Travel ban for Texas health care workers in Ebola case

Texas health officials have ordered any person who entered the room of the first Ebola patient at a Dallas hospital not to travel by public transport, including planes ship, buses or trains, or visit groceries, restaurants or theaters for 21 days, until the danger of developing Ebola has passed.

The instructions, issued by the Texas Department of State Health Service late Thursday, cover more than 70 health workers involved in providing care for Thomas Duncan, the Liberian national who became the first patient to test positive for Ebola in the United States.

Duncan, 42, died Oct. 8 at Texas Health Presbyterian Hospital in Dallas.

A timeline released Friday by a congressional committee shows that five hours after Duncan first went to the hospital with a fever and other symptoms, he was released Sept. 26 about 3:30 a.m., just 35 minutes after his temperate jumped to 103 degrees.

The timeline, one of two released by the House Energy & Commerce Committee, shows that nurses did not obtain his travel history. One nurse did note that Duncan had recently arrived from Africa but "attached no further significance" to the disclosure.

As state officials begin to tighten restrictions to cope with the Ebola crisis, administration officials said Friday that President Obama will appoint Ron Klain, who served as chief of staff to vice presidents Joe Biden and Al Gore, to be the new "Ebola czar" to coordinate government response to the medical emergency.

The hospital workers were ordered to undergo monitoring twice a day, including one face-to-face encounter.

The health department said anyone failing to adhere to the rules "may be subject to a communicable disease control order." The health workers were asked to sign a written acknowledgement of the directions when they appear for monitoring.

The new rules were issued in the wake of reports that one of the hospital nurses who treated Duncan -- 29-year-old Amber Vinson -- later flew to Cleveland and then took a return flight Oct. 13 on Frontier Airlines despite having a low-grade fever, indicating the possible onset of Ebola.

Vinson, who tested positive for Ebola on Tuesday, was hospitalized in Dallas and later transferred to Emory University Hospital in Atlanta. Another nurse, Nina Pham, 26, was the first nurse to test positive and has been transferred to the National Institute of Health hospital in Bethesda, Md.

Before Thursday's order, the health workers involved in the Duncan case had only been asked to self-monitor for symptoms of infection after two nurses were diagnosed with the virus.

The order, signed by David Lakey, commissioner of the state health department, said any of the health-care workers affected can stay at the hospital to facilitate monitoring for the three-week period.

In a related case, a health care worker who may have handled a specimen from Duncan was reported to be on a cruise ship in the Caribbean.

Industry giant Carnival says it was notified late Wednesday by the Centers for Disease Control and Prevention that a passenger on the Texas-based Carnival Magic was a lab supervisor at Texas Health Presbyterian Hospital. Carnival says the unnamed woman, who boarded the ship in Galveston on Sunday, has been placed in isolation on the ship and has shown no signs of illness.

The Belize government Thursday denied a U.S. request to allow the woman or her spouse to leave the ship and be evacuated through the international airport in Belize City. Friday afternoon, the Mexican government refused to allow the ship to dock in Cozumel, so the ship is headed back to its home port, Galveston, Texas, where it's due Sunday, Carnival said.

Hospital officials and the CDC came under harsh attack at congressional hearings Thursday over Vinson's trip on a commercial airliner within days of treating Duncan.

Dr. Thomas Frieden, director of the CDC, confirmed to Congress Thursday that she called the CDC and asked for permission to fly. He was told that she reported no symptoms when she called, although it has been determined that she had a low-grade fever.

Eight people in northeast Ohio were in voluntary quarantine because they had contact with Vinson, who visited family in the Akron area last weekend before flying from Cleveland back to Dallas.

Still, health officials in Ohio emphasized that Vinson didn't show symptoms during her visit and therefore shouldn't have been contagious yet. The disease isn't airborne; it's spread through direct contact with bodily fluids.

Meanwhile, the World Health Organization has admitted that it botched attempts to stop the now-spiraling Ebola outbreak in West Africa, blaming factors including incompetent staff and a lack of information.

"Nearly everyone involved in the outbreak response failed to see some fairly plain writing on the wall," WHO said in a draft internal document obtained by The Associated Press, noting that experts should have realized that traditional containment methods wouldn't work in a region with porous borders and broken health systems.

The U.N. health agency acknowledged that, at times, even its own bureaucracy was a problem. It noted that the heads of WHO country offices in Africa are "politically motivated appointments" made by the WHO regional director for Africa, Dr. Luis Sambo, who does not answer to the agency's chief in Geneva, Dr. Margaret Chan.

In late April, during a teleconference on Ebola among infectious disease experts that included WHO, Doctors Without Borders and the CDC, questions were apparently raised about the performance of WHO experts, as not all of them bothered to send Ebola reports to WHO headquarters.

WHO said it was "particularly alarming" that the head of its Guinea office refused to help get visas for an expert Ebola team to come in and $500,000 in aid was blocked by administrative hurdles.

Guinea, along with Sierra Leone and Liberia, is one of the hardest-hit nations in the current outbreak, with 843 deaths so far blamed on Ebola.

The Ebola outbreak already has killed 4,484 people in West Africa and WHO has said within two months, there could be new 10,000 cases of Ebola every week.

Contributing: Associated Press