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Man in Dallas With Ebola Initially Sent Home With Antibiotics

Wednesday, 01 October 2014 08:27 AM

A man with Ebola in Dallas was initially sent home from the hospital with antibiotics after seeking treatment for an unknown illness, officials said.

The man, whose name wasn’t released, is the first case of the deadly viral infection to be diagnosed outside of Africa. He traveled from Liberia and arrived in the U.S. on Sept. 20, the Centers for Disease Control and Prevention said yesterday.

The man is being kept in isolation in an intensive care unit. He had no symptoms when he left Liberia and began to show signs of the disease on Sept. 24, the CDC said. He sought care on Sept. 26, was hospitalized two days later at Texas Health Presbyterian Hospital and is critically ill, said CDC Director Thomas Frieden. The agency is working to identify anybody who had contact with the man and track them down, he said.

“There is no doubt in my mind that we will stop it here,” Frieden said at a press conference in Atlanta.

A CDC team of epidemiologists will follow anyone who has had contact with the man for 21 days, Frieden said. If they develop any symptoms, they’ll immediately be isolated, and public health officials will trace their contacts. The diagnosis was first confirmed by a Texas lab based on samples of the man’s blood and confirmed by the CDC.

Ambulance Workers

The man was traveling to the U.S. to visit family and was staying with them. He was exposed to only a “handful” of people during the time when he had symptoms, including family members and possibly some community members, according to Frieden, who said there was little risk to anyone on his flight.

“Ebola doesn’t spread before someone gets sick, and he didn’t get sick until four days until after he got off the airplane,” Frieden said. “So we don’t believe there was any risk to anyone on the flight at that time.”

The patient wasn’t involved in helping contain the Ebola outbreak effort, according to Frieden, who declined to give further details on the man’s nationality or travels. CDC researchers said because Ebola is spread through human fluids, he had to have had close contact with someone in Liberia who had the disease or had recently died from it.

After the patient sought medical care on Sept. 26 and was sent home with antibiotics, he returned in an ambulance to Texas Health Presbyterian two days later and was admitted, said Edward Goodman, an epidemiologist at the hospital. The ambulance workers and other health-care professionals who treated him are being monitored for symptoms, Goodman said.

Obama Briefed

The CDC and Texas doctors are discussing the use of possible experimental treatments, Frieden said, though no decision has been made.

President Barack Obama was briefed about the patient by Frieden, the White House said in a statement. They discussed the patient’s treatment and what was being done to trace the people the man might have contacted.

U.S. authorities didn’t disclose the flights or airlines the patient took from Liberia. No airlines serve Africa from Dallas/Fort Worth International Airport, the main domestic and foreign gateway to North Texas, and none of the major U.S. carriers with overseas networks -- American Airlines Group Inc., United Continental Holdings Inc. and Delta Air Lines Inc. -- flies to Liberia. Delta dropped operations last month in Monrovia, the country’s capital.

Traveler’s Itinerary

That left open the possibility the traveler arrived in the U.S. from somewhere else in Africa or via a connection in Europe, and may have stopped elsewhere on a domestic flight before reaching Dallas.

Another suspected Ebola case is being evaluated at a National Institutes of Health facility, U.S. officials said, the 13th such possible infection in the U.S. All others have tested negative.

A traveler from Africa showing up in the U.S. with Ebola “is not at all surprising,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “We are going to see more cases show up around the world.”

Osterholm said that while it is possible the patient may have infected other family members or close contacts before he was diagnosed, it is unlikely there will be any more people infected with Ebola in the U.S. as a result of the case, thanks to good infection control procedures here.

West Africa

“There shouldn’t be any new infections from this point on,” Osterholm said. “We are going to shut this down.”

The Ebola outbreak has been concentrated in the West Africa countries of Liberia, Sierra Leone and Guinea. The outbreak has infected 6,574 and killed 3,091 people so far, according to the World Health Organization. U.S. public health officials have been isolating and testing travelers who returned from the region with symptoms of the disease.

“This incident shows the vast differences between our health system and what’s available in West Africa,” said Celine Gounder, an infectious disease doctor and a former assistant commissioner in the New York City Department of Mental Health and Hygiene. “The patient was isolated quickly. By isolating the contacts, we can eliminate risk of further spread.”

Ebola has left Africa before, but only under controlled conditions. Aid workers who have fallen ill in the current outbreak have been flown to the U.S., the U.K., Spain and France for treatment. A researcher who fell ill in 1994 in Ivory Coast was taken to Switzerland for care.

Developing Vaccines

At least three American aid workers who were diagnosed with Ebola in Africa during this outbreak were evacuated to U.S. hospitals, treated and discharged.

There is no approved treatment for Ebola, though drugmakers are attempting to develop vaccines or medicines that could be used in this or a future outbreak. Current care involves isolating the patient so they can’t infect others, and providing supportive treatment such as intravenous fluids and antibiotics to fight opportunistic infections.

U.S. health officials have downplayed the chance of a major outbreak of the disease in the U.S., saying the country’s superior medical infrastructure would be able to quickly isolate the disease.

“It’s not a potential of Ebola spreading widely in the U.S.,” Frieden said on a July 31 conference call with reporters. “That is not in the cards.”

U.S. and European governments have been criticized for being slow to respond to the situation in Africa, and much of fight against the outbreak has been conducted by missionary and charitable groups with personnel on the ground, including Doctors Without Borders, Samaritans Purse and SIM USA. The groups have said they are overwhelmed, don’t have enough beds to treat patients and the outbreak is rapidly growing out of control.

Troop Effort

The U.S. Department of Defense has authorized sending 1,400 troops to Liberia to help fight Ebola in Western Africa, where the virus has crippled existing medical infrastructure.

The troops will supervise the construction of Ebola treatment units, conduct site surveys and provide engineering expertise, John Kirby, a press secretary for the department said yesterday at a news briefing. Half of the troops will come from the 101st Airborne Division while the remaining 700 will come from different parts of the Army.

The pledge to send troops was part of the U.S. effort to contain the spread of Ebola virus, and governments and international aid groups are sending money and personnel to help fight help outbreak. Leaders in Sierra Leone, Liberia and Guinea urged the international community to do more to keep the epidemic, the worst in history, from killing their people and harming their economies.


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A man with Ebola in Dallas was initially sent home from the hospital with antibiotics after seeking treatment for an unknown illness, officials said. The man, whose name wasn't released, is the first case of the deadly viral infection to be diagnosed outside of Africa. He...
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2014-27-01
Wednesday, 01 October 2014 08:27 AM
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