US health officials are alerting airline passengers who were on the same flight as a Texas nurse who was diagnosed with Ebola the following day.
The 132 passengers were on Frontier Airlines flight 1143 from Cleveland to Dallas-Fort Worth on Monday.
The hospital worker was involved in the care of a Liberian man who died of Ebola last week at the Texas Health Presbyterian Hospital in Dallas.
Crew members on the plane said the nurse showed no symptoms of Ebola during the flight.
The next morning she developed a high temperature, and on Tuesday night tested positive for the virus.
Infected Ebola patients are not considered contagious until they have symptoms.
The Centres for Disease Control and Prevention is asking the passengers to call the health agency so they can be monitored.
The Liberian Ebola patient was left in an open area of a Dallas hospital for hours, the largest US nurses’ union has said.
National Nurses United said the nurses treating him worked for days without proper protective gear and faced constantly changing protocols.
Nurses were forced to use medical tape to secure openings in their flimsy garments, worried that their necks and heads were exposed as they cared for the patient, said Deborah Burger of the union.
She convened a conference call with reporters to relay what she said were concerns raised by nurses at Texas Health Presbyterian Hospital, where Thomas Duncan – the first person to be diagnosed with Ebola in the US – died last week.
Among the nurses’ allegations was that the Ebola patient’s lab samples were allowed to travel through the hospital’s pneumatic tubes, opening the possibility of contaminating the specimen delivery system.
The nurses also alleged that hazardous waste was allowed to pile up to the ceiling.
Mr Duncan died on October 8, and the hospital said on Sunday that one of his nurses had tested positive for Ebola. She is in hospital and said to be in good condition.
Wendell Watson, a Presbyterian spokesman, did not respond to specific claims by the nurses but said the hospital has not received similar complaints.
“Patient and employee safety is our greatest priority and we take compliance very seriously,” he said.
“We have numerous measures in place to provide a safe working environment, including mandatory annual training and a 24/7 hotline and other mechanisms that allow for anonymous reporting.”
He said the hospital would “review and respond to any concerns raised by our nurses and all employees”.
The nurses alleged that Mr Duncan was kept in a non-isolated area of the emergency department for several hours, potentially exposing up to seven other patients to Ebola.
They said patients who may have been exposed to him were kept in isolation only for a day before being moved to areas where there were other patients.
Nurses treating Mr Duncan were also caring for other patients in the hospital, and preparation for Ebola at the hospital amounted to little more than an optional seminar for staff.
And in the face of constantly shifting guidelines, nurses were allowed to follow whichever ones they chose, the union claimed.
“There was no advance preparedness on what to do with the patient, there was no protocol, there was no system,” Ms Burger said.
Even today, Ms Burger said, some hospital staff at the Dallas hospital do not have proper equipment to handle the outbreak.
“Hospital managers have assured nurses that proper equipment has been ordered but it has not arrived yet,” she said.
The nurses’ statement said they had to “interact with Mr Duncan with whatever protective equipment was available,” even as he produced “a lot of contagious fluids”.
The Presbyterian nurses are not represented by Nurses United or any other union. Ms Burger said the nurses claimed they had been warned by the hospital not to speak to the media or they would be fired. She did not specify whether the nurses making the claims had treated Mr Duncan.
David Wright, deputy regional administrator for the US Centres for Medicare & Medicaid Services, which monitors patient safety and has the authority to withhold federal funding, said his agency will want to get all of the information the nurses provided.
“We can’t talk about whether we’re going to investigate or not, but we’d be interested in hearing that information,” he said.
The Centres for Disease Control and Prevention (CDC) did not immediately respond to requests for comment.
Mr Duncan first sought care at the hospital’s emergency room late on September 25 and was sent home the next morning. He was rushed by ambulance back to the hospital on September 28.
Unlike his first visit, mention of his recent arrival from Liberia immediately roused suspicion of an Ebola risk, records show.
The CDC said yesterday that 76 people at the hospital could have been exposed to Mr Duncan after his second ER visit. Another 48 people are being monitored for possible exposure before he was admitted to hospital.
The Texas nurse who contracted Ebola was no stranger to the risks of working around one of the world’s most feared viruses.
Nina Pham had studied microbiology and infection prevention in nursing school. A classmate says students discussed Ebola in detail.
Ms Pham continued her training after graduation, obtaining certification in critical care two months before Ebola arrived in the US.
Her infection raised new questions about whether American hospitals and their staffs are adequately prepared to contain Ebola.
The CDC acknowledged that Ms Pham might not have been infected if a special response team had been sent to Dallas immediately after the Liberian patient was diagnosed.