Ebola patient in Dallas hospital dies

Thomas Eric Duncan, the Liberian national who was the first patient diagnosed with Ebola in the United States, died Wednesday at a Dallas hospital, Texas Health Presbyterian Hospital said.

Duncan, 42, arrived in Dallas from Liberia on Sept. 20 and was admitted to Texas Health Presbyterian on Sept. 28. Two days later he was diagnosed with the deadly virus that has claimed 3,879 lives in West Africa, according to the World Health Organization.

Duncan, whose condition steadily deteriorated over the past 10 days, had been heavily medicated, on dialysis and in a semi-comatose state, said Saymendy Lloyd, a Washington-based Liberian activist who has been acting as a spokeswoman for the family. Duncan had also been receiving some experimental anti-Ebola drugs at his family's urging.

Duncan's body will be cremated to reduce the risk that it could infect others, said David Lakey, Texas health commissioner.

"His suffering is over," said Louise Troh, Duncan's fiancée who rented the apartment where he was staying. "My family is in deep sadness and grief, but we leave him in the hands of God. Our deepest sympathies go out to his father and family in Liberia and here in America. Eric was a wonderful man who showed compassion toward all."

"He fought courageously in this battle," said Wendell Watson, a hospital spokesman. "Our professionals, the doctors and nurses in the unit, as well as the entire Texas Health Presbyterian Hospital Dallas community, are also grieving his passing. We have offered the family our support and condolences at this difficult time."

Troh, who was relocated along with her family and is being monitored daily for any symptoms of Ebola infection, thanked the people of Dallas, a church, the local Liberian community and public officials "for all the love and support they have shown" during the ordeal. "Without their help, I can't imagine how we could have endured," she said.

The treatment of the family drew criticism when they were quarantined in the apartment with Duncan's contaminated belongings for six days before a hazardous materials crew arrived to bag up and sanitize the materials.

Duncan's 19-year-old son, Karsiah Duncan, who has not seen his father since he fled Liberia at the age of 3 to avoid a civil war, had flown to Dallas Monday to visit his father. But Duncan died before their scheduled meeting Wednesday via a closed-circuit video, Lloyd said.

Duncan, in a few lucid moments recently, had told a nurse he was excited about reuniting with his son, who plays football at an American university, after 16 years. 'I'm so proud of him, I can't wait to see him,'" Duncan told the nurse, according to Lloyd.

News of Duncan's death sent shock waves through members of the Liberian community in the Dallas-Fort Worth area, who were holding prayer vigils for his recovery.

"Not just shock but fear," said Bishop Nathan Kortu, a local Liberian leader. "Right now everybody is really afraid. For this man to be in an advanced country where we thought he was in a safety zone, for him to perish like this is a very big concern for the Liberian community right now."

Liberian funerals are typically elaborate affairs, with an all-night viewing of the body followed by funeral services and burial, followed by a large celebration laden with traditional African dishes and singing, he said.

"Liberians like to say good bye to loved ones who have died," Kortu said. "It's amazing that none of this will happen."

There are no proven treatments or vaccines for Ebola, but several Ebola patients treated in the USA and elsewhere have received experimental, unproven drugs for compassionate use.

The odds were not in Duncan's favor, doctors say. About 70% of Ebola patients in West Africa are dying of the virus, including 60% of those who get to the hospital, said Robert Murphy, a professor of medicine and biomedical engineering at Northwestern University in Chicago.

His condition was complicated by a two-day delay in treatment after a Dallas hospital initially sent him home without realizing he was infected with Ebola. Such delays can be deadly with infectious diseases, Murphy said.

"The quicker we can get patients into care, the better their odds for survival. He may have been too far gone for even our best supportive care," said Amesh Adalja, infectious disease specialist at the University of Pittsburgh Medical Center.

Three Americans treated for Ebola – Kent Brantly, Nancy Writebol and Richard Sacra – were evacuated from Liberia to top-flight American hospitals with specialized biocontainment units developed to treat Ebola and other dangerous diseases. All three survived.

"We've gotten lucky with the airlifted cases that they were able to get good supportive care," Adalja said.

But doctors may have had a more difficult time with Duncan. "We don't know his past medical history," such as whether he had any serious chronic diseases in addition to Ebola, Adalja said.

Duncan contracted the disease just before leaving Liberia in mid-September when he helped helped carry a 19-year-old woman, who was later diagnosed with Ebola, into a taxi to go to the hospital after her family was unable to get an ambulance.

The young woman, who was seven months pregnant, was turned away at the hospital because of lack of space in the Ebola ward. She returned home that evening, hours before she died.

At the airport in Liberia when he was departing, Duncan signed a form saying that he had not had contact with any person infected by the virus.

It is not clear whether he knew of her diagnosis, which initially appeared to be pregnancy-related, at the time he left the country. Officials in Liberia said Duncan showed no symptoms when he boarded the plane and he was therefore not contagious.

Ebola can only be spread through the bodily fluids of people showing signs of the disease. Unlike an infection such as tuberculosis, which primarily attacks the lung, Ebola affects many organs of the body at once, said Adalja.

Massive diarrhea and vomiting can cause dehydration and disrupt the normal balance of electrolytes, such as potassium, causing heart rhythm problems, he said. The virus can cause bleeding by making tiny holes in blood vessels and by harming platelets, a type of blood cell that normally helps the blood to clot. Ebola can cause kidney and liver failure, and prompt the immune system to overreact, further stressing the body. Many patients with Ebola die of septic shock, or a bloodstream infection, Adalja said.

As the first case of a person diagnosed with the disease in the United States, Duncan's hospitalization drew national attention to the deadly disease and efforts to keep it from spreading.

After Duncan's condition was diagnosed, city and state health officials moved quickly to track down as many as 80 to 100 people with whom he had contact in Dallas before he was hospitalized.

Dallas Mayor Mike Rawlings was notified of Duncan's death while at a Dallas City Council meeting. "We will stop the Ebola virus in its tracks in our community," he vowed later.

The case also drew attention to the screening procedures for travelers from West Africa entering the United States, prompting a tightening of regulations.

In Washington, White House spokesman Josh Earnest on Wednesday confirmed a new policy that travelers from West Africa will get fever screening for Ebola at five U.S. airports. These airports are the destination of 94% of passengers from West Africa, he said.

Contributing: Jason Whitely, who reports for WFAA-TV in Dallas