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ANDERSON COOPER 360 DEGREES

Texas Nurse Battling Ebola Identified; Ebola Survivor Kent Brantly Donates Blood

Aired October 13, 2014 - 20:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


ANDERSON COOPER, CNN ANCHOR: Welcome to this two-hour live edition of 360 from Dallas. We begin with breaking news.

Another patient in the United States being evaluated for Ebola. This one is at the University of Kansas Hospital which announced less than an hour ago that a man in his 40s who's not being identified yet has been to the hospital for about 12 hours. He was on a medic -- he was a medic on a ship off the coast of Africa involved in treating patients with various illnesses, although it's not known if any of those patients actually had Ebola.

He was sick while he was on the ship with fever, diarrhea and vomiting, and returned to the United States five days ago. The hospital says he's isolated, being rehydrated. Again, we do not for sure if he has Ebola. But given the part of the world he was working in, of course that is the concern.

Tonight there's also concern right here in Dallas. We are here looking for answers to troubling questions after a nurse tested positive for Ebola right at the hospital. More breaking news on her identity and her treatment. Her name is Nina Pham. She's 26 and she's treated Thomas Eric Duncan while he was here at Texas Health Presbyterian Hospital. Duncan, as you know, died last week.

Now we've just confirmed that she has received a blood transfusion from an Ebola survivor, Dr. Kent Brantly. The big question is, how did a health care worker contract Ebola even with the protective gear and all those precautions in place in a hospital setting? And what does that mean for future potential cases?

Now over the next two hours, we're going to hear from doctors and other experts about the protocols for treating Ebola patients and about whether this country's hospitals are actually ready.

We'll also hear about how the fear has been ratcheted up here in Dallas now that it's home to the first person to contract Ebola in the United States.

We begin with our senior medical correspondent Elizabeth Cohen who's here with me live.

Now you've just got the latest on her condition, correct?

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Right. We've still been told that she's in stable condition, so the hospital really has said very little about what they're doing to treat her or how she's doing.

COOPER: She, though -- and you found out this, she's the one who has received blood transfusion from Dr. Brantly?

COHEN: Yes, we were told that they asked for that transfusion, they asked for that donation yesterday and she received it yesterday. So the hospital moved quite quickly on that.

COOPER: And this is actually the third time that he's given a donation. We should point out Dr. Brantly is the one who -- the missionary who became infected in Liberia, was flown back here and was treated at Emory.

COHEN: That's right. So he's been reached out to three times and he said yes three times. He may have been reached out also for Mr. Duncan, we don't know but we were told that they couldn't find a match for Mr. Duncan who, as you said, passed away last week.

COOPER: Is it known exactly now how this nurse, Nina Pham, how she contracted Ebola?

COHEN: You know, they still don't know. And folks -- but, you know, officials tell me they may never know. There may not have been some a-ha moment where she actually got, you know, her exposure, but they say there may have been some inconsistencies with the type of gear that she was wearing and also with the process of putting them on and taking them off.

COOPER: Obviously, that's a critical component. And they say they want to have somebody watching you and -- kind of a buddy system when you're taking things off. Do we know if they have that at this hospital?

COHEN: Safety advocates really are unanimous on this, that you ought to have a buddy system. So if I were the one going in, you'd be watching me put it on and you would watch me do the procedure. And you'd say, hey, don't do this, you do that. And you would sort of coach me through it. And this hospital has not responded to whether or not they have that buddy system.

COOPER: When Thomas Eric Duncan became sick and became known, the city said that they were monitoring I think some 48 people in this city who had contact with him, but this nurse was actually not one of the people.

COHEN: That's correct. She was not one of them. So they were monitoring folks who had contact with him up until September 28th. He was admitted to the hospital on September 28th. They're thinking -- the authorities thinking was look these workers, they're wearing protective gear, therefore they are protected and so they can self- monitor. And that's what Nina Pham did, she self-monitored, she caught it herself, but it is of concern that they weren't being followed by authorities. Now they are.

COOPER: And they are -- I mean, they have people here now investigating exactly she may have done it.

COHEN: That's right. But again we may never really know.

COOPER: It may never really be known.

COHEN: Exactly.

COOPER: Are there -- there are concerns of other people in the hospital?

COHEN: Yes. As a matter of fact, to Tom Frieden, the head of the CDC, he was very clear on this. He said we may see more cases among the health care workers at this hospital because if there was a breach of protocol for her that got her infected there have been breaches in protocol for other workers.

COOPER: There's -- I mean, is this hospital able to care for her? Because I know there's been some talk about perhaps sending her to another facility.

COHEN: Right. It depends -- I mean, are they able to care for her? It depends how you define able. This is not a hospital that specializes in infectious diseases. It's not a hospital that, as far as we know, drills as much as some other bigger hospitals for these bio-safety hazards. You know, there are some hospitals that really drill on this a lot and really practice that.

COOPER: Right. Which is why the first patients were sent to Emory in Atlanta.

COHEN: Exactly.

COOPER: There's also a hospital in Nebraska.

COHEN: I will tell you, when there was a choice, when patients were coming from Africa, and when there was a choice, they were sent to two hospitals that specialize in dealing with biohazards. The University of Nebraska and Emory. There are only four hospitals that have that designation. They weren't sent to a community hospital like this.

COOPER: Right.

Elizabeth Cohen, appreciate the update. Thanks very much.

The fact that a nurse has now contracted Ebola has heightened concern obviously here in Dallas, particularly in the neighborhood where Nina Pham lives. Her neighbors say they often saw her walking her dog and describe her as friendly, always smiling. They're alarmed obviously here that she's contracted Ebola. Concerned for her. Many of them finding out by a reverse 911 call the city made to residents in the area. Listen.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: Please be advised that a health care worker who lives in your area has tested positive for the Ebola virus. This individual is in the hospital and is isolated. Precautions are already in place to clean all known potential areas of contact to ensure public health.

(END VIDEO CLIP)

COOPER: And the mayor of Dallas went to that neighborhood to talk to people. We're going to talk to him in our next hour. Obviously neighbors there wish her well. And they also hope that this will be the last Ebola diagnosis that hits so close to home.

Gary Tuchman reports tonight.

(BEGIN VIDEOTAPE)

GARY TUCHMAN, CNN NATIONAL CORRESPONDENT (voice-over): The first person we know to have contracted Ebola in the United States lives in this apartment building in this middle class neighborhood north of downtown Dallas. People who live in the street are saddened and shocked by what has happened to 26-year-old Nina Pham.

Betsy Bolger lives across the street from her.

BETSY BOLGER, NEIGHBOR: We usually see her once a day or so. We haven't seen her since maybe Thursday or Wednesday.

TUCHMAN: Betsy usually sees Nina when they are walking their dogs.

BOLGER: I would just say she's neighborly, she's friendly, she's positive, always has a smile. Not everyone smiles when they're walking their dogs and not everyone says hello, especially if they're engaged in not picking up after them. But she always picks up after her dog, and -- which is good. And I would tell my husband, she's -- you know, she seems like somebody that's comfortable in her skin, and respectable and belongs in the neighborhood.

She mentioned once that she was a nurse. And, you know, we said, oh, that's interesting and applauded her for doing that because health care workers have a really rough job being on the frontlines.

TUCHMAN (on camera): The prevailing feeling among residents on this block we've talked to is concern about their neighbor, but there is also substantial unease about not knowing details of how she came down with Ebola.

(Voice-over): City and county officials have gone door-to-door in the neighborhood to answer questions about how Ebola spreads, but it is nevertheless disconcerting to many neighbors.

JAMES GUAJARDO, NEIGHBOR: Pretty alarming, you know, I'm pretty concerned now. So I mean, hopefully, you know, this will stay contained.

TUCHMAN: On the corner of the block is the Dallas Beast Fitness Gym. Even though Nina Pham doesn't work out here the owner says some of its clients are on edge. LAVELL ROBERSON, GYM OWNER: Well, we just sterilize every day now,

every hour on the hour, we have wet naps, you know, disinfectant rags that we wipe off the equipment with. So we just make sure we keep everything a little more clean.

TUCHMAN: Jacob DeLuna is an electrical contractor doing work next door to the victim's apartment. He's worried.

JACOB DELUNA, ELECTRICAL CONTRACTOR: I'm nervous about it. I don't want -- in fact this morning I told my wife I didn't want to -- I really didn't want to come over here, but I asked her to pray for me and she did. So I'm believing that the Lord will protect.

TUCHMAN: This maintenance supervisor is carrying a mask just in case he feels the need to use it.

CLINT RABE, MAINTENANCE SUPERVISOR: The nurse contracted the virus, then, I mean, they usually take big precautions especially with this Ebola virus, you know. And it's scary. Seems like it might be more contagious than the doctors are saying.

TUCHMAN: Some neighbors tell us other residents have temporarily left their homes while work is taking place at the victim's apartment. But not Betsy Bolger and her husband who hope to welcome their dog-walking friend home soon.

BOLGER: Anybody who's willing to go on the front lines and (INAUDIBLE) she's doing and take care of an Ebola patient, direct contact, that's brave. And that's courageous and that's like an angel to me.

(END VIDEOTAPE)

COOPER: And Gary Tuchman joins me now.

Obviously -- and the dog is obviously very important to her. And there were the incidents in Spain where they euthanized, they killed the nurse's dog.

What's happening with the dog now?

TUCHMAN: We're being told Nina's dog, a little terrier named Bentley, will be taken good care of, no euthanization. Good care. Lots of food, lots of water, lots of love and they'll continue monitoring the dog.

COOPER: And I mean, some people will say look, why are you even talking about a dog when obviously so many people are dying in West Africa of this. This is a concern for health officials. They don't want people to feel like if you come forward with symptoms, that your dog is going to get killed. They want people to know that it's OK to come forward. You don't have to worry about what may happen to your dog.

TUCHMAN: That's precisely the issue, yes. We love dogs, but the fact is they are very concerned that if someone has some symptoms and they're afraid something will happen to their pet, that they won't come forward. So this is a way to encourage people to come forward and they will know that their animal will be OK.

COOPER: All right. Gary Tuchman, appreciate that.

I'm joined now, our chief medical correspondent Dr. Sanjay Gupta is going to join us. Obviously and Sanjay has been reporting in West Africa on the front lines of this -- outbreak. Also the director of the Department of Emergency Medicine at New York's Mt. Sinai Hospital joins us. He was involved in treating a possible case there which turned out not to be Ebola, Dr. Shearer. And Dr. Seema Yasmin, staff writer at the "Dallas Morning News," professor of public health at the University of Texas in Dallas, and a former CDC disease detective. She joins me here live.

Sanjay, what does it say that a nurse, not a family member of Mr. Duncan, not someone who randomly encountered him but a nurse could contract Ebola from him?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Well, you know, on one hand, you know, it's health care professionals who are dealing with patients who are the sickest from Ebola. We know that when they are sick, that's when they are potentially the most infectious, most contagious in that regard. So in part, it's health care workers often that are the ones who get sick, especially in the early parts of an outbreak.

On the other hand, she would be wearing personal protective gear so how does it happen despite the fact that she was wearing personal protective gear? Those are the two sort of issues here. The patient was the most infectious but she should have been protected.

It's concerning, to answer your question directly, Anderson, because the personal protective gear we know should work if it's all done properly. And it's not to place blame on her, but obviously something didn't work here.

Anderson, I just want to make one quick point. You and I talked about this last week. But you know, the Doctors Without Borders have been taking care of patients for a long time in really tough areas in Africa, Central and West Africa. There's been outbreaks since 1976. The Doctors Without Borders have not had a single transmission up until this year of one of their -- one of their health care team getting sick from a patient with Ebola.

So this idea that you can -- you can -- it's not preordained that it's going to spread from patient to doctor or nurse in this case. It can be done properly. Maybe it requires getting the Doctors Without Borders, frankly, come to some of these hospitals and training them and how they do this in the field because they've had a really good track record.

COOPER: Dr. Yasmin, I mean, you live here, you work here. How concerned are people? Because -- and do we know if the protective gear that they were using in this hospital is the same as we're seeing in a lot of that video that was being used in West Africa? DR. SEEMA YASMIN, FORMER CDC DISEASE DETECTIVE: It's so hard to know

without some direct responses from this hospital, Anderson. There are so many questions from local residents, what exactly was the protocol being used? Was there a buddy system, for instance, where somebody would have observed the nurse putting on her equipment and then had a checklist and said, yes, you did the right things or no, you missed something? So it's hard to tell without that transparency which is really key.

COOPER: Yes. Also, I mean, the National Nurses Union -- United Union, I should say, 76 percent of nurses said that their hospitals have not communicated a policy on the potential of admitting patients infected by Ebola.

Sanjay, I mean, that's pretty terrifying, not only for health care professionals but also for patients.

GUPTA: No. It absolutely is. And that was a startling statistic, especially given the fact that I've been -- you know, I was in West Africa in April. I was at the CDC shortly thereafter. And they were saying at that time, you know, back in May, we've got these plans going out to hospitals, community hospitals, emergency rooms, all over the country so this can be standardized. And obviously that didn't happen.

You know, infectious disease protocols, universal precautions, should be the same in hospitals really all over the country. And they should apply here with regard to Ebola as well. But obviously that's not happening. These nurses who are a part of that survey they just don't feel comfortable as things stand now.

COOPER: Dr. Shearer, I mean, at Mount Sinai there was an Ebola scare early on in August, you guys have containment facilities. The protective gear that you would wear, is it the same as being worn in West Africa? Is it that complete suit?

DR. PETER SHEARER, THE MOUNT SINAI HOSPITAL: Well, Anderson, it's not as complete as that, but it is -- it meets the CDC requirements for what you would need to be safe and to be able to care for patients safely. For them and for yourself.

COOPER: And how complex is -- I mean, just taking off that suit, Dr. Shearer, how -- I mean, did you have a buddy system? Because I've heard that's really critical in a health care setting to have somebody watching you take off the suit.

SHEARER: Right. It certainly is because, again, it's a step-by-step procedure. You want to make sure that each and every step along the way you're following the proper protocol, and that you have someone out there to call out to you if you're mistaking something, removing a glove, disposing of something. That certainly is critical.

Again, training and practicing is probably the most important thing, not just putting on but also taking it off.

COOPER: Dr. Yasmin, you know, now there's this issue of Dr. Nancy Snyderman who was in West Africa reporting. Her cameraman became sick. He's being treated in Nebraska. Her and her crew have returned to the United States. They were under not mandatory quarantine, but they were under quarantine, a voluntary quarantine. Apparently they violated that, went out for a meal, she's now apologized for that publicly, but now she's under mandatory quarantine.

How important is it for somebody who has come in contact with it to maintain a quarantine?

YASMIN: It's absolutely crucial, Anderson. Especially if they had that exposure they could potentially become a patient themselves. They need to be -- they need to make sure that they do isolate themselves.

Public health does have some kind of legal authority to say that you have to stay within your home. Oftentimes in my experience, you try not to use those. It can be very intimidating. We try and explain instead the importance that people do that themselves.

COOPER: Sanjay, one of the things that Dr. Snyderman said in her statement is -- you know, she apologized. But she said, look, I'm not experiencing any symptoms, none of us are. And therefore it's impossible for us to actually spread the virus. Correct?

GUPTA: Yes -- no, and I think that's a really crucial point. Dr. Yasmin was just describing as well. You remember those patients in Dallas that were quarantined, the family members and friends of Mr. Duncan. The reason they were quarantined was not because of the concern of a risk to public health. They weren't sick. They wouldn't spread the virus. The concern was, for whatever reason, they thought they may not get their monitoring, they may not get their temperature checked daily.

They thought these people would not show up for those appointments or those temperature checks. That's a very different reason. And I actually spoke to Nancy today. And she sort of highlighted that. She clearly made a mistake. She should have checked in with the Department of Health. But from a pure scientific standpoint and a pure risk to public health, she's not sick, she's not a risk to public health. It's what you've heard from the CDC all along.

And I think everybody does agree on that point. You don't spread this until you're sick.

COOPER: And Louise, the woman who was living with Thomas Duncan while he was visiting here in the United States, she's still under quarantine up until next week. We're going to talk to a pastor who has been spending time with her.

Sanjay Gupta, thanks, Dr. Shearer, great to have you on again. Seema Yasmin, as well. Thanks very much for being here.

A quick reminder, you make sure you set your DVRs so you can watch 360 whenever you'd like.

Just ahead tonight, when it comes to health care workers who have contact with Ebola patients, it's not just about the protective gear they wear but also, as we mentioned, how they put it on, how they take it off.

Now Sanjay is going to show us how that happens and why it's so critical. That's next.

(COMMERCIAL BREAK)

COOPER: The head of the CDC said today the United States needs to rethink the way Ebola infection control is being addressed because, in his words, even one infection is unacceptable. Now we don't know exactly how this nurse here contracted Ebola while she was treating a patient in Dallas, but as we mentioned before the break, an official tells CNN that CDC disease detectives interviewed her several times and thought there were, quote, "inconsistencies," to use their word, in the type of protective gear she wore and the process of putting it on and taking it off.

Now we want to show you exactly what that process looks like. Who better to do it than our 360 MD Sanjay Gupta. Take a look.

(BEGIN VIDEOTAPE)

GUPTA: I want to give you an idea of what the CDC is recommending in terms of how to protect yourself with this personal protective gear.

I'm also going to show you how to take it off which some say is the most dangerous part. I will point out as we start to do this, I work in an operating room every week. This is different than what most doctors, I think, are used to at least in the operating room.

I do want to point out this is a little different than how I suited up when I was in Guinea. But we're following CDC protocol. Now I want to show you how I'm going to take this protective equipment off and I'm also going to put a little chocolate sauce in my hand which could represent a possible Ebola contamination. Take a look.

This is the mask. So here's would be the most likely contaminated area, would be my gloves and maybe the front of my gown like this. OK. Now I got to -- I got to treat this as if I'm potentially contaminated. I come out, what I'm going to do with this particular gown, I'm going to rip it all off together and everything is going to come off simultaneously. But if a part of the glove sort of brushed against my hand, my arm there, that could potential be an exposure.

If the glove didn't come off properly I would reach underneath here as best I could. And yet underneath that, but perhaps if I didn't do it exactly right there could be another potential exposure there.

I'm reaching behind now as well as I can, but let's say the side of my face shield was contaminated and I touched here, that could potentially be an exposure. Same thing here now with the face mask.

So now take a look. Right there, see a little bit of chocolate sauce. One possible exposure and over here on my neck, one possible exposure.

(END VIDEOTAPE)

COOPER: And Sanjay is with us again along with Dr. Peter Shearer of New York's Mount Sinai Hospital.

Sanjay, it's fascinating to see you do that. I mean, taking the protective gear off, clearly the training isn't as effective or frankly even with a lot of training doing that all by yourself, it -- would seems like it would be incredibly easy to become contaminated. Those gloves looks like it could break very easily even.

GUPTA: Yes. There's no question. And I want to point out something you brought up earlier. And that is that what we just did was that was CDC protocol. We literally looked at the sheet, followed the guidelines exactly. It's also very different from what we saw out in West Africa with the Doctors Without Borders.

Simple thing, for example, when you come out of the tents in your protective garb, you're actually sprayed down with a bleach-like solution on to your gloves. You can dip your gloves even into a bucket of bleach before you start doing some of this other stuff.

There's just these other steps that make a difference.

Also you saw I got a contamination with that chocolate sauce on my neck, that's because not all my skin was covered. You know, I shave. There could be cuts on my neck because of shaving. That could be a possible entry point over there as well. It just wasn't covered up. So I was a little surprised when I really did this demonstration by following the CDC guidelines exactly. They weren't nearly as protective as what we saw in West Africa.

COOPER: Dr. Shearer, why not use the full kind of suits that -- like Doctors Without Borders are using in West Africa?

SHEARER: Well, you could make the argument that using an even more complex suit would also lead to a more complex procedure of putting on and taking off where there could be more room for errors.

I think what you need to do is make sure the people are trained in the equipment that they have at their hospital that's approved by the CDC and to repeat the trainings in it so that they can, just as Dr. Gupta saw, you know, identify the errors and improve on them.

One of the other things is -- when Dr. Gupta did it just earlier, he didn't necessarily have someone monitoring him. Re-advising him on what steps to take or where he may have made an error.

COOPER: Sanjay, do you think that would have helped you, to have somebody -- I mean, obviously it would have helped, but would it make a huge difference to have somebody watching you?

GUPTA: I think, you know, this whole notion of the buddy system, which again, I keep coming up to Doctors Without Borders, they do the buddy system over there. I think it would make a difference both in putting on and taking off. Putting on obviously less risky, but you want to make sure you've done everything correctly. Keep in mind, you know, I did this, you know, in a studio for this

program but someone who's about to go in and take care of a patient with Ebola, the nerves, the anxiety might be a little bit higher.

Could you miss a step? Having somebody else standing there, watching everything, inspecting you at the end I think makes difference, but especially when you take it off. And I think just -- there are a lot of steps, I agree. And you want to balance, you don't want to make it too complicated because more errors can occur.

But the fact that my skin is not fully covered under the CDC guidelines here, that was surprising to me and again very different than West Africa where they've done a really good job with this, of not getting secondary infections.

COOPER: Yes, Dr. Shearer, I mean, certainly as a layman, I would want to be covered as much as possible. And the idea of being sprayed down even before I took off the garment would be something I would certainly want to have happened.

With these kind of garments, though, I guess you can't be sprayed down because they're not resistant to liquids, right?

SHEARER: I mean, they're impermeable. But then some of them it depends on the ones they have -- some of them have zippers that water can pass through, some of them have -- they are tied down. And again if you had sprayed down Dr. Gupta, part of his skin was exposed and that could have created even a deeper exposure.

You can certainly still wash your hands after taking care of a patient with the gloves on, maybe that could also minimize it. There are additional steps people can take.

COOPER: All right. Dr. Shearer, appreciate you being on. Sanjay Gupta as well.

Fascinating to see that.

As always you can find out more on this story and others at CNN.com.

Just ahead in this hour, the medical waste collected by hazmat crews from the apartment Ebola victim Thomas Duncan stayed. That medical waste is in limbo tonight. It was destined for a landfill in Louisiana now authorities there are saying no way. We'll tell you the details ahead.

(COMMERCIAL BREAK)

COOPER: Welcome back. The breaking news tonight, a possible Ebola case here in Kansas. Here in Dallas tonight, the nurse who contracted Ebola while caring for Thomas Duncan has been identified. Her name is Nina Pham.

There's late word that she's now received a blood transfusion from an Ebola survivor, from Dr. Brantley who got Ebola in Liberia. She's the first American to actually contract Ebola without leaving the United States.

Workers wearing hazmat suits were dispatched to clean her apartment soon after she was diagnosed. They took away a barrel presumably full of possibly contaminated items from her apartment.

You may recall it took days before hazmat crews cleaned the Dallas apartment where Thomas dungeon stayed after arriving from Liberia. The mother of one of his children, Louise, who I talked to, and several other people were initially quarantined there. Now they have been moved.

Tonight, the medical waste that was finally collected from that apartment is in limbo. We're talking about from the apartment of Thomas Eric Duncan. The waste company had planned to take to it a landfill in Louisiana, but now authorities in Louisiana are refusing to accept it. Drew Griffin reports.

(BEGIN VIDEOTAPE)

DREW GRIFFIN, CNN SENIOR INVESTIGATIVE CORRESPONDENT (voice-over): It is this waste the attorney general of Louisiana is worried about. The bags of sheets and clothes and stuff that Ebola victim Eric Duncan may have touched or soiled while he was sick and living inside this Dallas apartment.

The bags of waste were hauled away, disinfected then placed into 55- gallon drums. The drums taken to this Port Arthur, Texas, facility for incineration, burned into ashes. The ashes what Louisiana's attorney general says he doesn't want in Louisiana.

There are too many unknowns at this point, says Louisiana Attorney General Buddy Caldwell and says it is absurd to transport potentially hazardous Ebola waste across state lines.

What's absurd, says infectious waste expert, Dr. Gavin Macgregor- Skinner is how uninformed Louisiana's attorney general is on the danger of incinerated Ebola waste and how that's adding to hysteria.

DR. GAVIN MACGREGOR-SKINNER, ELIZABETH R. GRIFFIN RESEARCH FOUNDATION: If he's concerned you do a simple test on the waste and you show there's no virus in there. We know that's a waste of money and resources because that virus is dead. It is not infectious, has no risk, zero risk to the environment, to people, to anyone being infectious.

GRIFFIN: Despite the lack of risk, the waste management company has sent out a statement saying it will not ship the Ebola ashes to a Louisiana landfill apparently to avoid a legal fight with the state's attorney general.

There is, though, a real problem in the U.S. dealing with Ebola waste and it's happening where it would be generated. Hospitals need to be equipped with these.

It is a supersized pressure steam device called an autoclave. Think of it as a huge, high temperature pressure cooker for hospital garbage capable of killing any germ or virus.

WALTER CASSITY, BAYLOR UNIVERSITY MEDICAL CENTER: It's a specialized waste and it requires on-site incineration or placed in an autoclave, which means it's sterilized here on site before we ship it off to the final disposition.

GRIFFIN (on camera): Anybody who does that has to be trained, I would imagine?

CASSITY: Correct, our personnel goes through training and it gets precautions as it left the area and went to isolation area before being placed in the autoclave.

GRIFFIN (voice-over): Many hospitals don't have these large scale devices to take care of the enormous amount of waste from just a single Ebola patient, which is why, privately we are told, many hospitals hope to never see anyone carrying the Ebola virus.

(END VIDEOTAPE)

COOPER: Drew, there are hospitals in the U.S. fully capable of handling Ebola patients and their waste, right?

GRIFFIN: Yes. Most major hospitals can handle this. They have isolation rooms, the capacity to get rid of the waste, but there are just four, believe it or not, in the U.S. that are fully certified and equipped and have been training specifically for Ebola treatment, Anderson.

That's why these known Ebola patients that we know about, the ones that are coming over from Africa are sent there, Emory here in Atlanta, the facility in Omaha, Nebraska, the National Institutes of Health in Bethesda, Maryland, and St. Patrick's Hospital in Missoula, Montana.

If you have a known Ebola patient, a known patient, this is where they're sent. The problem, Anderson, is what do you do with people just walking in to their nearest hospital as was the case in Dallas?

That's the emergency this country seems to be unprepared for and all the experts we've talked to say that's what needs to be addressed. What is the plan in your hospital if somebody walks in off the street? Are you equipped or not to handle this? Do you have the proper procedures in place to handle this -- Anderson.

COOPER: That's why the case here in Dallas is so concerning and raising so many questions about how prepared hospitals are to deal with this kind, but just to be clear, that waste from Thomas Eric Duncan's apartment, it's been incinerated. So it cannot spread the virus.

My understanding was even if it hadn't been incinerated, the virus doesn't live forever on its own. I mean, ultimately, it becomes inert, correct?

GRIFFIN: Right, well, I'm not a doctor and I'm not a scientist, but the doctors and the scientists, they all have been saying that this virus does not live long outside the body. It's not like it's going to last like the flu bug on a door knob or a light switch very long.

But keep in mind, this waste coming out of that apartment, it was disinfected first, then put into the drums, then the entire drum with everything in it was burned down to ashes.

Now, I'm not a doctor and I'm not a scientist, but I can guarantee you there's nothing alive in there that's going to cause anybody any harm.

COOPER: All right, Drew, appreciate it. That bears repeating. We don't want to cause panic here.

Just ahead, this dog was euthanized after his owner, a Spanish nurse, was diagnosed with Ebola. We talked about this earlier. In Texas authorities reaching a different decision, how big a risk do animals pose to humans if they contract Ebola? We'll take a look at that next.

(COMMERCIAL BREAK)

COOPER: Welcome back to breaking news tonight, a Kansas hospital is testing a patient for Ebola tonight. We've also learned the identity of the Dallas nurse who contracted Ebola while caring for Thomas Duncan. Her name is Nina Pham.

We can confirm that she has received a blood transfusion from Ebola survivor, Dr. Kent Brantly. Remember Dr. Brantly became positive with Ebola contracted it in Liberia, came back here, was treated at Emory. His blood has already been used in two other patients, now in this nurse, Pham.

The diagnosis has raised concerns here, obviously, in Dallas, about the safety of health care workers treating Ebola patients here, not only in Dallas, but across the country and around the world.

It also put a spotlight on animals, dogs, that are exposed to Ebola. As we've said, Dallas authorities have decided against killing Pham's dog. Her pet is being monitored by Animal Control officials and the SPCA.

The dog named, Excalibur, belonging to a Spanish nurse who contracted Ebola was not so lucky. Authorities killed that dog even though there's no documented case of any dog spreading Ebola to humans.

But it does raise the question about animals. One study shows dogs can get Ebola without showing any symptoms. Joining me now is David Sanders, an associate professor of biological sciences at Purdue University and also back with us is Dr. Seema Yasmin.

I mean, with all the questions about Ebola, do we know much about dogs and Ebola and other animals?

YASMIN: There are very few studies. One CDC study from 2001/2002 that shows in Gabon, dogs did come in contact with patients, but didn't become sick with the virus. The dogs could excrete the virus. So there was that transmission possible from dogs to humans, but no documented evidence of that happening.

COOPER: So it's interesting, Professor Sanders, I mean, the idea -- does that mean that dogs certainly can transmit the virus? Can they be tested for it if they're not showing signs for it?

DAVID SANDERS, BIOLOGY PROFESSOR, PURDUE UNIVERSITY: They can be tested for it. There are a variety of ways to test it, through looking at nucleic acids or antibody responses to the virus. The concept that viruses in animals can be transmitted to humans and can have potential harmful consequences, that's obvious.

I mean, we know that Ebola is circulating probably in fruit bats. They, as the natural host, don't actually show any signs of infection. They don't have any symptoms, yet somehow it's being transferred to humans either directly or through the intermediary of nonhuman primates.

So the infected animals that are not showing signs of infection can potentially be capable of transferring the virus to humans.

COOPER: So Professor, how long would a dog in this case need to be quarantined for before they don't have any risk?

SANDERS: That's a great question. So in general when we're talking about RNA viruses such as Ebola virus, they don't tend to persist. There are some that do. But we talk about the same type of incubation period for humans, three weeks, that sort of thing.

The problem is we haven't really studied the progress of Ebola in dogs. There's one study that was published on dogs in Gabon that had been eating infected -- infected individuals and they were able to see that they had antibodies.

But we didn't really follow the progression of the virus propagation in the dogs, so we really don't know for sure. What is necessary is observation, detection and quarantine until we're sure that the dog is no longer infected.

But I think one of the most important points is if you're going to keep the dog alive, you have to have some sort of decisions about what you're going to do later on if the dog is infected. What decision are you going to make at the time? You have to decide that up front.

COOPER: Dr. Yasmin, again, I talked about this with Gary Tuchman. But there are a lot of people watching saying why are you talking about dogs? It's inappropriate for you to worry about dogs when we have people dying in West Africa, more than 4,000 people.

The reason we're bringing this up -- and we've seen this in disasters before, people not wanting to leave their homes because they couldn't bring their animals to a shelter.

The fear is among health care workers and CDC officials and others is that if people are afraid that their dogs are going to be killed, they might not come forward if they're starting to show some symptoms. YASMIN: Absolutely. That's why we need to research this. Dogs are very much part of our families in the western world. They're very important to people. We need to understand what would happen to somebody if their dog did have the virus.

Like Dr. Sanders said, what would be the decision that would be play into that and what information can we get to people so they do feel safe to come forward if they have any symptoms of Ebola.

COOPER: Dr. Yasmin, appreciate it as always. Professor Sanders as well, thank you.

Just ahead, in this hour, how the loved ones of Ebola victim, Thomas Duncan are doing? It's been five days since his death here in Dallas. We'll talk to a pastor who has been helping them. That's coming up next.

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COOPER: Welcome back. Tonight's breaking news here in Dallas, Nina Pham, the Texas nurse that contracted Ebola after treating Thomas Duncan has received a blood transfusion that was donated by Dr. Kent Brantly, the American doctor who survived an Ebola infection.

It's the third time he's donated his blood to a patient. It was just five days ago that Thomas Duncan died. It's important not to forget that. His loved ones are grieving.

Pastor George Mason of the Wiltshire Baptist Church has been providing support. He joins me here in Dallas. Thanks so much for being with us again.

PASTOR GEORGE MASON, WILTSHIRE BAPTIST CHURCH: Pleasure to be with you.

COOPER: This just bears repeating because a lot of people point fingers at Thomas Duncan, and you know, this is a man who died because he helped a pregnant teenaged girl who collapsed in the village where he was saying. As much as people may be concerned about why he came here, the circumstances, he died because he helped somebody else.

MASON: Exactly. Isn't that what we want everyone to do? At the end of the day when people are sick and hurting, we want them to be there. I think it should bear remembering that she was a pregnant young woman and there's no sense that automatically because she's sick she must have Ebola.

COOPER: In fact, if she wasn't diagnosed with Ebola until well after he left.

MASON: Absolutely.

COOPER: That's based on the reporting of a reporter who was there and talked to officials.

MASON: It carries over even more because there's going to be a time here, Lord willing, that they're not symptomatic and they're out of quarantine, then the question is how will we tell their stories when they re-enter the community? Will people welcome them and celebrate that they're able to enter back into our lives?

COOPER: How concerned is Louise about that? You're in touch with Louise. She's a member of your congregation.

MASON: Reasonably so because you can't control other people's reactions to you. She would like people to know that they love the community they live in and the people that are in that area. She's an American citizen.

COOPER: She's been living here for years and years.

MASON: Many years. She reared her child here and she has other children and nieces and nephews and family around. She would like to re-enter the community and just be an American and hard working person.

COOPER: That's one of the things that you and your congregation is trying to help her with.

MASON: We are.

COOPER: She's got to find some place to live. You compare her to someone that lived through a fire. Everything she has got.

MASON: Well, that's absolutely right. But you have to add to that someone died in that fire, too. There's a certain human grief that's going on where she's mourning the loss of this person on the one hand that she didn't get to say goodbye to.

She didn't get to go to the hospital. She didn't get to have the rights of intimacy and love that come with that relationship, now she's grieving. She can't even touch anyone. These people are in this house all day long.

When I come in, we hug this way. We just talk like this. We say love you, you know? Because they can't touch each other, I can't touch them.

COOPER: How much longer -- does she have another week in quarantine?

MASON: Yes, a week from today is when they're eligible to come out. We hope to have everything ready for that to happen.

COOPER: She's had no symptoms.

MASON: No symptoms. Three times a day they take their temperature. They look at each other and what's that number and how are you doing? They record all of that. They don't live day to day, they live from temperature taking to temperature taking.

And they're trying to find god in the midst of this tension between grove and the future that they hope to have when they get out and to think about that. COOPER: Pastor Mason, I appreciate all you're doing. Thanks for being with us.

MASON: Thank you.

COOPER: We're following several other stories tonight. Kyung Lah has a 360 Bulletin -- Kyung.

KYUNG LAH, CNN CORRESPONDENT: Well, Anderson, North Korean leader, Kim Jong-Un has reportedly resurfaced and is giving field guidance at a new residential area. State-run media published these photos of him using a cane, but it's unclear when they were taken. Kim was last seen September 3rd at a concert with his wife.

ISIS is on Baghdad's door steps. Local forces are having a tough time battling the terror group in nearby Anbar Province. Some ISIS fighters are about 10 miles from Baghdad's Airport. ISIS has also gained for control near the Turkish border.

New protests and ten arrests in Ferguson, Missouri, today. Demonstrators at the Moral Monday march called for the arrest of the officer that shot Michael Brown in August.

Police in New York are searching for a man who threw a smoke bomb into a restaurant on Friday. He popped out of a subway emergency hatch and taught the canister and then disappeared underground. It's raising security concerns for the city's extensive subway -- Anderson.

COOPER: That's a bizarre story indeed. Kyung, thanks very much.

Now all this week on CNN we're sharing a series of special reports "Roots: Our Journeys Home." Several here at CNN are digging into our family trees.

In the next hour, I invite you to take a journey with me as I travel to the Deep South to uncover my own family's history. We'll have updates on Ebola, but we'll be playing you this part of my journey home. Here's a preview.

(BEGIN VIDEOTAPE)

COOPER: Trying to find the old Cooper family cemetery. It's here along the Mississippi/Alabama border. It's deep in the woods, hard to find. It's near a house where my great-grandfather William Preston Cooper used to live.

(voice-over): We traveled along a dirt roads for miles, a forest of trees and canyons of kudzu before we finally found it.

(on camera): Relatives might have been working to try to clear the undergrowth and cut down trees to try to clear the cemetery, but one of the kind of amazing things about it the cemetery is so old the headstones have disappeared or been worn away by the element. You can't see names of people any more. It's hard to tell what's a headstone.

(END VIDEOTAPE)

COOPER: My family's roots in the next hour of 360. Actually a lot of big surprises I learned about my family.

In minutes at the top of the hour, new information tonight on the nurse battling Ebola here in Dallas, the first transmission of the disease in the United States. She helped care for Thomas Duncan who died of Ebola last week. There are a lot of questions about how she herself got it. The latest next on 360. Stick around.

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COOPER: Thanks for joining us for this extended edition of 360. We're live in Dallas tonight where there is breaking news about the nurse who's been diagnosed with Ebola. New information tonight, her name is Nina Pham. She is 26 years old and she contracted Ebola after treating Thomas Duncan who died in the hospital last week.