Dallas officials said that relatives of the man infected with Ebola left their apartment after agreeing not to, which prompted officials to issue a confinement order overnight.
“They were noncompliant with the request to stay home,” Dallas County Judge Clay Jenkins, the county’s highest elected official, said at a news conference Thursday.
He said the individuals needed to stay home so that they could be tested at the same time daily, to ensure they have not been infected with the Ebola virus that sickened Thomas Eric Duncan, the Liberian who traveled last month to Texas and began to show symptoms during his visit.
Officials said food was being supplied to those in the apartment and that a service would be cleaning the area where linen and clothes used by Duncan remained.
At an earlier news conference, Centers for Disease Control and Prevention Director Tom Frieden said Duncan was free of symptoms and did not have a fever when he left Liberia on Sept. 19 by plane, an effort to reassure passengers on the several flights that they were unlikely to contract the infection. Ebola can only be spread from an infected person who has symptoms.
When he departed, Duncan allegedly told Liberian officials that he had had no contact with anyone who was infected with Ebola, though it was later learned that he had helped a pregnant woman who was infected seek medical treatment.
It was unclear if Duncan knew the woman was ill with Ebola. Liberian officials have said they have yet to make a final decision on whether to charge Duncan.
Texas officials said they broadened their search for possible contacts who might have been exposed to Ebola from the original 12 to 18 people to about 100.
There is a core group, people who lived in the apartment where Duncan stayed, and the rest who may have come into contact with him or the core group. Those people may also have had contacts who are among the 100.
The most stringent surveillance is on those who lived in the apartment where Duncan visited.
Under the order, the family must stay in the apartment where they are have their temperatures taken once a day by health officials, and are expected to test themselves a second time daily and report the results, officials said.
Jenkins said local and state officials were forced to weigh personal freedoms against the common good, and decided the order was necessary, although the four individuals “are part of Dallas County and they will be treated with ultimate dignity and respect.”
Officials have said five children were exposed and attended classes at four Dallas public schools.
“I’m concerned about those children in that apartment, but I’m concerned about all the other children in the county,” Jenkins said.
Dallas Police and sheriff’s deputies have been dispatched to the complex in the northeast section of the city to enforce the order, officials said.
Mayor Mike Rawlings said said police were “embedded” at the complex “to create a safe environment.”
“It was clear to me, a Democrat, and to Governor [Rick] Perry, a Republican, that the actions that we took, while unusual, were appropriate,” Jenkins said.
Zachary Thompson, director of Dallas County’s health department, said he and Dr. Christopher Perkins, the department’s medical director, met with the four individuals at the apartment late Wednesday, reviewed the order with them and ensured they understood.
“They emphatically said they would comply,” Thompson said.
He declined to discuss conditions in the apartment, although he did say Duncan's belongings and sheets he had used were placed in a sealed plastic bag.
Officials sent several days' worth of food to the apartment, and contracted with cleaners used by the county and area hospitals to handle other blood-borne illnesses such as HIV/AIDS, Jenkins said.
“We have some hygiene issues in that apartment,” Jenkins said.
But the county judge said the confinement order and monitoring were for the four individuals’ own good.
“It’s to their benefit,” he said.
Meanwhile, new details and questions continued to emerge about Duncan’s time in Africa and how he was exposed to Ebola.
A young pregnant woman in Paynesville, Liberia, is believed to be the Ebola contact who infected Duncan.
Duncan was in direct contact with Marthalene Williams, 19, who died Sept. 16. The day before, Duncan helped the family in a fruitless search for medical treatment for the sick woman.
Williams’ parents, Amie and Emmanuel Williams, left home early Thursday to seek medical treatment a day after their son and a neighbor died.
Binyah Kessely from the Liberian Airport Authority told the Associated Press on Thursday that Duncan would be prosecuted on his return to Liberia for making a false declaration on his airport form.
However, Steve Jackson, spokesman for the Justice Ministry, told the Los Angeles Times he knew of no plans to prosecute Duncan and said the solicitor general would make any decision on the matter.
The form requires people to state whether they touched or treated an Ebola patient, and Duncan denied having done so.
Duncan's neighbors said no one in the area knew that Marthalene Williams had died of the virus, and people believed she died of pregnancy complications.
Neighbors accused the family of hiding Williams' symptoms, but her treatment form from the local Blessed Home Clinic -- where she went the morning before she died -- indicated she was diagnosed with malaria and found to have very low blood pressure.
As her condition declined, they referred her to a hospital.
Hennessy-Fiske reported from Texas and Dixon from Liberia.