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A photo of Dr. Spencer posted on his Facebook page.

A person infected with Ebola cannot spread the disease untilthey begin to display symptoms, and it cannot be spreadthrough the air. As the person becomes sicker, the viral loadin the body builds, and they become more and morecontagious.

Dr. Spencers travel history and the timing of the onset of hissymptoms led health officials to dispatch disease detectivesimmediately began to actively trace all of the patientscontacts to identify anyone who may be at potential risk,according toa statement released by the department.

It was unclear if the city was trying to find people who mighthave come into contact with Dr. Spencer on the subway. TheMetropolitan Transportation Authority directed all questionsto the health department, which did not immediatelyrespond to requests for comment on the issue.

At Dr. Spencers apartment in Harlem, his home was sealedoff and workers distributed informational fliers about thedisease. It was not clear if anyone was being quarantined.

Health authorities declined to say how many people in totalmight have come into contact with Dr. Spencer while he wassymptomatic.

Mayor Bill de Blasio, speaking at a press conferenceThursday evening before the diagnosis, said Dr. Spencer hasgiven health workers a detailed accounting of his activitiesover the last few days.

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Our understanding is that very few people were in directcontact with him, Mr. de Blasio said.

Dr. Spencer had been working with Doctors Without Bordersin Guinea, treating Ebola patients, before returning to New

York City on Oct. 14, according to a city official.

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A photograph of Dr. Spencer on his LinkedIn page.

He told the authorities that he did not believe the protectivegear he wore while working with Ebola patients had been

breached but had been monitoring his own health.

Doctors Without Borders, in a statement, said it providesguidelines for its staff on their return from Ebolaassignments, but did not elaborate on those protocols.

Continue reading the main story

The individual engaged in regular health monitoring andreported this development immediately, the group said in astatement.

Dr. Spencer began to feel sluggish on Tuesday but did notdevelop afeveruntil Thursday morning, he told theauthorities. At 11 a.m., the doctor found that he had a 103-degree temperature and alerted the staff of Doctors WithoutBorders, according to the official.

The staff of Doctors Without Borders called the citys healthdepartment, which in turn called the Fire Department.

Emergency medical workers, wearing full personal protectivegear, rushed to Dr. Spencers apartment, on West 147thStreet. He was transported to Bellevue and arrived shortlyafter 1 p.m.

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He was placed in a special isolation unit and is being seen bythe pre-designated medical critical care team. They are inpersonal protective equipment with undergarment air

ventilation systems.

Bellevue doctors have prepared for an Ebola patient withnumerous drills and tests using test patients as well asactual treatment of suspected cases that turned out to befalse alarms.

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Bellevue Hospital has been designated the center for treatment of the Ebola virus in

New York City.CreditJoshua Bright for The New York TimesA health care worker at the hospital said that Dr. Spencerseemed very sick and it was unclear to the medical staff whyhe had not gone to the hospital earlier, since his fever washigh, at 103.

Dr. Spencer is a fellow of international emergency medicineat NewYork-Presbyterian Hospital/Columbia UniversityMedical Center, and an instructor in clinical medicine atColumbia University.

He is a committed and responsible physician who alwaysputs his patients first, the hospital said in a statement. Hehas not been to work at our hospital and has not seen anypatients at our hospital since his return from overseas.

Even before the diagnosis, the federal Centers for Disease

Control and Prevention dispatched a team of experts to assistin the case, before the test results were even known.

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More than 30 people have gone to city hospitals and raisedsuspicions of Ebola, but in all those cases, health workers

were able to rule it out without a blood test.

While the city stepped up its laboratory capacity so it can get

test results within four to six hours, because of theprecautions that need to be taken when drawing blood andtreating a person possibly sick with Ebola, it took until late inthe evening to confirm the diagnosis.

But doctors said that even before the results came in, itseemed likely that he was infected. Symptoms usually occur

within eight to 10 days of infection and Dr. Spencer washome nine days when he reported feeling ill.

Ebola is transmitted through bodily fluids and secretions,

including blood, mucus, feces and vomit.