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Across 3 continents, Ebola makes its way to US

SHARON COHEN
Associated Press

DALLAS (AP) — His week began thousands of miles away with a frantic bid to save a life.

It was Monday, Sept. 15, and Ebola, a terrifying disease, was ravaging West Africa, filling morgues and hospitals to capacity. In Monrovia, Liberia, the virus was about to claim one more person.

Marthalene Williams, seven months pregnant, had been diagnosed with low blood pressure when she was brought to a clinic, desperately ill.

Soon after coming home, she began convulsing. Thomas Eric Duncan, assisted by her family and others, lifted his neighbor into a taxi that rushed to a hospital maternity ward, where she was turned away. The 19-year-old woman returned to her house, where she died hours later.

That Friday, Sept. 19, Duncan arrived at Roberts International Airport in the capital of Monrovia.

He was about to embark on a three-leg journey, traveling from Africa, through Europe and into the United States. He would travel more than 8,000 miles before arriving at Dallas/Fort Worth International Airport in the early evening of Sept. 20.

His temperature, taken before he boarded the plane in Monrovia as part of precautionary government measures, had been below normal. But when he walked out into the steamy Texas night, he carried with him one of the deadliest diseases known to medicine.

Ten days later, he’d become the first person diagnosed in America with Ebola.

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The same day that neighbors say Duncan carried his dying neighbor back into her home, the U.S. was calling for an emergency meeting of the U.N. Security Council to address the growing Ebola crisis.

The worst Ebola outbreak in history has swept through Liberia, Sierra Leone and Guinea, and has stretched into Nigeria and Senegal. Nearly 7,500 people are believed to have been sickened by the disease and more than 3,400 have died, according to the World Health Organization.

Liberia has been hardest hit, with more than 3,800 cases and slightly more than 2,000 deaths. But even those ghastly numbers likely underestimate the scope of the disaster and the true toll may never be known. The World Health Organization has noted that in the notoriously overcrowded slum of West Point, in the capital, bodies are just tossed into the river.

Liberia is woefully lacking beds in isolation units needed to care for people. Doctors Without Borders has described the heartbreaking act of turning away people who seek treatment at their centers in Monrovia.

The horrifying impact of Ebola can be seen and heard throughout Liberia’s capital, from corpses on the street, men pushing the sick in wheelbarrows and the constant wail of ambulances. Even a public service phone message warns “Ebola is real” before a call comes through.

At the airport, nurses wearing white lab coats, face masks and gloves take the temperatures of departing passengers. There are giant dispensers with chlorinated water and buckets for hand-washing.

When Duncan arrived Sept. 19, his temperature was taken and recorded on a passenger screening form. It was 97.3.

Citing the Ebola outbreak, the form notes: “We need your help to prevent the spread of this disease.”

Ebola is transmitted through direct contact with saliva, sweat and blood. It is not contagious until the symptoms begin.

The form asks travelers if they have any of 10 listed symptoms — among them, fever, vomiting, diarrhea, stomach pain and fatigue. Duncan answered “no” to all.

He also was asked if he’d taken care of an Ebola patient or touched the body of anyone who’d died in an Ebola-stricken area in the last 21 days — the incubation period. He answered “no” to both questions as well.

It’s unclear if Duncan knew he may have been exposed to Ebola when he boarded his plane. While he had close contact days before with the pregnant woman, who neighbors now believe died from Ebola, she was never tested. It was initially suspected she had died of complications from her pregnancy.

This past week, however, Liberian authorities announced plans to prosecute Duncan when he returns, accusing him of lying on the questionnaire.

Once in Dallas, Duncan settled in at the Ivy apartment complex in the northeast part of the city, which is home to thousands of immigrants, many of them poor. This melting pot where dozens of languages are spoken is less than a five-minute drive from some of the toniest sections of Dallas.

Duncan was staying in a second-floor apartment with Louise Troh, her 13-year-old son, Duncan’s distant cousin and a family friend.

On Sept. 25, Duncan was feeling sick enough that he went to the emergency room at Texas Health Presbyterian Hospital. He was reported to have a fever, headache and abdominal pain, but no diarrhea or vomiting. The hospital said he told them he’d recently arrived from West Africa, but that he denied having been around anyone sick. He was released.

By Sunday morning, Duncan’s condition had worsened.

Youngor Jallah, 35, the daughter of Louise Troh, went to her mother’s apartment to check on him. He’d been vomiting and had diarrhea the previous night. When she arrived with crackers, Gatorade and tea, Duncan was too sick to come out for breakfast.

After she found him fully dressed with socks, shivering in bed under a thin polyester blanket, Jallah drove to a Wal-Mart to buy “the warmest blanket I could find.” When she returned, she noticed red in his eyes.

Jallah, a nurse’s assistant, took his temperature and blood pressure — both of which were unusually high — and called an ambulance. When it arrived, she warned the staff “this man is from a virus country.” They returned in protective gear and gloves.

Now Jallah is in self-imposed quarantine with her partner, Aaron Yah, and four children in their modest two-bedroom apartment. She’s wracked with regret for not taking precautions.

“I’m having all those bad feelings,” she told The Associated Press. “I’m just doubting myself every minute. I’m trying to take my mind off it, but I can’t do it.” She doesn’t kiss or hug her children, ages 2, 4 and 6, or her live-in partner’s 11-year-old son or share dishes with them.

She says she and Yah, also a nurse’s assistant, often work nights, and had left the children with her mother and Duncan every night of his stay.

Yah says he knows his active, affectionate children probably came in close contact with Duncan, but adds: “I know that with God, everything is possible, so I am just praying that nothing happens to them.”

Duncan remains in isolation, where he was listed in critical condition Saturday.

At the end of the week, Texas health officials said they had narrowed to about 50 the group of people they were monitoring who had some exposure to Duncan. All are having their temperatures taken daily. So far, none have shown symptoms of the virus. Nine people who are considered to be at higher risk are being watched more closely.

Duncan has remained in contact by phone with some relatives, including Josephus Weeks, a nephew living in Charlotte, North Carolina. Duncan’s mother is staying there.

“It can be scary sometimes and it can be uplifting sometimes,” Weeks says of their conversations. “The days when I’m able to get him to smile, to laugh, those days are good. That means that he’s feeling good and he’s got a little more strength to fight.”

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Sharon Cohen reported from Chicago. Krista Larson in Monrovia, Liberia, Nomaan Merchant in Dallas, Warren Levinson in New York, Sarah DiLorenzo in Dakar, Senegal, and Carley Petesch in Johannesburg contributed to this report.

Copyright 2014 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Don’t Settle for Student Loans to Pay for Online Education

Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
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