I can't believe that the first ER crew missed it. I mean, a patient comes in with a fever, nausea and diarrhea. He's from west Africa and is in the country to visit relatives, and you send him home?!?!?
This is where arrogance comes into play. The threat was downplayed by political and health field leaders. When the risk is seen as minimal your guard is not up. We are not used to dealing with such things.
That said, history taking is important and this was missed. Someone(s) took a poor history or they would have caught this the first time around - or, in arrogance or apathy, they ignored the information they uncovered, thinking it irrelevant somehow. Really no excuse for that.
I guess now we get at least 42 days to see if our modern system of health care can quickly and efficiently stop a disease like Ebola. It's an experiment that didn't need to be if we had placed proper and prudent public health measures like screening and quarantining travelers from regions where there is a raging deadly epidemic ahead of politics.
Even if contained to contacts since this person became sick, there is now the risk of potentially dozens of deaths from this one case. All the doctors, nurses, paramedics, people in the waiting room at the ER, registration personnel, people at the pharmacy, grocery store, and so on. Anyone he came in contact with and given that Ebola stays viable for quite a while, depending on conditions, a number of other people that never came into direct contact with this person are now at risk. Can we trace them all? Is it even possible we could identify them all? I don't think so. If we contain it to just one level of transmission it will be a miracle. Even if we do, if you or someone you love becomes infected and dies will that matter to you? As James Spann is fond of saying, it doesn't matter if today is another April 27, if it's your house that is hit then it's your April 27. But the power that be only care about the big picture - not about you. Listen carefully and that is unmistakable. To some degree that is the nature of their job, but that callousness is compounded by their sheer incompetence.