A New York City doctor who treated Ebola patients in West Africa became the first person to test positive for the virus in America's largest city, setting off fresh fears about the spread of the disease.
New York Mayor Bill de Blasio said residents were safe to travel around the city, even as officials disclosed that Dr. Craig Spencer had ridden subways, taken a taxi and visited a bowling alley since returning from Guinea on Oct. 17.
Spencer, 33, had worked with the humanitarian organization Doctors Without Borders in Africa. He first developed Ebola symptoms on Thursday morning and was taken from his Manhattan apartment to isolation at Bellevue Hospital by a team wearing protective gear, according to city officials. He had been taking his temperature twice a day since coming home, said city Health Commissioner Mary Travis Bassett.
Two friends and his fiancee are quarantined, she said. His fiancee was quarantined at the hospital, and all three were healthy. The taxi driver did not come into close contact and was not considered at risk, she said.
Spencer is the ninth Ebola case seen in the United States and the first case in America's largest city, setting off renewed fears about the spread of the virus, which has killed nearly 4,900 people, largely in Liberia, Sierra Leone and Guinea.
The virus is spread through direct contact with bodily fluids from an infected person and is not airborne.
"There is no reason for New Yorkers to be alarmed," de Blasio said at a news conference at Bellevue. "Being on the same subway car or living near someone with Ebola does not in itself put someone at risk."
Spencer was not feeling sick and would not have been contagious before Thursday morning, the health commissioner said.
"We consider that it is extremely unlikely, the probability being close to nil, that there would be any problem related to his taking the subway system," Bassett said.
The Centers for Disease Control and Prevention (CDC) will confirm the test results within 24 hours, Bassett said.
Spencer's apartment in Manhattan's Harlem neighborhood is isolated and sealed off, the health commissioner said.
"I see no reason for the tenants in the apartment building to be concerned," she said.
Joyce Harrison, who lives in the building across the street, said, "I feel sorry and hope they can nip this in the bud.
"I'll go right on with my daily routine and hope to God it doesn't come my way," she said.
The health commissioner said Spencer completed work in Guinea on Oct. 12 and arrived at John F. Kennedy International Airport in New York on Oct. 17.
Spencer's Facebook page, which included a photo of him clad in protective gear, said he stopped over in Brussels.
Spencer has specialized in international emergency medicine at Columbia University-New York Presbyterian Hospital in New York City since 2011.
Columbia in a statement said he has not been to work nor seen any patients since his return.
A woman named Morgan Dixon was identified on Spencer's Facebook page as his fiancee. Her LinkedIn profile described her as working in nonprofit management and international development with the Hope Program, a career development program for homeless and welfare-dependent adults.
The first person diagnosed with Ebola on U.S. soil, Thomas Eric Duncan, flew from Liberia to Texas and died in a Dallas hospital. Two nurses who treated him became infected and one took a commercial flight with a fever, prompting officials in several states to take steps to become better prepared to contain the virus.
The CDC did not name Spencer but said he "participated in the enhanced screening for all returning travelers from these countries" at Kennedy.
The enhanced screening was introduced this month at five major U.S. airports - including Kennedy - for travelers coming from Guinea, Liberia and Sierra Leone.
The doctor "went through multiple layers of screening and did not have a fever or other symptoms of illness," the CDC added in a statement.
Screening may have 'a limited effect'
The U.S. this week began requiring travelers coming from Liberia, Sierra Leone and Guinea to enter through one of five airports conducting increased screening for the virus. It also is directing those travelers to check in with health officials every day and report their temperatures and any Ebola symptoms for 21 days.
The United Nations World Health Organization said Thursday that such arrival screenings may have "a limited effect" in stopping the spread of the virus, but whether it adds anything to exit screening from affected countries is a decision for governments.
Passengers are already screened as they leave Liberia, Sierra Leone and Guinea, a measure that is critical for reducing the exportation of the virus, it said.
"So far 36,000 persons have been screened and 100 have been deferred from traveling," Isabelle Nuttall, director of global capacities alert and response in WHO's health security arm, said in an emailed comment.
The outbreak has killed at least 4,877 people and at least 9,936 cases of the disease have been recorded, the WHO said Wednesday, but the numbers are known to be under-reported and the true death toll may be three times as much.
Several countries -- including Haiti, Dominican Republic, Colombia, Jamaica and North Korea -- have restricted incoming travelers to some degree, though the committee has said there should be no general ban on international travel or trade. It reiterated that advice Thursday.
"A general travel ban is likely to cause economic hardship, and could consequently increase the uncontrolled migration of people from affected countries, raising the risk of international spread of Ebola," it said.
Quarantined in Connecticut
Connecticut has placed nine West Africans who recently arrived in the U.S. under quarantine for possible Ebola exposure.
A family of six West Africans, who arrived Saturday and were planning to live in the U.S., will be watched for 21 days in West Haven, Conn., state health authorities said Thursday. Officials have yet to say where the family came from.
No details were known about the other three people under quarantine.
The crisis is forcing the U.S. health care system to consider withholding some medical interventions because they are too dangerous to doctors and nurses and unlikely to help a patient.
Officials from at least three hospital systems interviewed by Reuters said they were considering whether to avoid some procedures or leave it up to individual doctors to determine whether an intervention would be performed.
The cause of exposure for the nurses infected after contact with Duncan, the first person diagnosed with Ebola on U.S. soil, has not been determined, but the CDC has said intubating the patient and giving him dialysis may have increased the risk of spreading the disease.
The CDC said Wednesday that 66 people, who are thought to have had contact with Duncan, have cleared the 21-day monitoring period after showing a clear bill of health, while another 108 were still under surveillance.
One of the infected nurses, Nina Pham, is in good condition at a National Institutes of Health hospital in Bethesda, Md. The family of the other nurse, Amber Vinson, said in a statement Wednesday that health officials were "no longer able to detect the virus in her body."
Six states account for nearly 70 percent of all travelers arriving from the affected countries: New York, Pennsylvania, Maryland, Virginia, New Jersey and Georgia. The new monitoring will begin in those states first and will be expanded to other states.
Mali's first Ebola case
Mali confirmed its first case of Ebola on Thursday, becoming the sixth West African country to be hit by the virus.
Malian Health Minister Ousmane Kone told state television that the patient in the western town of Kayes was a 2-year-old girl who had recently arrived from neighboring Guinea, where the outbreak began.
"The condition of the girl, according to our services, is improving thanks to her rapid treatment," the minister told state television.
A health ministry official, who asked not to be identified, said the girl's mother died in Guinea a few weeks ago and the baby was brought by relatives to the Malian capital Bamako, where she stayed for 10 days in the Bagadadji neighborhood before heading to Kayes.
People who came into contact with the patient in Kayes have been identified and placed under watch, the minister said, but he appealed to any person who believed he or she may have had contact with the girl to step forward.
Reuters and The Hartford Courant