GLITCH-Ebola Case in U.S. Draws Calls for Calm From Officials - WSJ

Top federal health officials, seeking to calm a nervous public, ruled out Friday the possibility of an Ebola outbreak in the U.S., as Texas officials moved to contain the first case of the deadly virus diagnosed in America.

Texas officials narrowed the list of people they are tracking for risk of contracting Ebola to 50 from 100, after a Liberian man, Thomas Eric Duncan, was found to have the disease in Dallas on Tuesday.

Only 10 of the 50 people have been identified as being at high risk for Ebola, and all are doing well, said David Lakey, commissioner of Texas Department of State Health Services.

“There’s no additional individuals that have any symptoms that would be consistent with Ebola at this time,” Dr. Lakey told reporters.

Senior U.S. officials in Washington sought to tamp down fears that the virus could spread through the U.S., saying the public should be confident in the American health-care system.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, said that while Ebola has spread rapidly in Africa, the U.S. is better equipped to treat and isolate victims, and trace those who have come into contact with them.

“There were things that did not go the way they should have in Dallas,” he said, but added that the U.S. health-care infrastructure should “stop Ebola in its tracks.”

Dr. Fauci also said that an early study of an Ebola vaccine has been under way for more than a month, and that it could be tested in West African patients by early next year. The vaccine, he has said, would give officials a potent weapon to protect health-care workers and combat Ebola in areas where the disease is spreading.

White House officials said they weren’t considering a travel ban as part of a broader effort to contain Ebola, which has killed more than 3,000 people so far this year in West Africa. Lisa Monaco, assistant to the president for Homeland Security and Counterterrorism, said such steps would impede the response, slowing down the ability of U.S. and international partners to get expertise and equipment to affected areas.

“Every Ebola outbreak over the past 40 years has been stopped,” she said. “We know how to do this, and we will do it again.”

Although Mr. Duncan is the first person to become ill with Ebola in the U.S. this year, four other patients have been evacuated from West Africa and treated for the disease in the U.S. in recent months. On Friday, a fifth man, Ashoka Mukpo, an American freelance journalist diagnosed with Ebola, was set to be transported to the Nebraska Medical Center in Omaha for treatment on Sunday, said his father, Mitchell Levy. Two people have also been treated for Ebola in Germany, including a doctor who was working for a nongovernmental organization in West Africa and arrived in the country for treatment Friday.

U.S. and Texas officials admitted Friday that other Ebola cases could surface in Dallas, where officials were initially slow to diagnose Mr. Duncan’s case, contain several people who were exposed to him and remove potentially infected materials from the apartment where he was staying.

“There certainly is a possibility that some of the people who have already been in very close contact with this patient might develop Ebola,” said Beth Bell, director of the National Center for Emerging and Zoonotic Infectious Diseases.

Texas Health Presbyterian Hospital Dallas said it has determined that it failed to detain Mr. Duncan when he initially sought care there on the night of Sept. 25 because his travel history wasn’t relayed to doctors due to a records glitch.

Mr. Duncan told nurses he had been in Africa. But doctors didn’t receive that information because it wasn’t included in the portion of the electronic records they rely on. They prescribed Mr. Duncan antibiotics and told him to go home.

He was eventually admitted to Texas Health Presbyterian on Sunday, after returning to the hospital by ambulance when his symptoms worsened, and was diagnosed with Ebola on Tuesday. He remains at the hospital in an isolation ward and is in serious condition.

Five children who were in contact with Mr. Duncan attended public schools Monday and Tuesday, after he was admitted to the hospital with Ebola symptoms.

The students were advised to stay home. But on Friday, Dallas school officials said that one of the students failed to heed the advice on Wednesday and returned to Sam Tasby Middle School.

“We’re not sure why the Tasby student showed up for school on Wednesday, but once he was identified, he was asked to go to the nurse’s office so that a parent could be contacted,” said Jon Dahlander, a spokesman for the Dallas Independent School District.

At the Dallas apartment where Mr. Duncan was staying, his dirty sheets and clothes were lying in sealed bags Friday morning as a result of a lack of a state permit to transport hazardous materials on Texas roads.

Judge Clay Jenkins, the highest-ranking elected official in Dallas County, said Friday evening that a hazmat team was cleaning out the apartment and a vendor with the permit would move the materials in sealed containers to a final destination.

“This is a paperwork nightmare,” said Dallas Mayor Mike Rawlings.

Four people who had been ordered to stay inside the apartment because they had come into close contact with Mr. Duncan were moved to a house at an undisclosed Dallas location that officials secured through a faith-based group.

Judge Jenkins said he personally drove with the people to the home and “apologized to them” for their inconvenience, adding that he didn’t consider them a threat. “They were very glad to be gone,” he said.

Before leaving Liberia, Mr. Duncan said in a questionnaire filled out by all departing passengers that he hadn’t been in contact with any Ebola victims, the Associated Press reported.

That appears to contradict accounts from a neighbor in Liberia that before traveling to Texas via Belgium, Mr. Duncan had escorted a woman to a treatment ward in Liberia’s capital, Monrovia, where she was turned away and died of the virus within hours.

Since August, Liberia’s airport has screened more than 10,000 passengers for Ebola’s hallmark symptom, a fever, said Information Minister Lewis Brown. Security guards at the gate, the ticketing lobby and then the security checkpoint press an infrared thermometer inches from the temples of passengers, waving through ones who show a temperature less than 37.5 degrees Celsius. Feverish passengers are held back for further study, he said, though he couldn’t say how often that had occurred.

The process, medical experts say, can easily identify people who are already feeling the symptoms from Ebola. Liberian officials put the process in place too late to stop a Liberian-American, Patrick Sawyer, who flew while violently ill to Nigeria, where he infected the staff of a major hospital. Since then, there have been no reports of symptomatic and contagious individuals boarding international flights in West Africa.

Still, a temperature check can’t figure out who has Ebola lying dormant in their bloodstream. Even a blood test wouldn’t confirm the presence of the virus until several days after its symptoms flared up. By then, a simple thermometer could separate potential Ebola victims from the healthy.

So airports in West Africa, Liberia’s included, are reduced to using questionnaires to determine which passengers might pose a risk to their final destination. Airlines have tried to play their part, too. On West Africa’s Asky Airlines, flight attendants have begun reading a new line during their safety demonstration: “We invite all passengers suffering from headaches, nausea, vomiting, having diarrhea or abnormal bleeding, to let the crew know,” they say in English, then in French, according to a script provided by the airline.

The Centers for Disease Control and Prevention issued a new advisory for U.S. health-care workers to “increase vigilance” when questioning patients with fever or other Ebola-related symptoms who have traveled recently to West Africa. Anyone who has recently traveled to West Africa and is exhibiting symptoms should be isolated and state and local health officials should be contacted immediately, the CDC recommended Thursday.

However, the U.S. has no plans to change the way people traveling from Ebola-infected countries are screened before entering the U.S., a CDC spokesman said Friday.

U.S. airlines said they follow the protocols on dealing with diseases from the CDC, which has issued a lengthy memo titled “Ebola Guidance for Airlines” that covers items including infection-control precautions for sick travelers on board, cleaning the plane and disposing of potentially tainted material in the cabin.

Airlines are accustomed to dealing with contagious diseases, including the outbreak of Severe Acute Respiratory Syndrome, or SARS, in 2003, and the more recent Middle East Respiratory Syndrome, a virus first diagnosed in Saudi Arabia in 2012.

“We have processes and procedures well defined by the CDC, with whom we are in close contact,” said a spokeswoman for Airlines for America, a trade group of U.S. carriers.

Michael VanRooyen, vice chairman of emergency medicine at Brigham and Women’s Hospital in Boston and a professor at Harvard Medical School, said CDC officials haven’t been clear enough in their messaging to health-care workers about what to do if someone who has recently traveled to West Africa comes to their hospital or clinic with Ebola-like symptoms.

But he said that closing off air travel from West Africa would be the wrong approach.

“We have excellent resources here,” he said. “There is no reason for us to freak out.”

—Drew Hinshaw, Susan Carey, Jon Ostrower, Thomas M. Burtonand Cameron McWhirter contributed to this article.

Write to Ana Campoy at ana.campoy@wsj.com, Nathan Koppel at nathan.koppel@wsj.com and Cameron McWhirter at cameron.mcwhirter@wsj.com

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