Health officials are assessing about 100 people to determine whether they have had contact with a man being treated for Ebola at a Dallas hospital, the Centers for Disease Control and Prevention (CDC) said Thursday. So far, they have identified "a handful" of individuals who may have had exposure that requires further monitoring.
"[O]ur approach is to cast a wide net, to reach out to as many people as there are who may have had contact so that we could identify all of those who might well actually have contact," said Tom Frieden, director of the CDC, on a press call Thursday. He added that health officials did not yet have a specific number of people believed to have truly had contact, but that officials would share that number when it became available.
"Bottom line here is that we remain confident that we can contain any spread of Ebola within the United States," said Frieden. "There could be additional cases who were already exposed. If that occurs, systems are in place so that they will not further spread Ebola."
In addition to looking at the 100 people, Texas health officials have ordered four family members of the Ebola patient, 42-year-old Thomas Eric Duncan, to remain in their home and not have any visitors until at least Oct. 19, when the disease's incubation period has passed. It can take up to 21 days for a person infected with Ebola to develop symptoms, at which point they become contagious.
David Lakey, the commissioner of the Texas Department of State Health Services, said Thursday that the decision to put a control order in place for Duncan's relatives was based on the need for proper monitoring, which includes having their temperatures checked twice a day. None of the family member are presenting any symptoms of Ebola, said Lakey, and he doesn't plan on quarantining any other individuals at this time.
Nearly 4,000 miles away, there were reports that a patient in Hawaii was placed in isolation after showing symptoms consistent with Ebola. But the CDC later said diagnostic testing had not been conducted because the patient did not fit the profile.
"The hospital acted in the best interests of the community, with an abundance of caution," said Dr. Linda Rosen, health director of the Hawaii State Department of Health. "We commend the facility for being prepared and remaining vigilant regarding the risk of Ebola. After investigation by the health department, it was determined that the individual did not meet the clinical or travel exposure criteria for an Ebola infection."
Duncan, a resident of Monrovia, Liberia, tested positive for the deadly disease on Tuesday -- 10 days after he arrived in Dallas, and two days after he was admitted to the hospital. According to the CDC, his temperature was normal when he boarded the plane in Liberia. He is currently in serious condition.
Initially, Duncan sought treatment for a fever and abdominal pain on Sept. 26, but the Texas Health Presbyterian Hospital sent him home with antibiotics. Officials said Duncan didn't display any obvious signs of Ebola, but also acknowledged that his travel history was not "fully communicated" throughout the hospital.
"I think this will certainly serve for the rest of the country as a very cogent lesson learned," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, on msnbc's "Morning Joe".
Frieden called the communication breakdown "a teachable moment," underscoring the need for every hospital to emphasize travel histories.
Joseph Weeks, Duncan's nephew, told NBC News that he was the one who alerted the CDC to his uncle's possible Ebola case.
“I feared other people might also get infected if he wasn’t taken care of, and so I called them to ask them why is it a patient that might be suspected of this disease was not getting appropriate care?” Weeks said.
An epidemiologist for the Dallas County Health and Human Services confirmed in a telephone call to NBC News Thursday that the department did speak with Weeks on Sept. 29, one day after Duncan was admitted to the hospital. Although Weeks expressed concern that his uncle had Ebola, he also told Texas state health officials that Duncan had zero contact with anyone carrying the disease, the epidemiologist said. Frieden said Thursday he was not aware of the family having reached out to the CDC, but that they were "looking into it."
Texas Gov. Rick Perry announced Wednesday that five “school-aged” children had come into contact with Duncan and were being monitored closely. The Dallas Independent School District said the students were instructed to stay home even though they were not presenting any symptoms, and were, therefore, not contagious. Some parents were still rattled by the news, however, and pulled their own kids out of school.
Because Ebola spreads though contact with bodily fluids, unlike airborne diseases, health experts are confident it won’t spread in the U.S., which has a far more sophisticated medical infrastructure than that of West African nations, where the current Ebola epidemic has killed over 3,300 people, according to the World Health Organization (WHO). Countries affected include Guinea, Liberia, Nigeria, Senegal, and Sierra Leone.
Though that kind of outbreak in the U.S. is highly unlikely, there may be more Ebola cases on the horizon. Frieden said Thursday that the best way to protect American lives was not to seal off those countries in West Africa, but to offer services that will control the epidemic.
"We can't make the risk zero until the outbreak is controlled in West Africa," he said. "What we can do is minimize that risk as is being done now in Dallas, by working to ensure that no more individuals are exposed than have already been exposed."