Using military and new protocols, U.S. ramps up Ebola response

By Anna Driver and Lisa Marie Garza DALLAS (Reuters) - The United States is issuing new protocols for health workers treating Ebola patients and a rapid-response military medical team will start training even as Americans' anxiety about the spread of the virus abates with 43 people declared risk free. The government's new guidelines, which were set to come out at 7 p.m. EDT on Monday, were expected to tell health workers to cover skin, eyes and hair completely when dealing with patients who have the virus that has killed more than 4,500 in Liberia, Sierra Leone and Guinea. There have been just three cases diagnosed inside the United States, a Liberian man, Thomas Eric Duncan, who died in Dallas, Texas, on Oct. 8 and two nurses who treated him and are now themselves patients. Among those released from monitoring were four people who shared an apartment with Duncan and had been in quarantine. The old guidelines for health workers, based on World Health Organization protocols, said workers should wear masks but allowed some skin exposure. The virus is spread through direct contact with the bodily fluids and tissue of infected people and it is not airborne. Dr. Anthony Fauci, director of the U.S. National Institutes of Health infectious diseases unit, said the two nurses "did not do anything wrong. Period," and that new protocols would come out within hours to a day. "The way that was written was a risk for the nurses," Fauci told a "town hall" meeting sponsored by Washington news radio station WTOP. "They went by the protocol. They got infected.” Nurses at Texas Health Presbyterian Hospital in Dallas came to the defense of the institution where all three U.S. cases were diagnosed. "This could have happened to any hospital. We were just the first in our country that it happened to. Some things went wrong and we are proud to say that Presbyterian has owned (up) to those things," said Julie Boling, an emergency department nurse. In Canada, unionized nurses said they were concerned that the country's public health agency plan for Ebola preparedness does not go far enough. Later this week, 30 military medical personnel are due to begin training at Fort Sam Houston in San Antonio, Texas, to move quickly to help deal with any possible case of Ebola in the United States, military officials said. They include 20 critical care nurses, five infectious disease doctors, and five trainers with "great knowledge" of infectious disease protocol, said Major Beth Smith, a spokeswoman for the U.S. Northern Command in Colorado Springs, Colorado. The man newly appointed by President Barack Obama to coordinate the response to Ebola inside the country, lawyer Ron Klain, will start work on Wednesday. Klain was invited to testify at a House of Representatives oversight hearing on Friday, but he will not attend. His mandate is to reduce fears and work on improving federal coordination with states to control the spread of the virus. There were signs that fears over Ebola and a series of false alarms reported in the past few weeks had tapered off. In the financial markets, it was evident that investors were growing more sanguine over the Ebola threat. Several of the stocks that were hit hardest - including airlines and hotels - bounced back sharply Monday. Shares of small biotech companies, medical equipment makers and drugmakers related to Ebola research and preparedness were down. Dr. Mark Rupp, an infectious disease specialist at the Nebraska Medical Center in Omaha, which is treating Ebola-infected cameraman Ashoka Mukpo, told a news conference on Monday he hoped the removal of people from watch lists in Dallas would help quell some of what he called irrational fear surrounding Ebola. "Simply being on a bus, being on a plane, closing schools, preventing cruise ships from docking – these are all just examples of irrational fear," Rupp said. The Nebraska hospital said Monday that Mukpo, diagnosed in Liberia, is doing "quite well" and that depending on test results he could be discharged in days. A patient who was admitted to Emory University Hospital in Atlanta on Sept. 9 after being infected in West Africa was released on Sunday, the hospital said in a statement on Monday. The patient asked not to be identified but will make a statement at a later date, Emory said. HUNDREDS MONITORED In Texas, 43 people who had contact with Duncan, the first person diagnosed with Ebola in the United States in late September, were cleared of twice-daily monitoring after showing no symptoms during a 21-day incubation period. Texas officials said 120 people in the state were still being monitored. Ohio state health authorities said 142 people were still being monitored for symptoms. Three people were still in quarantine because they had direct skin contact with a nurse who visited the state after being infected while treating Duncan. She and the other infected nurse are being treated for the disease. At the Catholic Conference Center in Dallas where Duncan's fiancée Louise Troh and the other three people closest to Duncan had been in quarantine, Bishop Kevin Farrell said they were relieved the isolation period had ended. "They felt like they were being persecuted," Farrell said. Four of five Dallas school students who have been cleared by health authorities to resume regular activities following exposure to the virus returned to school on Monday, one day earlier than expected. The United States and some European governments are checking selected airports for passengers traveling from Liberia, Sierra Leone and Guinea, the three West African countries worst hit by Ebola. In a similar move on Monday, Carnival Cruise Lines said passengers will be asked to fill out a questionnaire on whether or not they have experienced symptoms of fever or vomiting and if they have recently traveled to West Africa or had contact with someone known or suspected to have Ebola. One Carnival cruise was denied docking by Belize and Mexico last week because a Texas hospital lab worker on board might have come in contact with test samples from Liberian visitor Duncan. The worker has tested negative for the virus. (Additional reporting by Colleen Jenkins in Winston-Salem, North Carolina, Karen Brooks and Jon Herskovitz in Austin, Texas, Jim Forsyth in San Antonio, David Morgan, Susan Heavey and Doina Chiacu in Washington and David Bailey; Writing by Jim Loney and Grant McCool; Editing by Bernadette Baum, Howard Goller, Toni Reinhold)