DALLAS (AP) — Texas officials moved for the first time Thursday to force health care workers who had contact with a dying Ebola patient to stay home, reversing course after a nurse later diagnosed with the disease flew across the Midwest and deepened anxiety about whether the virus would spread in the U.S.
Seventy-five Texas Health Presbyterian Hospital Dallas employees who had contact with Thomas Eric Duncan were asked to sign legal documents in which they agreed not go to public places or use mass transit, according to Judge Clay Jenkins, top administrator for Dallas County.
The agreements are legally binding and can be enforced with a variety of remedies, Jenkins said, though he repeatedly declined to elaborate on specific punishments and expressed confidence that everyone would comply.
"From 21 days after their last exposure, we are agreeing that they are not going to go on any form of public conveyance — any sort of public transportation," Jenkins said. "We are agreeing that they won't go where people congregate — public spaces — and we are agreeing that they will self-monitor and allow us to monitor them twice a day."
It was one of several measures officials took Thursday amid a U.S. outbreak that has killed one person, infected two nurses and rattled nerves nationwide.
An official with the Centers for Disease Control and Prevention announced that the agency is expanding its Ebola investigation to include passengers on a Friday flight from Dallas to Cleveland with the nurse who was diagnosed with the disease after returning home to Texas. Officials already had been contacting passengers on a flight that Amber Vinson, 29, took Monday on her way back to Dallas from a weekend trip visiting family. Vinson is the second Dallas nurse diagnosed with the disease.
Dr. Chris Braden of the CDC said health officials couldn't rule out that Vinson may "have had the start of her illness on Friday." Officials previously stressed that Vinson didn't show symptoms during her Ohio visit.
People infected with Ebola aren't contagious until they start showing symptoms, such as fever, body aches or stomach pain, and then the disease is only transmitted through direct contact with bodily fluid. Still, Frontier Airlines said it is notifying passengers who either were on Vinson's flights or on later trips using the same plane, telling them to contact the CDC if they were concerned.
The CDC said Thursday that hospital staffers who had worn appropriate protective gear while treating Duncan before he died Oct. 8 initially had been deemed free to take commercial transport. But after the first nurse was diagnosed last weekend, staffers were placed on a status that calls on them to be evaluated by a public health physician every day and to stay off commercial transport.
An official has said the CDC cleared Vinson to fly Monday after she reported her temperature was below 100.4 degrees and she had no symptoms.
Also Thursday, the nurse who was the first person to contract Ebola in the U.S. was seen for the first time since her diagnosis in a video shot in her hospital room before she was transferred from Dallas to a specialized federal facility in Maryland. Vinson was taken to a similar location in Atlanta a day earlier.
Nina Pham is shown in the video — posted online by the hospital's parent company — smiling as she sits upright in a hospital bed while a man identified as her treating physician can be heard thanking her for getting well and being part of the volunteer team that took care of Duncan.
"Come to Maryland. Everybody," Pham laughs into the camera before wiping away tears with a tissue handed to her by an attendant in full protective gear.
Texas Health Presbyterian Dallas spokesman Wendell Watson said the transfer was necessary as authorities brace for the possibility of another infection in Dallas while so many members of the hospital's staff are sidelined.
Among the health workers being monitored for Ebola is Dallas County's top public health epidemiologist. Dr. Wendy Chung confirmed Thursday that she spent time at Duncan's bedside and is among those potentially exposed to the virus.
"Yes, I have been alongside other physicians and nurses in addressing this patient," Chung said in an email. "I am under the same monitoring protocols which are currently recommended for my clinical colleagues who are in the same exposure category as mine."
The Dallas hospital issued a statement late Thursday defending its practices and protocols and saying it followed what it described as frequently changing CDC guidelines and recommendations.
National Nurses United accused the hospital of sloppy procedures that endangered nurses by exposing them to the virus.
The hospital statement, while not referring to the union by name, said, "third parties ... who were not present when the events occurred are seeking to exploit a national crisis by inserting themselves into an already challenging situation."
Associated Press writer Terry Wallace in Dallas contributed to this report.