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Public health officials in Texas said Thursday that as many as 100 people may have had contact with the Liberian man diagnosed with Ebola. Four of these people, at least two of whom are family members, have been ordered to remain at home in an attempt to prevent the spread of the disease.
Still, authorities continued to stress that only Thomas Eric Duncan, the first person diagnosed with Ebola in the United States, had exhibited any symptoms of the disease.
“The only person who’s had symptoms is Mr. Duncan, who’s in the hospital,” Dallas County Judge Clay Jenkins said during a news conference Thursday afternoon. “And no one who has been around Mr. Duncan in the time he has been symptomatic has shown any indication of having contracted Ebola.”
The U.S. Centers for Disease Control and Prevention said the list of 100 people being assessed includes “potential, possible contacts.” It is unclear how many people had direct contact with Duncan. Authorities say the number of people who require monitoring will be much lower once that is determined.
A law enforcement officer was stationed at the apartment complex Duncan was visiting to make sure the quarantined individuals did not go out. The order, which was delivered by local health officials Wednesday night, says the family cannot have visitors without approval, must provide blood samples and must agree to any testing.
While authorities were reluctant to go into detail about why these four people without any symptoms were quarantined, they said it had to do with making sure they remained at home and accessible for monitoring.
“They were noncompliant with the request to stay home,” Jenkins said. “I don’t want to go too far beyond that.”
There are also issues of hygiene at this apartment, including properly disposing of the sheets on which Duncan slept and his belongings. The home had not been cleaned by Thursday afternoon because there has “been a little bit of hesitancy” in finding someone willing to do it, said David Lakey, commissioner of the Texas Department of State Health Services.
People who have come into direct contact with an Ebola patient who has symptoms must be watched for three weeks, beginning on the last day they had that contact. This process, which is called contact tracing, involves observing them for symptoms such as a high fever, at which point a person will be isolated.
Some students have not returned to the schools attended by five students who are believed to have had contact with Duncan, the school district reported. Those five students are staying at home, and attendance is down at these campuses, even as nurses have begun regularly visiting classrooms and counselors have been made available.
Duncan faces charges
Liberian authorities said Thursday they plan to prosecute Duncan for lying on an airport questionnaire, because he said he had not cared for an Ebola patient or touched anyone who had died from the disease, according to The Associated Press. Neighbors in the Liberian capital said they thought he became infected after he helped transport a sick, pregnant neighbor, the AP said.
Before leaving Liberia, Duncan had his temperature taken at the airport in Monrovia by a CDC-trained person. A thermometer approved by the U.S. Food and Drug Administration showed that he did not have a fever.
The screening at the airport in Monrovia, the capital, has been in place for months, said Deborah Malac, the U.S. ambassador to Liberia.
“They have confidence that everything that was supposed to have been done was done,” Malac said Thursday.
Additional screening protocols have been added since the beginning of the Ebola outbreak, which has killed more than 3,300 people in West Africa, according to the World Health Organization.
Showing symptoms
Duncan began showing symptoms about four or five days after he arrived in Texas, CDC Director Thomas Frieden said Thursday in a conference call with reporters.
Duncan visited Texas Health Presbyterian in Dallas shortly thereafter for medical treatment because he had a fever and some abdominal pain. He told a nurse that he had traveled from Liberia, but that information was not relayed to other health care workers, and he was released.
“This is a very sophisticated hospital,” Lakey, the state health services commissioner, said during the same conference call.
“They’ve done a lot of education related to preparedness for Ebola. … Unfortunately, connections weren’t made related to travel history and symptoms.”
As a result, Duncan left the hospital during the period when health officials say he was symptomatic, which is the only time Ebola becomes contagious.
A little more than two days later, he returned to the same hospital in an ambulance and was placed in isolation after being recognized as a potential Ebola patient.
