Texas officials didn’t comment on the nurses’ complaints during a morning conference call. The focus for health officials in Dallas is now toward the future, said Judge Clay Jenkins, the county’s chief executive, during the call. The county is preparing contingencies for more cases, he said.

“It will get worse before it gets better, but it will get better,” added Dallas Mayor Mike Rawlings at the briefing.

Immediately Isolated

The worker at Texas Health Presbyterian Hospital reported a fever yesterday and was immediately isolated at the hospital, the Texas Department of State Health Services said in a statement today. The preliminary Ebola test was run late yesterday at the state public health laboratory in Austin, and results were received at about midnight.

This is the second health-care worker infected with Ebola while caring for Duncan, a Liberian visitor to the U.S. who died at the hospital last week. Asked at the briefing about the hospital’s performance, Daniel Varga, the chief clinical officer for the hospital group, said “I don’t think we have a systemic institutional problem.”

’’No one wants to get this right more than we do,’’ Varga said.

The nurses’ union said the information about hospital safety lapses came from “registered nurses” at the hospital “who have familiarity what occurred at the hospital.” The Dallas nurses chose to remain anonymous “out of fear of retaliation,” the union said in a statement.

Contacts Identified

Health officials have interviewed the latest patient “to quickly identify any contacts or potential exposures, and those people will be monitored,” the Texas health department said. The type of monitoring depends on the nature of their interactions and the potential that they were exposed to the virus, according to the statement.

“An additional health-care worker testing positive for Ebola is a serious concern, and the CDC has already taken active steps to minimize the risk to health-care workers and the patient,” the CDC said in a statement today. “The CDC and the Texas Department of State Health Services remain confident that wider spread in the community can be prevented with proper public health measures.”

The new case is the third known instance of Ebola transmission outside of Africa, where the worst-ever outbreak is raging in Sierra Leone, Guinea and Liberia. A nurse who treated Duncan, Nina Pham, has contracted Ebola, as has Teresa Romero, a Spanish nursing assistant who cared for two infected missionaries evacuated to Madrid for treatment.

Airline Screening

The infections outside Africa have spurred the U.S. and U.K. to begin screening some airline passengers on arrival in the past few days.

“It’s really concerning that health workers wearing full personal protective equipment have developed Ebola,” said Raina MacIntyre, a professor of infectious diseases epidemiology at the University of New South Wales in Sydney.

“The initial response of authorities has been to blame the nurse, that they made a mistake in the donning and doffing of equipment or made some mistake in the protocol” she said. “But it’s also possible that the guidelines aren’t adequate.”

Surgical masks may also be inadequate, and respirators that provide more protection should also be considered, she said.

CDC Guidelines

The CDC’s most recent guideline update for putting on and removing protective wear suggest the second glove can be removed by hooking a bare finger under the glove, risking contact with the outside of the glove which could be contaminated, and does not mention protective boots at all, MacIntyre said.

More than 8,900 people have been infected with Ebola in the three countries, with more than 4,400 deaths, the World Health Organization said. The number of new Ebola cases in three West African nations may jump to between 5,000 and 10,000 a week by Dec. 1 as the deadly viral infection spreads, the WHO said yesterday. The fatality rate in the current outbreak is about 70%.

There’s no cure for Ebola, which jumps to humans from animals such as fruit bats and chimpanzees. The virus spreads from contact with bodily fluids such as blood, vomit and feces. Burial practices in West Africa, where mourners come in contact with corpses, have fueled the spread.

--With assistance from Makiko Kitamura in London.

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