DALLAS, Oct 2 (Reuters) - Up to 100 people may have had direct or indirect contact with the first person diagnosed with Ebola in the United States, and four people have been quarantined in a Dallas apartment, health officials said on Thursday.
Dallas County officials said 12 to 18 people had direct contact with the patient, who flew to Texas from Liberia via Brussels and Washington two weeks ago, and they in turn had contact with scores of others.
Officials said none of those thought to have had direct or indirect contact with the patient, who was being treated at a Dallas hospital, were showing symptoms of Ebola. The disease can cause fever, bleeding, vomiting and diarrhea and spreads through contact with bodily fluids such as blood or saliva.
Ebola has killed at least 3,338 people in Liberia and two other impoverished West African countries, Guinea and Sierra Leone, in the worst such outbreak on record.
Officials have said the U.S. healthcare system is well prepared to contain the hemorrhagic fever's spread by careful tracking of those who have had contact with the patient, Thomas Eric Duncan, and appropriate care.
Duncan initially sought treatment at Texas Health Presbyterian Hospital on the night of Sept. 25 but was sent back to the Dallas apartment where he was staying, with antibiotics despite telling a nurse he had just been in West Africa. By Sunday, he needed an ambulance to return to the same hospital after vomiting on the ground outside the apartment complex.
Police and armed security guards were keeping people about 100 yards away from the apartment on Thursday, with orange cones blocking the entrance and exit. Maintenance workers using high-pressure water were scrubbing the parking lot with bleach. The workers were not wearing any protective gear.
Dr David Lakey, Commissioner of the Texas Department of State Health Services, said that the four people under quarantine do not have a fever and are healthy.
"There's food being delivered to them we're arranging for that apartment to be cleaned," Lakey said.
U.S. officials initially described the number of people potentially exposed as a handful, and on Wednesday said it was up to 18. Then on Thursday, the Texas health department said there were about 100 potential contacts. Dallas County officials, said however, that more than 80 had direct or indirect contact.
"We are working from a list of about 100 potential or possible contacts," Texas health department spokeswoman Carrie Williams said.
"Out of an abundance of caution, we're starting with this very wide net, including people who have had even brief encounters with the patient or the patient's home. The number will drop as we focus in on those whose contact may represent a potential risk of infection."
The patient was in serious condition, Texas Health Presbyterian Hospital in Dallas said, no change from Wednesday.
LIBERIA COULD PROSECUTE
The head of the Liberian airport authority, Binyah Kesselly, said Liberia could prosecute Duncan for making a false declaration on his travel document. Kesselly said Duncan was asked in a questionnaire if he had come in contact with any Ebola victim or was showing symptoms of the disease.
"To all of these questions, Mr. Duncan answered 'no'," Kesselly said. Earlier, Kesselly said Duncan knew that he had come into contact with someone who had eventually been diagnosed with Ebola, even though he left Liberia with no signs of symptoms.
The New York Times said Duncan, in his mid-40s, helped take by car a pregnant woman suffering from Ebola to a hospital in Liberia, where she was turned away for lack of space. The woman died.
CNN reported that a Dallas woman who had a child with Duncan said he had sweated profusely in the bed they shared at her apartment. She said the sheets where he had lain were still on the bed.
The woman, whom CNN identified only as "Louisa," is quarantined in the apartment with one of her children, who is 13, and two visiting nephews in their 20s (Health officials described them as relatives of Duncan.) They were all in the home when Duncan began showing signs of illness, the report said. The woman said she mentioned twice to hospital staff that he had come from Liberia.
The U.S. Centers for Disease Control and Prevention's (CDC) director, Dr. Thomas Frieden, told reporters on Thursday that "the bottom line here is we remain confident that we can contain any spread of Ebola in the United States." Frieden said the agency had interviewed most of the 100 people who may have had contact with Duncan and "there are a handful who may have had exposure and who therefore may be monitored."
Dr. Amesh A. Adalja, an infectious disease physician at the University of Pittsburgh, said contact tracing is "bread-and-butter public health," and something health officials do regularly to track tuberculosis, measles and sexually transmitted diseases.
Adalja said the most disturbing part of the U.S. incident is that Duncan was sent home from the hospital with antibiotics.
"This really is something that shouldn't have happened," he said. "It just reinforces that taking a travel history has to be an essential part of taking care of patients."
On Wednesday, hospital officials admitted that the man's travel information had not been shared with other staff who were treating him.