http://www.nytimes.com/2014/10/02/us/after-ebola-case-in-dallas-health-officials-seek-those-who-had-contact-with-patient.html?hp&action=click&pgtype=Homepage&version=HpSum&module=a-lede-package-region®ion=top-news&WT.nav=top-news&_r=0
-- Health officials in Dallas said Wednesday that they believed the man who is the first confirmed case of the Ebola virus in the country had come into contact with 12 to 18 people, including some schoolchildren, when he was experiencing symptoms.
Gov. Rick Perry of Texas, speaking at a news conference, said that health officials were monitoring some school-age children had contact with the patient.
So far, none has been confirmed to be infected, officials said.
Other people who came into contact with him include relatives and the medical technicians who took him by ambulance to the hospital. At least three Dallas Fire and Rescue emergency medical technicians were being monitored and were in isolation at home, according to officials.
Even the emergency vehicle that was used — Ambulance No. 37 — is in isolation and not in service.
The patient who has not been identified, is the first traveler known to have brought the virus to the United States on a passenger jetliner — he arrived on Sept. 20 — and he is the first to be given an Ebola diagnosis outside of Africa, where the disease has already killed thousands.
The man started showing symptoms on Sept. 24 and sought medical care at Texas Health Presbyterian Hospital of Dallas on Sept. 26, but was sent home, according to the federal Centers for Disease Control and Prevention. He returned to the hospital two days later in worse condition, and is now being treated in isolation.
While symptoms during the early stages of Ebola are similar to those of many illnesses, there were questions on Wednesday about whether the hospital erred in not taking a detailed patient history when the man first sought medical treatment.
"That's one of the things we'll be looking at," Dr. Thomas R. Frieden, the director of the federal disease centers, told CNN on Wednesday.
"But we're reiterating the message for every health worker in this country: think about travel history," Dr. Frieden said. "If someone's been in West Africa within 21 days and they've got a fever, immediately isolate them and get them tested for Ebola."
The man, who was visiting relatives in the United States, was not ill during the flight to America, health officials said at a news conference Tuesday. Indeed, he was screened before he boarded the flight and had no fever.
Because Ebola is not contagious until symptoms develop, there is "zero chance" that the patient infected anyone else on the flight, Dr. Frieden said. Ebola is spread only by direct contact with body fluids from someone who is ill.
Health officials are tracking down people who might have been exposed to the patient during the time he was infectious, and will monitoring them for symptoms every day for 21 days — the full incubation period of the disease. Most people develop symptoms within eight to 10 days.
Anyone who starts running a fever or having symptoms is isolated and tested for Ebola. If the test is positive, that person is kept in isolation and treated, and his or her contacts are then traced for 21 days. The process is repeated until there are no new cases.
Since the outbreak in West Africa, there have been more than 100 reports to the disease centers from local health departments concerned that a patient might have been exposed to the virus, according to officials. Roughly 14 of those cases led to blood tests to determine if the virus was present. The man in Dallas is the first one whose test came back positive.
Dr. Frieden declined to disclose flight information or to say whether the patient is an American citizen. He said the man was not a health worker, and officials had no idea how he had become infected.
The Dallas-Fort Worth region is among the state's most ethnically and racially diverse. There are an estimated 10,000 Liberians living in the four-county area known as North Texas that includes Dallas County. One active community group, the Liberian Community Association of Dallas-Fort Worth, was founded more than 30 years ago. It appeared that the man had been staying with relatives who lived near the hospital in the Fair Oaks section of Dallas.
"The C.D.C. is on the ground, and we are going individual by individual that he had contact with, making sure they are in the appropriate isolation," said Mayor Michael S. Rawlings of Dallas. "There is very little risk at this point for folks that just live in the general area."
Mr. Rawlings, Mr. Jenkins and other officials stressed that Ebola is not an airborne illness and is not spread through casual contact. It is often spread through direct contact with the bodily fluids of a sick person.
"Riding on an airplane with someone, or walking through the Walmart with them, does not expose you to the infection," Mr. Jenkins said. "We believe that we have this contained and we will not see it spread."
Still, many in the community were skeptical of the assurances of public health officials, especially as they hear ever more dire reports from relatives and friends back in Africa.
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