The CDC’s guidelines and those issued by the Dallas County health department are nearly identical. The county’s version begins this way:
“1. Has the patient been in an EVD-affected area within 21 days before onset of symptoms (currently Guinea, Sierra Leone, Liberia, Democratic Republic of the Congo and Lagos, Nigeria)?”
EVD is an abbreviation for Ebola virus disease.
A “yes” answer leads to Question 2, which seeks replies to eight yes/no questions about Ebola exposure, including: Any direct contact with a known or suspected EVD patient in 21 days? Provided health care to one, or been inside a hospital treating EVD patients?
If there’s even one “yes” answer, the hospital goes to Question 3, which asks if the patient has ANY — the capitals are in the original — of the following:
Fever, even if subjective, meaning the patient feels feverish regardless of the thermometer reading?
Muscle pain? Stomach pain? Diarrhea or vomiting? Headache? Unexplained bleeding or bruising?
Even one “yes” answer leads to the following instruction:
“Immediately place the patient in a private room … while clinical evaluation is in progress and until cleared by the hospital infection preventionist.”
Relatives said Duncan told an ER nurse at Presbyterian that he had just come from Liberia. The hospital said in a prepared statement Thursday that he disclosed having been in Africa. If Duncan did not specify Liberia, it’s unclear whether the hospital asked where in Africa, which has 54 sovereign countries.
The hospital also said Duncan answered “no” when asked if he’d been exposed to Ebola.
But the plan anticipates that some patients will give inaccurate or untruthful answers. Under the guidelines, even if a patient denies exposure, just being from Liberia and feeling feverish — even if the fever is below the official Ebola diagnostic marker of 101.5 — should be sufficient to trigger isolation and further evaluation.
Duncan’s stomach pain and headache were further evidence of trouble. Although Presbyterian initially called his complaints vague, and later said his symptoms were not severe, the CDC emphasizes that in its early stage, Ebola can resemble less serious diseases.
None of the responses by hospital personnel were what the guidelines contemplate. The mention of his travels apparently brought no follow-up.

Friday night brought the hospital’s third version, in the form of another brief news release: There was no glitch. There never had been a glitch. Everyone who needed to know that Presbyterian had a sick patient from Africa, including physicians, did know.