Story: New York Times
By MANNY FERNANDEZ
OCT. 8, 2014
DALLAS — Thomas Eric Duncan, 42, the patient with the first case of Ebola diagnosed in the United States and the Liberian man at the center of a widening public health scare, died in isolation at a hospital here on Wednesday, hospital authorities said.
Mr. Duncan died at 7:51 a.m. at Texas Health Presbyterian Hospital, more than a week after the virus was detected on Sept. 30. His condition had worsened in recent days to critical from serious as medical personnel worked to support his fluid and electrolyte levels, crucial to recovery in a disease that causes bleeding, vomiting and diarrhea. Mr. Duncan was also treated with an experimental antiviral drug, brincidofovir, after the Food and Drug Administration approved its use on an emergency basis.
Hours after the death, hospital officials said that a second patient had been admitted after reporting possible exposure to Ebola.
“Right now, there are more questions than answers about this case,” the hospital said. Two medical workers in protective suits could be seen helping a man walk into the hospital from an ambulance.
Health officials in Dallas said the man might have had contact with family members of Mr. Duncan‘s. Sgt. Chris Dyer, president of the Dallas County Sheriff’s Association, told a local NBC affiliate that the man was a sheriff’s deputy who had been in the apartment where Mr. Duncan stayed.
Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention, said that the man did not appear to have the virus. “We don’t have a concern for symptoms consistent with Ebola or definite contact,” Dr. Frieden said, but “he is being assessed.”
After Mr. Duncan arrived at the Dallas/Fort Worth International Airport on Sept. 20, he set off a chain of events that raised questions about health officials’ preparedness to detect and contain the deadly virus. His case spread fear and anxiety among those he encountered, however briefly, and turned the places, vehicles and items he touched into biohazardous sites that were decontaminated, dismantled, stored or, in some cases, incinerated.
State health officials said that they would follow C.D.C. guidelines in handling Mr. Duncan’s remains, sealing the body in two bags and disinfecting the bags. The sealed bags can be transported without the need for protective gear for those not directly handling the remains, officials said.
The body will be cremated — a process that will kill any virus in the body so the remains can be returned to the family. “We will continue to treat Mr. Duncan with dignity and respect,” said Dr. David Lakey, the commissioner of the Texas Department of State Health Services, “and we’re taking great care to make sure there is no additional risk that others could be infected.”
Local, state and federal officials have expressed confidence that they have been able to limit the spread of the disease in Dallas and said Wednesday that none of the people being monitored had shown any symptoms of the virus.
Officials are monitoring 48 people in the Dallas area, most of whom have not been quarantined but are instead staying home while they are under observation. Ten of those are considered high risk, including seven health care workers and three relatives and community members who had contact with Mr. Duncan. The other 38 are considered low risk, and include people who may or may not have had direct or indirect contact with Mr. Duncan.
The mayor of Dallas, Mike Rawlings, also offered some assurance to Dallas residents. “I remain confident in the abilities of our health care professionals and the medical advances here in the U.S.,” Mr. Rawlings said, “and reassure you we will stop the Ebola virus in its tracks from spreading into our community.”
Mr. Duncan’s death renewed the focus on the hospital’s handling of the case and why he was initially sent home after seeking treatment. Mr. Duncan first went to the emergency room at Texas Health Presbyterian Hospital feeling ill on Sept. 25, five days after arriving in Dallas. He was released by the hospital, which had failed to view him as a potential Ebola case for reasons that remain unclear. He returned there and was admitted Sept. 28 after his condition worsened.
Since then, the hospital’s release of information has been marked by contradictory statements. It apparently provided the C.D.C. and its own administrators with the wrong date for when Mr. Duncan first went to the hospital, originally saying that it was Sept. 26 but later clarifying that it was Sept. 25. One hospital statement continues to include the wrong date of Mr. Duncan’s diagnosis, which was confirmed on Sept. 30 but is noted as Sept. 29 in the statement.
In explaining why Mr. Duncan was initially sent home, the hospital said at first that there had been a flaw in the records system and suggested that while the nurses might have had access to the information about his travel history, the doctor who treated Mr. Duncan had not. But the hospital later retracted its claim that the records system was to blame, explaining that there was no flaw in the system and that the physician could indeed have viewed information about Mr. Duncan’s travels from Africa.
“I trust a thorough examination will take place regarding all aspects of his care,” Louise Troh, 54, the woman Mr. Duncan had traveled to Dallas to see, said in a statement released at Wilshire Baptist Church.
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