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How Did the Nurse Get It? What We Know (and Don't) About Ebola

The first known person-to-person transmission of Ebola in the United States has heightened anxieties and widened the circle of potential victims.
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Revelations that a nurse at a Texas hospital contracted Ebola has fed fears that an outbreak could happen on American soil, despite officials’ assurances that the odds remains slim. But the new case has raised questions about whether American hospitals are equipped to handle the disease, and it forces authorities to rethink their approach to containment.

With the nation on high alert — and with dozens more people being monitored for potential exposure — here are answers to some key questions about the current outbreak.

How many people have contracted Ebola this year?

There have been about 8,400 reported cases, all but two dozen of which have been confined to three countries at the heart of the epidemic: Guinea, Sierra Leone and Liberia, according to the Centers for Disease Control and Prevention. There have been four travel-related cases, including Thomas Eric Duncan, the Liberian victim who carried the disease to Texas and apparently infected the nurse before his death. Additionally, five people who were diagnosed in West Africa have been transported to and treated in the United States.

More than 4,000 have succumbed to Ebola, prompting the head of the World Health Organization on Monday to call the current outbreak “the most severe, acute health emergency seen in modern times.” Duncan’s death on Oct. 8 was the first in the United States.

Is there a cure?

There is no cure for Ebola, but detected early and with the proper care, those afflicted can recover from the virus. Experiments are underway on several potential vaccines. That includes a Canadian-made vaccine that its makers say has been 100 percent effective in preventing the spread of the Ebola virus among animals. Testing on healthy humans, to determine side effects and proper dosage, began Monday in a lab in Maryland, and results are expected in December. The U.S. government is also testing a vaccine on medical workers in Mali, with trials possible early next year.

How did Thomas Eric Duncan bring Ebola to America?

Authorities believe Duncan contracted Ebola while helping a stricken pregnant woman to the hospital in Liberia shortly before flying to Texas to be reunited with the mother of his teenage son. He reportedly denied being exposed to the disease when he left Liberia, and showed no symptoms until days after he arrived in Dallas. The disease is only contagious when a victim is showing symptoms, and can only be transmitted through bodily fluids, including blood, vomit, feces, urine and semen.

How did the nurse get it?

The 26-year-old nurse, Nina Pham, was among the first health care workers to treat Duncan at Texas Presbyterian Hospital, and is said to be in stable condition. She reportedly wore a protective gown, gloves mask and shield, so authorities presume that her infection — the first known person-to-person transmission of Ebola in the United States — may have come as a result of a “breach” in protocol. Their investigation will include a look at how health care workers remove their protective gear and whether the dialysis and intubation of Duncan played a part. That may lead to changes in treatment, such as withholding some procedures in cases of victims that cannot be saved.

What is being done to prevent Ebola’s spread in America?

The CDC, the nation’s lead public health agency, has issued a Warning Level 3 notice for U.S. citizens to avoid travel to the Ebola hot zone. The CDC has also stepped up screening at points of entry into the United States, including the airports that accept passengers from the three West African countries at the center of the outbreak: New York Kennedy, Newark Liberty, Washington Dulles, Chicago O’Hare and Hartsfield-Jackson in Atlanta.

In the cases of Duncan and Pham, health officials have attempted to identify everyone who had potentially risky contact with the victims and quarantine them for the 21-day maximum incubation period. In Duncan's case, 48 people are being monitored. In Pham's case, authorities are monitoring one person who has been identified as having contact with her when she was "potentially, but most likely not infectious," CDC head Thomas Frieden said Monday.

What happens to the bodies of those who have died?

Health authorities recommend that people who have died of Ebola be cremated or buried in an airtight casket. Duncan’s body was cremated. Now, a debate is raging over the fate of Duncan’s belongings, which also were incinerated. The ash was supposed to end up in a Louisiana landfill, but the operator backed out Monday as local lawmakers vowed to seek a court order blocking such a move.