First Imported Ebola Case in America

Although some questioned the wisdom of treating Americans stricken with Ebola in West Africa in the U.S., the discussion changed dramatically when the first case imported from West Africa was diagnosed in Dallas, Texas.

On September 25, 2014, Thomas Eric Duncan, a Liberian who had recently traveled to the U.S., sought care for fever, headache and abdominal pain at Texas Presbyterian Hospital in Dallas. Although he told the ER that he had just arrived form Liberia, he was diagnosed with a sinus infection and returned to his fiancée’s apartment. On September 28, he was transported to the hospital because of persistent fever and progressive symptoms, and was hospitalized.  On September 30, he became the first patient to have laboratory-confirmed Ebola virus infection diagnosed in the United States. He died on October 8th. 

Along with contact tracing, the apartment where Mr. Duncan had stayed needed to be decontaminated. News cameras flew overhead while people were moved out of the apartment, and emergency personnel decontaminated the area. None of the four people who stayed in the apartment with Mr. Duncan contracted Ebola.

Within seven days after Mr. Duncan’s death, Ebola symptoms developed in two nurses directly involved in his care, and those nurses were confirmed to have Ebola. Both nurses subsequently recovered, thanks in part to early diagnoses and advanced treatments.

Texas Presbyterian Hospital, Dallas, Texas. Photograph by Stewart F. House, Getty Images

Next Steps in Dallas: Contact Tracing and Infection Control

On September 30, two days after the diagnosis of Ebola was confirmed in the “index” patient from Liberia, CDC and Texas health officials began contact tracing, identifying 48 possible or confirmed contacts, including family members.  A total of 147 healthcare workers who were involved in Mr. Duncan’s care or the care of the two nurses were closely monitored for 21 days after their last exposure to an Ebola patient. Out of an abundance of caution, passengers who were on a plane from Cleveland to Dallas with one of the nurses before her diagnosis were also monitored.

Ebola did not develop in any other community or healthcare–related contacts of the three Ebola patients.

Dr. David Kuhar

Dr. David Kuhar, team lead and deputy team lead of the group sent to Dallas,  discusses the index patient in Dallas passing away and what it meant for his team. (Transcript)

Barbara Knust

Barbara Knust, an epidemiologist and Ebola subject matter expert at CDC headquarters in Atlanta, discusses the response to the Dallas nurses becoming infected, as well as some of the surrounding stigma. (Transcript)

Carmen Villar

Carmen Villar, the Chief of Staff at the CDC, reflects on the Ebola case identified in Dallas. (Transcript)