Liberian national Thomas Eric Duncan died in an isolation ward of a
Dallas hospital, 11 days after being admitted on Sept. 28.
The case has stirred attention and concern that someone with Ebola
had been able to fly into the United States from Liberia, raising
the specter more passengers could arrive and spread the disease
outside of West Africa, where nearly 4,000 people have died in three
impoverished countries.
The White House said extra screening for fever will be carried out
for arriving passengers from West Africa. The screening will start
at New York's John F. Kennedy airport from the weekend, and later be
used at Newark Liberty, Washington Dulles, Chicago O'Hare and
Hartsfield-Jackson Atlanta.
Duncan's death prompted questions about the timeliness of his care.
The patient initially sought treatment two days before being
admitted, but was sent home with antibiotics.
"I trust a thorough examination will take place regarding all
aspects of his care," Duncan's fiancée, Louise Troh, wrote in a
statement. Troh, in quarantine, added, "I am now dealing with the
sorrow and anger that his son was not able to see him before he
died."
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Dr. Craig Smith, medical director for infectious disease at
University Hospital in Augusta, Georgia said Ebola, like any
disease, was easier to beat the sooner it was treated.
"I'm not surprised he unfortunately passed away," Smith said. "I
think two days would have made a big difference."
Duncan had been in critical condition and on a ventilator and kidney
dialysis at Texas Health Presbyterian Hospital. He was given an
experimental medication to try to keep him alive, starting Saturday,
six days after being admitted.
But Ebola experts also asked why Duncan received the experimental
drug brincidofovir, made by Chimerix Inc, which has not been tested
on humans or animals, rather than Tekmira Pharmaceuticals drug TKM-Ebola,
which has been tested on humans. TKM-Ebola was given to another U.S.
patient, Dr. Rick Sancra, who contracted Ebola while working in
Liberia and was cured.
“We know Dr. Sacra was pretty damn sick when he began treatment,”
said virologist Thomas Geisbert of the University of Texas Medical
Branch, who has done pioneering work on Ebola treatments. It
“potentially saved him."
NO SYMPTOMS
Duncan was able to fly to the United States from Liberia because he
did not have a fever when screened at the airport in the capital,
Monrovia, and filled out a questionnaire saying he had not been in
contact with anyone infected with Ebola.
Liberian officials have said Duncan lied on the questionnaire and
had been in contact with a pregnant woman who later died.
Duncan was not screened on arrival in the United States. Starting
this weekend, though, JFK airport will use a non-invasive device to
take the temperature of passengers, who also will fill out detailed
questionnaires created by the U.S. Centers for Disease Control and
Prevention (CDC).
Canada said on Wednesday it would step up airport screening of
people arriving from affected West African countries. Those who are
ill or say they have been in contact with a sick person will have
their temperature taken by a quarantine officer.
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Hospital spokesman Wendell Watson said in an emailed statement that
Duncan died at 7:51 a.m. The hospital said he was 45 years old.
About 48 people who had direct or indirect contact with Duncan since
he arrived on Sept. 20 are being monitored, but none have yet shown
any symptoms, according to health officials.
The CDC and other U.S. health officials say the chances of Ebola
spreading in the United States are very slim.
Texas Health Presbyterian said a man had been admitted on Wednesday
after reporting he had contact with Duncan and was exhibiting
symptoms. Other officials said he was a law enforcement officer who
had visited the apartment where Duncan had been staying, days after
the Liberian went to the hospital.
U.S. Centers for Disease Control and Prevention (CDC) Director Dr.
Thomas Frieden described the person as someone who "does not have
definite contact with Ebola or definite symptoms of Ebola."
The hospital has not released details on how it will handle Duncan's
body but said it will follow protocols from the CDC. Texas State
health authorities said Duncan's remains will be cremated. The
guidelines recommend careful preparation of the body before
movement, including enclosing it in two bags and disinfecting the
bags. The body can then be transported without the need for
protective gear for a driver or others who are near the body but
they are not to handle the remains before cremation.
The current Ebola outbreak, the worst on record, began in March. On
Wednesday, the World Health Organization updated its toll of the
disease. WHO said Ebola has killed 3,879 people out of 8,033 cases
by the end of Oct. 5. WHO says 41 people have been killed in an
unrelated outbreak in Democratic Republic of the Congo.
Ebola can take as long as three weeks before its victims show
symptoms, at which point the disease becomes contagious. Ebola,
which can cause fever, vomiting and diarrhea, spreads through
contact with bodily fluids such as blood or saliva.
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While several American patients have been flown to the United States
from West Africa for treatment, Duncan was the first person to start
showing symptoms on U.S. soil. A nurse in Spain who treated a priest
who worked in West Africa is also infected.
(Additional reporting by Patricia Zengerle and Roberta Rampton in
Washington, Marice Richter in Texas, Sharon Begley and Yasmeen
Abutaleb in New York, David Ljunggren in Ottawa; Writing by Richard
Valdmanis and Jon Herskovitz; Editing by Peter Henderson and Grant
McCool)
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