U.S. officials confirmed Sunday that the Ebola virus has been spread within the country for the first time ever and warned that more cases could be reported in the coming days.
A female health care worker who attended to another patient hospitalized for Ebola in Texas tested positive for the virus.
The head of the Centers for Disease Control and Prevention said the transmission was the result of an unspecified breach in protocol.
But officials also said the nurse was wearing the proper equipment when providing care to Thomas Eric Duncan during his second visit to Texas Health Presbyterian Hospital, presenting an unsettling development as public health workers try to stop the spread of the virus around the globe.
The worker wore a gown, gloves, mask and shield while she cared for Mr. Duncan during his second visit to the hospital, said Dr. Daniel Varga of Texas Health Resources, which runs the hospital.
Dr. Thomas Frieden, head of the CDC, said Sunday that there was a breach in protocol in the case.
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“At some point, there was a breach in protocol, and that breach in protocol resulted in this infection,” he said.
But Dr. Frieden also said the worker has not been able to identify what breach might have led to her infection. He said about 50 other people who have come into contact with Mr. Duncan also could be at risk, though none was showing symptoms.
“Unfortunately, it is possible in the coming days we will see additional cases of Ebola,” he said.
He said it appears that only one person had contact with the nurse, and that person was under active monitoring.
The female patient reported a low-grade fever Friday night and was hospitalized and referred for testing. The preliminary result was received late Saturday, state health officials said.
Hazardous materials crews were deployed to decontaminate the worker’s apartment, and neighbors were notified.
“While this is obviously bad news, it is not news that should bring about panic,” Judge Clay Jenkins of Dallas County said earlier Sunday.
Mr. Duncan, who had the first known case of Ebola diagnosed in the U.S., died Wednesday. Mr. Duncan, who had traveled from Liberia to Texas, first came to the hospital in late September complaining of symptoms, but was sent home with antibiotics. He was readmitted and his diagnosis was determined days later, on Sept. 28.
President Obama was briefed on the news of the second diagnosis by Lisa Monaco, assistant to the president for homeland security and counterterrorism, and later on the CDC’s response by Health and Human Services Secretary Sylvia Mathews Burwell.
The president directed that the CDC investigation into the apparent breach in infection control protocols move “as expeditiously as possible” and the additional CDC officers dispatched to Dallas work closely with state and local authorities and hospital staff to review infection control procedures and the use of personal protective equipment.
Rep. Michael T. McCaul, Texas Republican and chairman of the House Homeland Security Committee, said policymakers should consider banning flights and restricting travel by citizens of the heavily affected countries in West Africa.
“I think we need to target more the individuals themselves and look at the idea of potentially temporarily suspending the 13,000 visas that would be coming out of this region, allowing health care workers to go in, because they have to contain the threat,” Mr. McCaul said on the CBS program “Face the Nation.”
“But then, when it comes to the sort of original population out of West Africa leaving, I think that until this gets under control, that’s a measure that policymakers ought to be looking at,” he said.
On Saturday, John F. Kennedy International Airport became the first airport to start additional screening procedures for passengers coming into the country from West Africa. Similar screenings are set to begin at Washington Dulles International Airport, Newark Liberty International Airport, Chicago O’Hare International Airport and Hartsfield-Jackson Atlanta International Airport.
Sen. John McCain, Arizona Republican, said on CNN’s “State of the Union” that his constituents are not comforted and he would like to know “who’s in charge” and called for the screenings to go further.
“I would say that we don’t know exactly who’s in charge. There has to be some kind of czar. I think that we have to look at people coming into the United States, not only at our airports here but at the places where they leave from,” Mr. McCain said.
The Arizona Republican noted that things U.S. officials have said would not happen — Ebola arriving in the U.S. via an airplane flight and now an infection in a hospital in a developed nation — have in fact happened.
“Americans have to be reassured here, and I don’t think we are comforted by the fact that we were told there would never be a case of Ebola in the United States, and obviously that’s not correct.”
The World Health Organization said Friday that more than 4,000 people have died in the Ebola epidemic, the vast majority in Guinea, Liberia and Sierra Leone.
Almost 400 of those deaths were doctors and other health care providers, and such workers are especially at risk for contracting Ebola. Although the virus is contagious, it doesn’t spread easily and not from casual contact.
A Spanish nurse’s assistant recently became the first health care worker to be infected outside Africa. She cared for two priests who later died.
The first Ebola cases on American soil were medical workers flown back to their home country for treatment. They became infected in Africa while doing Christian missionary work.
The disease’s spread in Africa is widely attributed to poor sanitation and corpse handling practices, and medical officials have long insisted that a major outbreak simply could not happen in developed countries.
To be infected, a person must come into contact with the bodily fluids — blood, bodily waste and vomit primarily, but also saliva, semen or sweat — of a person who has symptoms or recently died of the disease. The person being infected also must offer an entry point besides the skin — cuts, scrapes or touching the nose, mouth or eyes with infected hands.
The infected person is not contagious during the incubation period, which can be up to three weeks, when there are no symptoms of Ebola.
• This article is based in part on wire service reports.