The Ebola victim who sparked fears that a historic outbreak of the disease could spread globally was an American citizen, it was revealed last night.

Patrick Sawyer died this week after becoming noticeably ill on a flight from Liberia in West Africa, where the worst ever outbreak of Ebola is gathering pace, to the city of Lagos in Nigeria.

His case sparked alarm across the globe because he was able to board an international flight while carrying the incurable disease – potentially infecting other passengers who could fly across the world in a nightmare scenario for health experts.

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Bereaved: Decontee Sawyer, with her husband, Patrick, on their wedding day in 2008. Patrick was planning to come back to America in August for two of his girls' birthdays

Patrick Sawyer, 40, was planning to return home to Coon Rapids, Minnesota, to be reunited with his children for two of his daughters' birthdays in August.

But his death in Lagos, Africa's most populous city, has health workers scrambling to trace those who may have been exposed to him across West Africa, including flight attendants and fellow passengers.

His devastated wife, Decontee Sawyer, 34, shudders when she thinks how close Sawyer came to returning home to the States for his daughters' birthdays carrying the dreaded virus.



'It's a global problem because Patrick could've easily come home with Ebola,' Decontee said to KSTP. 'Easy. Easy. It's close, it's at our front door. It knocked down my front door.'

On the way home: Patrick Sawyer with his wife Decontee - the couple were expecting to be reunited next month for two of their daughters' birthdays

The risk of travelers contracting Ebola is considered low because it requires direct contact with bodily fluids or secretions such as urine, blood, sweat or saliva, experts say. Ebola can't be spread like flu through casual contact or breathing in the same air.

Patients are contagious only once the disease has progressed to the point they show symptoms, according to the WHO. And the most vulnerable are health care workers and relatives who come in much closer contact with the sick.



Still, witnesses say Sawyer, a 40-year-old Liberian Finance Ministry employee en route to a conference in Nigeria, was vomiting and had diarrhea aboard at least one of his flights with some 50 other passengers aboard. Ebola can be contracted from traces of feces or vomit, experts say.



Sawyer was immediately quarantined upon arrival in Lagos - a city of 21 million people - and Nigerian authorities say his fellow travelers were advised of Ebola's symptoms and then were allowed to leave. The incubation period can be as long as 21 days, meaning anyone infected may not fall ill for several weeks.



Health officials rely on 'contact tracing' - locating anyone who may have been exposed, and then anyone who may have come into contact with that person.



That may prove impossible, given that other passengers journeyed on to dozens of other cities.



Loss: Patrick Sawyer with one of his daughter's at home in Coon Rapids, Minnesota, before he began to commute internationally between the United States and Liberia for work

Global worries: The death of Patrick Sawyer after an international flight between Liberia and Nigeria has sparked fears that he could have unwittingly spread the Ebola virus

Sawyer, who worked for the Liberian Finance Ministry married his wife Decontee in December 2008, in Coon Rapids.



The couple, who both hold US citizenship are originally from Liberia and Decontee arrived in the country with her family in 1991 and Patrick came in the early 2000s.

The couple are part of the large Liberian community in Minnesota, who moved there in the aftermath of the nation's two civil wars in the 1980s and late 1990s.



His job had taken him back to West Africa to promote economic development there and he was last in the United States in September said Decontee to the Pioneer Press.



His long absences away from home had become common and before he boarded the plane to Lagos last week he had been caring for a sister who was ill with what was revealed to be Ebola, although according to Decontee, he and his family did not know that at the time.



Cautious: Dr Brantly of Samaritan's Purse relief organization is shown wearing protective clothing as he works with Ebola patients in Liberia. Brantly, who is an American doctor is now also being treated after somehow becoming infected with the virus

Surrounded by death: Liberian health workers in protective gear on the way to bury a woman who died of the Ebola virus from the isolation unit in Foya, Lofa County, Liberia

Decontee learned he was ill with Ebola on Thursday and then on Friday she was told her husband of six years had passed away from the virus.



Distraught, Decontee said that she had come forward to share her husband's fate so that the public can understand how quickly the virus can spread.



'Patrick was coming here. What if he still wasn't displaying symptoms yet and came?' Sawyer asked, according to the Pioneer Press.



'He could have brought Ebola here. Someone else could bring Ebola here.'

Health experts say it is unlikely Sawyer could have infected others with the virus that can cause victims to bleed from the eyes, mouth and ears.



Still, unsettling questions remain such as how could a man whose sister recently died from Ebola manage to board a plane leaving the country?



Taking care: Medical staff working with Medecins sans Frontieres prepare to bring food to patients kept in an isolation area at the MSF Ebola treatment centre in Kailahun in Sierra Leone

Caution: Sierra Leone now has the highest number of Ebola cases, at 454. The outbreak started in Guinea

U.S. health authorities have warned the deadly virus can spread 'like a forest fire'.

Stephan Monroe of the Centers for Disease Control and Prevention said yesterday that 'Ebola poses little risk to the general U.S. population.'

However, he told AFP: 'The concern is that the outbreak can be reseeded, much like a forest fire with sparks from one tree. That is clearly what happened in Liberia.'

Sawyer's death on Friday has led to tighter screening of airline passengers in West Africa, where an unprecedented outbreak that emerged in March has killed more than 670 people in Guinea, Sierra Leone and Liberia.



But some health authorities expressed little confidence in such precautions.

Map of West Africa showing areas that have confirmed and suspected cases of the deadly ebola virus; includes chart showing previous ebola virus outbreaks. Most border crossings in Liberia have been closed to try and halt the deadly virus

EBOLA: DEADLY, CONTAGIOUS AND INCURABLE - COULD IT LEAVE AFRICA? An Ebola virus virion The current outbreak of Ebola has spread to at least four countries in West Africa since the start of the year. So far, it has claimed 672 victims, and infected 1,093. Countries affected include Liberia, Guinea, Sierra Leone, and Nigeria.

The disease spreads through contact with blood, body fluids or contact with tissue from infected people or animals. It has only a 10 per cent survival rate. U.S. health authorities have warned the deadly virus can spread 'like a forest fire'. Civil servant Patrick Sawyer collapsed at Lagos airport in Nigeria on July 20 after flying in from Liberia, where he had attended the funeral of his sister, who had also succumbed to the disease.

His plane also landed in Togo on its way to Nigeria, prompting fears that the virus may have also reached a fifth country.

Nigeria, Guinea, Liberia and Sierra Leone are now screening air passengers – but doctors say this may not be effective because Ebola has an incubation period of two to 21 days and cannot be diagnosed on the spot.

Symptoms include high fever, bleeding and damage to the nervous system. There is no vaccine or cure. It is spread by contact with infected blood or other bodily fluids.

All outbreaks since 1976 when Ebola was first identified have been in Africa, with the previous highest death toll being 280.

Unprecedented: The outbreak has spread to Guinea, Sierra Leone, Liberia and has now killed a man in far more densely populated Nigeria. The outbreak is the deadliest ever of the terrifying disease as the death toll crept past 700

'The best thing would be if people did not travel when they were sick, but the problem is people won't say when they're sick. They will lie in order to travel, so it is doubtful travel recommendations would have a big impact,' said Dr. David Heymann, professor of infectious diseases at the London School of Hygiene and Tropical Medicine.

Back home in Minnesota, Decontee is reeling from the news that her husband has passed away.

'I have three daughters who will never get to know their father,' Decontee Sawyer said in an interview with the Pioneer Press.

Recalling her husband, Decontee said told Kare11 he was 'larger than life' and that she is stills shocked that someone so strong could have their life ended so suddenly.

Missed: Brantly and Writebol, right, are both in isolation, which is devastating for their families, friends said

International travel has made the spread of disease via airplanes almost routine. Outbreaks of measles, polio and cholera have been traced back to countries thousands of miles away.



Even Ebola previously traveled the globe this way: During an outbreak in Ivory Coast in the 1990s, the virus infected a veterinarian who traveled to Switzerland, where the disease was snuffed out upon arrival and she ultimately survived, experts say.

Two American aid workers in Liberia have tested positive for the virus and are being treated there. U.S. health officials said Monday that the risk of the deadly germ spreading to the United States is remote.



One, Texas-trained doctor Kevin Brantly is said to be in grave condition as the virus takes hold of him.



According to his former colleague at John Peter Smith Hospital in Fort Worth, Dr. David Mcray, Brantly is 'terrified' the disease will progress further.



Still, colleagues and family members said Brantly, 33, knew of the risks associated with working in one of the world's poorest countries during an epidemic and did not regret his choice.



Infected: Nancy Writebol, pictured with her husband David, also became infected while working in Liberia

'Kent prepared himself to be a lifetime medical missionary,' said his mother, Jan Brantly. 'His heart is in Africa.'

During his four-year family medicine residency, he accompanied Mcray on medical missions to Uganda and earthquake-devastated Haiti. He also spent several weeks working in Tanzania, where a cousin lives and works as a medical missionary, Mcray said.



Before contracting Ebola, Brantly and his family 'really enjoyed Liberia.'



Despite his fears, Brantly said earlier Monday that he's got no regrets about going to Africa.



Brantly is one of two Americans fighting for their lives. Married missionary Nancy Writebol, from Charlotte, North Carolina, is also sick at a Liberian hospital as the continent struggles against the worst outbreak in history.



Writebol had moved to Liberia with her husband. She worked as a hygienist, spraying protective suits worn by health care workers treating Ebola patients in Monrovia, the Charlotte Observer reported.



Writebol and her husband David are not medical personnel, but rather Christian missionaries with 15 years experience serving disease and poverty-stricken third world nations.

Devoted: Kent Brantly, pictured with his wife Amber and their two children, contracted Ebola while working with patients in Liberia. He and his family chose to stay in the country even after Ebola began to spread

Originally from Charlotte, North Carolina, the couple raised two sons before moving overseas, first to Ecuador and Zambia before moving to Liberia.



'It's just devastating news,' her pastor, Reverend John Munro, said. He described the couple as religious, humble people who were desperate to stay and help despite the congregation's fears.



Her husband, David, delivered the terrible news to the congregation over Skype, he said.



'He's devastated,' Munro said. 'He can't really be with his wife. She’s in isolation. Ebola is very contagious. She's not doing well. It's grim news.'



The outbreak started in Guinea in February and spread to neighboring Liberia and Sierra Leone in weeks.



Dr. Samuel Brisbane on Sunday became the first Liberian doctor to die in an outbreak the World Health Organization says. A Ugandan doctor working in the country died earlier this month.

The mere prospect of Ebola in Africa's most populous nation has Nigerians on edge.



In Nigeria's capital, Abuja, Alex Akinwale, a 35-year-old entrepreneur, said he is particularly concerned about taking the bus, which is the only affordable way to travel.

Brave words: Dr. David Mcray reads a recent message sent to him by his friend and colleague Dr. Kent Brantly during a news conference Monday, from Texas. Brantly is one of two American aid workers that have tested positive for the Ebola virus while working to combat an outbreak of the deadly disease at a hospital in Liberia. Brantly said he's terrified but doesn't regret moving to Africa as a missionary

'It's actually making me very nervous. If I had my own car, I would be safer,' he said. 'The doctors are on strike, and that means they are not prepared for it. For now I'm trying to be very careful.'



It's an unprecedented public health scenario: Since 1976, when the virus was first discovered, Ebola outbreaks were limited to remote corners of Congo and Uganda, far from urban centers, and stayed within the borders of a single country.



This time, cases first emerged in Guinea, and before long hundreds of others were stricken in Liberia and Sierra Leone.



Those are some of the poorest countries in the world, with few doctors and nurses to treat sick patients let alone determine who is well enough to travel.



In Sawyer's case, it appears nothing was done to question him until he fell sick on his second flight with Asky Airlines. An airline spokesman would not comment on what precautions were being taken in the aftermath of Sawyer's journey.



Liberian Assistant Health Minister Tolbert Nyenswah told The Associated Press last week that there had been no screening at Liberia's Monrovia airport.



A Liberian money exchanger wears protective gloves as a precaution to prevent infection with the deadly Ebola virus while transacting business with customers in downtown Monrovia, Liberia, on Sunday



That changed quickly over the weekend, when President Ellen Johnson Sirleaf said a new policy on inspecting and testing all outgoing and incoming passengers will be strictly observed.



She also announced that some borders were being closed and communities with large numbers of Ebola cases would be quarantined.



International travelers departing from the capitals of Sierra Leone and Guinea are also being checked for signs of fever, airport officials said. Buckets of chlorine are also on hand at Sierra Leone's airport in Freetown for disinfection, authorities said.



Still, detecting Ebola in departing passengers might be tricky, since its initial symptoms are similar to many other diseases, including malaria and typhoid fever.



'It will be very difficult now to contain this outbreak because it's spread,' Heymann said. 'The chance to stop it quickly was months ago before it crossed borders ... but this can still be stopped if there is good hospital infection control, contact tracing and collaboration between countries.'



Nigerian authorities so far have identified 59 people who came into contact with Sawyer and have tested 20, said Lagos State Health Commissioner Jide Idris.

