The airline passenger who brought Ebola into the U.S. initially went to a Dallas emergency room last week but was sent home, despite telling a nurse that he had been in disease-ravaged West Africa.
The decision by Texas Health Presbyterian Hospital to release Thomas Duncan could have put others at risk of exposure to the disease before he went back to the ER a couple of days later, when his condition worsened.
On Wednesday, a day after Duncan's diagnosis was confirmed, a nine-member team of federal health officials was tracking anyone who had close contact with him after he fell ill on Sept. 24. The group of 12 to 18 people included three members of the ambulance crew that took Duncan to the hospital and a handful of schoolchildren. They will be checked every day for 21 days, the disease's incubation period.
"That's how we're going to break the chain of transmission, and that's where our focus has to be," Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, said.
Duncan explained to a nurse at Texas Presbyterian last Thursday that he was visiting the U.S. from Liberia, but that information was not widely shared, the hospital said. Hospital epidemiologist Dr. Edward Goodman said Duncan had a fever and abdominal pain during his ER visit, not the riskier symptoms of vomiting and diarrhea.
Duncan was diagnosed with a low-risk infection and sent home with a prescription for antibiotics, according to his sister, Mai Wureh.
He was listed in serious but stable condition Wednesday.
Ebola is believed to have sickened more than 7,100 people in West Africa, and killed more than 3,300. Liberia is one of the three hardest-hit countries.
In Texas, neither the ambulance crew nor the children showed any symptoms. They were restricted to home while their conditions are observed.
Ebola symptoms can include fever, muscle pain, vomiting and bleeding, and can appear as long as 21 days after exposure to the virus. The disease is not contagious until symptoms begin. It spreads only by close contact with a patient's bodily fluids.
Duncan man left Liberia on Sept. 19, arrived the next day to visit relatives and started feeling ill four or five days later, said Frieden, the CDC director.
Duncan worked at a shipping company in Monrovia, Liberia, but had just quit his job, his boss said. He lived alone.
Duncan may have become infected after his landlord's daughter fell gravely ill. On Sept. 15, Duncan helped his landlord and his landlord's son carry the stricken woman to the hospital, his neighbors and the woman's parents said. She died the next day.
Health officials in Dallas said Wednesday that they believed Duncan came in contact with at least 12 to 18 people when he was experiencing symptoms. The five children, who possibly had contact with Duncan at a home over the weekend, attended four different schools, which authorities said would remain open. As a precaution, they said all the schools would undergo a thorough cleaning.
Contributing: New York Times