Everything You Need to Know About Ebola in America

PHOTO: The Texas Health Presbyterian Hospital is pictured in this 2013 file photo.
Tony Gutierrez/AP Photo

Thomas Eric Duncan, the Liberian man who is battling the Ebola virus in a Texas isolation unit, appears to have weakened, according to his family, and a cleaning crew began today sanitizing the Dallas apartment where Duncan had been staying.

The number of people needing monitoring for possible contact with Duncan was reduced from 100 to 50 today with only 10 believe to a "high risk" for infection.

The first case of Ebola to develop in the U.S. has health officials scrambling to figure out new protocols, like how to dispose of Duncan's clothing and bedding, officials said.

The specter of Ebola has made the public and health officials jittery and federal authorities have checked dozens of suspect cases, but so far no other case in the U.S. has been determined to be Ebola.

Here’s everything you need to know about what happened and what it means?

Who was infected?

Eric Thomas Duncan was diagnosed with Ebola in Dallas on Sept. 28, about a week after arriving from Liberia to visit family, health officials said. He was placed in isolation, and the Centers for Disease Control and Prevention announced that it confirmed the diagnosis on Sept. 30.

Duncan is a former chauffeur from Liberia, his former boss said.

Duncan's nephew told ABC News that they were able to speak to him by phone in the isolation unit earlier this week, but he is now so sick he can no longer talk on the phone.

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How did he catch Ebola?

According to Duncan’s neighbors in Monrovia, he helped carry a sick pregnant woman to a taxi and take her to a maternity ward and two Ebola wards. She was turned her away from all of the facilities. The woman, who was 19 years old and about seven months pregnant, was convulsing and vomiting.

He rode with her in the taxi to the three facilities and back. When the cab stopped at the edge of the housing compound, he carried the woman to her home. At that point, she was vomiting blood.

The woman died the next day, but it’s not clear whether Duncan knew she died of Ebola.

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Why didn’t he get stopped at the airport?

Because of the outbreak, people flying out of the country are screened for fevers and asked about possible exposure to Ebola patients.

Duncan didn’t have a fever, and he wasn’t symptomatic on the plane, officials said.

Despite his experience with the pregnant woman, he checked “no” on an airport exit form asking whether he’d had contact with anyone who had Ebola. The Liberian government has said that it intends to prosecute Duncan for lying on the form.

He left Liberia on Sept. 19 and flew to Brussels. From there, he flew to Washington’s Dulles Airport and arrived in Dallas-Fort Worth Airport on Sept. 20.

When did he get sick?

Duncan arrived at the emergency room of Health Presbyterian Hospital Dallas on Sept. 26, but he was sent home with antibiotics.

Duncan told the nurse he’d recently been to West Africa, but she didn’t relay that information to the rest of the hospital staff. The hospital now says that a lapse in the electronic records system is to blame.

Two days later, when his symptoms worsened, Duncan came back to the hospital in an ambulance and was put in isolation.

Did he get anyone else sick?

No one else appears to have gotten sick yet.

The Centers for Disease Control and Prevention started with a list of 100 people who had contact with Duncan and might need monitoring. That group includes five school age children who have been told to stay home from school for 21 days and be monitored for symptoms. The list was reduced to 50 today, with 10 considered to be at "high risk" of infection.

A judge has ordered Duncan’s Dallas relatives, with whom he was staying, to remain in their home after violating officials' initial request not to leave.

A specialized cleaning crew arrived today to clean and sanitize the apartment.

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How does it spread?

Ebola is transmitted through contact with bodily fluids -- such as blood and urine -- from an infected person. This can happen via direct contact or through contaminated equipment, needles or medical equipment.

The virus is not airborne, meaning you can’t get it simply by breathing the same air as an infected person. And it is not expected to mutate and become airborne, the World Health Organization said.

In theory, the virus could spread through tiny respiratory droplets if an Ebola patient sneezes or coughs on you and you get those droplets in your eyes, nose or mouth. But sneezing is not an Ebola symptom and coughing only occurs when the patient is near death. This type of transmission has not yet been reported.

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What’s going on in West Africa?

Ebola has killed 3,338 people and infected 3,840 others since the outbreak began in March, making it the worst outbreak since the virus was discovered in 1976.

More people have died from Ebola in the last seven months than in every other Ebola outbreak to date combined, according to data from the World Health Organization.

Although those who have received care on American soil have generally fared well, WHO officials have said that the world needs to do more to stop the outbreak in Africa and keep it from expanding.

The CDC warned that the outbreak could reach 1.4 million cases by the end of January without proper intervention. But with additional resources and intervention, the outbreak could be over by about the same time, the agency said.

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What about the other American Ebola patients we had here?

Although four Americans have been treated for Ebola in the United States, all of them contracted it in West Africa.

Dr. Kent Brantly, missionary Nancy Writebol and Dr. Rick Sacra contracted Ebola while treating patients in Liberia. Brantly and Writebol received supportive care at Emory University Hospital, and Sacra received it at Nebraska Medical Center. They were later declared virus-free and discharged. A fourth patient, who remains unnamed, contracted Ebola in Sierra Leone and received care at Emory University.

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