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Ebola Virus Outbreak

It's Over: Texas' Ebola Outbreak Has Ended

Image: A member of the CG Environmental HazMat team disinfects the entrance to the residence of a health worker at the Texas Health Presbyterian Hospital who has contracted Ebola in Dallas, Texa

A member of the CG Environmental HazMat team disinfects the entrance to the residence of a health worker at the Texas Health Presbyterian Hospital who has contracted Ebola in Dallas, Texas, October 12, 2014. JAIME R. CARRERO / Reuters file

The Ebola outbreak in Texas has ended.

As of midnight Friday, it was 21 days since anyone got Ebola or was in contact with someone who got Ebola.

“God willing, we are going to be Ebola-free Friday midnight,” said Dallas County Judge Clay Jenkins, the elected official who oversaw the county’s response to its three-person outbreak, before the deadline passed.

It started when Thomas Eric Duncan, a Liberian citizen planning to settle in the United States, became sick and was at first mistakenly sent home from Texas Health Presbyterian Hospital in Dallas. He returned two days later by ambulance and was diagnosed with Ebola.

Officials had to track as many as 50 people who may have been in contact with Duncan. But the real scare came when two nurses, Nina Pham and Amber Vinson, became infected while caring for him. Vinson had traveled to Ohio to make wedding plans and, even though she wasn’t diagnosed until she came back to Dallas, her travels set off waves of anxiety.

A bridal store she had visited closed, schools closed, the airplane she traveled on was disinfected. One Ohio teacher stayed home because his wife flew on the same plane as Vinson had. Scientists who have studied Ebola for decades said such precautions were overkill; supporters of the measures said it was better to be safe than sorry.

Workers in hazmat suits disinfecting apartments and sidewalks became an almost common sight in Dallas.

Now, three weeks later, it’s clear that no one else was infected. As predicted by the Centers for Disease Control and Prevention and many other experts, the people at greatest risk were health care workers in close, prolonged contact with a patient who was actively having symptoms. Not even Duncan’s fiancée, Louise Troh, who cared for Duncan after he became ill and who lived in her apartment with him, became infected.

“I think it is a reinforcement of the basics of what we know about this disease,” said Health and Human Services Secretary Sylvia Burwell.

Ebola survivor Amber Vinson defends her decision to fly 4:49

Texas state health officials say they monitored 177 people, including health care workers, household members and others, who had contact with Duncan, Pham or Vinson or with medical specimens or waste.

The last person being monitored handled medical waste on Oct. 17, the state health department said in a statement.

“We’re happy to reach this milestone, but our guard stays up,” said Dr. David Lakey, commissioner of the Texas Department of State Health Services.

Earlier this week, Ohio stopped monitoring 163 people who may have been in contact with Vinson.

Vinson, who was taken to Emory University Hospital’s special biocontainment unit for treatment, left the hospital October 28.

The 21 days is based on the longest known incubation period for Ebola. Experts say most transmissions happen between 6 and 12 days.

They also point out that patients only transmit the virus after they’ve developed symptoms, usually vomiting or diarrhea but also — not likely but possibly — an initial fever. Vinson said she flew with a temperature of 99.5 degrees, not considered a fever.

The CDC says in retrospect, Vinson should not have flown on a commercial aircraft and has since issued new guidelines that limit some health care workers who might be at high risk of infection.

But CDC also notes that Ebola is spreading out of control in Sierra Leone, Guinea and West Africa because of a lack of health care infrastructure, not because Ebola is terribly contagious. The World Health Organization says more than 13,000 people have been infected and close to 5,000 confirmed dead.

Those infected are health care workers or friends and family members caring for the ill, or mourners at funerals — not casual community contacts. Quick isolation of people once they begin showing symptoms can control the spread of Ebola.

Vinson, 29, defends her decision to fly.

“I'm an (Intensive Care Unit) nurse; I embrace protocol and guidelines and structure, because in my day-to-day nursing, it is a matter of life and death, and I respect that fact,” she said in an exclusive interview on TODAY. “I would never go outside of guidelines or boundaries or something directly from the CDC telling me I can't go, I can't fly. I wouldn't do it.”

Now, a single U.S patient remains in isolation: Dr. Craig Spencer, a Doctors Without Borders volunteer who became ill after his return from treating Ebola patients in Guinea, is being treated in New York’s Bellevue Hospital.

But health officials caution that someone incubating Ebola could arrive in the United States at any moment, and say the only way to truly protect Americans is to stop the epidemic in West Africa.

And officials are still monitoring contacts of Spencer and people coming into the country from Ebola-affected areas. New York's health department is monitoring 357 people,mostly travelers but also a few staff who have been caring for Spencer, as well as ambulance staff who brought him to the hospital.

NBC's Amy Calvin contributed to this article.