State and local health officials sought to quiet fears in Dallas after disclosing Wednesday that they are monitoring more than a dozen people, including five schoolchildren, who had close contact with the nation’s first Ebola-stricken victim.
The patient, identified in media reports as Thomas Eric Duncan, a 42-year-old resident of Monrovia, Liberia, remained in Texas Health Presbyterian Hospital as authorities tried to patch together his activities after he became ill here while visiting family members.
Among other key developments in a fast-moving day: Hospital officials said they erred in sending Duncan home when he first sought treatment a week ago; paramedics who later transported him to the hospital tested negative for the virus; and Dallas plans to begin an extensive cleaning of the schools the students attended.
None of those who came into contact with Duncan when he was experiencing active symptoms — meaning the disease was contagious — have shown signs of being infected.
“We’re confident that it’s isolated and it’s being contained, but everyone is working tirelessly to double- and triple- and quadruple-check their work, to make sure that we’ve done an absolutely thorough job of identifying anyone who might be at any risk,” Dallas County Judge Clay Jenkins said.
At a news conference at Presbyterian Hospital, Gov. Rick Perry said the patient was receiving “the very best care” there. Duncan, who is in isolation, was said to be in serious but stable condition. A day earlier, he was described as critically ill. Health officials have declined to disclose his name, citing privacy laws.
Perry praised the hospital and health workers.
“This case is serious, but rest assured that our system is working as it should,” he said. “There are few places in the world better-equipped to meet the challenge this patient poses. The public should have every confidence.”
Presbyterian officials acknowledged, however, that the hospital’s emergency room staff mistakenly sent Duncan home with antibiotics when he sought treatment a week ago. His symptoms seemed minor — a low-grade fever and abdominal pain — but he told a nurse that he had recently arrived from Africa.
NBC News reported that one of Duncan’s relatives has accused Presbyterian of mishandling the case.
“I called CDC to get some actions taken because I was concerned for his life and he wasn’t getting the appropriate care,” said Duncan’s nephew, Josephus Weeks. “I feared other people might also get infected if he wasn’t taken care of, and so I called them.”
Weeks told NBC that “got the ball rolling” and he was referred to state health officials, who he said acted appropriately.
On the lookout
U.S. hospitals have been instructed to watch for patients with Ebola symptoms, such as Duncan’s, especially in people who have recently traveled to or from West Africa.
“Regretfully, that information was not communicated to the whole team,” said Dr. Mark Lester, Presbyterian’s executive vice president.
Duncan returned to the hospital Sunday morning with unmistakable Ebola symptoms and was placed in isolation. His Ebola test came back positive Tuesday.
Ebola is an infectious and frequently fatal disease marked by fever and severe internal bleeding. It is spread through contact with an infected person’s bodily fluids, including sweat, saliva, blood and urine.
Even before Duncan’s test result was known, Dallas County health workers had begun to track the people who had personal contact with him. So far, 12 to 18 people, including five school-age children, have been identified as contacts during the four days Duncan was contagious but not hospitalized.
Dallas school Superintendent Mike Miles said that starting Wednesday, the children, who attend four Dallas schools, are being kept home. Dallas County will monitor them — along with the adults who were in contact with Duncan — watching for signs of Ebola. Each person, for example, will be tested daily for fever, usually the first symptom of the disease.
“The students didn’t have any symptoms,” Miles said at the news conference. “The odds of them passing the virus [to others] is low.”
The monitoring effort will last for 21 days, the longest time it takes Ebola symptoms to appear after a person is exposed to the virus. It was not clear if the children will be kept indoors throughout the incubation period or what restrictions have been placed on the adults.
The schoolchildren were not being quarantined — kept in strict isolation, under force of law — though they have been ordered to stay away from their schools, said Dr. Christopher Perkins, the county medical director.
On such decisions, local officials will be guided by the Centers for Disease Control and Prevention, which has sent a team of Ebola experts to Dallas.
“If the CDC says they’re not to leave their homes, we’ll follow that,” Jenkins said.
“We are talking to the best doctors in the world to prevent the spread of this disease.”
Zachary Thompson, director of Dallas County Health and Human Services, said Duncan’s contacts are being asked to obey certain rules, though he did not elaborate.
“If they don’t follow our guidelines, more stringent rules will be followed,” he said.
Thompson denied reports of a possible second Ebola case in the Dallas area.
He said no one is being tested at this time, but with the ongoing investigation, more patients could be found.
“There is no confirmed second case, but don’t be shocked if there is a second case,” he said. “When you start doing surveillance during the contact investigation, you always have to take into consideration the possibility of a second case.”
Patient’s path
Duncan left Liberia on Sept. 19 aboard a Brussels Airlines jet, according to a Belgian official. After a layover of nearly seven hours in Brussels, he boarded United Airlines Flight 951 to Dulles International Airport near Washington, D.C.
After another layover of nearly three hours, he flew Flight 822 from Dulles to Dallas/Fort Worth International Airport, the airline confirmed.
Dr. Tom Frieden, the director of the CDC, emphasized that there is “zero chance” that Duncan could have infected anyone on those flights because he had no Ebola symptoms at that time.
Jenkins asked the media not to incite public fear about the Ebola case. He asked reporters, for example, not to knock on doors in the Vickery Meadow neighborhood where Duncan was staying. The northeast Dallas area is a dense apartment community that is home to many refugee and immigrant families.
“You’ve got a neighborhood of 25,000 people and 33 languages,” he said. “We don’t want to panic the neighborhood and run people underground, so to speak. We need people to remain calm.”
One resident told the Reuters news agency that Duncan had been seen vomiting on the ground outside the complex as he was being loaded into an ambulance.
“His whole family was screaming,” said Mesud Osmanovic, 21. “He got outside and he was throwing up all over the place.”
Jenkins said he planned to visit one-to-one with Vickery Meadow residents to explain to them that they are safe from exposure to Ebola.
“We are going to go talk to those people,” he said. “That’s the best way to reassure them that they’re OK.”
Dallas Mayor Mike Rawlings asked reporters to help public officials defuse anxiety about Ebola.
“You are all intelligent,” the mayor said. “Science says that if you are not exhibiting symptoms of this, there is zero chance that you can transmit this. Tell them: It’s zero chance.”
Staff writers Reese Dunklin, Brooks Egerton and Dianna Hunt and The Associated Press contributed to this report.
