tejeda said Thursday, standing in uniform outside the prison, rifle in hand.

Survivors said they watched helplessly as the guard who had the keys fled without unlocking their cells.

“He threw the keys on the floor in panic,” said Hector Daniel Martinez, who was being held as a homicide suspect.

Martinez said an inmate who was not locked in because he also worked as a nurse picked up the keys and, braving the scorching heat, went from one cell block to another, opening doors.

“He went into the flames and started breaking the locks,” said Jose Enrique Guevara, who was five years into an 11-year sentence for auto theft. “He saved us, I tell you.”

Guevara said the nurse could get only a handful of the keys and had to use a bench to break the lock of the cellblock where the fire started.

But by that time, it was already too late for hundreds of prisoners.

Inside the prison Thursday, charred walls and debris showed the path of the fire, which burned through five of the 10 barracks, each crammed with 70 to 105 inmates, sleeping in bunk beds piled four high and reaching to the ceiling.

Bodies were piled in the bathrooms, where inmates apparently fled to the showers, hoping the water would save them from blistering flames. Prisoners perished clutching each other in bathtubs and curled up in laundry sinks.

“It was something horrible,” said survivor Eladio Chica. “I saw flames, and when we got out, men were being burned, up against the bars. They were stuck to them.”

Prisoners who survived unscathed or with minor injuries remained inside the prison after the fire, locked inside the undamaged cellblocks. Those with more serious injuries were taken to hospitals and were trickling back Thursday. Some were being treated by the nurse credited with saving so many lives.

Miguel Angel Lopez, a guard on duty inside the prison, said he called the fire brigade as soon as he saw the blaze, but it took firefighters 30 minutes to get inside.

Fire officials told The Associated Press they were blocked from entering the prison for half an hour by guards who thought they had a riot or breakout on their hands.

“This tragedy could have been averted or at least not been so catastrophic if there had been an emergency system in all the penitentiaries in the country,” human rights prosecutor German Enamorado told HRN Radio.

Honduras has been the site of two other major prison fires, in 2003 and 2004, that killed a total of 176 inmates. Government officials were convicted of wrongdoing in the 2003 blaze.

The U.N. recently named Honduras as the country with the world’s highest murder rate, with 82 homicides per 100,000, much of it related to drug trafficking and street gangs. That’s almost five times higher than Mexico, where drug-related deaths are rampant. The U.S. recently pulled its Peace Corps workers from the country for security reasons.

The U.S. State Department has criticized the Honduran government for harsh prison conditions, citing severe overcrowding, malnutrition, and lack of adequate sanitation.

Howard Berman, then-chairman of the U.S. House Committee on Foreign Affairs, questioned U.S. aid to Honduras last fall, saying human rights abuses involving security forces had “reached a distressing pitch.”

“The most chilling aspect of this rather gruesome set of problems is that U.S. government assistance is flowing into the thick of it,” Berman wrote to Secretary of State Hillary Rodham Clinton.

A Honduran government report obtained by the AP said 57 percent of the inmates at Comayagua had not been convicted of any crime, but were either awaiting trial or being held as suspected gang members.

This is not unusual. Nationwide, more than half of the 11,000 inmates in the country’s 24 prisons are awaiting trial, as yet unconvicted. Every prison is crammed with more people than it was built for, and there’s rarely enough food. Prisoners are beaten and tortured, and gangs control the inside because there is, on average, just one guard for every 65 prisoners.

The records show that authorities routinely confiscate marijuana and crack, handmade weapons and cell phones at Comayagua, where prisoners grow corn and beans and raise chickens on the 36 acres of farmland surrounding the facility.

During a recent review, Comayagua’s electrical system was in order, and drinking water was available. But the air and ventilation systems were listed as insufficient, and the report says prisoners were not informed of their rights.

There was no doctor assigned to the prison, no psychological services and, unlike many other Honduran prisons, no system that allowed prisoners to earn privileges.

Honduran authorities said they are still investigating other possible causes of the fire, including that it could have been set in collusion with guards to stage a prison break.

“All of this isn’t confirmed, but we’re looking into it,” said attorney general’s spokesman Melvin Duarte.

The Interamerican Court on Humans Rights issued a report in 2006 recommending measures to avoid prison overcrowding and training and equipment to deal with emergencies and evacuations after the fires in 2003 and 2004. It issued another critical report in 2010 noting that none of the changes had been made. National prison system director Danilo Orellana declined to comment on the supervision or the crowded conditions at Comayagua, referring questions to the prison police commander, who did not respond to an AP request late Wednesday.

President Porfirio Lobo on Wednesday suspended Orellana and other top prison officials.

On Thursday morning, officials continued their investigation at the prison, where murals of Catholic saints, Jesus Christ and psalms stand out in an otherwise miserable place. Two palm trees flanked the front entrance where a sign read: “Let there be justice, even if the world perishes.”

The State Department said it was sending Bureau of Alcohol, Tobacco, Firearms and Explosives investigators to Honduras. The team will include forensic chemists, explosives enforcement officers and dogs that can sniff out explosives and accelerants.

Printed on Friday, February 17, 2012 as: Honduran prison overcrowding lets 355 prisoners burn to death