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Thomas Eric Duncan, the first patient to die of Ebola in the United States, was initially released by Texas Health Presbyterian Hospital in Dallas.

Thomas Eric Duncan, the first patient to die of Ebola in the United States, was initially released by a Dallas hospital.

The Cambridge Health Alliance is prepared to handle Ebola patients, a spokesman said, with a plan that appears to avoid many of the missteps that occurred when a Liberian man with the virus sought treatment at a Dallas hospital.

The Cambridge system, which includes Cambridge and Somerville Hospitals and Whidden Memorial Hospital in Everett, as well as 15 primary care clinics, is evaluating patients “with signs or symptoms of infection” for risks, including “travel from countries where Ebola is occurring,” Alliance spokesman David Cecere said.

Texas Health Presbyterian Hospital in Dallas initially sent Thomas Eric Duncan home when he came to the emergency room with symptoms of the illness Sept. 25, five days after arriving in the United States from Liberia. He returned three days later, feeling worse, and was admitted and diagnosed with Ebola, the first case in the United States. Duncan died today at the hospital.

Duncan reportedly told medical workers on his first visit that he had come from Liberia, one of three West African countries where the Ebola epidemic is raging. The handling of his case has sparked fears about the ability of the U.S. health care and public health systems to prevent an outbreak here.

Training, specialists in place

Cecere said CHA staff are trained in using “personal protective equipment,” a term for gloves, gowns, face masks and other equipment that protect medical workers from patients’ blood and bodily fluids. Ebola is spread by direct contact with blood and bodily fluids; many health care workers in Liberia, Sierra Leone and Guinea have died after caring for patients with Ebola.

The Alliance has infectious-disease specialists prepared to manage Ebola cases, and its laboratories are capable of handling samples correctly, Cecere said. The Massachusetts state laboratory is seeking certification to test blood for the virus; samples now are sent to a laboratory of the U.S. Centers for Disease Control and Prevention in Georgia, Department of Public Health spokesman David Kibbe said.

The department last month ordered doctors to report any suspected cases or potential Ebola contacts to the state and to their local public health board. Suspected cases are patients with fever, vomiting or other Ebola symptoms and a history of travel to an area of epidemic within the past 21 days.  Department officials have said no one in Massachusetts has a confirmed case of Ebola; Kibbe declined to say how many suspected cases have been reported.

Cecere said the contractor who removes hazardous waste from Alliance facilities is licensed to dispose of material such as clothing potentially contaminated with the Ebola virus. In Dallas, bedding and clothing used by Duncan was not removed for several days from an apartment where he stayed because, officials said, it was not clear who was licensed to dispose of it.

The material remained in the apartment along with four people, including a teenager, who were quarantined because they had close contact with Duncan. Officials have been monitoring them and other contacts for symptoms of the virus. So far they haven’t shown symptoms.

Another worry: Enterovirus 68

The Alliance is also dealing with a much more prevalent infectious disease: a respiratory virus called enterovirus 68. The virus has spread in recent weeks, particularly among children, and some young patients have been  admitted to hospitals and intensive care units with severe respiratory symptoms. A 4-year-old New Jersey boy who died last week is considered the first fatality of the disease.

This week the Alliance sent a message to all its patients who use the system’s electronic communication system, MyChart, providing information about the virus,  including a list of symptoms that should prompt parents and others to seek emergency treatment. A message was also posted on the Alliance website.

Next story: Health Alliance stiffens Ebola preparation, but will send infected to Boston hospitals