A hazardous-materials crew on Friday decontaminated the Texas apartment where an Ebola patient stayed, while local Dallas officials said the 10 people deemed to have been at the highest risk of exposure to him are now under isolation while they are being closely monitored.
The decontamination team was to collect bed sheets, towels and a mattress used by the infected man before he was hospitalized, as well as a suitcase and other personal items belonging to Thomas Eric Duncan, officials said.
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Later in the day, the family of four who live in the apartment was placed in a Dallas County deputy's patrol car and driven away. Their destination was not known.
Neighbours stood on their balconies and watched the family's grim departure from behind a black tarp hung to shield their front door from view.
The residence where they will stay had been offered only a short time earlier. Until then, a search for shelter had come up short. The city had been refused by hotels, apartments and other providers.
"No one wants this family," said Sana Sayed, a Dallas city spokeswoman.
The cleaning crew planned to place the items in industrial barrels and take them to a storage facility, according to Dallas County Fire Marshal Robert De Los Santos.
Once the proper permits are issued, the materials were to be hauled away for permanent disposal, probably by incineration at a landfill.
The first Ebola diagnosis in the U.S. has raised concerns about whether the disease that has killed 3,400 people in West Africa could spread in the U.S. Federal health officials say they are confident they can keep it in check.
'What we're seeing in the U.S. is this full court press, absolute over-aggression to make sure nothing happens.' - Dr. Michael Gardam, director of infection prevention and control at University Health Network
"The U.S. is prepared to deal with this," said U.S. homeland security adviser Lisa Monaco. "This outbreak began in March this year. Since that time and since screening measures began, there have been tens of thousands of individuals travelling from affected regions.
"We are very confident we can stop this and other cases in their tracks," Monaco said, admitting the U.S. may see more cases in the future.
Elsewhere, NBC News reported that an American freelance cameraman working for the network in Liberia has tested positive for the virus and will be flown back to the United States, along with the rest of the news crew.
The family living in the apartment has been confined to their home under armed guard while public-health officials monitor them — part of an intense effort to contain the deadly disease before it can get a foothold in the United States.
"What we're seeing in the U.S. is this full court press, absolute over-aggression to make sure nothing happens. They will leave no stone unturned so that there is no way this is going to get away on them. If the same thing happened in Toronto, we'd do the same thing," Dr. Michael Gardam, director of infection prevention and control at the University Health Network in Toronto, told CBC.
Louise Troh, originally from Liberia, shares the apartment with her 13-year-old son and two nephews.
Judge Clay Jenkins, Dallas County's top administrative official, said he went to the apartment with two epidemiologists to apologize for the delay in removing the soiled items, which happened five days after Duncan was admitted to the hospital. He said officials are working to make sure the family is comfortable and to improve their accommodations.
"I am concerned for this family," he said. "I want to see this family treated the way I would want to see my own family treated."
About 50 monitored for exposure
The confinement order, which also bans visitors, was imposed after the family failed to comply with a request to stay home.
Also Friday, Texas health officials said they had narrowed the number of people they were monitoring from as many as 100 to about 50 who had some type of exposure to Duncan.
Texas Health Commissioner David Lakey said all 50 are meeting with health workers and having their temperatures taken daily. So far, none shows symptoms of the virus. Ten are considered to be at higher risk and are being monitored more closely.
"Inevitably they have been in close contact with this person," Gardam said of those considered high risk. "They may be people living in the same home. They may be using the same washroom. You would be directly exposed to their body secretions."
The virus that causes Ebola is not airborne and can only be spread through direct contact with the bodily fluids — blood, sweat, vomit, feces, urine, saliva or semen — of an infected person who is showing symptoms. Those fluids must also have an entry point.
For example, people might get infected by handling soiled clothing or bed sheets and then touching their mouth, or if they are not wearing gloves while doing those tasks and have a cut on their hand.
Troh's 35-year-old daughter lives a few blocks away in a small apartment with her partner and four children. The two families often visited each other's homes.
Health officials have told Youngor Jallah to keep her family at home. But unlike at her mother's apartment, there are no armed guards preventing them from leaving.
Now she is wracked with regret that she did not take greater precautions in her dealings with Duncan.
"I'm just doubting myself every minute," she said Friday in an interview with The Associated Press. "I'm trying to take my mind off it, but I can't do it."
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She is not kissing or hugging her children, ages 2, 4 and 6, or her partner's 11-year-old son, or sharing dishes with them.
The family is also getting by without electricity after a brief but violent hailstorm Thursday knocked out power.
CDC Director Tom Frieden dismissed suggestions that people travelling from West Africa should not be allowed into the U.S.
"The fact is that if we tried to seal the border, it would not work because people are allowed to travel," he told ABC's Good Morning America. "It would backfire because it would make it harder to stop the outbreak."
Electronic records flaw
Duncan arrived in Dallas on Sept. 20 and fell ill a few days later. After an initial visit to the emergency room at Texas Health Presbyterian Hospital, he was sent home, even though he told a nurse he had been in West Africa.
He returned to the hospital two days later, on Sunday, and has been kept in isolation ever since. He's listed in serious but stable condition.
In a statement issued late Thursday, Texas Health Presbyterian Hospital said it followed communicable disease protocols by asking Duncan if he had come into contact with anyone who was ill. He replied that he had not.
A flaw in the electronic health records systems led to separate physician and nursing workflows, meaning the travel history documented by nurses was not passed on to physicians, hospital spokesman Wendell Watson said. He said the system has been corrected.
"I take nothing lightly, but the system that is in place makes it very unlikely that we would have an outbreak," said Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases. "Even though there were missteps, there were good things that happened in Texas as well. The individual is isolated and the most important thing, contact tracing, is being done."