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October 03, 2014 01:00 AM

Those in danger of Ebola infection in Texas narrowed to 50

Steven Ross Johnson
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    A crew begins cleaning the apartment where Ebola patient Thomas Duncan stayed and where four people are confined under quarantine.

    Health officials have narrowed their hunt for possible additional cases of Ebola to 50 people from 100 identified as having direct or secondary contact with the Liberian man diagnosed with the disease in Dallas. Ten people are considered to be at “high risk.”

    Texas Department of State Health Services Commissioner Dr. David Lakey said on Friday no one on the list had developed symptoms associated with the virus, and that all of the people being monitored are receiving visits from public health personnel who check their body temperatures twice daily.

    “Most of those individuals are at low risk,” Lakey said.

    Meanwhile the four people who were in the apartment with the patient, identified in news reports as Thomas Eric Duncan, remained under quarantine Friday. Public health officials started cleaning the residence after days of delay while they obtained permits allowing crews to remove items that could be contaminated with the virus.

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    “I want to see them treated as I would want my own family treated,” said Dallas County Judge Clay Jenkins, the county's top elected official, adding that he visited the family Thursday night to personally apologize for the way the situation has been handled. “We are making efforts to make sure that their accommodations and their comfort improves.”

    Duncan is being treated at Texas Health Presbyterian Hospital Dallas, which said on Friday that he remained in serious condition. He arrived in the U.S. on Sept. 20 from Liberia to visit family members living in Texas. The New York Times has reported that four days before his trip he helped carry a pregnant woman near the capital city of Monrovia who was convulsing from the disease.

    Hospital officials have said a communication breakdown was responsible for clinicians releasing Duncan after he came to the emergency department on the evening of Sept. 25, only to be admitted and placed in isolation on Sept. 28 after his symptoms worsened.

    Texas Health Resources, the parent company of the hospital, issued a statement late Thursday providing new details regarding Duncan's initial visit to the emergency department.

    In it they state that Duncan, when asked, said he had not been in contact with anyone sick in Africa, and that a nurse did enter his travel information into the hospital's electronic health-record system but that separate workflows for doctors and nurses prevented physicians from seeing the information.

    “Protocols were followed by both the physician and the nurses,” the statement read. “However, we have identified a flaw in the way the physician and nursing portions of our electronic health records interacted in this specific case.”

    Duncan is the first positive diagnosis for Ebola made in the U.S. More than 6,500 people throughout Guinea, Liberia, Nigeria, Senegal and Sierra Leone have been infected since March, according to the World Health Organization, which has resulted in more than 3,000 deaths.

    Follow Steven Ross Johnson on Twitter: @MHsjohnson

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