The missteps in Dallas’s handling of the first Ebola case diagnosed in the United States have revealed an uncomfortable reality: state and city plans for handling the deadly virus are based on generic recommendations for everything from measles to floods, to hurricanes and dirty bombs.

Even before Sunday’s news that a health worker who treated the Dallas case had herself contracted the disease, officials acknowledged they need to do more.

Reuters checks with health departments in six states and cities that have large West African communities, Philadelphia, Boston, New York City, Minnesota, New Jersey, Maryland and Rhode Island, show that they are scrambling to adapt those generic plans to Ebola.

If they are not able to stay one step ahead of any cases, then lapses that characterized Ebola patient Thomas Eric Duncan’s treatment in Dallas could recur. In the Texas case that led to unnecessary exposure to the victim.

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