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This epilogue accompanies case number 2055.0. In September 2014, as several West African countries continued to battle a deadly outbreak of the Ebola virus, Dallas, Texas, emerged as ground zero for the disease in the U.S. This case recounts how, over the course of three days, Thomas Eric Duncan, who had recently arrived in the city from Liberia, reported twice to Dallas Presbyterian Hospital exhibiting signs of illness. Having sent him home after his first visit, the hospital admitted him after his second; and with his symptoms worsening rapidly, tests soon revealed everyone’s worst fear: he had Ebola. “Fears and Realities” describes how local, state, and federal public health authorities, along with elected officials and hospital administrators, responded to the alarming news – a hugely difficult task made all the more challenging by confusion over Duncan’s background and travel history, and, eventually, by the intense focus and considerable concern on the part of the media and public at large. Efforts to curtail the spread of the disease were further complicated when two nurses who had cared for Duncan also tested positive for Ebola, even though they apparently had followed CDC protocols when interacting with him. With three confirmed cases of the disease in Dallas – each patient with their own network of contacts – authorities scrambled to understand what was happening and to figure out a way to bring the crisis to an end before more people were exposed to the highly virulent disease.

Learning Objective:
This case prompts readers to consider the very difficult challenges public health authorities and elected officials confronted in trying to organize their response to cases of Ebola in Dallas, Texas. It raises important questions about public communication, crisis decision-making, multi-organizational coordination, and general emergency response strategies in the face of significant novelty, incomplete and conflicting information, and rapidly evolving circumstances.

Other Details

Case Author:
Kirsten Lundberg
Faculty Lead:
Arnold Howitt
Pages (incl. exhibits):
United States
Funding Source:
Robert Wood Johnson Foundation, Association of State and Territorial Health Officials