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White House says US is prepared to stop spread of Ebola

Hazardous material workers hung plastic to cover the front door of the apartment where Thomas Duncan had stayed in Dallas.Larry W. Smith/EPA

DALLAS — Health officials Friday narrowed down to 10 the number of people considered most at risk of contracting Ebola after coming into contact with an infected Liberian man. They also moved the four people who had shared an apartment with the man from their potentially contaminated quarters, as local and federal officials tried to assure the public that the disease was contained despite initial missteps here.

The four people, a girlfriend of Thomas E. Duncan, the Liberian who is the first person in the United States to develop symptoms of Ebola, and three of her relatives had been under orders not to leave their home, and Texas officials apologized to them for not moving faster to have the apartment cleaned of potentially infectious materials.

The cleanup began Friday afternoon, more than a week after Duncan first went to the hospital but was sent home because information about his travels from Liberia was not properly relayed. Workers in yellow protective suits scoured the apartment, whose entryway and balcony were covered with a black tarp.

“I want to see them treated as I would want my own family treated,” said county Judge Clay Jenkins, the top elected official of Dallas County, who visited the family inside the apartment Thursday night. The four were in quarantine Friday at a private residence.

In Washington on Friday, while military officials revealed the Army would more than double the number of soldiers it is sending to west Africa to help contain the Ebola virus there, senior White House officials tried to play down the problems in the handling of the Ebola case in Dallas. They insisted that the public health system in the United States was working effectively and would prevent an epidemic of the deadly virus from taking root in this country.

White House aides defended the administration’s response to the disease, saying the federal Centers for Disease Control and Prevention had been working closely for months with state health officials, doctors, and hospitals.

Around the country, anxiety spread quickly Friday as two hospitals in the Washington area each reported a possible case of Ebola (one later tested negative), and an activist working in Liberia prepared to return to the United States after being told he had the virus.

Besides the 10 people considered most at risk in Dallas, another 40 people are being monitored daily in the city but are considered at relatively low risk, officials said. No one has developed symptoms of the disease. The first signs of the illness often appear within eight to 10 days, but can take as long as 21 days.

The misstep at Texas Health Presbyterian Hospital, where Duncan is being treated in serious condition, was followed by the acknowledgment Thursday that the apartment where he had stayed with a friend, Louise Troh, as well as three of her relatives, had not been sanitized, with the sheets and towels that he had used while vomiting still there.

The hospital released a statement late Thursday essentially blaming a flaw in its electronic health records system for its decision to send Duncan home the first time he visited its emergency room, saying there were separate “work flows” for physicians and nurses in the records so that doctors did not receive the information he had come from Africa. They promised to change the system and said it was also being “modified” to specifically refer to the Ebola-endemic regions in Africa.

But some health policy experts said it was not the only lapse that needed to be examined.

Dr. Ashish Jha, a professor at Harvard University’s School of Public Health, said there appeared to be “literally multiple failures” that led to Duncan’s release Sept. 25, only to be hospitalized three days later when his symptoms worsened. Among them, he said, are that the nurse who learned Duncan had just come from Liberia failed to tell a doctor directly.

“In a well-functioning emergency department, doctors and nurses talk to each other,” Jha said. “Also, why didn’t the physician think to ask the question separately? Anyone who comes in with a febrile illness, a travel history, that’s a fundamental part of understanding what might be going on.”

White House officials acknowledged the public’s growing nervousness but said Americans had little to worry about.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said he was convinced that “the system that’s in place, with our health care infrastructure, would make it extraordinarily unlikely that we would have an outbreak.”

In a briefing with reporters Friday, Rear Admiral John Kirby, the Pentagon press secretary, said the total US military presence in west Africa could rise to as high as 4,000.

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