UPDATED: 3 p.m.

Updated 3:00 p.m.

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Update: CBS 11 has confirmed the second Ebola patient is 26-year-old Nina Pham. KRLD’s LP Philips spoke to a family friend of the Pham’s Monday afternoon who said the nurse is in “stable” condition. “They are in shock… everybody doesn’t know what is going on, especially her mother — she was devastated — when she heard the bad news,” said Thomas Ha, who attends the same church as Nina Pham.

Ha said the Pham family may be seeking solace at their church.

(credit: Facebook)

(credit: Facebook)

DALLAS (CBSDFW.COM/AP) — Health officials are still working to determine how a nurse who cared for Ebola patient Thomas Duncan in Dallas contracted the deadly virus, one day after the CDC confirmed the positive test result.

The nurse at Texas Health Presbyterian Hospital, who is a 2010 graduate from Texas Christian University’s nursing program in Fort Worth, has been unable to pinpoint exactly how and when she contracted Ebola.

The nurse, who has not been publicly identified, wore protective gear while treating the Liberian patient, said Dr. Tom Frieden, head of the Centers for Disease Control and Prevention. Duncan was the first person in the U.S. diagnosed with Ebola.

WATCH: Dr. Darrin D’Agostino answers questions about Ebola

Health officials are looking into how the worker removed her personal protective gear, which includes a gown, two sets of gloves, a face mask and an eye shield and are also are examining the intensive medical procedures Duncan received. Those procedures include kidney dialysis and use of a breathing machine.

Both involve inserting tubes into blood vessels or an airway and can raise the risk of contact with bodily fluids, officials said.

The missteps with the first patient and now the infection of a caregiver raised questions about assurances given by U.S. health officials that any American hospital should be able to treat an Ebola patient and that the disease would be contained.  According to the CDC’s Director Dr. Tom Frieden, new procedures have been put in place to protect health care workers caring for the second patient, including a buddy system that requires those workers be watched as they put on and take off protective equipment.

The infected nurse reported a low-grade fever on Friday night and was immediately isolated and referred for further testing. Those preliminary ​test results, received late Saturday night, showed a lower level of the virus in her blood stream than was detected in Duncan’s tests.

Complete Coverage Of Ebola In North Texas

Health officials said that the patient is in stable condition.  Frieden said the worker was with the original Ebola patient on “multiple occasions, and that included extensive contact.”

Dr. Daniel Varga, chief clinical officer at the hospital, said the worker was thought to be at a low risk for getting the virus.

But, according to Frieden, “at some point, there was a breach in protocol, and that breach in protocol resulted in this infection.” Investigators with the CDC are now looking into what that breach could have been. They are focusing the investigation on the kidney dialysis process, the removal of Duncan’s respiratory equipment, and the removal of the worker’s protective gear.

There is concern that other hospital workers could also be at risk if they had a similar breach in protocol.

“If this one individual was infected and we don’t know how within the isolation unit, then it is possible other individuals could have been affected as well, so we consider them to potentially be at risk and we are doing an in-depth review and investigation,” said Frieden.  However, Frieden offered an apology and clarification about the breach in protocol.

“Some interpreted that as finding fault with the hospital or the health care worker and I’m sorry if that was the impression given.  That was certainly not my intention.  People on the front lines are protecting all of us,” said Frieden.  “I feel awful that a health care worker became infected in the care of an Ebola patient.  She was there trying to help the first patient survive and now she has become infected.”

Frieden said in a Monday news conference that “every hospital in this country needs to think about Ebola as a possibility” for anyone who has traveled to West Africa and has a fever or other Ebola symptoms.  He called rapid diagnosis critical across the country’s health care system.

“The developments in Dallas are cause to double down on all our efforts to make sure health care workers and hospitals are properly trained and that they meticulously follow guidelines while triaging potential Ebola patients or providing care to Ebola patients,” CDC spokesman Tom Skinner said to CBS News.

Health officials have interviewed the patient and identified only one other individual who may have been exposed while the health care worker was showing symptoms. This individual has been placed in isolation as a precaution.

The nurse’s dog was also in the apartment and crews late Sunday brought the animal food and water.  Dallas Mayor Mike Rawlings told USA Today the animal would not be euthanized.  Health authorities said on Monday they were working to find a location to care for and monitor the dog.

The patient lives in the 5700 block of Marquita Avenue in Dallas. Mayor Rawlings walked around the neighborhood on Sunday morning to help ease fears and answer the questions of concerned residents.

(credit: KTVT/KTXA)

(credit: KTVT/KTXA)

Hazmat crews spent several hours cleaning her apartment on Sunday, both inside and out. The company initially hired to clean the apartment, The Cleaning Guys, says they were asked to step down to make way for a state contractor.

Two new cleaning services, OMI Environmental and Protect Environmental, arrived at the apartment on Monday morning. OMI says they are the lead cleaning agency on site and it’s expected the decontamination process will wrap up by the end of the day.


Dallas police officers stood guard outside the complex Sunday and told people not to go inside. One said an industrial barrel outside contained hazardous waste taken from inside the building. Nearby residents periodically came out of their homes to ask about the commotion.

The latest news capped a day of revelations about the second case, which came less than a week after Mr. Duncan died from the Ebola virus.

At a news conference on Sunday, Dallas County Judge Clay Jenkins stated that this is “not news that should bring about panic.”

Dallas Mayor Mike Rawlings reiterated this information, saying that the citizens of the city are safe.

“We have a plan in place to send hazmat units into the patient’s apartment,” he said, noting that the individual’s car has already been decontaminated. There is also a pet at the home that needs to be removed.

“This development is understandably disturbing news for the patient, the patient’s family and colleagues, and the greater Dallas community,” the Centers for Disease Control said in a statement.

No other individuals — either hospital workers or those among the initial 48 people being monitored — have shown any Ebola symptoms so far.

According to the CDC, the longer a person is infected with the virus the more infectious they become, which could explain why the health care worker contracted the disease while family members of Duncan have not yet shown any symptoms.  However, Frieden warned Duncan’s family members are among those who continue to be monitored and have not yet reached the end of the 21-day incubation period under which symptoms could appear.

Meanwhile, CDC officials are reviewing their list of people who may have been exposed to the virus, and plan to take more aggressive action in monitoring. There is expected to be a new number of people being watched by the CDC, but that number is not yet known.

“We knew a second case could be a reality, and we’ve been preparing for this possibility,” Dr. David Lakey, commissioner of the Texas Department of State Health Services. “We are broadening our team in Dallas and working with extreme diligence to prevent further spread.”

Dr. Lakey said in Monday’s news conference that the contact investigation is a top priority and that employees from other parts of the state are in Dallas to assist with the investigation.

(©2014 CBS Local Media, a division of CBS Radio Inc. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed. The Associated Press contributed to this report.)

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