Texas health officials on Friday quarantined four family members of the first person diagnosed with Ebola in the United States, Thomas Eric Duncan, while he remained in serious condition at a Dallas area hospital.
The confinement order was imposed after the family failed to comply with a request not to leave their apartment, according to Dallas County Judge Clay Jenkins. The four family members are being closely watched for any symptoms of the disease.
“We don’t have the confidence we would have been able to monitor them the way that we wanted to,” Texas State Health Commissioner David Lakey said.
By the Friday afternoon, a cleanup crew had begun its decontamination work at the apartment complex where Duncan stayed with family.
Officials at Texas Health Presbyterian Hospital, where Duncan is receiving care, said a disposal vendor was in place to remove any potentially contaminated materials from the hospital.
Meanwhile, authorities have widened their search for people who had direct or indirect contact with Duncan. Health officials said on Thursday that 12 to 18 people had direct contact with Duncan, who flew to Texas from Liberia via Brussels and Washington two weeks ago.
All told, up to 100 people had direct or indirect contact with Duncan, and Texas health officials said about 50 are being monitored daily. Of those, 10 were described as being "at high risk."
None of those were showing symptoms of Ebola, Dallas County officials added.
But some of those who had come into contact with Duncan admitted to confusion and distress at how the process was playing out.
Duncan's stepdaughter, Youngor Jallah, in an interview with Al Jazeera, said her family had self quarantined themselves but had not received any official word from public health officials.
County health officials told Jallah, her husband and four children they should stay inside their apartment for safety. But because they had not been ordered to remain there, Jallah explained, they have not received official food deliveries after being isolated in their apartments since Monday.
When asked whether they had been barred from leaving their apartment, Aaron Yah, Jallah's husband, said, “We don't actually know if we are … But were are doing it because to be on the safe side and for precaution.”
As of midday Friday, the family was still waiting on Dallas County officials for a definitive answer.
Jallah said her family was finding it difficult to weather their self-imposed quarantine, and that while public officials had been showing up to take their temperatures and ask them what they needed, deliveries of food had not arrived.
Meanwhile, in Liberia the head of the country's airport authority, Binyah Kesselly, said the government could prosecute Duncan for denying he had contact with someone who was eventually diagnosed with Ebola. The government said he failed to declare that he helped neighbor Marthalene Williams after she fell critically ill on Sept. 15. Williams later died.
Kesselly said Duncan was asked on a questionnaire whether he had come in contact with any Ebola victim or was showing any symptoms. “To all of these questions, Mr. Duncan answered no,” Kesselly said.
Ebola can cause fever, bleeding, vomiting and diarrhea and spreads through contact with bodily fluids such as blood or saliva. Duncan’s case put U.S. health authorities and the public on alert over concern for the potential of the virus to spread from Liberia and two other impoverished West African countries, Guinea and Sierra Leone. The virus has killed at least 3,338 people in the worst such outbreak since the disease was identified in 1976.
Another American was diagnosed with Ebola on Thursday. Ashoka Mukpo, an Al Jazeera America contributor and freelance cameraman working for NBC News tested positive for the disease and will be flown back to the U.S. from Liberia for treatment.
Mukpo, 33, was hired Tuesday to be a second cameraman for Dr. Nancy Snyderman, the network’s chief medical editor, who is on assignment in Monrovia with three other NBC News employees. He quarantined himself and sought medical advice Wednesday after coming down with symptoms.
Elsewhere on Friday, Howard University Hospital in Washington said it admitted and isolated a patient with possible symptoms of Ebola who had recently traveled from Nigeria. The move was made out of "an abundance of caution," officials said. The Centers for Disease Control says outbreaks in Nigeria and Senegal appear to have been contained.
Meanwhile, as part of U.S. effort to help contain the spread of the deadly virus, the Pentagon on Friday said the number of military personnel that could be deployed to West Africa could reach nearly 4,000, more than earlier estimates of about 3,000.
"We project that there could be nearly 4,000 troops deployed in support of this mission but we are obviously assessing the requirements on a daily basis," said Rear Admiral John Kirby, the Pentagon press secretary. "It may not go that high."
Duncan arrived in Dallas on Sept. 20 and fell ill a few days later. The Texas Health Presbyterian Hospital emergency room sent Duncan home last week, even though he told a nurse he had been in West Africa.
In a statement issued late Thursday, the hospital said it followed communicable disease protocols by asking Duncan if he had come into contact with anyone who was ill. He replied that he had not.
A flaw in the electronic health records systems led to separate physician and nursing workflows, meaning the travel history documented by nurses was not passed onto physicians, hospital spokesman Wendell Watson said. He said the system has been corrected.
Duncan's symptoms included a 100.1 F temperature, abdominal pain, a headache and decreased urination, the hospital said. He said he had no nausea, vomiting or diarrhea. Based on that, the hospital decided to release him.
He returned two days later and has been kept in isolation since Sunday. Duncan was listed Thursday in serious but stable condition.
Al Jazeera and wire services