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Health care workers scheduled to fight Ebola in West Africa receive training at an old military base in Anniston, Alabama.

Health care workers scheduled to fight Ebola in West Africa receive training at an old military base in Anniston, Alabama.

Nahid Bhadelia

Ebola infection in Dallas nurse underscores critical need for proper training

A nurse in Dallas who was treating the first case of Ebola diagnosed in the United States has become infected with the virus herself even though she was wearing protective gear. “At some point, there was a breach in protocol,” said Tom Frieden, head of the U.S. Centers for Disease Control and Prevention (CDC), at a press conference this morning.

The nurse, who Frieden said had “extensive contact” with the patient, was wearing full personal protective equipment (PPE). The patient, Thomas Eric Duncan from Liberia, died 8 October. Frieden noted that Duncan had respiratory intubation and kidney dialysis as “a desperate measure to try to save his life,” which he suggested may have been linked to the transmission. “Both of those procedures may spread contaminated materials and are considered high-risk procedures,” he said.

Frieden said CDC will “undertake a thorough investigation to understand how this may have happened and we will ramp up infection control to do whatever we can to minimize the risk that there would be any future infections.”

The case has similarities to that of a nurse infected in a Spanish hospital after taking care of a priest who had contracted the disease in Sierra Leone, and both raise questions about the training procedures that hospital staff receive before they come into contact with Ebola patients. “There’s a need to enhance the training and protocol to make sure the protocols are followed,” Frieden said today, and although all U.S. hospitals need to know how to diagnose Ebola infection, it may be safer to provide care at designated facilities that have received more extensive training, he said. “That’s something we'll absolutely be looking at.”

It's not known exactly how the Dallas nurse was prepared for taking care of Duncan. But the extreme precautions needed to treat Ebola are a new experience for most health care workers, and they need to practice extensively to learn the proper procedures. The video below, provided by CDC, gives an idea of how volunteers scheduled to help fight Ebola in West Africa learn the cumbersome and clumsy process of donning and doffing the suits.


The footage is from one of the first of a series of safety training sessions that CDC is holding at an old military base in Anniston, Alabama. Here’s the syllabus for the course and other details about it.


Doctors Without Borders, which has led the clinical response to the current Ebola epidemic, similarly conducts training courses for health care workers. The video above shows a recent course held in Brussels.

*The Ebola Files: Given the current Ebola outbreak, unprecedented in terms of number of people killed and rapid geographic spread, Science and Science Translational Medicine have made a collection of research and news articles on the viral disease freely available to researchers and the general public.