Ebola patient Thomas Eric Duncan died at 7:51 a.m. Wednesday at a Dallas hospital, leaving loved ones to grieve and public health officials to ponder how to stop the often-lethal virus from spreading in the U.S.

A total of 48 people are being monitored after having some type of contact with Duncan, including four who are kept isolated and guarded at a home in Dallas. None were displaying symptoms as of Wednesday afternoon.

Duncan’s girlfriend, Louise Troh, is one of the 10 considered high-risk. She released a statement Wednesday saying, in part, “I trust a thorough examination will take place regarding all aspects of his care. I am now dealing with the sorrow and anger that his son was not able to see him before he died.”

Duncan, 42, first sought care at Texas Health Presbyterian Hospital Dallas on Sept. 25 but was sent home with antibiotics, even though he told a nurse he was from Liberia, the heart of the devastating Ebola outbreak in West Africa. The information apparently was not relayed to everyone on his medical team. He returned to the hospital by ambulance Sept. 28 and was placed in isolation.

Duncan received supportive care, as well as an experimental drug, but it was not enough to stop the virus.

The couple’s son, Karsiah Duncan, lives in San Angelo and attends Angelo State University. He came to Dallas before his father died but was not allowed to see him.

A service in Thomas Eric Duncan’s memory took place Wednesday at Wilshire Baptist Church, 4316 Abrams Road in Dallas, where Troh attends church.

City and county leaders reacted to Duncan’s death with statements of condolence for family members and reassurance for the public.

Mayor Mike Rawlings said the city “will stop the Ebola virus in its tracks from spreading into our community. I want to reinforce to the public that this was an isolated incident of the Ebola virus contracted by the individual while residing in another country.”

Dallas County Judge Clay Jenkins also released a statement, saying his thoughts are with Duncan’s family and friends, “especially his fiancée Louise; their son, Karsiah; and all those who loved him.”

White House press secretary Josh Earnest also responded: “There’s no doubt that medical professionals all across the country are more vigilant about this now.”

Duncan’s death, he said, “underscores why the president has made it a priority to stop the spread of this disease at the source.”

Schools offer counseling

Five students at four Dallas district schools who may have had contact with Duncan have not shown symptoms and will not return to school until after the 21-day incubation period. Ebola shows symptoms two to 21 days after exposure.

The school district plans to make counseling available to students and staff, according to its statement at www.dallasisd.org/healthupdates.

Duncan had stayed with Troh and other family members at The Ivy Apartments in Dallas before he was hospitalized. She and the three others who had been confined to the apartment were moved Friday to a home in a gated community that was donated for the purpose.

The apartment was decontaminated by The Cleaning Guys of Fort Worth, who donned hazmat suits and worked round-the-clock.

Zachary Thompson, Dallas County’s health and human services director, is asking the Centers for Disease Control and Prevention to assess the northeast Dallas complex — or recommend someone who can — to boost the “comfort level” of the residents.

Dr. David Lakey, commissioner of the Texas Department of State Health Services, called the past week “an enormous test of our health system, but for one family it has been far more personal. Today, they lost a dear member of their family.”

He added, “We’ll continue every effort to contain the spread of the virus and protect people from this threat.”

Body to be cremated

Duncan’s remains will be handled according to strict guidelines established by the CDC. The bodies of Ebola victims are extremely infectious.

“This is a difficult time for the family, and our thoughts are with them,” Lakey said. “We will continue to treat Mr. Duncan with dignity and respect, and we’re taking great care to make sure there is no additional risk that others could be infected.”

The guidelines include enclosing the body in two bags and disinfecting the bags. Then the body can be removed from the patient room and the room can be disinfected.

The body will be cremated. The guidelines also say it could be “buried promptly in a hermetically sealed casket.” But Lakey explained why the state recommended cremation and the family agreed, his statement says.

Cremation will kill any virus in the body, so the remains can be given to the family afterward.

CDC guidelines for healthcare workers, including for those handling remains, are at www.cdc.gov/vhf/ebola/hcp/index.html.

This report includes material from the Star-Telegram archives.