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ANDERSON COOPER 360 DEGREES
U.S. Ebola Patient Flew On United Airlines; Mayor: Patient May Have Had Contact With 20 People; Hospital Released Ebola Patient By Mistake; Ebola Survivor Recounts Her Battle; Graham Suspect Linked To Another Case; Dunn Convicted of Murder in Loud Music Killing; Japan Volcano: Death Toll Rises To 48
Aired October 1, 2014 - 21:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
ANDERSON COOPER, CNN ANCHOR: So there are big questions about that and many more things tonight. We're taking your questions as well. Tweet us using #EbolaQ&A right here at the bottom of your screen. You can see it.
A lot of ground to cover for Medical Correspondent, Dr. Sanjay Gupta, Elizabeth Cohen, Aviation Government Regulation Correspondent Rene Marsh and 360's Gary Tuchman. First Elizabeth Cohen, the timeline of Mr. Duncan's journey from health to deadly illness. So walk us through how he ended up to the hospital?
ELIZABETH COHEN, MEDICAL CORRESPONDENT: All right. So let's go though this timeline then Anderson. So first of all, on September 28th, Mr. Duncan arrived in the United States form Liberia. On September 25th, he visits the emergency room here, Presbyterian and is sent home. Now, while he's there, a nurse asked, have you had recent travel to West Africa and he says yes but we're told by the hospital that information was not communicated to the rest of the care team.
On September 28th -- so three days later, he visits Presbyterian again. This time he's brought in an ambulance and he is isolated. On September 29th, a family friend calls for CDC complaining that the hospital is moving too slowly. Anderson?
COOPER: Anderson? So the Dallas Mayor said that Mr. Duncan may have come in contact with so many as 20 people. How much do we know about those people? How they're doing? Have they been tested?
COHEN: Right, we're told that five of those people are children. Some of those folks were told are ambulance workers. So I assume many of the others are family members. As far as we know Anderson, they have not been tested and I'll tell you why. We're told that all of his contacts are healthy. No one is showing any symptoms. The way that an Ebola test works, it's not perfect. It is only going to work if you're already having symptoms.
So let's say, for example that we could look into a crystal ball and we knew that I was going to get Ebola tomorrow. If you tested -- that I was get sick tomorrow. I was going to be ill tomorrow. If you tested me today, I would be negative even though the virus is inside of me. You have to have the virus inside you and you have to be sick in order to get a positive result. So there's really no reason to test perfectly, you know, people who are not showing any signs of the disease. There's just no reason to do it. So as far as we know, no testing has been done.
COOPER: And I mean, the good news, if there is any in all of that is that it's not until someone actually shows signs of the virus actually get sick that they then can transmitted to other people so they maybe positive for the virus...
COOPER: ... it can't be tested but they're also not going to be able to transmit it?
COHEN: Right Anderson. Those two things go hand and hand. You don't have enough virus in you when you're asymptomatic, when you're not showing symptoms. You don't have enough virus in you to get someone else sick. You also don't have enough virus to sort of trip (ph) a test and to take that test go positive. So those two things go together.
COOPER: He was transported to the hospital by an ambulance, reportedly got sick in the ambulance -- he was vomiting and the ambulance I mean were the ambulance crew? Are they OK? Do we know -- have they've been test or being quarantined at all?
COHEN: What we have told is that they are being monitored and we've been told -- there're sort of conflicting reports, some authorities who've said they've been tested and some authority say, they haven't been tested but again, if they're feeling well and we're told that they're feeling well, a test is not going to be helpful, it's always going to be negative. So there's really no reason to test them if they're feeling well.
Now, as far as that ambulance have, you know, were told that he was vomiting in the ambulance on the way to the hospital, you know, it was decontaminated afterwards as you would anytime someone vomits. You know, an interesting question and we don't know the answer to is, when they decontaminated it they didn't realized he had Ebola. So did they take proper precautions when they decontaminated -- because they don't know what they were dealing with and that certainly worrisome.
COOPER: This maybe a question that you can answer because maybe it's not known but, I mean, if they don't dispose off that stuff properly, how long is that -- could that actually infect somebody else?
COHEN: No -- Ebola is actually a relatively fragile virus so I think there's not a lot of concern about that possibly getting someone sick because first of all, even though they didn't know that it was Ebola it's vomit, it's got germs in it. They would always or argue -- and hope they would always dispose of it in a responsible way.
But I don't think that's a concern, but certainly I would want to, you know, I would want to -- if I were the folks who cleaned up that vomit I would be thinking back, "Jesus, did I protect myself properly"...
COHEN: ... all those questions would certainly be top of mind.
COOPER: All right. Elizabeth Cohen, thanks very much.
As she mentioned at the top of the program Thomas Duncan came to this country by air. At least some of the way in United Airlines, during his trip, he went through some of the busiest airports on earth and traveled in close quarters with hundreds of people. For more on that angle, we got Rene Marsh. So what do we know about exactly the flight he took?
RENE MARSH, CNN AVIATION CORRESPONDENT: Well, Anderson, we know that this man, he left Liberia on September 19th. He arrives in Belgium. We know that that flight was six hours and then from Belgium, he took a United Airlines Flight 951 to Washington to Dulles. We know that that was an eight-hour flight. He had a three hour layover once he got to Dulles, and then he hoped on another United Airline Flight 822. That flight we know was about two and a half hours. And then, at that point, he made his final destination which is Dallas. Anderson?
COOPER: So were the passengers who travel with him on this flights, were they alerted at all? I mean, obviously people would want to know although as Elizabeth Cohen points out because he wasn't sick on the flight, he wasn't showing any signs of the illness. He would not have been able to transmit anything to any passengers.
MARSH: Absolutely. We know that during the flight no one knew that this man was essentially carrying the virus because as you said, he was not displaying any symptoms not even the airline knew but we do know that today, the CDC alerted United Airlines and the carrier voluntarily release the flight information. So, now passengers know. If you were on United Airlines Flight 951 or United Airlines flight 822 during this timeframe, you were on that plane with this man.
COOPER: Is there a protocol for cleaning the aircraft because obviously, we all know aircrafts now are not clean this much between flights because of quick turn around in times. And again, because he wasn't sick on the flight, he could not have been infecting anybody else on-board that flight as long as he wasn't sick or showing signs of being sick. But do we anything about the protocol on that, what they do with the plane?
MARSH: Right. So we can tell you a little bit about the plane. We do know that both planes are now in use for flight aware.com, one of this plane, it is at Dulles airport right now as we speak and it's actually schedule to fly out to Frankfurt in about another hour from now. The second plane also was in service today. As far as cleaning goes, the planes are usually cleaned after a situation like this. So we have no reasons to believe that the planes were not cleaned Anderson.
COOPER: OK. So we don't really have confirmation one way or the other but again, we should just point out, lest people completely freak out, this guy was not sick on the plane, he's not showing any symptoms of the virus therefore could not transmit the virus therefore, there is really no concern for the passengers or that aircraft itself. Rene Marsha, appreciate that.
Back to Dallas, back in the community where Thomas Duncan was staying, people as you might imagine are worried. Gary Tuchman joins us now with more on that. You've been on the Townhouse Community where this man was staying, how concerned are people there?
GARY TUCHMAN, CNN NATIONAL CORRESPONDENT: Well, that Townhouse Community Anderson is five minutes from this hospital and most of the people who live there are immigrants, mostly form Africa, from Asia, from Latin-America. And to be honest with you, when we got there, a lot of the residence had no idea what was going on. They don't know why police were there. They didn't -- why we were there. It's fair to say that among to those people and the people who knew there is a lot of concern.
COOPER: What about in Dallas' Liberian community? What are you hearing?
TUCHMAN: Yeah. There is a substantially sized Liberian community here. We talk with some community leaders who are basically telling us that there is a stigma to dreaded disease like this and it's time to make an a call to all Liberians here. Don't worry about being a stigma. If you have any symptoms ask for help. One pastor told us that Liberians are very tough but now it's not a time to be tough, now is the time to seek help if you have any symptoms like that.
COOPER: And as you reported in our last hour, the victim may have had contact with his girlfriend's five kids, they've now been pulled out of their schools for the time being -- what are the parents of other kids in the school saying? And as far as we know, the kids themselves are not showing any signs.
TUCHMAN: Well, exactly right. No signs, whatsoever. And the five kids have no signs either and that's obviously good news. But keep this in mind, never in the history of United States of parents ever had a deal with an Ebola related situation in their school. So when parents came to pick up their children they were very concern, many came very early.
The schools will be open again tomorrow but some of the parents we've talked to have not made a decision about whether to send their children back to these four schools that are affected. Now, we talk to one little girl and who showed us they flier that they got today. All the children got a flier describing the situation that's in English and Spanish. Take a look.
(BEGIN VIDEO CLIP)
TUCHMAN: This morning, we are made aware that student in your school may have had contact with an individual who is recently diagnosed with the Ebola virus.
When you heard about this Ebola stuff what did you think?
UNIDENTIFIED FEMALE: We are scared.
TUCHMAN: You're twins and you're talking at the same time. But are you OK now?
UNIDENTIFIED FEMALE: Yes.
TUCHMAN: Is there taking good care? The students who are here didn't have Ebola. You know that, right?
UNIDENTIFIED FEMALE: Yes.
TUCHMAN: OK. So you're coming back to school tomorrow?
UNIDENTIFIED FEMALE: Yes.
(END VIDEO CLIP)
TUCHMAN: The schools are cleaned everyday after school but it's fair to say Anderson that they will be much more tightly cleaned and sanitized this evening, next evening, the evening after that, school officials want parents to know that.
COOPER: Yeah. And again, I just want to stress, I know I'm repeating it but the kids who came and contact with Mr. Duncan are not showing any signs of it so therefore they could not have transmitted to other kids at the school. Gary, I appreciate that
According to this episode federal officials all the way from President Obama are now expressed confidence that the public health system was up to the job of handling Ebola, the recent events though call (ph) some of that confidence into question.
Our Chief Medical Correspondent Dr. Sanjay Gupta joins us now with more on that.
It just seems like there were major missteps in how this was handled. You're the CDC now. How do they explain that?
DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: I think they have a great explanation for this Anderson. And look, it's an incredibly historic thing that is happened here, right? This has never happened where a patient has been diagnosed with the Ebola in this country.
Patients have been flown into this country after they -- already diagnosed somewhere else for treatment but this a first and obviously it raises some concerns but it wasn't that unexpected. And as a result -- I mean, they've been planning this for months and talking about all kinds of things, right? Everything from vaccine trials to experimental medications, contact tracing, asking for a travel history, that sort of the most basic stuff -- very, very important but very, very, basic stuff.
And as a result of not completely getting the right information here, they probably delayed this guy getting into isolation area and delayed starting to get him tested and that's a huge mistake.
Dr. Tom Frieden is the head of the CDC. He's the guy that sort of been tip of the spear on this. I asked him about that particular issue earlier today. (BEGIN VIDEO CLIP)
GUPTA: What is the guidance? Should that person had been tested?
THOMAS FRIEDEN, CDC DIRECTOR: We weren't there, so I can't tell you exactly what that person said...
GUPTA: You're advising public health department, so the last time I was here. There was a call with many primary care doctors to educate them on this exact issue. That was a couple of months ago.
Should this person have been tested?
FRIEDEN: You know, we know that in busy emergency departments all over the country, people may not ask travel histories. I don't know if that was done here but we need to make sure it is done going forward. That's the bottom line.
GUPTA: Because right now there could be -- this could be playing out right now in other emergency rooms around the country, this exact situation where there could be somebody who has a fever and that having Ebola but they're not tested. As a result they have many, many more contact that's why outbreaks occur.
FRIEDEN: Absolutely. It's a big country. It's a big healthcare system. That's why we do extensive outreach to provide information so that all over the country people are thinking about that. And if people come in and get their history taken -- have you been in West Africa in the past 21 days and if they have a fever, immediate isolation and testing.
In fact, we were already felt that about 100 calls about patients from around the country who may fit that description. Only 14 of them actually met criteria for testing and this is the first week positive (ph)...
(END VIDEO CLIP)
GUPTA: And just to give you a little bit of the history of the day to day, you know, first what we heard was that when the patient first went to the hospital, he didn't disclose that he was from Liberia and he wasn't asked. That turned out and not to be true.
Later on we heard that in fact he was asked, did disclosed that he had just been in Liberia but a nurse who check that questionnaire did not communicate it effectively to the rest of the team. You know, look -- again, this is low-hanging truth.
Hopefully, this sends a message to other emergency departments and public health departments around the country. This -- we cannot get wrong if we're going to be serious about stemming this sort of outbreak in those country.
COOPER: Yeah, and you wish the CDC Director would just kind of, you know, say really what he thinks which is obviously this was a mistake. I mean, he clearly went, you know, did not want to -- I don't know I just be critical of this hospital or whatever but -- Sanjay we're going to have more with you in just a little bit.
Coming up next, given what you just heard from the CDC Director and what we're learning about the apparent miscommunication with Thomas Duncan home despite some clear red flags. The question is how prepared our hospitals in the United States.
Drew Griffin took a look, joins us right after the break.
COOPER: Looking tonight at Ebola in America, the case of Thomas Duncan and what may easily be more cases to come as we reported at the top. He went to the hospital with fever and vomiting, told the nurse he'd come from Liberia and yet doctors still sent him home.
Somehow, the Liberian information ever got the people if they needed to know it. Now, that's just one patient in just one hospital. What happens when it's more than just one? And when they do ultimately deal with an Ebola case, what's the protocol for things like sanitation and medical waste?
Elizabeth Cohen report and Mr. Duncan vomited in the ambulance or hospitals, cleaning crews, (inaudible) prepared for that.
Drew Griffin has been looking toward. He joins us now. So what have you learn Drew?
DREW GRIFFIN, CNN SENIOR INVESTIGATIVE CORRESPONDENT: Anderson, when it comes to how many American hospitals are really prepared to accept Ebola patients. The answer is really only a handful.
You know, before this case we had Emory here at Atlanta, the Nebraska Medical Center, they accepted Ebola patients but they knew they were coming in advance. They had a chance to prepare, prep the staff.
This Texas case, this is the first walk-in Anderson of an Ebola patient. The hospital clearly stumbled. And that say infectious disease experts really needs to change.
(BEGIN VIDEO CLIP)
DR. GAVIN MACGREGOR-SKINNER, ELIZABETH R. GRIFFIN RESEARCH FOUNDATION: We have a lot of hospitals that are prepared and really probably don't even want patients.
And so what we've seen -- we've seen hospitals now are downloading paper-based guidance plans from the internet and then they had working out how the management -- through the management, how do they do the implementation, and how is the hell, how to make these things happen to ensure that if they do unfortunately get an Ebola patient, everyone in the hospital was going to be safe.
(END VIDEO CLIP)
COOPER: Wow, they're downloading stuff from the internet, that one is exactly comforting. Are there guidelines at those hospitals and other hospitals about medical waste that's generated by treating Ebola patients'?
GRIFFIN: You know, that's a good question and it speaks to what Elizabeth Cohen was talking about, would that vomit in the ambulance. There's a lot of waste. It's got to be gotten rid of safety.
You know at Emory they had two patients here. A doctor told a staff meeting at the peak, when they were treating those two patients, they were generating up to 40 bags of medical waste a day. And what then? You know, every hospital has procedure Anderson. Every -- practically every hospital in the country hires outside contractors to take care of the trash in the case of Ebola waste.
However, the rules are still being sorted out. A Washington based trade group that represent this waste howlers told us basically that, "current federal regulations effectively restrict transportation of this material."
(BEGIN VIDEO CLIP)
MACGREGOR-SKINNER. Are willing to take away what is a Level IV Category A disease and disperse and get rid of that waste safely? And we believe that's not their argument because we haven't tested it. We haven't visited hospitals. We haven't on the risk assessments and we haven't done on-site visits and evaluated their capabilities and their competencies and their capacity.
(END VIDEO CLIP)
GRIFFIN: Look, the waste is more of administrative problem really but you've got to, you know what you have to do prepare for this? You got to drill, drill, drill. These hospital staffs need to get their act together Anderson. They got to deal with the very real possibility that tomorrow one guy could walk-in, say I've been to Liberia and have a fever.
Right now, this stumble in Texas, as bad as it was, and they have led to more people being exposed, it could be a great wake up call for every hospital out there that's basically have been putting off this kind of drills and they're now downloading papers on how they handle Ebola patients.
COOPER: Yes, I mean obviously it's something that all hospitals got to get up to speed on. Drew Griffin, thanks.
Digging deeper now with a leader in the field Dr. Anthony Fauci, Head of the National Institute of Allergy and Infectious Diseases.
Dr. Fauci the fact this Ebola patient went to emergency room. He was vomiting, had a fever, told the nurse he was visiting from West Africa but wasn't tested for Ebola, how does that happen? What do you make of that?
DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES: Well that certainly was an example of something that shouldn't happen and, you know, it fell between the cracks. The patient mentioned that he had come from Liberia and it was not translated or transmitted to the people who are making the decision about what the disposition of the patient was. It's unfortunate things like that happen. It's unfortunate it happened under these circumstances.
COOPER: Is there a nation plan in place here because I know the CDC had warned, you know, and told the hospitals and medical professionals to essentially be on the look out to, you know, to be alert for signs of Ebola. That message clearly in this case didn't resonate.
FAUCI: Well, it didn't but the CDC really has been stressing that. It was not for lack of trying. They put out several announcements of communications to healthcare providers, to clinics, to emergency rooms that taking travel history when someone presence with a symptom complex that is compatible with Ebola. You have to do a travel history and take the travel history under consideration when you make a clinical decision. Unfortunately, it didn't happen this time but the CDC has really been trying to get that message across.
COOPER: When you talk about, you know, contact with fluid, this is not airborne, that's important to stress, it's important to people not panic about that. I've got some tweets last night and I didn't know the answers. And one of the tweets I got was if you're on airplane with somebody who was infected and they're sweating a lot and they leaves sweat on say the armrest of the seat that you are then sitting next to her. You touch that armrest or you're the next passenger who sits on that plane, is that possible to contact -- contracted that way?
FAUCI: Well I mean obviously when you have a hypothetic like that you can never say, no zero chance but the one thing that you want to put into context that if a person is sick enough to be sweating and getting fever and chills that person today is not going to be able to get on the plane because if you were or I we're Monrovia right now and we wanted to get on the plane and we had a fever or we were symptomatic they would not let us on the plane.
So, the scenario that you put forth as a hypothetical is extraordinarily unlikely to happen and just like with this patient, when the patient got on the plane he was perfect well. He had no symptoms and no fever in fact he was well for several days after he got here to the United States. He arrived on the 20th and the symptoms did not start until the 24th and that's the reason why officials are fairly confident and quite confident that the people on the plane were no danger at all.
COOPER: So it's not until the person is actually starts to show symptoms that they actually can transmit the virus through bodily fluid contact?
FAUCI: That's correct Anderson. In fact there's a considerable amount of experience of multiple outbreak certainly none as biggest this one dating back from 1976 that a person is not transmitting until they actually begin to have symptoms. And that's the reason why taking a person's temperature and asking if they have symptoms is very important in the pre-flight screening when someone is trying to get on the plane.
COOPER: All right, Dr. Fauci, I appreciate you're being on. Thank you very much.
FAUCI: Good to be with you.
COOPER: Well, coming up, woman who knows better than anyone what Thomas Dunkan is now facing. Nancy Writebol, she survived Ebola after being given experimental serum getting treatment in Atlanta. We're going to hear from her and her husband when this special hour continues.
COOPER: Ebola in America as we've been learning tonight, not everyone in American seems ready for it, certainly a lot hospitals however if anyone tonight truly knows what patient Thomas Duncan is going through right now it is Nancy Writebol. She contracted the virus during missionary work in Ebola clinic in Liberia. She was treated successful there and in Atlanta. I spoke with her and her husband David earlier tonight.
(BEGIN VIDEO CLIP)
What does it feel like? I mean what did you actually feel early on and then as it progress?
NANCY WRITEBOL, EBOLA SURVIVOR: Well, you know, I started out with a fever and I felt really weak and achy, had a headache and I thought I had Malaria which, when I went to the hospital and was tested for malaria the test was positive. And so I just felt like I...
COOPER: When you say you it felt like malaria, I mean I've had malaria but a lot of people have not experience that did it feel like kind of flu to you?
N. WRITEBOL: Yes, I mean it just makes you really weak and the fever and the headache, for me that was always a sign of feeling malaria. And I think that's a sign for most people that, you know, you get this fever, you get this headache, you're weak, and your muscles ache everywhere.
So, you know, those are some signs of malaria. It's also signs of Ebola. I mean, you are weak, you've got a fever. You might feel nauseated and as the disease progresses there is diarrhea. There of course, you know, it's a hemorrhagic virus and so there's the possibility of some bleeding.
COOPER: Were you throwing up as well because, I mean again its fluids which is the big concern, you know, there is report this person may have thrown up in the ambulance heading into the hospital? Was that part of what do you experienced?
N. WRITEBOL: No, thankfully I never threw up.
COOPER: And one thing David, I mean I remember you and I talking about and one thing I was thinking about with both you and with Nancy is just that feeling of isolation and I know your faith kind of -- would certainly helped with that but -- that you're not able to reach out and comfort your loved one. I know when Nancy -- when you first told Nancy that she had tested positive, you know, you wanted to hug her and she had to say to you, "No, no, you know, don't touch me."
DAVID WRITEBOL, HUSBAND OF EBOLA SURVIVOR: Yes, It is isolating and, you know, the patient feels alone and not able to reach the family, watching that certainly does and so, you know, the thing to do and the thing that s helpful is to verbally communicate as much as you can and to put into word as best as you can, encouragement and support and that's not always easy.
COOPER: I also understand Dr. Brantley's blood was actually used to treat at least one other patient with Ebola here in United States. Is that something and that's a potential treatment. People have been affected their blood could be used. Is that something -- and if this is too personal, feel free to, you know, tell me it's too personal, is that something you've done that you're blood has, you know, you've given your blood to do that or is something they've asked?
N. WRITEBOL: I've been asked but my blood type has not matched.
COOPER: I see.
N. WRITEBOL: And so it's not then possible for me to donate blood but I've been willing to donate and...
COOPER: You were willing to go back to Liberia so that does not surprise me that you're willing to donate your blood. You've volunteer to go back...
N. WRITEBOL: Right.
COOPER: ... and help others which is again testified to the kind of person you and David are. And I guess just final Nancy, I mean if, you know, this man is currently with some serious condition, his friends, his families, if any of them are listening to this, what would you say to them? What would you advice them?
N. WRITEBOL: Well, in the first place we would just want them to know that we have been praying for them and we know this is a very difficult time. I think one of the things that they should know about Ebola is that, you know, you can have really good days Anderson, and then you can have really bad days and it's an up and down disease and so, if they're having a really bad day don't give up because it's very possible the next day is going turn around and look better.
COOPER: Nancy and David, it's always a pleasure to talk to you and I'm sorry for asking you, you know, you vomit that sort of a personal question. I don't think I've ever asked a guest have they vomited before so - that's not in my usual line up of questions. But I do think it's important for people to kind of understand the symptoms and things. So again, Nancy and David, thank you so much. I really I just love talking to you both.
N. WRITEBOL: Thank you, thank you so much.
(END VIDEO CLIP)
COOPER: They are just a lovely couple. Just ahead tonight, you've been asking questions on the Facebook, on Twitter, we got medical experts here would answers about Ebola that's coming up.
Coming up next with Elizabeth Cohen and her crew learning about traveling to in from West Africa when they went to report from Liberia and I talked to her about some of the screening they got and some of the screening they did not get, next.
COOPER: This special hour of 360, Ebola in America continues now with the steps that are being taken to contain the disease and some surprising details about what is not being done in containing the virus. CNN's senior medical correspondent Elizabeth Cohen just got back from Liberia four days ago. In a moment she'll tell us about the screening that she and her screw received when they were traveling. But first here's a quick look on our reporting from Liberia.
(BEGIN VIDEO CLIP)
COHEN: We are taking you inside an Ebola isolation unit in rural Africa.
A worker carrying our camera.
Going deeper, still more sick patients. Children.
This is as close as I can to this Ebola isolation unit and I want to introduce you to four young women. Elizabeth (ph), Susan (ph), Fatu (ph), and Masa (ph). They came here with Ebola but they were given the HIV drug and now they're doing well. They're able to walk around and they'll be discharged soon.
(END VIDEO CLIP)
COOPER: Elizabeth Cohen joins me now from Dallas. What kind of screening did you undergo when you made it back to the U.S. and even when you left there?
COHEN: So I'll start when I left Liberia Anderson. It was thorough and when they checked my temperature, all of our temperature not once, not twice but three times. Once when we got into the -- when we drove into the airport, and once inside the airport, and then again inside the airport. And they asked us, "Are you experiencing diarrhea, vomiting, abdominal pain, et cetera, et cetera?" "Have you been closed to any Ebola patient? Have you attended any burials."
And what's interesting is there was a team of nurses there and I noticed they were really looking at people's faces because if you're going to lie and say, no, no I feel fine they were really looking to see if you were sick or not. Now, when I got to the United States, I would have to say that it was not so thorough. You know, back in August the White House Spokesman said we are carefully monitoring people who are coming into the U.S. but that was not what I found. They -- when I got there and handed my passport, I said, "I'm a journalist who was just covering Ebola in Liberia" and he said, "Oh, OK well, I think I got an e-mail that I'm supposed to ask you something or tell you something. Hold on a second" and he left his desk to confirm with colleagues and those colleagues feedback and said, "You're supposed to monitor yourself for the next 21 days."
And so I said what am I supposed to look for and they couldn't tell me. And my two colleagues that I was traveling with Anderson, my photographer Orlando Ruiz and my producer John Bonifield, they were told to monitor themselves for anything. The only thing they got was poorly -- was that to show his boots to see if he had mud on them.
Which has nothing to do with the Ebola...
COHEN: ... so I don't know why they did that.
COOPER: That's an agricultural issue.
COHEN: But -- yeah, I was really surprised. Right, exactly that's an agricultural issue. Right, right.
COOPER: Fascinating. Elizabeth Cohen, thanks very much.
There are a lot of questions about Ebola. We've giving a lot of Twitter, how it's spread, what this case in the United States would mean. You've been asking questions on Facebook, in Twitter.
We will assemble an Ebola brain trust if you will. Tonight to answer those questions, joining me now live are Dr. Irwin Redlener, Director of the National Center for Disaster Preparedness at Columbia University, CNN Chief Medical Correspondent Dr. Sanjay Gupta, and David Quammen author of many book including the upcoming "Ebola: The Natural and Human History of a Deadly Virus".
Dr. Redlener, let me start with you here. We're getting a view or questions about obviously travel safety. And I want to read this one for Christine (ph) and she asked, "Should the airlines be taking better precautions to sanitize seats, armrest, wash rooms for bodily fluids in between flights especially international one?"
DR. IRWIN REDLENER, COLUMBIA UNIVERSITY: Well, the key things to remember Anderson is this is a very important points that repeated a lot which is that before you have symptoms even if you have the Ebola virus incubating in your body, you are not contagious.
So, I don't think people should be overly concerned about that. The airlines are doing what they need to do. And if they let people on with symptoms that's the whole of the story but...
COOPER: If somebody get sick mid flight or something then the airline...
REDLENER: Then we have the whole of the story. That airplane then would need to be taken away -- it will be properly clean and so forth.
But for patients -- for people, for passengers, who are getting on the airplane who do not have symptoms and are checked like -- Elizabeth was just saying, we're not really worried about that.
COOPER: Do you think it's inevitable that there'll be more cases that slip through in the United States? More like things that we've in Dallas where the hospital sent the guy away?
REDLENER: Yeah, I do think there's going to be inevitable slip-in so to speak into the United States and other countries around the world. That's inevitable. But what I don't think we're going to see is an epidemic from it.
You know, New York City for example has a pretty large population of people from West Africa who are going back and forth visiting one another. And something is going to end up slipping up. But we have a very robust -- theoretically both the hospital and healthcare systems although there's been real problems here too, and a public health system that is able to track and identity people who might be at risk.
So we're going to depend on the systems and as I say there's plenty of a problem on those systems still, but that's going to keep us from getting anything even remotely resembling was happening in West Africa.
COOPER: All right, David along those lines of traveling peers, the virus there's another viewer of question. This one is from Beth (ph). She asked, "Why we're allowing commercial flights in from affected areas?" I mean, you've traveled a lot obviously it's not as simple as that. People have connecting flights from all over the world but though, I'm getting a lot of view or tweets saying, why not just stop all flights from Monrovia or from other places from West Africa.
DAVID QUAMMEN, AUTHOR "EBOLA": Well, for one thing if we did that would be stopping flights that are carrying medical personnel, aid workers, volunteers into those areas. I think that it would be really terrible if those countries became isolated, Isolated either on the way in or on the way out that they were fighting this battle alone.
It's really important for plane travels to continue taking supplies in, taking expert people in, taking brave and generous volunteers in, and on occasion when it's time for them to rotate out bringing them home.
COOPER: And as we said, you know, even direct flights -- a lot of these places don't have direct flights to United States, they're connecting through other places and that makes whole level complications.
Sanjay, I just want to stress how many of the viewer questions we're getting is about, how people contact Ebola? Mark asked, "Can Ebola be transmitted by a sneeze?" Well obviously, a lot of sneezing on planes.
GUPTA: Well -- yeah -- I mean, theoretically, you know, given if a sneeze projected some bodily fluid and that bodily fluid then got unto somebody else and caused an infection that way, perhaps, it's unlikely but possible way...
COOPER: But that would only be from...
GUPTA: ... of transmitted, not in the way that...
COOPER: ... somebody who sneezes who is not only infected but is actually showing symptoms?
GUPTA: With that -- that's an absolute. I mean, as you already mentioned I think we've made pretty clear that you're not transmitting this virus until you're sick. Why? You could have the virus in your system but it's not at the high enough load to make you sick yet.
So, two things sort are happening in concert. Once they gets to a high enough load to make somebody sick, there's enough virus on your body to make you sick then it's also high enough concentrations in your bodily fluids to start being excreted, transmitted and possibly infecting other people. So you would be sick.
But again sneezing, not the sense of this becoming airborne and sort of being out in the air and then possibly floating to the air and infecting somebody else. It wouldn't possibly cause an infection that way...
GUPTA: ... because it's not an airborne virus but if someone were to sneeze on somebody else and that person had an open area of their skin perhaps or whatever, it could possibly cause an infection.
But, you know, I know we're sort of doubling on the fringe (ph) a little bit Anderson. With questions like that, I think when you look at blood for example it has exponentially more virus for the same amount of bodily fluid as compared to whatever somebody might sneeze up. So, while that is theoretically possible, it's just very unlike Anderson.
COOPER: Do we know Sanjay, how long it is from when a person comes in and contact with Ebola gets infected before they actually show symptoms.
GUPTA: Well, that's called the incubation period and really ranges anywhere they say from 2 to 21 days. When you hear that people need to be taken a temperature for 21 days, that's where that number comes from. It's the outer range of incubation.
If you do not have symptoms by 21 days, you're probably not going to get it. But typically it's between 8 and 10 days. That's the sort of most common time where -- after an exposure someone will develop symptoms if they're going to. COOPER: All right. We're going to have to take a quick break. We're going to mow with our panel and getting to more of your questions right after this. We'll be right back.
COOPER: Welcome back to the special hour of 360, Ebola in America. We're back with our panel to and answer your questions. Dr. Irwin Redlener with us, Director of the National Center for Disaster Preparedness at Columbia University, David Quammen, author of Ebola, The Natural and Human History of a Deadly Virus and CNN Chief medial correspondent Dr. Sanjay Gupta.
Dr. Redlener, another viewer question, this is form Kerry (ph), I want to put on the screen. She asked, "What would prevent the disease from being passed from an infected vomit-covered bed sheet being thrown into a public washing machine?" I've gotten a lot of questions like this...
IRWIN REDLENER, COLUMBIA UNIVERSITY DOCTOR: Yes, yes.
COOPER: ... which -- it sounds very specific but something going into, you know, into the water...
REDLENER: Right. Not only is a specific question -- it's actually an important question. It's a question that the hospitals are even facing. What are they doing with all those bed sheet and the vomit and the other material that come out of the way...
COOPER: That's actually a big question I have and Elizabeth Cohen was talking about this guy vomited in an ambulance and I mean it's a gory detail to get into but...
COOPER: ... how long is this waste infections? And what do you do with it?
REDLENER: You know, even on a person who's diseased from Ebola that virus is going to live in the secretions on the skin for three days, seven days in that range there...
COOPER: That long?
REDLENER: So, that's why even handling the corpses of people who've expired from Ebola...
COOPER: Or there bags of waste.
REDLENER: ... is very important. Here, even in United States, we have some very important technical issues about who can actually handle those bags of waste and where are they going? COOPER: How are they dealing it within Dallas? Do we know?
REDLENER: Well, I don't think they've resolved that yet, because one of the issues is that the Department of Transportation, the federal Department of Transportation has certain regulations. For example, you have to have hazardous material transport training in order for you to even touch those bags or move them. CDC has different kinds of ways of evaluating who can -- how and how that waste would be transported. And right now as far as the hospitals concerned, many of them don't have yet the capacity to even figure out how to handle that waste and that is an issue.
COOPER: To that viewer's question I mean, if you put the soiled sheets into a public washing machine...
COOPER: ... is that then dangers -- that -- I mean...
REDLENER: Yeah, it's potentially dangerous. The washing machine of course is water heated to whatever level it is, it may or may no be dealing with some of that but we really are hoping that we don't have to encounter situations like that.
COOPER: David, a viewer named Jacob (ph) asked, "Does this disease have certain areas where it will spread faster like cold or hot regions?" A lot of your focused has been on where diseases start and now, they spread. Is there link to climate?
QUAMMEN: Well, there's certainly a link to tropical ecosystems because there's so much biological diversity there. And these disease, they call them zoonotic diseases, they come out of animals, are more likely to come out of the tropical areas because there are more species of animal, plants, fungi, and bacteria there. With more species, different kinds of creatures the more viruses they are.
So as we disturb those habitats, we see a lot of these diseases coming out of the tropical forest like Central African forest, the South East Asian forests. So...
COOPER: And because of the growth of bush meat trade, because of the, you know, the increase of road travel, air travel, that's why we're saying a lot of more of these viruses coming out of the forest areas or that use to be isolated just like with Ebola.
Sanjay, we're getting a lot of questions about how Ebola is transmitted and so I do want to get to try to -- as many of these -- to try dispel as many unwanted peers as possible.
Galen (ph) asked, "Every time we exhale, we expel moisture in our breath. I believe that would be considered bodily fluid. So would it be possible to be contaminated by close contact? Am I right or wrong?"
GUPTA: No. I wouldn't read too much into that Galen (ph) and I can appreciate that concern again but, you know, what we're really talking about, when it comes to Ebola it is more droplets, you know, and the moisture that comes out of your mouth, I guess you're suggesting, that's more of gas and again, that could be something that would -- if it was airborne, that could be a concern but when it comes to Ebola -- there's a couple of different points.
First of all, it doesn't behave like and airborne virus. It's actually -- it's heavier, it's going to drop more quickly to the ground but also, because of the way that we actually -- where the virus lives in the body, it doesn't tend to live in the respiratory track as much as it does in the blood as we were talking about earlier.
So, even if you're quite sick with Ebola you would still have a small amount of virus really in your upper respiratory track.
COOPER: All right, Sanjay I appreciate you being on, and Dr. Redlener, fascinating stuff, thank you very much, and David Quammen as well, I look forward to reading your book.
We'll be right back.
COOPER: The latest on other stories are falling (ph), Deborah Feyerick has (ph) a 360 Bullet.
DEBORAH FEYERICK, CNN CORRESPONDENT: Well, Anderson, the suspect in the disappearance of UVA student Hannah Graham has been linked to another case involving a young woman. Jesse Matthew was connected to a sexual assault investigation in 2003 when he briefly attended Christopher Newport University in Virginia. Matthew was also accused of rape a year before at Liberty University but no charges were filed.
A Florida Jury convicted Michael Dunn a first degree murder in the 2012 shooting death of 17-year-old Jordan Davis. Jurors end on first trial deadlock on the murder charge, Dunn kill Davis after an argument of a loud music outside of Jacksonville Gas Station.
In Japan, search teams have discovered 12 more bodies on Mount Ontake bringing the confirmed death toll to 48. 30 bodies have been removed from the mountain which begun erupting Saturday. Seismology are warning another big eruption maybe just days away.
And demonstrator staged a sit-in outside the gates of Hong Kong's Chief Executive as part of continuing pro-democracy protest. Some demonstrators say the next step could be occupying government building. Anderson?
COOPER: All right. Deborah Feyerick, thanks very much. That does it for us. We'll see you again on 11:00 P.M. Eastern for another edition of 360, CNN Tonight, starts now.