The delay came amid reports that as many as 100 people could have had contact with the victim, Thomas E. Duncan. And it came a day after the hospital acknowledged it had misdiagnosed him when he first visited.
When Mr. Duncan, 42, was first taken to the emergency room at Texas Health Presbyterian Hospital on Sept. 25, he was examined and sent home with antibiotics by doctors who apparently did not suspect Ebola. A nurse had learned from Mr. Duncan that he had traveled from Liberia, one of three African countries where the virus is rampant, but that detail apparently was not communicated to the rest of his medical team, hospital officials said.
The woman with whom Mr. Duncan was staying told CNN that she had been with him the first time he sought treatment at the hospital and that she had twice emphatically told workers there he had been in Liberia.
The international air travel system has also proved to have porous screening procedures that rely heavily on the honesty of travelers and the diligence of airport workers. The chairman of the Liberian national airport authority, Binyah Kesselly, said Thursday that Mr. Duncan had been deceptive about his exposure to the virus when he flew out of Roberts International Airport in Monrovia on Sept. 19.
Mr. Kesselly said that Mr. Duncan, who was screened before boarding and did not have a fever, answered “no” to a question about whether he had had contact with any person who might have been stricken with Ebola in the past 21 days. That is the maximum period of incubation for Ebola.
In fact, four days earlier, Mr. Duncan helped take a young woman, who was critically ill with Ebola, to a hospital. After she was turned away, he carried her from a taxi back to her home, where she soon died, according to her relatives and neighbors.
In the United States, local and national health officials have also been unclear, and sometimes contradictory, about how many people in the Dallas area may have come into contact with Mr. Duncan while he was contagious (the virus can be transmitted through bodily fluids like saliva, blood and vomit).
They said Wednesday that they believed 12 to 18 people had direct contact. On Thursday morning, a spokeswoman for Dallas County Health and Human Services said it was thought that 80 people had contact directly with Mr. Duncan or secondarily with his direct contacts. Then in an afternoon news conference, Dr. Thomas R. Frieden, the director of the Centers for Disease Control and Prevention, said that health workers were assessing 100 people — including hospital workers and emergency medical technicians — to determine whether they had been exposed. That number does not include secondary contacts, a spokesman for the agency said.
The woman who spoke to CNN said Mr. Duncan had been sweating profusely and suffering from diarrhea. He also vomited in the apartment complex parking lot, according to local health officials. Like all others exposed to Mr. Duncan, who is listed in serious condition, the woman has not shown Ebola symptoms.
The failure to sanitize his sheets and towels also revealed a broader problem in handling materials possible infected with the virus. Hospitals say they face a major challenge disposing of waste generated in the care of Ebola patients because two federal agencies have issued conflicting guidance on what they should do. As a result, hospitals say, waste may pile up and they cannot get rid of it.
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Global Pandemics