The first patient to be diagnosed in the United States with Ebola virus disease has died.
Thomas Eric Duncan developed Ebola symptoms about four days after arriving in the US from Liberia on September 20, became ill on September 24, and sought medical care at the Texas Health Presbyterian Hospital in Dallas on September 26. Duncan was admitted to the hospital on September 28 after he had developed symptoms consistent with Ebola.
Based on Duncan’s travel history and symptoms, the CDC recommended testing for Ebola. The hospital isolated the patient and sent specimens for testing at the CDC and at a Texas lab participating in the CDC’s Laboratory Response Network. The CDC and the Texas Health Department then reported the laboratory test results to the medical center.
Diagnosis of Ebola can be difficult, because early symptoms such as fever are nonspecific to Ebola infection and are observed in patients with more commonly occurring diseases such as malaria and typhoid fever. Basic treatment interventions, when applied early, can be effective, however. Such treatments include providing IV fluids and balancing electrolytes, maintaining oxygen status and blood pressure, and treating other infections if they occur. Experimental treatments for Ebola have been tested and proven effective in animals but have not been tested in randomized clinical trials. Recovery depends on a patient’s immune response, and infected persons develop antibodies that can last for at least 10 years.
“Ebola can be scary. But there’s all the difference in the world between the US and parts of Africa where Ebola is spreading,” said Tom Frieden, MD, MPH, Director of the CDC. “The United States has a strong health care system and public health professionals who will make sure this case does not threaten our communities. While it is not impossible that there could be additional cases associated with this patient in the coming weeks, I have no doubt that we will contain this.”
Duncan did not exhibit symptoms of Ebola during his flight from West Africa, and the CDC does not recommend that people on the same flight undergo monitoring. The CDC points out that Ebola is contagious only if the person is experiencing active symptoms. Duncan reported developing symptoms several days after his return flight.
Ebola is characterized by neurologic symptoms such as headache and confusion, as well as a fever greater than 101.5° F, muscle pain, weakness, abdominal pain, and diarrhea.
Within the past decade, the US has had five imported cases of viral hemorrhagic fever diseases similar to Ebola. None resulted in any transmission in the US.
—Colby Stong