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Ebola crisis: How did the virus get into the US? Ebola crisis: Could the virus spread in the US?
(about 17 hours later)
A Liberian man who was the first person to be diagnosed with the deadly Ebola virus in the US has died in hospital in Dallas. A nurse who was caring for him is also infected. How did the virus get to the US and will the country cope? A Liberian man who was the first person to be diagnosed with the deadly Ebola virus in the US has died in hospital in Dallas. Two nurses who cared for him are also infected. How did the virus get to the US and could it now spread?
The outbreak gripping West Africa is the world's worst, infecting nearly 9,000 people and killing more than 4,400.The outbreak gripping West Africa is the world's worst, infecting nearly 9,000 people and killing more than 4,400.
Thomas Eric Duncan travelled to the US from one of the worst affected countries, Liberia, and died a little after two weeks later.Thomas Eric Duncan travelled to the US from one of the worst affected countries, Liberia, and died a little after two weeks later.
How did he arrive undetected and what are the risks to Americans?How did he arrive undetected and what are the risks to Americans?
Who are the first US patients?Who are the first US patients?
Duncan, a Liberian national, tested positive in Dallas, Texas, on 30 September, 10 days after he arrived in the US to visit his former girlfriend and their 19-year-old son.Duncan, a Liberian national, tested positive in Dallas, Texas, on 30 September, 10 days after he arrived in the US to visit his former girlfriend and their 19-year-old son.
He worked as a driver for a courier service and lived in the Paynesville 72nd Community suburb of Monrovia.He worked as a driver for a courier service and lived in the Paynesville 72nd Community suburb of Monrovia.
Despite aggressive treatment in hospital, including an experimental drug, he succumbed to the virus on 8 October.Despite aggressive treatment in hospital, including an experimental drug, he succumbed to the virus on 8 October.
US officials announced on 12 October that a female health worker who had treated Duncan before he died was also infected, according to a preliminary test. Nurses Nina Pham, 26, and Amber Vinson, 29, became infected while caring for Duncan.
Nina Pham, 26, became infected during Duncan's second visit to hospital, when he was diagnosed with Ebola. Top US health official Tom Frieden originally said there had been a breach of protocol by health workers that led to the nurse becoming infected.
Top US health official Thomas Frieden originally said there had been a breach of protocol by health workers that led to the nurse becoming infected. However, nurses working at the hospital have said they were given little guidance and inadequate protective clothing to deal with the infection.
However, nurses working at the hospital later said they were given little guidance and inadequate protective clothing to deal with the infection.
Are these the first people in the US to have Ebola?Are these the first people in the US to have Ebola?
No, a small number of American aid workers who contracted the virus while abroad have recovered after flying back to the US for treatment. But Duncan and the health worker were the first diagnosed within the US.No, a small number of American aid workers who contracted the virus while abroad have recovered after flying back to the US for treatment. But Duncan and the health worker were the first diagnosed within the US.
Three of the aid workers were colleagues at the same hospital in Liberia. Kent Brantly and Nancy Writebol were flown back to Atlanta for treatment, while Rick Sacra, a family doctor from Massachusetts, recovered in Nebraska.Three of the aid workers were colleagues at the same hospital in Liberia. Kent Brantly and Nancy Writebol were flown back to Atlanta for treatment, while Rick Sacra, a family doctor from Massachusetts, recovered in Nebraska.
Another American to contract Ebola, NBC cameraman Ashoka Mukpo, was transported from Liberia and is being treated at the Nebraska Medical Center in Omaha.Another American to contract Ebola, NBC cameraman Ashoka Mukpo, was transported from Liberia and is being treated at the Nebraska Medical Center in Omaha.
A fourth American who has not been named has also recovered after being flown to Atlanta.A fourth American who has not been named has also recovered after being flown to Atlanta.
Do we know how Duncan was infected?Do we know how Duncan was infected?
It is believed he came into contact with Marthalene Williams, a young Ebola-infected woman in Liberia on 15 September, according to a report by the New York Times.It is believed he came into contact with Marthalene Williams, a young Ebola-infected woman in Liberia on 15 September, according to a report by the New York Times.
Duncan is said to have helped take her to hospital, but she was later turned away due to lack of space in the Ebola treatment ward. He helped to carry her home, where she died hours later.Duncan is said to have helped take her to hospital, but she was later turned away due to lack of space in the Ebola treatment ward. He helped to carry her home, where she died hours later.
Williams's brother, Sonny Boy, also later displayed symptoms of Ebola and died en route to a local hospital.Williams's brother, Sonny Boy, also later displayed symptoms of Ebola and died en route to a local hospital.
How did an infected person come into the US undetected?How did an infected person come into the US undetected?
Duncan was screened for Ebola symptoms at Roberts International Airport, located near the Liberian capital of Monrovia. He displayed no signs of the virus and was allowed to board an SN Brussels Airlines flight to Brussels, Belgium, then on to Washington Dulles and finally Dallas-Fort Worth.Duncan was screened for Ebola symptoms at Roberts International Airport, located near the Liberian capital of Monrovia. He displayed no signs of the virus and was allowed to board an SN Brussels Airlines flight to Brussels, Belgium, then on to Washington Dulles and finally Dallas-Fort Worth.
Binyah Kesselly, chairman of the board of the Liberia Airport Authority, said it would be "nearly impossible" to identify a person infected with the Ebola virus if the person were not showing symptoms.Binyah Kesselly, chairman of the board of the Liberia Airport Authority, said it would be "nearly impossible" to identify a person infected with the Ebola virus if the person were not showing symptoms.
Isolating affected countries is a move opposed by the US Centers for Disease Control and Prevention because, they say, it could make the epidemic worse by disrupting the flow of aid.Isolating affected countries is a move opposed by the US Centers for Disease Control and Prevention because, they say, it could make the epidemic worse by disrupting the flow of aid.
Are the passengers on Duncan's flight in danger?Are the passengers on Duncan's flight in danger?
The Centers for Disease Control and Prevention (CDC) do not plan to monitor passengers on Duncan's flights.The Centers for Disease Control and Prevention (CDC) do not plan to monitor passengers on Duncan's flights.
According to CDC Director Thomas Frieden, Mr Duncan was not considered infectious at that time and posed "zero risk of transmission" to those on the aircraft.According to CDC Director Thomas Frieden, Mr Duncan was not considered infectious at that time and posed "zero risk of transmission" to those on the aircraft.
How dangerous is Ebola anyway?How dangerous is Ebola anyway?
Ebola basics: What you need to knowEbola basics: What you need to know
Could it now spread in the US?Could it now spread in the US?
Dr Tom Frieden, head of the CDC, has warned that other cases could follow.Dr Tom Frieden, head of the CDC, has warned that other cases could follow.
He said that 48 people who may have had contact with Duncan were being monitored for symptoms as an investigation was conducted into how the new infection could have occurred. He said that 48 people who may have had contact with Duncan before he was diagnosed and isolated were being monitored for symptoms.
The one person possibly exposed to Ms Pham is also being monitored. Another 77 health workers, including the two infected nurses, have been potentially exposed to Duncan while he was in hospital.
However, health officials have expressed confidence they can contain the virus because basic sanitation levels are so different between America and Africa. A man who was possibly at risk from Ms Pham is being monitored. And the 132 passengers who shared an aeroplane with Ms Vinson from Cleveland to Dallas are being sought, although the risk is low.
Health officials have expressed confidence they can contain the virus because basic sanitation levels are so different between the US and Africa.
The hour after America knewThe hour after America knew
Should Duncan have been diagnosed earlier?Should Duncan have been diagnosed earlier?
Duncan sought medical attention at Texas Health Presbyterian Hospital on 25 September, where hospital officials said he displayed a low grade fever and abdominal pain. Basic blood tests were performed, but he was not screened for the Ebola virus.Duncan sought medical attention at Texas Health Presbyterian Hospital on 25 September, where hospital officials said he displayed a low grade fever and abdominal pain. Basic blood tests were performed, but he was not screened for the Ebola virus.
A nurse asked Duncan if he had travelled from Africa, and he said he had, but that detail was not fully communicated to the medical staff, an oversight the hospital now says was "regretful".A nurse asked Duncan if he had travelled from Africa, and he said he had, but that detail was not fully communicated to the medical staff, an oversight the hospital now says was "regretful".
Duncan was given antibiotics and a pain reliever and sent home, where his condition worsened, says his sister.Duncan was given antibiotics and a pain reliever and sent home, where his condition worsened, says his sister.
On 28 September, a friend of Duncan's contacted the CDC for advice, and was instructed to call the Texas Department of Health, who sent an ambulance.On 28 September, a friend of Duncan's contacted the CDC for advice, and was instructed to call the Texas Department of Health, who sent an ambulance.
Are US hospitals ready?Are US hospitals ready?
Dr Frieden, director of the US Centers for Disease Control and Prevention, admitted the CDC was slow to react to the first case in Texas but he announced a raft of new measures directed at the hospital in Dallas treating Ms Pham and also nationwide.Dr Frieden, director of the US Centers for Disease Control and Prevention, admitted the CDC was slow to react to the first case in Texas but he announced a raft of new measures directed at the hospital in Dallas treating Ms Pham and also nationwide.
Health workers across the US were "very distressed" that a nurse could have been infected, he said as he set out a new action plan:Health workers across the US were "very distressed" that a nurse could have been infected, he said as he set out a new action plan:
This plan was reaffirmed by President Obama on Wednesday, who cancelled two days of engagements to stay in Washington to monitor what he promises will be a more "aggressive" response.
Ebola patients treated outside West Africa*Ebola patients treated outside West Africa*