A man who took a commercial flight from Liberia that landed in Dallas on Sept. 20 has been found to have the Ebola virus, the Centers for Disease Control and Prevention reported on Tuesday. He is the first traveler to have brought the virus to the United States on a passenger plane and the first in whom Ebola has been diagnosed outside of Africa in the current outbreak. As the disease has swept across West Africa, many health experts said it would be only a matter of time before it reached the United States. Hospitals and health departments around the country have been preparing for it, and a number of false alarms have occurred. But this time, the case is real.
The man, who was visiting relatives in the United States, was not ill during the flight, health officials said at a news conference Tuesday evening. Indeed, he was screened before he boarded the flight and had no fever. Because Ebola is not contagious until symptoms develop, there is “zero chance” that the patient infected anyone else on the flight, said Dr. Thomas R. Frieden, director of the disease centers. Ebola is spread only by direct contact with body fluids from someone who is ill. The man who has been found to have Ebola showed no symptoms when he boarded his plane in Liberia.
A team from the C.D.C. is being dispatched to Dallas to help trace any contacts who may have been infected, including family members, health care workers and others with whom the patient spent time in Dallas. Health officials in Texas said they had already begun that process. Dr. Frieden said the family and community contacts were few, no more than a handful. But he said it was possible that family members who were with the man while he was ill would turn out to be infected.
Contact tracing involves identifying people who might have been exposed to the patient during the time he was infectious, and then monitoring them for symptoms every day for 21 days — the full incubation period of the disease. Most people develop symptoms within eight to 10 days of being exposed. Anyone who starts running a fever or having symptoms is then isolated and tested for Ebola. If the test is positive, that person is kept in isolation and treated, and his or her contacts are then traced for 21 days. The process is repeated until there are no new cases. Describing these methods as “tried and true,” Dr. Frieden said, “I have no doubt that we’ll stop this in its tracks in the U.S.”
Dr. Frieden declined to disclose flight information or to say whether the patient is an American citizen. He said the man was not a health worker, and officials had no idea how he had become infected. The man did not get sick until about Sept. 24, several days after he arrived. He is being treated at Texas Health Presbyterian Hospital in Dallas, and is critically ill, Dr. Frieden said. He said there was no reason to move the patient to another hospital, noting that any hospital in the United States capable of isolating patients for other infectious diseases could safely handle an Ebola case. Doctors and the patient’s family are discussing whether to try experimental treatments, Dr. Frieden said. The hospital’s epidemiologist, Dr. Edward Goodman, said: “We have had a plan in place for some time now for a patient presenting with possible Ebola. Ironically, we had a meeting the week before of all the stakeholders who might be involved. We were well prepared to care for this patient.”
Feeling ill, the man first sought medical help on Friday, and was treated and sent home. Ebola was not recognized. Officials did not say where that initial visit took place. Dr. Frieden said the early symptoms of Ebola, like fever and nausea, can easily be mistaken for other illnesses. But he added that public health experts have for months been urging doctors and nurses to take a travel history on anyone who shows up with such symptoms and to be on the alert for Ebola in anyone who has been to Guinea, Liberia or Sierra Leone.
With worsening symptoms, the man sought care again on Sunday, and was then admitted to the hospital in Dallas and placed in isolation. Blood samples arrived at the disease centers on Tuesday, and tested positive for Ebola. A state lab in Texas also tested samples, and got positive results.
Dr. Frieden briefed President Obama by telephone on Tuesday afternoon about the case, explaining what the White House described as the “stringent isolation protocols” being used to treat the patient and efforts to trace the patient’s contacts to mitigate the risk of the virus spreading.
Dr. Frieden told the president that the C.D.C. had been prepared for an Ebola case in the United States, according to an account of the call distributed by the White House, “and that we have the infrastructure in place to respond safely and effectively.”
The Obama administration was working to prevent a public panic over the case, using social media to describe how Ebola can — and cannot — be transmitted.
“You cannot get Ebola through the air, water or food in the U.S.,” the White House said on Tuesday night in a posting on its official Twitter account. “Ebola can only spread from contact with the blood or body fluids of a person or animal who is sick with or has died from the disease.”
Another official Twitter posting said, “America has the best doctors and public health infrastructure in the world, and we are prepared to respond to Ebola.”
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