A Liberian man hospitalised with Ebola in the US went to an emergency room seeking treatment and told a nurse he had come from Africa, but was turned away.
More people may have been exposed to the contagious man after he first sought treatment on September 25 because an apparent miscommunication among staff resulted in his release back into the community for several days, Texas hospital officials admitted.
Identified as Thomas Eric Duncan, the man - the first person to be diagnosed with Ebola on US soil - flew from Liberia, the hardest-hit nation in West Africa's deadly Ebola outbreak, and arrived in Texas on September 20 to visit family. He fell ill on September 24.
Duncan went to the hospital the next day but was sent home because the medical team "felt clinically it was a low-grade common viral disease", said Mark Lester, executive vice president of Texas Health Resources.
"He volunteered that he had travelled from Africa in response to the nurse operating the checklist and asking that question," Lester added.
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"Regretfully, that information was not fully communicated throughout the full team."
A hospital statement issued later in the day said his initial symptoms on September 25 were "low-grade fever and abdominal pain", and that "his condition did not warrant admission".
Duncan is currently in serious but stable condition.
He came in contact with schoolchildren before he returned via ambulance to the Texas Health Presbyterian Hospital Dallas on September 28, and was placed in strict isolation.
"I know that parents are being extremely concerned about that development," Texas governor Rick Perry said.
"These children have been identified and they are being monitored and the disease cannot be transmitted before having any symptoms."
The Emmett J. Conrad High School in Dallas wrote to tell parents that a student there may have had contact with the unnamed Ebola patient, but stressed the child was not showing any symptoms.
"There is nothing to suggest that the disease was spread to others," the school said.
The incubation period for Ebola is between two and 21 days. Patients are not contagious until they start to have symptoms. Ebola can lead to massive bleeding and fatal organ failure.
A 10-member team of experts from the US Centers for Disease Control and Prevention has landed in Texas to assist the investigation.
While health experts say the public should not panic - since Ebola is spread not through the air but only through close contact with bodily fluids - medical personnel are on the lookout for more cases of Ebola on US soil.
Zachary Thompson, the director of Dallas County Health and Human Services, told local media that "there may be another case that is a close associate with this particular patient".
Three crew members who worked in the ambulance that transported the patient have tested negative, but they will be monitored for 21 days, the City Of Dallas said on Twitter.
Anthony Fauci, the head of the National Institute for Allergy and Infectious Disease, said the man should have been identified as a suspected Ebola case the first time he sought care.
"If the person said, 'Well, I just came back from Liberia,' that would have been an enormous red flag for anybody, given the publicity that we have," Fauci told CNN.
