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Nurse Amber Vinson may have had symptoms of Ebola longer than first thought

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(CNN) — A nurse with Ebola may have shown symptoms of the virus as many as four days before authorities once indicated, meaning that she might have been contagious while flying on not just one, but two commercial flights, officials said Thursday.

Amber Vinson

Amber Vinson

Amber Vinson was hospitalized Tuesday, one day after she took a Frontier flight from Cleveland to Dallas. Tests later found that Vinson — who was among those who cared for Thomas Eric Duncan, the first person diagnosed with Ebola in the United States, at Dallas’ Texas Health Presbyterian Hospital — had Ebola.

Authorities indicated that Vinson had a slightly elevated temperature of 99.5 degrees Fahrenheit, which was below the fever threshold for Ebola, but didn’t show any symptoms of the disease while on her Monday flight. This is significant because a person isn’t contagious with Ebola, which spreads through the transmission of bodily fluids, until he or she has symptoms of the disease.

But on Thursday, Dr. Chris Braden of the Centers for Disease Control and Prevention told reporters in Ohio that “we have started to look at the possibility that she had symptoms going back as far as Saturday. … We can’t rule out (that) she might have had the start of her illness on Friday.”

“So this new information now is saying we need to go back now to the flight that she took on Friday the 10th and include them in our investigation of contacts,” said Braden.

Specifically, the CDC announced later Thursday that is “expanding its outreach to airline passengers now to include those who flew from Dallas-Fort Worth to Cleveland on Frontier flight 1142” last Friday — which is how Vinson got to Ohio, from Texas, originally.

The medical director in Summit County, Ohio, where Vinson spent time before returning to Texas, told CNN that two things have changed: what the CDC defines as a “contact” of someone with Ebola and more information has been gathered on how Vinson was feeling.

“What the CDC has discovered, through interviews, is that she may not have been feeling well earlier than we initially thought on (Monday),” said the director, Dr. Marguerite Erme.

“… It was nothing you could point your finger at and say, ‘Ah, this is a particular disease,” Erme added. Nonetheless, the new information “kind of signified that maybe she had the illness longer than what she had when (hospitalized).”

Vinson said felt fatigue, muscle ache and malaise while she was in Cleveland and on the flight home, a federal official with direct knowledge of the case told CNN’s Elizabeth Cohen. Vinson did not have diarrhea or vomiting while in Cleveland or on the flight home.

This development could significantly expand the number of people who might have been in contact with Vinson while she was contagious.

Earlier, CDC Director Dr. Tom Frieden had said there’s an “extremely low” risk to anyone on Frontier’s Cleveland-to-Dallas flight, though his agency was reaching out to all 132 passengers as part of “extra margins of safety.” Frontier is also grounding its six crew members for 21 days — the maximum time between when a person can contract Ebola and show symptoms — out of what its CEO says is “an abundance of caution.”

Yet now “12 confirmed contacts of Amber Vinson in Ohio … are currently under quarantine,” according to Summit County’s assistant health commissioner Donna Skoda. They include four people who worked at a bridal store, where the 29-year-old nurse went as part of her wedding planning.

Nurse moving to National Institutes of Health hospital

Vinson was flown Wednesday to Atlanta’s Emory University Hospital, where Frieden said she is “ill but clinically stable.”

Workers at that hospital — which previously treated Americans David Brantly and Nancy Writebol for Ebola — are also caring for an unnamed person with Ebola who came there September 9.

Another nurse at Texas Health Presbyterian Hospital, meanwhile, is heading to a National Institutes of Health hospital in Bethesda, Maryland, just outside Washington.

Nina Pham

Nina Pham

The Dallas hospital said that transferring Nina Pham “is the right decision (because) many of the medical professionals who would normally staff the intensive care unit (are) sidelined for continuous monitoring.” Some 76 workers who cared for Duncan, like Vinson and Pham, have been asked to do things like regularly take their temperatures to gauge whether they have Ebola.

Texas Health Presbyterian’s critical care medicine chief Dr. Gary Weinstein said “she has improved so much in a short period of time.” Pham sounded upbeat and grateful in the same statement about her upcoming move to Maryland.

“I’m doing really well thanks to this team, which is the best in the world,” Pham said. “I believe in my talented co-workers.”

The fourth person now being treated in the United States for Ebola, freelance NBC cameraman Ashoka Mukpo, is “getting better every day” at Nebraska Medical Center, hospital spokesman Taylor Wilson said Thursday.

Obama opposes travel ban

Even if there are only a limited number of cases now, the Ebola crisis has gotten Washington’s attention.

There also was a lot of Ebola-related activity in Washington. Some was proactive and far-reaching, such as President Barack Obama signing an executive order authorizing the deployment of National Guard troops to West Africa — where most all of the nearly 9,000 reported Ebola cases and 4,500 deaths have been occurring, according to the World Health Organization — to help authorities there deal with the devastating outbreak.

The President said later Thursday that “it may be appropriate for me to appoint an additional person” — a so-called Ebola czar — to focus exclusively on the virus.

Obama also voiced opposition to instituting a travel ban to prevent the virus from spreading from West Africa into the United States, explaining that “history shows that there is a likelihood of increased avoidance (that could lead to) more cases rather than less.”

“The problem is that — in all the discussions that I’ve had thus far with experts in the field, experts in infectious disease … a travel ban is less effective than the measures that we are currently instituting,” the President said.

Federal and Texas health officials faced heated questioning on Capitol Hill about how Ebola has been handled so far in the United States and how it will be handled in the future.

Dr. Daniel Varga — the chief clinical officer for Texas Health Presbyterian Hospital’s parent company, Texas Health Resources — admitted hospital staff “made mistakes” the first time that Duncan visited there in late September, letting him leave despite his symptoms and the fact he’d just come from West Africa.

“We did not correctly diagnose his symptoms as those of Ebola,” Varga testified Thursday to the U.S. House Energy and Commerce Committee. “We are deeply sorry.”

While procedures may change — especially after some well-publicized mistakes — Frieden said his agency’s overarching goal will not.

“Our top priority, our focus is to work 24/7 to protect Americans,” Frieden said. “That’s our mission.”

Schools closed, flight crew grounded

While only four people are confirmed to have Ebola now in America, many more are on guard.

A few schools in Texas’ Belton Independent School District closed Thursday because two students were on the same Cleveland-to-Dallas flight as Vinson. Two schools in the Solon school district in suburban Cleveland also shut down because a staffer “traveled home from Dallas on Frontier Airlines on Tuesday on a different flight, but perhaps the same aircraft” as Vinson, the school district said in a statement.

The federal government is weighing putting those who treated Duncan on a “Do Not Board list” that would prohibit them from flying commercially, an official familiar with the situation told Elizabeth Cohen, CNN’s senior medical correspondent.

With two of its own nurses infected with Ebola, Texas Health Presbyterian Hospital “is offering a room” to any concerned employee “to avoid even the remote possibility of any potential exposure to family, friends and the broader public.”

“We are doing this for our employees’ peace of mind and comfort. This is not a medical recommendation,” the hospital said. “We will make available to our employees who treated Mr. Duncan a room in a separate part of the hospital throughout their monitoring period.”

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