Half-brother of Dallas Ebola patient lives in Phoenix

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By Mike Gertzman By Mike Gertzman
By Mike Gertzman By Mike Gertzman

(CNN) -- Wilfred Smallwood, who says he's a half-brother of Dallas Ebola patient Thomas Eric Duncan, said Thursday that he doesn't believe Duncan knew he had Ebola when he left Liberia for the United States.

Smallwood said that when Duncan first visited Texas Health Presbyterian Hospital, neither Duncan nor the hospital knew then that he had Ebola.

This was Duncan's first time in the United States, Smallwood said. Smallwood left Liberia nine years ago to move to the United States, where many relatives live. Smallwood currently lives in Phoenix.

Duncan, a resident of Liberia, was visiting his son and his son's mother in Dallas, Smallwood said.

Health officials are reaching out to as many as 100 people who may have had contact with Duncan, a spokeswoman with the Texas Department of State Health Services said Thursday. These are people who are still being questioned because they may have crossed paths with the patient either at the hospital, at his apartment complex or in the community.

"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," spokeswoman Carrie Williams said. "The number will drop as we focus in on those whose contact may represent a potential risk of infection."

The number of direct contacts who have been identified and are being monitored right now is "more than 12," a federal official told CNN on Thursday.

"By the end of the day, we should have a pretty good idea of how many contacts there are," the official said.

Being "monitored" means a public health worker visits twice a day to take the contact's temperature and ask them if they are experiencing any symptoms.

None of the people being monitored has so far shown symptoms. Most are not being quarantined, though Dallas County health officials have ordered four close relatives of the patient, Thomas Eric Duncan, to stay home and not have any visitors until at least October 19.

"The family was having some challenges following the directions to stay home, so we're taking every precaution," Texas Department of Health spokeswoman Carrie Williams said about why the state had issued a legal order. "Food and other needs of the family are being worked out logistically today. Those needs will be specifically covered to allow them to stay in the house."

While Duncan remains in serious but stable condition at a Dallas hospital, two things are still spreading: fear and frustration. Some parents are scared to take their kids to the schools that his girlfriend's children attended.

Others are upset at the hospital where Duncan first sought care, which sent him home and raised the possibility he could infect others for at least two additional days.

Here's the latest on how the case is affecting others:

'I just got scared'

Duncan was in Dallas visiting his girlfriend, Liberian community leader Stanley Gaye said.

Among the people he encountered: his girlfriend's five children, Gaye said.

Dallas Independent School District Superintendent Mike Miles said the patient came in contact with five students who attended four different schools in the area.

Sam Tasby Middle School is one of those schools.

"I just got scared because I thought that that kid came to that school and probably got contact with him," said Nellie Catalan, whose child attends the middle school.

"I know it doesn't get (spread) by the air, but you never know."

More than 3,500 students attend the four schools, which are getting cleaned and sanitized over the next few days.

But student Denise Trujillo said she's still worried.

"I don't feel like going to school tomorrow," she said.

While the five students who were near Duncan are staying home and being monitored, their schools will remain open.

'It gets bad -- fast'

Because the early symptoms of Ebola can include abdominal pain, fever and vomiting -- ailments that also come with other illnesses -- there are concerns about how to distinguish between Ebola and, say, the flu.

But the answer is fairly simple.

"Ebola tends to progress much more quickly," said Sanjay Gupta, CNN chief medical correspondent. "It gets bad -- fast."

And once it gets bad, Ebola can bring on a host of ghastly symptoms, including diarrhea and unexplained bruising and bleeding.

But Ebola is much harder to contract than the flu. The virus can be spread only through the bodily fluids of people who have active symptoms of the illness.

'They dropped the ball'

On September 24, four days after he arrived in Dallas from Liberia, Duncan started feeling symptoms. That day is significant because that's when he started being contagious.

Late the following night, he went to Texas Health Presbyterian Hospital Dallas with a low-grade fever and abdominal pain, the hospital said.

Duncan told a nurse he had been in Africa.

But "regretfully, that information was not fully communicated throughout the full team," said Dr. Mark Lester, executive vice president of Texas Health Resources.

Duncan was sent home with painkillers and antibiotics, only to return in worse condition on September 28. That's when he was isolated.

"It was a mistake. They dropped the ball," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said of the miscommunication at the hospital.

"You don't want to pile on them, but hopefully this will never happen again. ... The CDC has been vigorously emphasizing the need for a travel history."

Gupta said this mishap doesn't make sense.

"A nurse did ask the question, and he did respond that he was in Liberia, and that wasn't transmitted to people who were in charge of his care," he said. "There's no excuse for this."

And one of Duncan's friends said he was the one who contacted the Centers for Disease Control and Prevention with concerns that the hospital wasn't moving quickly enough after Duncan's second hospital visit.

But the hospital said the patient's condition "did not warrant admission" last week.

Searching for others

Duncan's contacts will be monitored for 21 days -- the longest amount of time it takes for Ebola symptoms to show up.

If any of Duncan's contacts show symptoms, they will be isolated.

So far, so good.

The paramedics who transported Duncan to the hospital haven't shown symptoms, said Rawlings, the Dallas mayor.

Neither have his girlfriend's children.

"They are doing well. ... They are doing fine," said Gaye, the Liberian community leader. "All she asks for are our prayers."

But if one of those contacts ends up having Ebola, the tedious processes of tracking and monitoring a web of contacts would have to start all over again.

CNN's Gary Tuchman reported from Dallas; CNN's Holly Yan reported and wrote from Atlanta. CNN's Jacque Wilson, Devon Sayers, Jennifer Bixler, Catherine E. Shoichet, Ashley Fantz, Jake Tapper, John Branch, Jason Morris and Greg Botelho contributed to this report.

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