U.S. Ebola Update: Family Members Told to Stay Home as Texas Checks 100 for Exposure

Yasmeen Scott stands by her five-year-old son Bishop, and daughter Akeelah, 8, before dropping them off at their school, Hotchkiss elementary. Photograph: Tony Gutierrez/AP
Yasmeen Scott stands by her five-year-old son Bishop, and daughter Akeelah, 8, before dropping them off at their school, Hotchkiss elementary. Photograph: Tony Gutierrez/AP

Tom Dart in Dallas and Lauren Gambino in New York, The Guardian, October 2, 2014

Health officials in Texas have ordered four “close” family members of the Dallas Ebola patient to remain home to prevent the possibility of the disease spreading, and raised the number of people who may have had contact with him to 100.

The four family members had been previously told not to leave their home, but an order was issued on Wednesday night to ensure compliance. The measure is precautionary as they are not showing symptoms at this time.

RELATED: Ebola Update: First U.S. Case Confirmed

“We have tried-and-true protocols to protect the public and stop the spread of this disease,” Dr David Lakey, the Texas health commissioner, said in a statement on Thursday. “This order gives us the ability to monitor the situation in the most meticulous way.”

On Wednesday, health officials estimated the number of people who came into contact with the patient, identified as Thomas Eric Duncan of Liberia, as being between 12 and 18, including five school-age children. State health officials said they was working from a list of 100 potential or possible contacts, although they expected the final number to be lower.

“Out of an abundance of caution, we’re starting with this very wide net, including people who have had even brief encounters with the patient or the patient’s home,” said Carrie Williams, a spokeswoman with the Texas department of state health services.

Out of an abundance of caution, we're starting with this very wide net, including people who have had even brief encounters with the patient

— DSHS Press Office (@TexasDSHS) October 2, 2014

Duncan was exposed to the disease days before traveling to the US in late September. The New York Times reported that while in Liberia, Duncan helped his landlords transport their pregnant daughter, who showed symptoms of the disease, to the hospital.

But there was not enough space at the Monrovia hospital’s Ebola treatment ward to care for the young woman, seven months pregnant and convulsing, and she was turned away. Duncan helped the young woman’s parents bring her home, and she died hours later. The bodies of Ebola victims remain highly infectious.

CNN interviewed a woman, believed to be Duncan’s girlfriend, at the Dallas home where he was staying, who said she had taken him to Texas Health Presbyterian hospital when he first became ill. Duncan told a nurse he had recently travelled from Liberia, but the information was not fully shared with medical colleagues who were assessing him, and he was sent home with a course of antibiotics.

CNN anchor Anderson Cooper said the woman reported being at work when Duncan’s condition worsened. When her daughter went to their apartment to bring Duncan tea, she found him convulsing and vomiting, and called an ambulance.

The woman said the sweaty sheets on which he slept were still on their bed. She had put towels into plastic bags, CNN reported. Despite having been visited officials from the Centers for Disease Control and Prevention (CDC), she was unclear what to do with the material.

Cooper said the pair appeared to have shared the same bed when Duncan was ill. “It’s not clear to me what kind of contact they had,” Cooper said, adding that the woman did not believe she had come into contact with any of his bodily fluids.

The woman, along with three other housemates, are under a strict order not to leave their apartment and not to receive visitors. Cooper said the woman is worried about other people’s perception of her and her family after this incident.

Dallas mayor Mike Rawlings told CNN that there are state and county officials as well as the CDC monitoring the apartment and its tenants under quarantine.

“We have locked this apartment down,” Rawlings said.

The mayor said that two-thirds of the people on their list of possible contacts may have interacted with Duncan at the hospital. The rest are people are those that he may have come into contact with at the apartment or elsewhere in Dallas.

He said Duncan is in the same condition as he was on Wednesday, which is “serious but stable”.

A letter sent by the principal of Tasby middle school students in Dallas on Wednesday informed parents that one of the five children who ”may have made contact” with Duncan was a student at the school. Similar letters were sent to parents at three other schools.

Ebola: We are working from a list of about 100 possible contacts and will soon have an official contact tracing number that will be lower.

— DSHS Press Office (@TexasDSHS) October 2, 2014

The letter sought to calm parents. “Individuals are not contagious until symptoms appear. Because of this, there is no imminent danger to your child.”

While there was a steady flow of students in red T-shirts arriving at Tasby on Thursday morning, some parents were of two minds about allowing their children to carry on as normal, and had not been reassured by the letters.

Several parents dropping off their children said that they were worried and considering pulling students out of classes. Some already have.

Brittany Morris was taking her six-year-old son, DaMarrius, to Jack Lowe Sr elementary school, which is not one of the affected schools but shares a campus with Tasby. She said that even as she approached the gates, she was debating with the boy’s father whether to let the first-grader enter.

“We’re questioning right now as we’re walking to school whether we should let him go,” the 25-year-old said. “They should have closed the school. How do we know they’re telling the truth about who they came into contact with?”

Without knowing details about Duncan’s movements while he was contagious but not isolated, Morris said she was fearful about walking freely around the neighbourhood and interacting with others. “We could have passed right by the guy. What grocery store did he go to? Things like that, I wonder,” she said.

Some parents reportedly turned up early on Wednesday afternoon to collect their children within minutes of learning about Duncan’s possible contact with pupils. Cecilia Jial, arriving on Thursday with her two children, said she considered keeping them at home, but noted that other children were still attending school. I’m a little bit scared, I’m not confident, I’m worried.”

Students leave Tasby middle school, where a fellow classmate who was in contact with a man diagnosed with the Ebola virus had been removed from school.
Students leave Tasby middle school, where a fellow classmate who was in contact with a man diagnosed with the Ebola virus had been removed from school. Photograph: Mike Stone/Reuters

The affected schools will receive additional custodial and health workers, as well as extra staff from the district’s translations and psychology departments, among others.

Myo Aye, a father, said he would try to speak with Tasby’s principal and teachers. “I have two children, I’m very worried,” he said. “Yesterday some parents pulled students out of school.”

A spokesman for the Dallas independent school district said it would not know how many children stayed home on Thursday until later in the morning.

Ebola has so far killed more than 3,000 people in West Africa since the outbreak began in March, according to the World Health Organisation.

Duncan flew from Monrovia to Dallas on 19 September, stopping over in Brussels and Washington DC before arriving in Texas on 20 September. He was checked for fever before boarding the plane, and did not show any symptoms of having the disease.

As Ebola is not transmittable until symptoms appear, health officials believe the passengers aboard Duncan’s flights from Liberia to Texas are not at risk.

Duncan did not begin to show symptoms until 24 September. Two days later he went to Texas Health Presbyterian hospital. Duncan told a nurse he had traveled from Liberia but the information was not relayed to other medical staff, who diagnosed him as suffering from a “low-grade common viral disease”, prescribed him antibiotics and let him leave.

Officials said Duncan had a fever and abdominal pain during his first ER visit, not the riskier symptoms of vomiting and diarrhea. Duncan was taken back to the same hospital by ambulance two days later. Witnesses said he was vomiting as he was taken into the ambulance.

Texas Health Presbyterian hospital is reviewing how the situation would have been handled if all staff had been aware of the man’s circumstances.

David Wright, the regional director of the US Centers for Medicare & Medicaid Services, would not say if the hospital was under investigation.

Wright told the Associated Press that federal investigators, if they were conducting an inquiry, would examine if a hospital complied with a “reasonable physician standard” in deciding whether to admit a patient with a potential medical emergency.

This article originally appeared on guardian.co.uk


This article was written by Tom Dart in Dallas and Lauren Gambino in New York from The Guardian and was legally licensed through the NewsCred publisher network.