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Retracing Ebola's Steps

AUDIE CORNISH, HOST:

Several developments in the Ebola story today. President Obama named an Ebola czar to coordinate the nation's response to the deadly virus. Meanwhile in Dallas, authorities asked dozens of health care workers who came into contact with Ebola patient Thomas Eric Duncan to voluntarily restrict their movements or face mandatory quarantine. And officials expanded the number of Americans under possible watch for the illness. These include hundreds of passengers who flew with an Ebola patient We've asked NPR's Rob Stein to trace the arc of the U.S. Ebola response.

ROB STEIN, BYLINE: The outbreak that's dominating the news today and gripping the nation began very quietly, in a remote village in the tiny African nation of Guinea back in December. And even by last spring, the outbreak wasn't setting off huge alarm bells. Experts, like Esther Sterk of Doctors Without Borders, thought the virus would be quickly contained, like every other Ebola outbreak since the 1970s.

ESTHER STERK: We will manage to contain this outbreak, but when - it's a bit difficult to say at the moment.

STEIN: But this wasn't like any other Ebola outbreak. This time the virus was showing up in urban areas, not isolated rural villages as it had before. It spread quickly within Guinea and then to neighboring countries of Sierra Leone and Liberia. By then, it was out of control. But Ebola didn't really get America's attention until early August, when two U.S. missionaries, including Dr. Kent Brantly, returned to the U.S. for treatment after getting infected. This from NBC News.

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LESTER HOLT: The stark image of a sick American doctor sealed from head to toe arriving back on U.S. soil today gave us a glimpse of just what health workers fighting the Ebola outbreak in Western Africa are up against.

STEIN: Days after Brantly arrived in Atlanta, Margaret Chan, head of the World Health Organization, declared the epidemic in West Africa as the worst in history.

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MARGARET CHAN: Countries affected to date simply do not have the capacity to manage an outbreak of this size and complexity on their own.

STEIN: She issued an urgent call for help, and the world did finally start to respond. Dr. Thomas Frieden, the director of the U.S. Centers for Disease Control and Prevention, traveled to the heart of the epidemic himself.

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TOM FRIEDEN: This is the biggest, most complex and most difficult outbreak of Ebola that we've had to deal with.

STEIN: But it all still felt very far away. That is, until September, when Thomas Eric Duncan arrived in Dallas from Liberia to visit his fiance. Duncan had Ebola. Suddenly, the virus was dominating the news again. The CDC's Tom Frieden assured the public everything was under control.

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FRIEDEN: I have no doubt that we'll stop this in its tracks in the U.S.

STEIN: It turned out the nation wasn't nearly as prepared as Frieden and others said. The hospital in Dallas where Duncan initially sought help misdiagnosed him and sent him home. Then, last week, Duncan died. Within days came word that Nina Pham, one of the nurses who cared for Duncan, had gotten infected and then just a few days after that, a second nurse, Amber Vinson, was also diagnosed. The CDC's Frieden.

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FRIEDEN: I think we could - in retrospect - we could have sent a more robust hospital infection control team and been more hands-on with the hospital from day one.

STEIN: But that wasn't all. It turns out the second had flown had flown to Cleveland and back to Dallas in the days just before she was diagnosed. The two infected nurses were airlifted to specialized hospital units in Maryland and Atlanta for treatment. Schools in Ohio and Texas closed to help calm nervous parents. Then, officials announced another Dallas health care worker who may have been exposed to the virus had gotten on to a cruise ship. As the week's events unfolded, President Obama canceled two days of travel to stay at the White House and focus on Ebola.

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PRESIDENT BARACK OBAMA: First of all, what I've directed the CDC to do is that as soon as somebody is diagnosed with Ebola, we want a rapid response team - a SWAT team essentially - from the CDC to be on the ground as quickly as possible.

STEIN: And today, the president named Ron Klain, a former chief of staff for Vice Presidents Joe Biden and Al Gore, to coordinate the nation's response to Ebola. Rob Stein, NPR News. Transcript provided by NPR, Copyright NPR.

Rob Stein is a correspondent and senior editor on NPR's science desk.