Thomas Eric Duncan: 6 ways his case differs from other U.S. Ebola cases

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(Photo: Facebook / Thomas Eric Duncan / MGN)

His family is devastated. The woman he planned to marry haunted by the “what ifs.” And many are wondering why Thomas Eric Duncan died when several other Ebola patients treated in the United States survived.

Duncan was hospitalized eight days after he arrived from Liberia, and later tested positive for Ebola. He died Wednesday, but not much is known about his medical history.

Here are six ways his case differs from other patients in the U.S.:

Duncan wasn’t hospitalized right away

Unlike the American patients, who were quickly tested and quarantined at the first sign of Ebola, Duncan wasn’t.

Duncan arrived in Dallas from Liberia on September 20, and he made his initial visit to Texas Health Presbyterian Hospital on September 25.

He was treated for a fever, vomiting and abdominal pain — all symptoms of Ebola. But he was sent home with antibiotics and was not screened for the virus. Relatives say he told hospital staff he’d come from Liberia.

Three days later, he was hospitalized in worse condition and was quickly isolated. He became the first case of the deadly virus diagnosed on American soil.

“What if they had taken him right away? And what if they had been able to get treatment to him earlier?” said pastor George Mason of Wilshire Baptist Church in Dallas.

MORE: A local doctor answers questions

He didn’t get an experimental drug immediately

Duncan received experimental medicine on October 4 — six days after admission to the hospital. It was a far longer wait than four other Ebola patients treated in the United States. Those patients — two each at Atlanta’s Emory University Hospital and the University of Nebraska Medical Center — got experimental medicine immediately. They’re all U.S. citizens; Duncan was a Liberian.

His family is claiming bias.

“We feel he didn’t get the medicine and treatment for the disease because he’s African and they don’t consider him as important as the other three,” said Josephus Weeks, his nephew.

Not so, the hospital says.

Since the drugs are still experimental, individual hospitals have to file the paperwork with the Food and Drug Administration for permission to use them. The hospital declined to tell CNN when it filed for permission.

He got a different experimental drug

Duncan got the experimental drug Brincidofovir.

Two of four patients who survived after treatment in the U.S. received a different drug, ZMapp. Experts say there’s no proof that ZMapp or any drug is effective in treating Ebola. A Spanish priest infected with Ebola died after taking it in August.

The Centers for Disease Control and Prevention said ZMapp stocks have since been depleted.

A third American patient received TKM-Ebola — another experimental drug approved by the FDA recently for wider use.

The fourth one, NBC cameraman Ashoka Mukpo, who got infected in Liberia and was airlifted to Nebraska on Sunday, got the same drug as Duncan.

The hospital treating him had no advance notice

The Atlanta and Nebraska facilities knew in advance they were expecting Ebola patients, a crucial element for a disease so rare in the United States.

Hospitals that took care of the four are also among the most well-equipped nationwide to battle the deadly virus.

Despite lack of notification, Texas Health Presbyterian Hospital said Duncan got top-notch care and his medical team consulted daily with the CDC and Emory.

Information on his case has been muddled

Details on Duncan’s background have not been as clear-cut.

His relatives said he made it clear to the hospital that he had just come from Liberia. His symptoms pointed at Ebola, they said.

Initially, the hospital said Duncan was “not exhibiting symptoms specific to Ebola” when he first went to the hospital. And, they said, details about his travel history weren’t communicated to doctors.

But later, the hospital said a flaw in electronic records had kept doctors from seeing his travel history. Then it said his travel history had been documented and was available to his care team.

Family believes his insurance status played a role

Duncan had just arrived from Liberia to visit his girlfriend and son, and probably had no insurance.

The Rev. Jesse Jackson, who’s serving as a spokesman for the family, said that was a concern.

“I would tend to think that those who do not have insurance, those who do not have Medicaid, do not have the same priorities as those who do,” the civil rights leader said.

But the hospital denied the claim.

Duncan was treated like everyone else, “regardless of nationality or ability to pay for care,” Texas Health Presbyterian Hospital said.


  • RJ

    As horrible as this is for the family and for all involved in his treatment, there’s a big difference between all the other patients brought back to the U.S. and his: Early testing and detection. If he knew he had been in contact with Ebola (the only way he could get it since it isn’t airborne) he should have gotten tested before symptoms occurred — not get back, wait 5 days and then go get checked out. Time is of the essence with this and many other serious illnesses and if you know you had been exposed — why not get checked out just to feel safe?

    I feel horrible for the family, but making this into a racial (naturally, Jesse Jackson got involved and had to make a statement) or discriminatory thing is unfair, especially when comparing it to the other cases where it was known before they set foot on U.S. soil that they were infected. It’s apples and oranges.

    • Gomar

      Duncan came here knowing he was exposed to ebola, lied on his departure paperwork, and CBP entrance questions to seek better care.

      Texas Presbyterian wasn’t ill suited to handle infectious disease such as this, and by dying, Duncan is used to instill more paranoia, and send a message to Liberians considering travel to the U.S. for treatment that look, you’re not automatically safe in the U.S. either.

      • RJ

        Texas Presbyterian may not have been ill suited to handle infectious diseases such as this, but the others were much better suited and had significant prep time before the patients arrived to make sure they were ready. That’s what makes this different. Everything else you stated is your opinion. In fact, the U.S. has been downplaying, not creating, paranoia regarding Ebola in the U.S. The CDC and even local hospitals have stated that the U.S. can handle Ebola cases should they arise and that there is no need for the public to panic.

        Non-U.S. residents shouldn’t be able to get into the country to get medical attention anyway, so that point is moot. If they are legal residents, even if not citizens, they should be able to come to U.S. for treatment. However, the difference here is that the treatment for all of the others started before they left Africa. They were already being treated before getting to U.S. soil. That is NOT true of Mr. Duncan. The question that needs answered is if he knew he was exposed, why’d he wait 5 days to go to Texas Presbyterian. I’d have alerted anyone I could to get checked out ASAP, especially knowing what it is doing across the pond. I’m not saying he had any malicious motives … just that his priorities were in the wrong place if, indeed, he came back to the U.S. to get better treatment. Hard to argue that when he waited 5 days to even get checked out.

  • SoSueMe

    He came here knowing he was exposing people to this disease. He lied on the paperwork. He was sick when he boarded the plane. He should have been treated to the tried and true remedy: lead treatment. dosage of 158 grains dispensed at 1300 ft/sec to the forehead. Best to put a plastic bag over the head to contain the splatter.
    Get ready, till president Ebola stops flights in and out of the Ebola hot zones, there will be more like Duncun. As far as Jackson, he’s a race baiting idiot.

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