On October 8, 2014, Thomas Eric Duncan, the first person diagnosed with a case of the Ebola Virus Disease in the U.S., dies at age 42 at Texas Health Presbyterian Hospital in Dallas. Shortly before his death, Duncan, who lived in Liberia, had traveled to America from West Africa, which was in the throes of the largest outbreak of the often-fatal disease since its discovery in 1976. After Duncan passed away, two nurses who’d cared for him at the Dallas hospital contracted Ebola; however, both recovered.

On September 15, 2014, Duncan helped transport a sick pregnant woman to a hospital in Monrovia, Liberia. There was no space for the woman at the facility, so she was taken back to the residence where she’d been staying and died not long afterward from Ebola. On September 19, Duncan—whose relatives later said didn’t know he’d been exposed to Ebola—flew to Dallas to visit his fiancé. He arrived in Texas on September 20 and five days later went to the emergency room at Texas Health Presbyterian Hospital complaining of abdominal pain and dizziness. Duncan told a nurse he’d recently traveled from Africa but this information wasn’t effectively communicated to the rest of the medical team, who after a matter of hours sent him home with antibiotics.

On September 28, Duncan, his health deteriorating, returned to the hospital by ambulance. Two days later, the Centers for Disease Control and Prevention announced Duncan (who wasn’t named publicly at the time) was the first person in America diagnosed with Ebola, a disease that spreads through direct contact with body fluids of an infected individual. (Within a year after the West African Ebola outbreak first was reported in March 2014, thousands of people in Liberia, Sierra Leone and Guinea had perished.) Duncan’s diagnosis sparked anxiety and fear about Ebola across the U.S.; at the time, there were no proven treatments or vaccines for the disease. Health officials started tracking the dozens of people who might’ve come into contact with Duncan after he first became ill, and four of his family members were placed under quarantine for three weeks. None of these people developed Ebola.

Duncan died on October 8 and three days later a nurse who’d cared for him at Texas Health Presbyterian Hospital tested positive for Ebola. Four days later, a second nurse at the hospital was confirmed to have contracted the disease. Both women were placed in isolation units at separate medical centers, treated with experimental drugs and declared Ebola-free later that month.

As a result of the events in Dallas, federal officials instituted enhanced screening procedures at a group of U.S. airports handling travelers coming into the country from places with Ebola outbreaks. Officials also issued new guidelines for protective gear worn by health care workers treating patients infected with the virus. A total of two people died in the U.S. during the 2014 outbreak.