Health officials say it’s likely more people will travel to the U.S. carrying Ebola. Georgetown University Medical Center infectious disease specialist Jesse L. Goodman:
I would expect that so long as there is such a widespread epidemic in Africa, that even with good screening at the airports, etc., it’s possible there will be additional cases. This is a global public health emergency, and I think this indicates that.
The man identified as the first Ebola patient in the U.S. was incubating the disease when he traveled from Liberia to Dallas on Sept. 19-20, but he showed no symptoms while he was traveling, so his fellow travelers are not at risk.
A Hazmat team from the private company Cleaning Guys arrives at the apartment where Duncan was staying. Louise Troh, her son Timothy Wayne, 13, nephew Oliver Smallwood, 21, and his friend Jeffrey Cole, are among 10 people legally ordered to stay inside. The team plans to dispose of bedsheets, a mattress, and clothes that Duncan brought from Liberia to prevent his bodily fluids from contacting other people in the apartment. Dallas County Fire Marshall Robert De Los Santos:
The family is in good spirits and they are being closely monitored. Our ultimate aim is to move those people out of this apartment but we don’t know when
A person who traveled to the U.S. from Nigeria is hospitalized at Howard University Hospital in Washington with possible Ebola symptoms. Hospital spokesperson:
We can confirm that a patient has been admitted to Howard University Hospital in stable condition, following travel to Nigeria and presenting with symptoms that could be associated with Ebola. In an abundance of caution, we have activated the appropriate infection control protocols, including isolating the patient. Our medical team continues to evaluate and monitor progress in close collaboration with the CDC and the Department of Health.
The hospital is unable to reveal more due to privacy reasons.
Mukpo’s father confirms that he will be transported to the isolation unit at the Nebraska Medical Center in Omaha on Sunday, the same facility where Rick Sacra was treated. His mother, Diana Mukpo:
[He is] very, very frightened, but his spirits are relatively good. We intend to go wherever he ends up.
The D.C. Department of Health says there are no confirmed Ebola cases in D.C. It is working with the CDC and Howard University Hospital to monitor ‘any patients displaying symptoms associated with the Ebola virus.’
An inmate at Cobb County Jail in Atlanta is being tested for the virus. The person was arrested for a DUI overnight and told officials he had recently traveled to Africa after he developed a fever while in custody.
Shady Grove Adventist Hospital in Rockville, Maryland, says a patient is in isolation with ‘flu-like symptoms and a travel history that matches criteria for possible Ebola.’ Lab results indicate the patient has another illness.
We are working closely with the Montgomery County Health Department and State Department of Health and Mental Hygiene (DHMH) as well as the CDC to manage this case and to ensure we continue to be prepared to care for patients with Ebola symptoms.
Initial Ebola tests of a prisoner at Cobb County Jail in Atlanta return negative. The area where the inmate was quarantined has been cleaned and the jail has lifted a ban on local agencies bringing in new inmates. Prison authorities are waiting for further test results, and the prisoner has been transfered to another medical facility.
The office of Dallas County DA Craig Watkins is considering state charges of aggravated assault against Duncan:
We’re dealing with the issue that he may have knowingly exposed individuals in Dallas County to the Ebola virus. We’ve prosecuted individuals, for knowingly exposing individuals to HIV – which is aggravated assault.
Liberia requires journalists to obtain official permission to cover many aspects of the outbreak under new rules aimed at protecting patient privacy. Journalists can be arrested and prosecuted if they fail to get written permission from the health ministry before contacting Ebola patients, conducting interviews or filming or photographing healthcare facilities. Tolbert Nyenswah, assistant minister of health and head of Liberia’s Ebola Incident Management System:
We have noted with great concern that photographs have been taken in treatment centers while patients are going in to be attended by doctors. That is invasion of the dignity, privacy and respect of patients. Ebola patients are no different from any other patients. We should do that (report) under permission so that we don’t just take pictures or send out stories of naked people (in a way) that does not respect their privacy.
62 doctors and 103 nurses from Cuba arrive in Sierra Leone after more than two weeks of training with international experts at a Havana hospital specializing in tropical diseases. Another 296 Cuban doctors and nurses will go to Liberia and Guinea after training. Deputy Health Minister Madina Rahman:
We have 165 medical officers, qualified health professionals that are here to help us in the fight against Ebola. As we know we need as much healthcare and professionals as possible. This will make a dent in the fight, we need more if we can get more
NBC says 33-year-old American freelance cameraman Ashoka Mukpo has contracted a ‘low amount’ of the virus and is quarantined in Liberia and will be flown back to the U.S. Mukpo had been on assignment in Monrovia with Chief Medical Editor and Correspondent Dr. Nancy Snyderman and three other NBC News employees. His prognosis is good. Staff note from NBC News President Deborah Turness:
We are doing everything we can to get him the best care possible. He will be flown back to the United States for treatment at a medical center that is equipped to handle Ebola patients. We are also taking all possible measures to protect our employees and the general public.
The rest of the crew, including Dr. Snyder, are ‘being closely monitored and show no symptoms or warning signs’ but will be flown to the U.S. and quarantined for 21 days.
Mukpo’s mother, Diana, says his virus is in the ‘early stages’ and she is optimistic he will be cured.
At one point he was trying to help decontaminate a car. He had most of the protective gear on, but he thinks something might have splashed on his body at that point. That’s one possibility, but really, one doesn’t know fully.
Hospitals around the U.S. have reported 100 cases of Ebola-like symptoms since July. A CDC official says many hospitals remain unsure about how they are supposed to react when a suspected patient shows up. Atlanta’s Emory University Hospital, which has treated several Ebola patients from West Africa, has provided information and advice to hospitals, many of which are struggling with a lack of awareness about safety protocols and fear among some workers who feel ill-prepared. Washington-area health officials say they are trying to identify gaps in preparedness plans.
Five schools in Dallas are set to install Wello Inc.-made WelloStation temperature monitoring devices to detect fluctuations in students’s body temperatures. Wello Inc.:
The WelloStation measures your body’s core temperature using a patented, non-contact and non-invasive process. An elevated body temperature is the number one indicator of infection. WelloStation quickly screens for fevered individuals so you can either prevent them from entering or perform additional medical checks.
Chicago-based LifeSecure supply shop owner David Scott says he has shipped about 50 Extended Infection Protection kits worth $149.95 packages in the last two weeks with sales spiking in the three days since Duncan was diagnosed with Ebola. The kits include respirators, eye protection, gloves and biohazard bags. Scott:
People don’t tend to think about these things until they’re in the headlines, then they panic-buy.
Sales of $124.89 disposable DuPont Co. (DD) Tyvek suits surged 233% in 24 hours to 2:19 p.m. New York time on Amazon.com and DuPont, based in Wilmington, Delaware, says it has tripled production of some items used for Ebola protection and has
worked hard to shift products geographically and made a available a broader range of styles suitable for various treatment levels.
Sales of 3M Co.’s (MMM) particulate respirators, starting at $22, were up 4,004% according to Amazon’s data. Soap.com, a site owned by Amazon, said hand sanitizer sales jumped 20% this week.
CDC Director Frieden says a travel ban would make it harder to get supplies to west Africa. African Union aid workers experienced difficulty getting aid to Liberia:
Their ability to get there was delayed by about a week because their flight was canceled and they were stuck in a neighboring country
CDC officials walk a man believed to be traveling from Liberia off United flight 998 at Newark after he falls ill. A source says the man had been vomiting. He is quarantined with his daughter, who appears to be about 10, at University Hospital.
Duncan has worsened and is in critical condition, Texas Health Presbyterian says. The hospital doesn’t provide other details.
International aid workers recruit survivors to give courses to medical workers. Shevan Jacob, a WHO trainer who worked on previous Ebola outbreaks in Uganda and the DR Congo:
We tell the health workers that our role here is to protect and save lives … Many are afraid, they all have lost colleagues to the disease
Training takes two weeks including three days of theory classes, two days in a mock ETU, and working for five days in a real unit with a mentor.
A Spanish nurse is reported to be the first person contract the virus outside Africa. Health Minister Ana Mato says the woman treated Viejo at a Madrid hospital before he died of the virus. The woman went to the Alorcon hospital in the Madrid suburbs with a fever and was placed in isolation. The infection is confirmed by two tests and she was admitted Sunday. The fever was her only symptom. Madrid director of primary health care Antonio Alemany says authorities are drawing up a list of people she had contact with.
CDC Director Tom Frieden, who is unofficially leading the U.S. response to Ebola says the virus becoming airborne is a possible but unlikely outcome in the current epidemic:
The rate of change [with Ebola] is slower than most viruses, and most viruses don’t change how they spread. That is not to say it’s impossible that it could change [to become airborne]. That would be the worst-case scenario. We would know that by looking at … what is happening in Africa. That is why we have scientists from the CDC on the ground tracking that.
The disease kills roughly half the people it infects, and lacking a vaccine or cure, its traceable chain of transmission through bodily fluids is one reason officials believe they can contain it.
WHO European director Zsuzsanna Jakab says that while more cases will spread in Europe, the continent should be well prepared to control the disease.
Such imported cases and similar events as have happened in Spain will happen also in the future, most likely. It is quite unavoidable … that such incidents will happen in the future because of the extensive travel both from Europe to the affected countries and the other way around. The most important thing in our view is that Europe is still at low risk and that the western part of the European region particularly is the best prepared in the world to respond to viral haemorrhagic fevers including Ebola.
Monnig, a sheriff’s deputy who served a quarantine order to the apartment where Thomas Eric Duncan was staying, is being examined at Texas Health Presbyterian Hospital for possible exposure to Ebola. Monnig, although not in direct contact with Duncan, exhibits symptoms and history that warrant testing. Dallas County Sheriff’s Office:
The deputy expressed concern and we directed that deputy to the Dallas County Health & Human Services for care. We now wait for further information as medical staff attends to the deputy.
Duncan is pronounced dead at 7:51 a.m. at Texas Health Presbyterian Hospital Dallas, where he was admitted Sept. 28 and has been kept in isolation. Texas officials are monitoring 10 people who had direct contact with him while he was symptomatic, as well as 38 others who may have had contact. None have shown symptoms of the disease to this point. They will be monitored for 21 days, the normal incubation period for the disease. Hospital:
Mr. Duncan succumbed to an insidious disease, Ebola. He fought courageously in this battle. Our professionals, the doctors and nurses in the unit, as well as the entire Texas Health Presbyterian Hospital Dallas community, are also grieving his passing. We have offered the family our support and condolences at this difficult time.
Africa Command commander Gen. David Rodriguez tells a Pentagon briefing that U.S. personnel will handle lab samples from Ebola patients. The majority of the 3,000-4,000 personnel deployed will not have direct contact with patients.
The health and safety of the team supporting this mission is our priority.
Rodriguez had previously said some U.S. personnel would have direct contact with patients, but later clarified the remark.
Excalibur is taken from the Madrid apartment where Teresa Romero and her husband live, sedated, euthanized, and incinerated. Protesters tried to stop the dog being taken away in a van, but police with batons cleared a path. A petition to save the dog received nearly 350,000 signatures on change.org.
A Dallas County sheriff’s deputy is possibly infected with the Ebola virus. Deputy Monnig had spent time in the apartment of the late Ebola patient Thomas Eric Duncan, although he did not have direct contact with him. His son thinks that the symptoms are not related to Ebola, and that his father will therefore not test positive for the virus:
He was in the apartment for 30 minutes, which we were told is no chance to contact the virus
A federal Customs and Border Protection agent who works on the front lines at Newark International says customs officers at the tri-state air hub don’t have proper training and equipment to handle potential Ebola cases. He says that there are no doctors or CDC personnel assigned to the airport.
They are assuring the public everything is being done, but it is not
Federal officials announce that temperature screening of passengers arriving from Liberia, Sierra Leone and Guinea will start at New York’s Kennedy International as early as this weekend, and at Washington Dulles International, O’Hare International, Hartsfield-Jackson International and Newark Liberty International next week. About 90% of passengers from the three countries arrive via these five airports, with 43% flying via Kennedy alone. Of 36,000 passengers who left the three countries in the past two months, about a quarter came to the U.S., and 77 had Ebola-like symptoms but none had the virus.
Health officials say the number of people expected to contract the virus from each person who has already contracted it – the ‘reproduction number’ – is currently at epidemic levels of 1.5-2, and the outbreak won’t decline until it falls below one. CDC Director Frieden:
The speed at which things are moving on the ground, it’s hard for people to get their minds around. People don’t understand the concept of exponential growth
WHO assistant director general Bruce Aylward describes the situation in west Africa:
The situation is worse than it was 12 days ago. It’s entrenched in the capitals. Seventy percent of the people [who become infected] are definitely dying from this disease, and it is accelerating in almost all settings
Obama appears to contradict CDC advice in a video message to residents of west Africa:
You cannot get it through casual contact like sitting next to someone on a bus.
CDC advice to travelers to west Africa worried about Ebola:
Limit your contact with other people when you travel to the doctor; avoid public transportation.
Turnout for the Red River Showdown college football weekend in Dallas may be being affected by the news that Duncan contracted the virus. Jay Khan, General Manager of RJ Mexican Cuisine:
The buzz is definitely different. The West End is still going to have a lot going on… but, the decorations and the preparations that we usually do? It’s definitely not there this year. I think [Ebola] is affecting it. No doubt about that.
Another explanation is that both the University of Texas and University of Oklahoma college teams are coming off losing seasons and there is no championship at stake.
Officials in hazmat suits board U.S. Airways passenger flight 85 out of Philadelphia on landing in the Dominican Republic, after a passenger apparently joked about having the virus. A passenger who recorded the incident:
Once we landed in Punta Cana we were told by the flight attendants that there was a situation and that a passenger may have been in Africa and had Ebola. She was certain it was a hoax but they did not take any chances and had a full hazmat crew board the plane and take the passenger off. It was later confirmed that the passenger was never in Africa and after 2hrs we were finally able to get off the plane.
CDC Director Frieden tells a forum in Washington that includes the heads of the UN, World Bank, and IMF, that the spread of the virus is unseen since the AIDS epidemic:
I would say that in the 30 years I’ve been working in public health, the only thing like this has been AIDS … We have to work now so that it is not the world’s next AIDS.
An additional 100 U.S. Marines arrive in Monrovia on four MV-22 Ospreys and two KC-130s, increasing the number of American troops in Liberia to just over 300. Sierra Leone President Ernest Bai Koroma:
Our people are dying
Liberian lawmakers are debating whether to grant Sirleaf wider powers to restrict movement and public gatherings. A proposal would give authorities to seize property ‘without payment of any kind or any further judicial process’ to combat Ebola and allow Sirleaf to ‘limit the right to assembly for any reason.’
The UK introduces enhanced screening measures at Heathrow, Gatwick and Eurostar terminals for passengers arriving from Liberia, Guinea and Sierra Leone. Cameron:
Quite rightly, we’re taking all the steps we can to keep our own people safe here in the UK. What we do is we listen to the medical advice and we act on that advice and that’s why we’re introducing the screening processes at the appropriate ports and airports.
There are no direct flights to the UK from the affected areas but people can fly via Paris or Brussels.
UN special envoy on Ebola David Nabarro tells the General Assembly that the number of cases is probably doubling every three to four weeks, and the response needs to be 20 times greater. He says that without a mass global mobilization:
the world will have to live with the Ebola virus forever
Farrakhan claims the virus is a ‘race-targeting bioweapon’ created by the U.S. government:
There is a weapon that can be put in a room where there are Black and White people, and it will kill only the Black and spare the White, because it is a genotype weapon that is designed for your genes, for your race, for your kind … So, if you are poor and ignorant; if you are Black or Brown, you are being selected for destruction.
The British national who died in Macedonia may have had alcohol poisoning, not Ebola. Unnamed official:
We have serious indications from several places that he consumed large amounts of alcohol, so the theory that this might be the cause of death is very much in play.
The UN body says practices like rubbing a patient’s body with limes and onions or drinking saltwater are ineffective against the virus, and warns against fake vaccines and cures.
Decades of scientific research have failed to find a curative or preventive agent of proven safety and effectiveness in humans, though a number of promising products are currently under development. All rumours of any other effective products or practices are false. Their use can be dangerous. In Nigeria, for example, at least two people have died after drinking salt water, rumoured to be protective.
Dr. Aileen Marty talks to Jorge Ramos of Fusion after returning from a 31-day WHO mission to Nigeria, and says no checks were performed at Miami International Airport:
I get to the kiosk…mark the fact that I’ve been in Nigeria and nobody cares, nobody stopped me
She says this highlights a lack of preparation to handle travelers from Ebola-affected areas:
If we don’t change our entry method and this outbreak continues to get completely out of control…it’s likely to be seen in other countries.
The WHO warns that Ivory Coast, Guinea-Bissau, Mali and Senegal top a list of 13 countries urged to be prepared for Ebola cases. Other countries the agency is concerned may get Ebola cases are Benin, Cameroon, Central African Republic, Democratic Republic of the Congo, Gambia, Ghana, Mauritania, Nigeria and Togo. Daouda Coulibaly, head of the epidemiological monitoring service at the Ivory Coast’s National Institute of Public Health:
We are extremely at risk given the fact we share borders with two countries heavily affected
Mayor Bill de Blasio puts New York City on alert but says authorities have clear protocols to handle any potential Ebola cases.
There has not been a case in New York City. There is no cause for alarm… The city is particularly well prepared for any possible instance of Ebola because of our extraordinary health care system. Physicians, hospitals, emergency medical personnel are trained in how to identify this disease and how to quickly isolate anyone who may be afflicted.
Scientific American says that the outbreak highlights problems with procedures, equipment and training worldwide. It notes a Guardian report that the doctor who attended Spanish nurse Teresa Romero Ramos complained his hazmat suit’s sleeves were too short, while Romero herself told Spanish media she may have contracted the virus by accidentally touching her face with a gloved hand as she removed her protective gear. It says the cleanup team at Thomas Eric Duncan’s apartment wore full-face respirators and Level B Saranac suits. Cleaning Guys vice president Brad Smith:
We followed the recommendations of the [U.S. Centers for Disease Control and Prevention] but went one level above that as far as personal protective equipment
European countries are monitoring dozens of patients amid fears the outbreak could spread. 35 people in Macedonia have been placed in isolation after a British man died there and his friend was hospitalized. Lab samples are being tested in Frankfurt to determine if they had Ebola. In Prague, a Czech man is being tested for Ebola while in Spain, seven people turned themselves in voluntarily to an isolation unit, while six other people who had contact with nurse Teresa Romero are already being monitored. Romero’s condition remains serious but stable.
A 14-year-old boy from Colorado visiting Brooklyn is reported to have been placed in isolation at Brookdale University Hospital and Medical Center and treated according to Ebola protocols, after showing flu-like symptoms. The patient said that he had recently returned from a trip to Sudan, and reportedly lied to authorities so he could fly home. An official with the city’s Department of Health and Mental Hygiene tells 1010 WINS there are no patients currently suspected of having Ebola in New York City. WCBS 880 reports that New York City health officials also confirm he tested negative for Ebola. The boy’s uncle says the family did not think he had Ebola but sent him to hospital after he felt dizzy:
These are regular procedures that the officials needed to take just to make sure everything’s OK. I’m perfectly OK with it
New York’s John F. Kennedy International Airport starts screening arriving passengers for the virus. The CDC has stated that not every incoming passenger will be screened. In fact, only about 150 people per day will be screened. The country of origin will be a factor in deciding whether or not a passenger will receive further attention. The CDC admits that even with these measures, it will not be impossible to prevent the virus from entering the United States:
No matter how many of these procedures are put into place, we can’t get the risk to zero.
John F. Kennedy International Airport begins Ebola screening. Inspectors will use special procedures to screen people traveling from Liberia, Sierra Leone or Guinea. CDC:
Our hope is that the screening will improve vigilance and increase awareness about the Ebola disease for those individuals traveling from the affected areas.