Officials in Dallas County, Texas, are urging residents who had contact with the first U.S. Ebola patient to agree to monitor themselves, voluntarily restrict their travel, and refrain from visiting public places for 21 days.
Local authorities considered asking Gov. Rick Perry to issue a disaster declaration in response to the Ebola virus. But during a hearing on Thursday afternoon, they decided the action was unnecessary.
Thomas Eric Duncan was the first of three patients in Texas to be diagnosed with the virus. Duncan, a Liberian man, later died at Texas Health Presbyterian Hospital in Dallas on Oct. 8. Since his death, two nurses who treated him — Amber Vinson and Nina Pham — have tested positive for Ebola.
Earlier this week, hours after officials confirmed that Pham was infected with the disease, Perry cut short his previously scheduled European trip to return to his home state. Nine days ago, the Republican governor created a 15-member task force in charge of discussing recommendations for how Texas officials should address the treatment and response to the disease.
Also on Thursday, President Barack Obama signed an executive order that provides him the immediate authority to order U.S. National Guard and Reserve forces to Liberia to assist with the growing fight against Ebola. The initial deployment could include eight engineers and logistics specialists to assist in the construction of treatment centers, a source told NBC News.
After canceling campaign travel plans for Wednesday and Thursday, Obama said the United States must monitor Ebola "in a more aggressive way." He directed the Centers for Disease Control and Prevention (CDC) to form a rapid response team immediately on site in the event that future cases are diagnosed. Obama also met with his cabinet officials and called members of Congress and foreign leaders to discuss ongoing efforts.
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Briana Aguirre, who works at the hospital, on Thursday said she can no longer defend the staff's care of Ebola patients because administrators didn't discuss the virus or protocols until Duncan arrived earlier this month. She said she watched her co-workers violate basic principles of nursing while treating him.
"We never talked about Ebola and we probably should have," Aguirre said Thursday during an interview with the "Today" show. Instead, she said, "they gave us an optional seminar to go to. Just informational, not hands on. It wasn't even suggested we go. … We were never told what to look for."
Aguirre didn't tend to Duncan, who was initially put in an area with as many as seven other patients. But she learned from her colleagues who treated him that there was mass confusion over procedures, including how to handle his lab work.
"It was just a little chaotic scene. Our infectious disease department was contacted to ask, 'What is our protocol?' And their answer was, 'We don't know. We're going to have to call you back,'" she said.
Americans' fear of Ebola and disapproval of the government's response to containing the disease continues to grow, as two-thirds in the country say they are concerned at the possibility of an outbreak occurring here. Members of Congress and candidates running for office in next month's midterm elections are calling for the resignation of Dr. Tom Frieden, director of the CDC. They also are demanding the implementation of no-fly lists and travel bans to countries in West Africa, where thousands of individuals have been affected by the virus.
At least 4,500 people have died worldwide from the disease, and more than 9,000 cases have been detected, said Dr. Isabelle Nuttall, director of the World Health Organization's Department of Global Capacities Alert and Response. To date, 427 health care workers have been infected and 236 have died. Data shows that cases are doubling every four weeks, and Ebola is still widespread in the West African nations of Guinea, Liberia, and Sierra Leone.
At a House hearing on Thursday afternoon, Dr. Frieden emphasized his worry that Ebola could spread more widely in Africa, and consequently further threaten the U.S. health system.
"We know how to control Ebola," he said. But, he added, "there are no short cuts in the control of Ebola, and it is not easy to control it. To protect the United States, we have to stop it at the source."
Ebola isn't transmitted until someone has symptoms, emphasized Dr. Jennifer Hanrahan, chair of the Infectious Control Committee at the Metro Health Medical Center in Cleveland during a Thursday press conference. The virus isn't airborne — individuals cannot be infected by the disease unless they have direct contact with a patient exhibiting Ebola symptoms, she added.
"A lot of the steps being taken are because we know a lot of people are upset and worried," she told reporters. "People are responding to this emotionally, not based on scientific evidence, and that's understandable. This is a scary disease."
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An Air France plane traveling from Lagos, Nigeria, to Madrid, was isolated in Spain Thursday morning after a Nigerian passenger complained of a fever, shivers, and a headache. The jet and its 183 passengers were taken to a special area and put in isolation for at least an hour and a half. Last week, a nurse in Spain also contracted Ebola while caring for a patient.
Late Wednesday, doctors at Yale-New Haven Hospital in Connecticut admitted a patient to be evaluated for Ebola-like symptoms. The man, a student at Yale University, had been in Liberia, but showed no symptoms when he left the country to return to the United States. Doctors performed tests on the patient Thursday morning, and expected to have preliminary lab results by early Friday. The man remains in stable condition.
Precautionary measures were taken for those with Ebola-like symptoms at other locations across the country on Thursday, including at Ozark Health Medical Center in Clinton, Arkansas, and at a transit station in Boston.
Enhanced screening of international travelers began Thursday at five major U.S. airports: Virginia's Dulles International, New York's John F. Kennedy International, Chicago's O'Hare International, Georgia's Hartsfield-Jackson Atlanta International, and New Jersey's Newark Liberty International.
Earlier this week, members of a nurses union said they had been given little to no support in anticipation of potential Ebola outbreaks. They added that their concerns have been "essentially ignored" by the White House and CDC.
On Wednesday, Vinson was the second American health care worker to be diagnosed with Ebola in Texas. She traveled on a flight from Cleveland to Dallas this week with more than 100 people. Vinson reportedly wasn't warned to refrain from boarding the commercial jet, even after updating the CDC on her elevated temperature of 99.5 degrees Fahrenheit.
"I believe that they should have known that they were not handling this well, this Ebola crisis. They should have known that it was getting out of hand, that they should have called in more help," Aguirre said.
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Aguirre, who provided care for Pham, also told "Today" that she was shocked by the insufficient protective gear her administrators provided her, and pointed out that several inches of her neck were left exposed.
Doctors expected Pham would be transported from Dallas to the National Institutes of Health's isolation unit in Bethesda, Maryland, by Thursday afternoon.
As a precaution, the CDC is evaluating each passenger who traveled on the Frontier Airlines flight with Vinson. According to Frontier Airlines CEO David Siegel, six crew members were placed on paid leave "out of an abundance of caution" and over concerns that Vinson “may have been symptomatic earlier than initially suspected; including the possibility of possessing symptoms while onboard the flight."
Nurses from the Cleveland Clinic and the MetroHealth System in Ohio were some of the passengers on board. Consequently, both health systems have also placed those individuals on paid leave while their health is monitored daily.
"We are confident that these nurses are at low risk of exposure since we understand that the Dallas nurse did not have symptoms at the time. We have taken this measure as an extra precautionary step for our employees, patients, and visitors," administrators from the health systems said Thursday in a joint statement.
Classes were cancelled at Cleveland-area schools on Thursday as authorities continued to track Vinson's travels during her short stay in Ohio.
Previously on Tuesday, paramedics dressed in hazmat suits escorted Vinson by stretcher from the Texas hospital to an airplane for a flight to Atlanta. But one individual, a medical safety coordinator, stood next to Vinson only wearing a button-down shirt, pants and sunglasses. He neglected to cover his body with gloves, a mask or protective eyewear.
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An executive for Phoenix Air, which has completed 11 transport missions for Ebola patients, said at least one person needs to watch for potential problems and listen for nearby planes. The hazmat suit limits a person's peripheral vision, smell, and hearing.
Ashoka Mukpo, the NBC News freelance cameraman who contracted Ebola and is recovering, posted a hopeful message to his Twitter account for the two Dallas nurses.