A New York City physician who worked with Doctors Without Borders treating Ebola patients in West Africa is in stable condition Friday after testing positive for the virus a day earlier, city health officials said. He is the fourth case confirmed in the United States.
The 33-year-old emergency room doctor, Craig Spencer, returned from Guinea more than a week ago and reported coming down with a 100.3-degree fever and diarrhea on Thursday. City Health Commissioner Mary Travis Bassett said Spencer had no temperature elevation before Thursday morning — so it’s not likely he was contagious before then.
A specially trained team wearing protective gear transported Spencer to Bellevue Hospital from his Manhattan apartment, the city said in a statement. Bellevue is a designated Ebola treatment center, and Spencer is being treated in a specially built isolation ward there.
The U.S. Centers for Disease Control and Prevention (CDC) confirmed Spenser’s diagnosis on Friday. The CDC has also dispatched an Ebola response team to New York, and the city's disease detectives have been tracing the doctor's contacts to identify anyone who may be at risk.
The first confirmed case in the United States' largest city set off renewed fears about the spread of the virus, which has killed nearly 4,900 people in Liberia, Sierra Leone and Guinea. Just days ago, U.S. airports began using enhanced screening for travelers arriving from West Africa, and John F. Kennedy International Airport in New York was the first to implement the measures. Yesterday the CDC named New York as one of six states that will begin active post-arrival monitoring of these travelers.
"I'm really concerned," said Kiki Howard, 26 a student who lives on the block next to Spencer's home in Harlem. "There's a school at the end of the block. My main concern is for the safety of the children."
Officials took pains to counter those fears.
At a news conference Thursday night, New York Mayor Bill de Blasio sought to reassure the public that they are safe from Ebola. "Being on the same subway car or living near someone with Ebola does not in itself put someone at risk," he said. Health officials say the chances that the average New Yorker will contract Ebola, which is spread through direct contact with the bodily fluids of a symptomatic infected person, are slim. The virus is not airborne.
The White House on Thursday said President Barack Obama had been briefed on the situation in New York.
Obama asked New York Gov. Andrew Cuomo and de Blasio to remain in close contact with Ron Klain, Obama's Ebola "czar," and public health officials in Washington. The president pledged more help if needed to ensure proper care for Spencer, as well as safety for health workers and the public.
Mayor: NYC is prepared
Spencer arrived at JFK Airport on Oct. 17 and went through the ramped-up screening. The CDC said in a statement he "participated in the enhanced screening for all returning travelers from these countries." He "went through multiple layers of screening and did not have a fever or other symptoms of illness."
Spencer's apartment was cordoned off, and his fiancée, who was not showing symptoms, was being watched in a quarantine ward at Bellevue. The Department of Health was on site across the street from the apartment building Thursday night, giving out information to area residents.
"We have been preparing for months for the threat posed by Ebola," said de Blasio. "We have clear and strong protocols which are being scrupulously followed in this instance, and Bellevue hospital is especially designed for isolation, identification and treatment of Ebola patients. Every hospital in the city is prepared in the event that other patients come forward."
Spencer brings to nine the number of people treated for the disease in U.S. hospitals since August. Only two contracted the virus in the United States.
Thomas Eric Duncan, the first person diagnosed with the disease in the U.S., was a Liberian man who fell ill days after arriving in Dallas. He went to a hospital, which sent him home without checking him for Ebola, only to admit him three days later. He died on Oct. 8, becoming the only U.S. fatality so far.
The New York City case surfaced days after dozens of people who were exposed to Duncan emerged from the 21-day incubation period with clean bills of health, easing a national sense of crisis that took hold when his nurses, Nina Pham and Amber Vinson, became infected.
Following weeks of treatment, the National Institute of Health declared Pham virus-free on Friday and she was released from medical care. The 26-year-old arrived last week at the National Institutes of Health (NIH) Clinical Center in Maryland. She flew there on Oct. 16 from Texas Health Presbyterian Hospital Dallas.
Dr. Anthony Fauci, infectious disease chief at the NIH, gave Pham a hug and told reporters at a news conference on Friday that five consecutive tests showed no virus left in her blood.
According to a rough timeline provided by city officials, Spencer left Guinea on Oct. 12, traveled in Europe, and arrived in New York on Oct. 17. On Oct. 21, he felt fatigued, but the next night he went bowling at the Gutter, a bowling alley and bar in the Williamsburg neighborhood in Brooklyn. He also took an Uber taxi, but officials do not believe the driver is at risk.
Attempted to self-isolate
When Spencer felt worse Thursday, he and his fiancée made a joint call to authorities to detail his symptoms and his travels.
"He did attempt to self-isolate," said Bassett at the Thursday night press conference. "But our impression is that he spent most of his time at his apartment. He was taking his temperature twice a day, and he was mindful of his contact with people. He was very alert about the signs and symptoms of Ebola, coming from a place where Ebola is ravaging the population."
She said only three people, one of whom is in the hospital, came into close contact with Spencer — two friends and his fiancée. Those who need to be quarantined can opt for home quarantine, the commissioner said.
"The apartment is isolated. Nobody is going into the apartment. The super will not let anybody in," Bassett said. She added that the doctor's apartment was sealed off. "I see no reason for the tenants in the apartment building to be concerned."
"He left his key in his apartment and closed the door" when he went to hospital, said New York State Health Commissioner Dr. Howard Zucker, adding that Spencer wanted to make sure the key wasn't "floating around."
"Right now the concern is for the health care workers at Bellevue," said CDC Director Tom Freiden, who said agency officials were already there and more Ebola specialists were on the way.
Four other American aid workers, including three doctors, were infected with Ebola while working in Africa and were transferred to the U.S. for treatment in recent months. All recovered.
Health care workers are vulnerable because of close contact with patients when they are at their sickest and most contagious. In West Africa this year, more than 440 health workers have contracted Ebola, and about half have died.
Spencer works at New York–Presbyterian/Columbia University Medical Center. He had not seen any patients or been there since his return, the hospital said in a statement.
He is a "dedicated humanitarian" who "went to an area of medical crisis to help a desperately underserved population. He is a committed and responsible physician who always puts his patients first," it said.
With wire services