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Texas family that hosted Ebola patient confined to home
Ebola Victim Brother Werm
Wilfred Smallwood, who identified himself as a brother of Ebola patient Thomas Eric Duncan, speaks about his brother, while holding a photo of him Wednesday in Phoenix. Duncan has been kept in isolation at a hospital since Sunday. He was listed in serious but stable condition. - photo by Associated Press

Many sick in US Ebola patient's Liberia hometown

By KRISTA LARSON
Associated Press

MONROVIA, Liberia — Thomas Eric Duncan rushed to help his 19-year-old neighbor when she began convulsing days after complaining of stomach pain. Everyone assumed her illness was related to her being seven months pregnant.

When no ambulance came, Duncan, Marthalene Williams' parents and several others lifted her into a taxi, and Duncan rode in the front seat as the cab took Williams to the hospital. She later died.

Within weeks, everyone who helped Williams that day was either sick or dead, too — victims of Ebola, the virus that is ravaging Liberia's capital and other parts of West Africa, with more than 3,300 deaths reported.

The disease is spread through direct contact with saliva, sweat, blood and other bodily fluids, and all those who fell ill after helping Williams had touched her. She turned out to have Ebola.

Duncan is now hospitalized in an isolation ward in Texas after falling sick with Ebola following his arrival last month on a family visit. He has become a symbol of how the lethal disease could spread within the U.S.

Here in Liberia, however, he is just another neighbor infected by a virus that is devastating the cluster of tin-roof homes along 72nd SKD Boulevard where Williams lived.

"My pa and four other people took her to the car. Duncan was in the front seat with the driver, and the others were in the back seat with her," recounted her 15-year-old cousin Angela Garway, standing in the courtyard between the homes where they all lived. "He was a good person."

Meanwhile, Liberian authorities Thursday announced plans to prosecute Duncan, saying the delivery driver lied about his Ebola status upon leaving the country.

On an airport screening questionnaire obtained by The Associated Press, Duncan said that he hadn't come into contact with an Ebola patient. However, it is not clear whether he had learned of Williams' diagnosis before traveling.

In an interview with Canada's CBC News, Liberian President Ellen Johnson Sirleaf said she was "very saddened" and "very angry" with Duncan for putting Americans at risk, adding: "I just hope that nobody else gets infected."

In the neighborhood where Williams lived, some people were no longer willing to take any risks Thursday, not after seeing what happened to those who showed compassion for the pregnant woman.

As 9-year-old Mercy Kennedy sobbed along with neighbors mourning news of her mother's death, not a person would touch the little girl to comfort her.

Mercy's mother had helped to wash the pregnant woman's clothes, and had touched her body after she died at home when no hospital could find space for her, neighbors said.

On Thursday, little Mercy walked around in a daze in a torn nightgown and flip-flops, pulling up the fabric to wipe her tears as a group of workers from the neighborhood task force followed the sound of wailing through the thick grove of banana trees and corn plants.

"We love you so dearly, yeah," one man wearing rubber gloves told her from a safe distance. "We want to take care of you. Have you been playing with your friends here?"

With Mercy's mother dead, neighbors fear it is only a matter of time before she, too, shows signs of the virus, and they want to know which other children may have come into contact with her while she was fetching water.

Pewu Wolobah, a member of the neighborhood anti-Ebola task force, lamented that even as Americans try to trace all of Duncan's contacts there, the virus is spreading through Duncan's old neighborhood faster than anyone can keep track.

The aunt of the pregnant victim died on Wednesday after collapsing in her house next door to the Williams home. Her 15-year-old daughter Angela is left behind, along with the pregnant woman's three younger siblings — Ezo Williams, 16, Tete Williams, 12, and Stanley Williams, 3 — and the family dog.

Their parents left Thursday morning for an Ebola treatment center. As word spread that they, too, took a taxi, the health workers expressed alarm.

"Does anybody know the taxi number or the license plate?" one man called into the crowd. "We need to find this vehicle!"

All the cases, including Duncan's, appear to have started with Williams, though some wondered how a pregnant woman who stayed at home could have contracted Ebola. Maybe it was her boyfriend, who hasn't been seen in weeks, they said. Or could it have been her close friend known as Baby D, who has since died herself?

The tragedy of Williams' death could grow larger still: Neighbors and relatives said more than 100 people came to a wake for her. No one could say for sure how many people may have touched the body.

"We had a lot of people come from a great distance to sympathize with her family," said Joseph Dolo from the anti-Ebola task force. "She had a lot of friends."

 

DALLAS — Four members of a family the U.S. Ebola patient was staying with were confined to their Texas home under armed guard Thursday as the circle of people possibly exposed to the virus widened and Liberian authorities said they would prosecute the man for allegedly lying on an airport questionnaire.

The unusual confinement order was made after the family was "noncompliant" with a request not to leave their apartment, according to Dallas County Judge Clay Jenkins.

Texas State Health Commissioner David Lakey said the confinement would help ensure the relatives can be closely watched, including checking them for fevers over the next three weeks.

"We didn't have the confidence we would have been able to monitor them the way that we needed to," he said.

Several days of food have been delivered to the apartment. The family will not be allowed to receive visitors, officials said.

Officials were concerned about the cleanliness of the home and hired a cleaning service to come, Lakey said.

"The house conditions need to be improved," he said.

The infected man's belongings, including clothes and possibly bed sheets, are bagged inside the home so the family cannot come into contact with them until they are removed, Jenkins said.

Elsewhere, Texas health officials expanded their efforts to contain the virus, reaching out to about 80 people who may have had direct contact with Thomas Eric Duncan or someone close to him.

None of the people is showing symptoms, but public-health officials have educated them about Ebola and told them to notify medical workers if they begin to feel ill, Erikka Neroes, a spokeswoman for the Dallas County Health and Human Services agency, said Thursday.

The group will be monitored to see if anyone seeks medical care during the three weeks immediately following the time of contact, Neroes said.

The 80 people include 12 to 18 who came in direct contact with the infected man, as well as others known to have had contact with them, she said.

"This is a big spider web" of people involved, Neroes said.

The initial group includes three members of the ambulance crew that took Duncan to the hospital, plus a handful of schoolchildren.

The virus that causes Ebola is not airborne and can only be spread through close contact with someone who has symptoms. People have to come into direct contact with the patient's bodily fluids — blood, sweat, vomit, feces, urine, saliva or semen — and those fluids must have an entry point.

For example, people might get infected by handling soiled clothing or bed sheets and then touching their nose, mouth or eyes, or if they are not wearing gloves while doing those tasks and have a cut on their hand.

"If you sit next to someone on the bus, you're not exposed," CDC Director Dr. Tom Frieden said.

In Liberia, authorities announced plans to prosecute Duncan, alleging that he lied on a form about not having any contact with an infected person.

Duncan filled out a series of questions about his health and activities before leaving on his journey to Dallas. On a Sept. 19 form obtained by The Associated Press, he answered no to all of them.

Among other questions, the form asked whether Duncan had cared for an Ebola patient or touched the body of anyone who had died in an area affected by Ebola.

"We expect people to do the honorable thing," said Binyah Kesselly, chairman of the board of directors of the Liberia Airport Authority in Monrovia. The agency took the case to the Ministry of Justice, which will formally prosecute it.

Neighbors in the Liberian capital believe Duncan become infected when he helped bundle a sick pregnant neighbor into a taxi a few weeks ago and set off with her to find treatment.

The case has raised questions about whether a disease that has killed 3,300 people in West Africa could spread in the United States. U.S. health officials say they remain confident they can keep it in check.

Duncan arrived in Dallas on Sept. 20 to visit the family and fell ill a few days later. His sister, Mai Wureh, identified him as the infected man in an interview with The Associated Press.

A Dallas emergency room sent Duncan home last week, even though he told a nurse that he had been in disease-ravaged West Africa. The decision by Texas Health Presbyterian Hospital to release him could have put others at risk of exposure to Ebola before he went back to the ER a couple of days later when his condition worsened.

The man has been kept in isolation at the hospital since Sunday. He was listed Thursday in serious but stable condition.

Liberia is one of the three countries hit hardest in the epidemic, along with Sierra Leone and Guinea.

In Duncan's Liberian neighborhood, a collection of tin-roofed homes, has been ravaged by Ebola. So many people have fallen ill that neighbors are too frightened to comfort a 9-year-old girl who lost her mother to the disease.

The 19-year-old pregnant woman was convulsing and complaining of stomach pain, and everyone thought her problems were related to her pregnancy, in its seventh month. No ambulance would come for her, and the group that put her in a taxi never did find a hospital.

She eventually died. In the following weeks, all the neighbors who helped have gotten sick or died, neighbors said.

___

Paye-Layleh reported from Monrovia, Liberia. Associated Press writers Nomaan Merchant and Paul J. Weber in Dallas, Emily Schmall in Fort Worth and Krista Larson in Monrovia also contributed to this report.

 

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