New York City physician Dr. Craig Spencer has been diagnosed with Ebola virus disease and is in isolation at Bellevue Hospital in New York City, officials announced.

While the editors at InsideSurgery.com are not participating in his care, we are closely following the developments and past history of Dr. Spencer, who is on staff at Columbia Presbyterian Hospital.

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It appears from mainstream media reports that Dr. Spencer recently treated patients in Guinea while working for the famed volunteer medical care organization Doctors Without Borders.

He returned to the United States on October 17 via a connecting flight through Brussels.

Dr. Spencer was apparently well until yesterday late day when he developed fatigue and nausea. However, since he was not placed on any mandatory or even voluntary quarantine he chose to be out and about in New York City, taking cabs and the subway and going bowling last evening.

Then, this morning around 10 a.m. he developed a fever to 103 degrees and alerted authorities, who transported him to Bellevue Hospital. At a press conference, this evening city and state health officials repeatedly stressed that because he did not develop the fever this morning, he poses very little risk to the general public.

This is unfortunately not correct. The medical literature is clear that the risk of contagion occurs when the patient shows signs or becomes symptomatic and Dr. Spencer, although not febrile, was very clearly symptomatic last evening when he was out in public.

The officials are wrongly assuming that the first sign of Ebola is fever but data published in the New England Journal of Medicine clearly contradicts this and details that fever is not the first symptom in up to 15% of patients.

Dr. Spencer has done a grave disservice to the citizens of New York by making the decision to ignore his fatigue and nausea and go out in public. He, of all people, should have had a heightened sensitivity to the course of the disease and the risk of spreading the disease to the general public.

He did not have the end stages of the disease such as cardiac failure and hemorrhage, but he surely must know the disease constellation of the early phase of Ebola virus disease.

Yet, knowing he was not feeling well, he disregarded this to pursue his personal pleasure, much as nurse Amber Vinson did in taking a trip to Cleveland to plan her wedding.

If Dr. Spencer recovers, his medical career should be over.