Liz Szabo

USA TODAY

The Centers for Disease Control and Prevention confirmed on Tuesday the first case of Ebola in a critically ill patient diagnosed in a U.S. hospital.

The patient — who has been isolated since his symptoms were recognized — is an unnamed man in intensive care at Texas Health Presbyterian hospital in Dallas.

Hospital workers noted his case because of his symptoms and recent travel history. It is not known whether he has infected others, although CDC officials are tracing his contacts.

The man left Liberia Sept. 19 and arrived in the USA the next day but had no symptoms when leaving Africa or arriving here, said Thomas Frieden, the CDC director. The patient became sick Sept. 24, and he sought care two days later. He was sent home but returned to a hospital and was admitted Sept. 28. Frieden did not reveal the man's nationality but said he came to the USA to visit relatives.

Frieden said there is no danger of the sort of widespread outbreak seen in West Africa.

"This is the first case of Ebola diagnosed in the U.S. and the first strain of this Ebola diagnosed outside of Africa," Frieden said. "I have no doubt that we will control this case of Ebola so that it does not spread widely in this country. It is certainly possible that someone who has had contact with this patient could develop Ebola, but there is no doubt in my mind that we will stop it here."

Ebola patients are contagious once they begin showing symptoms, such as fever, diarrhea and vomiting, Frieden said.

Someone with these symptoms could infect health care workers, such as people working in an emergency room. The virus is spread only through contact with bodily fluids, such as blood or vomit, says Brett Giroir, CEO at Texas A&M Health Science Center, an intensive care specialist.

Ebola does not spread through the air, like measles or the flu, said David Lakey, commissioner of the Texas Department of State Health Services.

Because the man was not sick on the plane or in the airport, Frieden said he's not worried that others on his flight will become sick. Health officials are not contacting fellow passengers. "There is zero risk of transmission on the flight," Frieden said. "He was checked for fever before getting on the flight."

He said health officials are following a "handful" of contacts, including a few family members and friends. The man stayed with family, not at a hotel.

The Dallas Fire-Rescue crew that transported the Ebola patient on Sunday is now under quarantine. The city has activated its Emergency Operations Center on "Level 2: High Readiness" in response to Tuesday's developments, WFAA-TV reported.

"I have no doubt that we will stop this in its tracks," Frieden said, but as long as the epidemic is spreading out of control in West Africa, "we have to be on our guard."

Infectious disease experts agreed with Frieden that Ebola is unlikely to spread very far in the USA because of stringent infection control measures in place at American hospitals. There are no plans to transfer the patient to a specialized hospital with a biocontainment unit, Frieden said, noting that any hospital that has the ability to isolate a patient can treat someone with Ebola.

Frieden said there have been five cases of patients with similar hemorrhagic fevers in the USA, including Lassa fever and Marburg virus, and none of them infected anyone else.

"There is no cause for concern," says Peter Hotez, dean of the National School of Tropical Medicine and professor at Baylor College of Medicine in Houston. "The Ebola virus is not easily transmitted from person to person, and we have an outstanding infrastructure in place both to contain the virus and trace contacts. There will not be an Ebola epidemic in the United States."

Giroir noted that other Ebola patients who have been airlifted from West Africa to American hospitals have done well, at least partly because of the good intensive care provided.

"We need to take this extremely serious and with extraordinary care, but Ebola is able to be controlled with appropriate isolation and public health measures," Giroir says. The Dallas hospital is "an extraordinarily fine hospital with very capable physicians and staff."

Tuesday evening, Texas Gov. Rick Perry announced plans to visit Dallas to evaluate the response to the Ebola situation.

Standard public health measures for Ebola include asking patients when they first fell ill and for the names of everyone with whom they've been in contact since then. Officials contact all those people and monitor anyone at risk for 21 days to see whether they develop symptoms of Ebola, Frieden said.

Patients who aren't sick by that point aren't considered at risk for Ebola. Patients who develop fevers are isolated immediately and given treatment, Frieden said.

Those time-consuming but low-tech methods were used to contain the Ebola outbreak in Nigeria. The CDC reported today that the Ebola outbreak in Nigeria appears to be over after 20 confirmed or probable cases and eight deaths. An Ebola outbreak in Senegal has been successfully confined to one patient, who traveled to that country from Guinea but didn't infect anyone in Senegal.

Ebola has infected 6,553 people and has killed 3,083 in the three countries hit hardest by the epidemic — Guinea, Sierra Leone and Liberia — the World Health Organization says. The number of cases has doubled every three weeks, and the CDC estimates that the disease could affect up to 1.4 million people by January if it's not quickly put under control.

Three Americans have survived Ebola after getting intensive care in specialized biocontainment units in the USA.

Physician Kent Brantly and missionary Nancy Writebol were treated and released from Emory University Hospital, and physician Richard Sacra was treated and discharged from Nebraska Medical Center in Omaha. Writebol and Sacra served in Monrovia, Liberia, with missionary group SIM USA. Brantly worked with missionary group Samaritan's Purse.

All three received experimental therapies, because there are no approved vaccines or treatments for Ebola.

Brantly and Writebol got the experimental drug ZMapp, which contains man-made antibodies against Ebola. Supplies of that drug — which was early in the development process when the Ebola epidemic broke out — are exhausted.

Sacra received a drug called TKM-Ebola, which blocks the virus' ability to replicate. In addition, Brantly received a blood donation from an Ebola survivor while he was in Liberia. Brantly then donated blood to Sacra.

Doctors don't know whether any of these experimental treatments were responsible for curing patients or if the Americans survived because of excellent supportive care to prevent dehydration and other dangerous complications.

About 70% of Ebola patients in this outbreak have died, according to the World Health Organization.

Sen. Chris Coons, D-Del., urged people not to react with fear to the news of the Dallas patient.

"Americans need to remain calm and listen to the precautionary measures being suggested by the CDC," said Coons, chair of the Senate Foreign Relations Subcommittee on African Affairs. "Ebola cannot be contracted through the air or the water supply and requires direct contact with the bodily fluids of someone already infected and exhibiting symptoms. It was only a matter of time before an Ebola case would be emerge here in the United States, but as we're seeing in Dallas today, our public health system has the resources, capabilities and knowledge to address and contain this virus quickly and safely."

Coons praised the U.S. effort to help fight Ebola in Guinea, Liberia and Sierra Leone.

"The U.S. is doing the right thing by stepping up to the growing challenge of combating the spread of Ebola in West Africa and developing a vaccine and treatment," Coons said. "Without America's aggressive and proactive engagement, there is a real threat that this virus might become a global pandemic."

President Obama has committed more than $750 million in resources and is deploying 3,000 troops. Coons noted that Congress authorized $58 million in funding for the Department of Health and Human Services to expedite development, testing and production of a vaccine and treatment.

Contributing: Janet St. James and Josh Davis, WFAA-TV, Dallas.



