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Dallas Ebola Patient Was Not Diagnosed On First Hospital Visit


We're going to begin this hour in Dallas, with new details about the first Ebola case diagnosed in the United States. Today authorities said the man had contact with five schoolchildren, in addition to a handful of other people, before he was admitted to a Dallas hospital. He is now in serious but stable condition.


We also learned more today about the process at the hospital where the patient was seen. He had recently been in Liberia. Still, the hospital first released him, then admitted him again two days later, when he was finally suspected of having Ebola. NPR's Wade Goodwyn has the story.

WADE GOODWYN, BYLINE: It was quite a gathering of politicians, health officials and doctors at Presbyterian Hospital in Dallas. Earlier in the day, health officials said they were monitoring more than a dozen people who'd been in close contact with the man who came from Liberia. And that wasn't all, as Governor Rick Perry explained.


TEXAS RICK PERRY: Today we learned that some school-age children have been identified as having had contact with the patient, and are now being monitored at home for any signs of the disease.

GOODWYN: The group of doctors, health officials and politicians at Presbyterian were determined to make one point - the general public's health was not at risk. Dr. David Lakey, commissioner of the Texas Department of State Health Services.

DAVID LAKEY: This is not West Africa. This is a very sophisticated city, very sophisticated hospital. And the dynamics are so significantly different than they are in West Africa, that the chances of it being spread are very, very, very small.

GOODWYN: There was more information as to how and why the ER staff at Presbyterian Hospital didn't suspect Ebola the first time the patient arrived there. Dr. Mark Lester explained the emergency room nurse did ask the man if he had traveled from West Africa.


MARK LESTER: He volunteered that he had traveled from Africa in response to the nurse operating the checklist and asking that question.

GOODWYN: This information about the patient's travel from West Africa was critical to the doctors making the correct diagnosis. But somehow it wasn't passed along to the team who saw and diagnosed the man from Liberia.


LESTER: The clinicians did not factor it in, so it was not part of their decision making.

GOODWYN: So the man was given antibiotics that were useless to him and sent back into the world to potentially expose others to Ebola. But there were other factors that explain how the ER team missed the fact that their patient had Ebola. Dr. Edward Goodman is Presbyterian's lead infectious disease specialist.


EDWARD GOODMAN: Since his arrival on Friday, he was not vomiting or having diarrhea, and therefore, there was no exposures. So we really think there is very little likelihood that any healthcare worker was exposed on Friday, and certainly virtually zero exposure starting Sunday.

GOODWYN: The man not being all that sick and the doctors not knowing their patient had just come from Liberia, lead the clinicians astray. And that lesson has not been lost on the larger medical community in Dallas. At general practitioner Dr. Karen King's office, it certainly ramped up the staff's awareness. Nurse Linda Cole says they've seen no anxiety from the patients, but the medical staff is on the lookout now.

LINDA COLE: Absolutely, I mean, you know, it's better to err on the side of caution. I'd rather send somebody to the hospital that doesn't have anything but just flu than to take a chance. So if there's any chance that it might be something, we'll take further action.

GOODWYN: Nurse Cole says she doesn't expect to see any worry from patients about Ebola unless the disease breaks into the general population. Wade Goodwyn, NPR News, Dallas. Transcript provided by NPR, Copyright NPR.

Wade Goodwyn is an NPR National Desk Correspondent covering Texas and the surrounding states.