Ebola-infected passenger was sent home from ER


By Lauran Neergard and Paul J. Weber , AP

DALLAS–The airline passenger who brought Ebola into the U.S. initially went to a Dallas emergency room last week but was sent home, despite telling a nurse that he had been in disease-ravaged West Africa, the hospital said Wednesday in a disclosure that showed how easily an infection could be missed.

The decision by Texas Health Presbyterian Hospital to release the patient, who had recently arrived from Liberia, could have put others at risk of exposure to Ebola before the man went back to the ER a couple of days later, when his condition worsened.

A day after the diagnosis was confirmed, a nine-member team of federal health officials was tracking anyone who had close contact with him after he fell ill on Sept. 24. The group of 12 to 18 people included three members of the ambulance crew that took the man to the hospital and a handful of schoolchildren.

They will be checked every day for 21 days, the disease’s incubation period.

“That’s how we’re going to break the chain of transmission, and that’s where our focus has to be,” Dr. Tom Frieden, director of the Centers for Disease Control and Prevention (CDC), told The Associated Press Wednesday.

The CDC reminded the nation’s health care providers to ask patients with symptoms if they’ve traveled recently. The American College of Emergency Physicians planned to alert its members as well.

The patient explained to a nurse last Thursday that he was visiting the U.S. from Africa, but that information was not widely shared, said Dr. Mark Lester, who works for the hospital’s parent company.

“Regretfully, that information was not fully communicated” throughout the medical team, Lester said. Instead, the man was diagnosed with a low-risk infection and sent home.

He was prescribed antibiotics, according to his sister, Mai Wureh, who identified her brother, Thomas Eric Duncan, as the infected man in an interview with The Associated Press.

Duncan has been kept in isolation at the hospital since Sunday. He was listed in serious but stable condition.

Hospital epidemiologist Dr. Edward Goodman said the patient had a fever and abdominal pain during his first ER visit, not the riskier symptoms of vomiting and diarrhea.

But the diagnosis, and the hospital’s slip-up, highlighted the wider threat of Ebola, even in places far from West Africa.

“The scrutiny just needs to be higher now,” said Dr. Rade Vukmir, a spokesman for the American College of Emergency Physicians. Lack of Symptoms Ebola is believed to have sickened more than 7,100 people in West Africa and killed more than 3,300, according to the World Health Organization. Liberia is one of the three hardest-hit countries in the epidemic, along with Sierra Leone and Guinea.

In Texas, neither the ambulance crew nor the children showed any symptoms. They were restricted to home while their conditions are observed. It was not exactly clear how Duncan knew the children, but his sister said he had been visiting with family, including two nephews.

At an address listed for the family in Kannapolis, North Carolina, a man who identified himself as Duncan’s brother told reporters the family was “just stressed out.”

Ebola symptoms can include fever, muscle pain, vomiting and bleeding, and can appear as long as 21 days after exposure to the virus. The disease is not contagious until symptoms begin. It spreads only by close contact with a patient’s bodily fluids.

The man left Liberia on Sept. 19, flying from Brussels to Dulles Airport near Washington. He then boarded a flight for Dallas-Fort Worth, according to airlines, and arrived the next day to see relatives.