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Hospital Released U.S. Ebola Patient By Mistake; Officials May Isolate U.S. Troops Return from Ebola Zone; Mortars Heard in Baghdad Green Zone

Aired October 1, 2014 - 19:00   ET


ERIN BURNETT, CNN HOST: OUTFRONT next, breaking news, Ebola in America, new details tonight about how the system failed. Why was the Ebola patient sent home after he told hospital staff he was feverish and had just flown in from West Africa, the center of the outbreak?

Plus he had direct contact with at least five children. What is the threat to them and their classmates?

And an exclusive interview with the Ebola patient's co-workers, they talked just before he left for Dallas. Let's go OUTFRONT.

Good evening. I'm Erin Burnett. OUTFRONT tonight, the breaking news on the first Ebola diagnosis in America. Many developments to talk about tonight, but perhaps most disturbing this, new details about how a Texas hospital's mistakes exposed the public to the deadly virus.

The patient identified late today as the man you see here, Thomas Eric Duncan is a 42-year-old man from Liberia. He went to Texas Health Presbyterian Hospital on Thursday. A feverish Duncan told hospital workers he had just arrived from West Africa, the center of the Ebola outbreak.

But somehow doctors gave him some antibiotic, some pain reliever and sent him home. That crucial decision exposed the public including schoolchildren to Ebola for about three days and then for 72 hours, Duncan is not in isolation. He is not even in a hospital, he is out walking around.

When he finally returned to the hospital on Sunday he told the staff again that he had just arrived from Liberia. He was feverish. He was vomiting. It was only then that they finally admitted him. Duncan was diagnosed yesterday with Ebola, five days after he first went to the hospital.

Let's say that again. Five days after he first went to the hospital. He is now listed in serious condition. As you can you imagine how this case has been handled is fueling outrage tonight.

And we start our coverage with our senior medical correspondent, Elizabeth Cohen. She is outside of the hospital in Dallas. And Elizabeth, the question I have is how could this have happened? ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: You know what, Erin, unfortunately miscommunications happen at hospitals with a great deal of frequency, but seldom does it have this kind of potentially devastating consequences.


COHEN (voice-over): The family of 42-year-old Ebola patient, Thomas Eric Duncan, says he's in pain and hasn't eaten for a week. Now in serious condition at Texas Health Presbyterian Hospital.

Now health authorities are closely monitoring between 12 to 18 people including five children. They all had contact with Duncan, on this, his first trip from Liberia to the United States. Authorities want to make sure they too don't develop the signs of Ebola.

JUDGE CLAY JENKINS, DALLAS COUNTY: The public can be assured, you're going to be safe. This virus is isolated, is being contained, will be contained.

COHEN: But there are safety questions here in Dallas and in the United States. Duncan arrived in the U.S. from Liberia on September 20th, five days later he went to the hospital for care but was sent home. And officials say in response to a nurse's question, Duncan volunteered he traveled from Africa.

MARK LESTER, EXECUTIVE VICE PRESIDENT, TEXAS RESOURCES: That nurse was part of a care team and it was a complex care team taking care of him in the emergency department. Regretfully, that information was not fully communicated throughout the full team. And as a result, the full import of that information wasn't factored into the clinical decision-making.

COHEN: Two days later, Duncan returned to Texas Health Presbyterian Hospital. A close friend tell CNN the hospital wasn't moving fast enough so the friend called the CDC. The CDC directed them to the Texas Department of Health leading to a phone call to Presbyterian Hospital.

Duncan was then isolated and after tests, it was confirmed he had Ebola. We are told Duncan has called family and friends from the hospital, prayed with them on the phone and cried.

While there are questions about the hospital's handling, there are also concerns about screening at U.S. airports. I came back from Liberia just four days ago with two colleagues.

At the airport, we told immigration officials we've been covering Ebola. No one took our temperature or asked if we've near patients. Only I was told to monitor my health for 21 days, but no one told me what to look for.

Back in Dallas, the children and relatives of the patient have been advised to stay home.

MIKE MILES, DALLAS INDEPENDENT SCHOOL DISTRICT SUPERINTENDENT: We have custodians, of course, cleaning the buildings every day, but we're going to add custodial staff to those buildings. It's not a hearty virus and so regular disinfectants is going to help.

COHEN: Health officials say everyone who had contact with Duncan is feeling fine and are not in quarantine.

DR. DAVID L. LAKEY, COMMISSIONER, TEXAS DEPARTMENT OF STATE HEALTH SERVICES: People cannot transmit this disease until they have symptoms. So individuals who do not have symptoms are not going to transmit this disease to individuals. The chance of them transmitted is zero.

COHEN: Health officials say even with this first case of Ebola diagnosed in America, the U.S. will never get to be anything like West Africa, where poverty and a weak health system have led to chaos and misery.


COHEN: And now as I mentioned, this kind of miscommunication like what happened at this hospital here, this is sadly not an unusual event. There are experts who have written an entire books about miscommunication at hospitals. Hopefully this event is a very clear call that something needs to be done -- Erin.

BURNETT: All right, thank you very much, Elizabeth. And certainly something that can fuel shock and outrage when you consider Texas is supposed to be one of the 13 states in the United States that was supposed to be completely ready for this to happen.

"The New York Times" tonight is reporting something very important. They are saying that Duncan had direct contact with a pregnant woman who had Ebola just four days before he left Liberia for the United States.

"The New York Times" reports that Duncan helped the sick woman get to the hospital by taxi. She was convulsing and yet turned away at the hospital because there weren't enough beds. She died hours later.

"The New York Times" also reports that others who have come into contact with her are now sick or dead. Another potentially huge sign that U.S. officials missed when screening Duncan before he came into the United States.

Chief medical correspondent, Dr. Sanjay Gupta is OUTFRONT. Sanjay, I mean, that also in of itself is shocking. Sure, he didn't have a temperature. He had just days before he was helping carrying a pregnant woman who died hours later of Ebola. Shouldn't they have known that?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Well, you know, it is difficult not to pile on a little bit, right, Erin, with regard to this. There is no question this is a dropped ball. There was a misstep in terms of how it was handled. And look, history is going to record this because this was the

first patient diagnosed with Ebola in the United States and what should be low hanging fruit sort of an easy thing to handle, they missed it.

The travel history, when you have a patient who says look I'm from Liberia. I have a fever. I'm vomiting. I fit the criteria. That is the criteria that the CDC has set out for these hospitals, very, very clear and they just missed it.

As much as we talk about vaccine trials and experimental medications and contract tracing, this is 101 stuff and it didn't get done properly here, Erin. And as a result, I will point out, there are other people who had contact with him after he was sick.

And that has got to be hugely frustrating I'm sure for him, but especially for those people, that did not need to happen.

BURNETT: It didn't. And again to your point, that we know now he was sick and went to the hospital and was sent home with just antibiotic and pain killer. That was it. So another 48 hours then went by before he came back to the hospital and was finally admitted. So that is 48 more hours where he was clearly having symptoms and others could have been exposed.

GUPTA: No question. He got an antibiotic, which first of all, they said he had a viral illness. They didn't think it was Ebola. Antibiotics wouldn't work for that. It's a little bit of a side point, but an important one.

And he got those pain workers. It is still a little baffling as to why, when the guy is saying, I am from Liberia. I have these symptoms. They fit with Ebola. Why something more didn't happen?

What we heard was the nurse talking about she had taken that travel history, but it didn't get communicated to the team in charge. I don't understand it. Usually the lead person -- there is a lead person on the teams that will sign off on the discharge paperwork before a patient is sent home.

It just shouldn't have been missed and these hospitals have been going through drills over and over again to not miss these sorts of things.

BURNETT: All right, Sanjay Gupta, thank you. Sanjay is going to be back with us in just a few moments though to answer some of the crucial questions such as when is a symptom a symptom. When can you really contract Ebola from somebody?

But right now the mayor of Dallas, Mike Rowlings is OUTFRONT. Mayor, thank you so much for taking the time to be with us.

I just wanted to ask you first about this "New York Times" report. They are reporting that Mr. Duncan just a few days before he left Liberia had helped a pregnant woman, helped carry her. She a few hours later died of Ebola. And others who interacted with her at that time are either dead

or sick. He would have known that she died. He was honest when he came to the hospital about the fact that he came from West Africa, from that area. Did he tell them also that he had been with someone who died of Ebola?

MAYOR MIKE ROWLINGS, DALLAS: I don't know exactly what conversation took place. They were trained to take that information. They took that information and Dr. Gupta is right that the miscommunication happened. There is no excuse for it and we are trying to get on with making sure that our citizens are safe here in Dallas.

BURNETT: Who is responsible for that failure?

ROWLINGS: Well, I think basically the hospital is first and foremost accountable for all of their patients and their safety. I feel great about Presbyterian Hospital. It's historically a great one. My daughter was born there and I've used it many, many times. When we deal with a tough situation like this, we have to be perfect. In this case, they weren't.

BURNETT: And what about the issue of the ambulance. Even after this, the ambulance was used for another two days. I know it was decontaminated, but it was still in service. Now obviously that stopped. Was that also a mistake?

ROWLINGS: Well, not at all, because they assumed this person had some other illness. Once they came back and picked him up, they realized this guy was from West Africa and they then put all of their gear in place, they had their protocol and they followed it exactly.

Those folks have been put in isolation at this point. The ambulance has been put in isolation. And once this thing kicked in, I think all of the things were done correctly, but that early-on decision was important.

BURNETT: And one thing that confuses me in terms of what officials really know and maybe hopefully you can help me understand this a little bit, because if the ambulance is now in isolation because they are worried the virus could be somewhere on it.

At the same time they are saying it is not a hearty virus, it dies very quickly. Those two things seem to be in conflict with each other. Mayor, are you conformable that no one else has been infected by Mr. Duncan in Dallas at this point? Are you also unsure?

ROWLINGS: Well, first of all, I think we have to take every precaution even though I don't believe the ambulance is an issue. We know that he contacted some people, OK. Maybe up to 20 individuals. We've got a cross jurisdictional team tracking each of the individuals, interviewing them to make sure there are no symptoms shown.

As Dr. Gupta said, you cannot transfer this unless you are showing symptoms. And they've got -- it takes a while to incubate so time is on our side to make sure that we capture this and nip it in the bud so nobody else gets infected. Hopefully in 21 days everybody is healthy.

BURNETT: And let me ask you the question about his identity, the family and the friends of Mr. Duncan relayed this to the media. The hospital and the airline wasn't releasing it. In this kind of a case, I have to ask you, of such important public health especially when we look at the future here, wouldn't this be a case where you would release the name?

ROWLINGS: No. We are law-abiding governments here and we have HIPPA regulations and we're going to make sure that the patient is first important and then we are going to make sure that we followed up everybody he's contacted and make sure they are not infected and we monitor those individuals. But privacy is important to me and I think to this government.

BURNETT: I understand that, but what about people who might not know his name might have come into contact with him and would only know if they saw a picture. He wouldn't even know their name, someone he touched when he was buying something at Walmart. That is frightening, isn't it?

ROWLINGS: No question. And that is where we've got to play detective on this, retrace each of his steps and find everybody that he's in contact with.

BURNETT: All right, Mayor Rowlings, thank you so much. I appreciate your time tonight.

ROWLINGS: Thank you.

BURNETT: And OUTFRONT next, the U.S. Ebola patient had to take several flights to get home. We now know he was on two United flights. How many others could have been exposed?

Plus 3,000 Americans will soon be in the Ebola hot zone and what will happen when they come home?

And the missteps, the missed signs by officials handling this first Ebola case in America. We'll get answers from the chief of the CDC.


BURNETT: Breaking news tonight, we're learning troubling new details about a breakdown in communication that allowed a man with Ebola to be sent home from the hospital. We are now learning for three days before he would be quarantines, according to the hospital, Thomas Duncan had originally told a nurse he has been in West Africa just days earlier when he was sick and that information though never made it to doctors.

Just moments ago, I spoke to Duncan's former boss in Monrovia, Liberia. He told me Duncan is extremely fortunate to be getting the care he is getting in the United States because in Liberia, he says, he could have died.


UNIDENTIFIED MALE: We do not have the facilities right now, medical facilities here. We are asking for international assistance. But since he came to America, he is blessed to be there to able to get well.


BURNETT: The Obama administration is closely monitoring the treatment of the first person testing positive for Ebola in the U.S. And Jim Acosta joins me life from the White House.

Jim, what is the latest there?

JIM ACOSTA, CNN SENIOR WHITE HOUSE CORRESPONDENT: Erin, the White House is urging the public to be calm as the centers for disease control tries to get a handle of this Ebola case in the U.S. Last month, President Obama said at the CDC that it was unlikely that someone with Ebola would reach this country's shores. But the confirmed case in Dallas, White House press secretary Josh Earnest told me earlier today that this patient does not pose a risk. Here is what he had to say.


JOSH EARNEST, WHITE HOUSE DEPUTY PRESS SECRETARY: It is our view that we have the medical infrastructure that is necessary to meet -- to try to treat this individual that does have Ebola in a way that doesn't pose a significant risk to other patients in the hospital, to the doctors and nurses who would be caring for that individual and certainly doesn't pose a significant risk to the broader community.


ACOSTA: In the meantime, the White House is using social media to spread the facts about Ebola. Officials have been tweeting and posting on Instagram this message and we can throw it up on screen. It says you can't get Ebola through air. You can't get Ebola through water. You can't get Ebola through food in the U.S., adding later that the virus can only be spread through contact with the blood or body fluids of people or animal sick with Ebola. But Erin, despite these efforts to get the word out, make no mistake, this is something the White House is watching very, very closely tonight -- Erin.

BURNETT: As they should be. Thank you very much, Jim.

And now Dr. Sanjay Gupta is back. Dr. Ian Lipkin joins me, director of the center for infection and immunity. He was also a consultant for the movie "Contagion," and Dr. Semma Yasmin, formerly epidemiologist at the CDC, now a medical writer for the "Dallas Morning News."

We have been compiling viewer questions. And you can tweet us with #EbolaQ&Awithyours. Here are some of the ones we had.

Sanjay, I want to start with you. We know the symptoms here, throwing up, fever, sick to your stomach. Those symptoms, of course, can start very mild. It could be anything, right? Indigestion, a light cold, just feeling under the weather. So I guess the question a lot of people have been tweeting is, is it possible someone could be walking around with light symptoms for quite some time, for days interacting with people not knowing they are spreading the virus?

DOCTOR SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: They are very unlikely, for a couple of reasons, Erin. First of all, it can start off looking pretty similar to flu as you mentioned. But Ebola tends to progresses much more quickly. It gets bad fast, I guess, is what I'm saying.

But I think the history here is also really important. A lot of people will have flu-like symptoms. And in fact a lot of people coming back from Africa are going to have things that cause fever that are not Ebola. But the real thing is the history here. Are you -- were you in contact with people who had Ebola? You talked about this particular person. He has been with somebody who had Ebola.

So the history becomes so important here. Again, we talked about this earlier. They missed part of the history or at least an act upon part of that history of this particular patient. But it is absolutely critical. Flu-like symptoms in Africa, contact with Ebola patients, that raises your antenna.

BURNETT: And we have a tweet here. Brandy said, the quote is "couldn't an Ebola patient spread the virus if they are showing flu- like symptoms and no fever?" And I guess the question from this is when is a symptom a symptom in the contagious sense? They keep saying, well, if you don't have symptoms you are not contagious. But at what moment are you technically showing a symptom? At what moment could it become contagious?

DOCTOR IAN LIPKIN, DIRECTOR, CENTER FOR INFECTION AND IMMUNITY: I think Sanjay mentioned this a moment ago. People are very sick. They don't just have flu-like symptoms, they have high fever, they have muscle aches, they have vomiting, they have nausea, they have diarrhea. They are all sorts of things. It is a very severe illness. And early on, it is true that you might mistake flu for this, but it rapidly progresses.

BURNETT: Even though, I mean, we are told this man went to the hospital and at least three days went by and he went home. He was sick enough to go to the hospital but not sick enough for them to keep him. I think that's what --

LIPKIN: So many people have said this already. I mean, we are shocked that the travel history was not taken seriously or it was move forward, it was not -- did not lose some sort of containment. It should have done.

BURNETT: Semma, we also talked to people here in New York for their question. And I just want to play one of them for you.


UNIDENTIFIED FEMALE: Can you contract the virus through a subway pole or in a confined place like a subway or a bus?


BURNETT: So Dr. Yasmin, what is your response? Can Ebola survive on a surface like a subway pole or doorknob, anything like that?

DOCTOR SEMMA YASMIN, FORMER CDC EPIDEMIOLOGIST: So the science tells us it can survive but not so very long. And that it can really easily disinfected, actually, just using regular bleach and other routine products that are routinely used in hospitals. There are has been lot of concern about transmission on places like subways. OF course, Ebola is not transmitted through the air. Not transmitted to water either. It has to be direct contact with infected bodily fluids.

BURNETT: And to that point, Sanjay, someone else asks whether it spreads only by physical contact and, you know, our Elizabeth Cohen reported that three feet distance was considered absolutely safe when she was in Liberia. But what if someone coughs, the saliva travels several feet, hits your skin, isn't that the same as touching a person?

GUPTA: It is theoretically possible that someone could become infected the way you are describing it, Erin. But you know, we are talking about things on the fringe here a little bit now, right? I mean, first of all, it would still be bodily fluids but now, there is the bodily fluid got on your skin or got on your body in some way and caused an infection that way, it is less like.

And also, the amount of virus in what you are coughing or sneezing up versus the virus that in your blood, we're talking exponentially different. You could have hundred times more virus than the same amount of blood as you would have, what you cough or sneeze up. So yes, it is a possibility. But you know, you want to target things that are going to be the most troublesome, the most problematic. Theoretically, it is possible, but that is a low yield area.

BURNETT: And Dr. Lipkin, one viewer tweeted quote "we are told not to panic, yet government officials and doctors are wearing hazmat suits when close to infected people. What is the truth?

LIPKIN: I agree that this is something that is disconcerting and disconcerting in West Africa as well. And they are coming into contact with secretions that Sanjay was referring to earlier, diarrhea and vomit and so on. It is very different than simply walking through a subway or walking through a mall. Where again, it is theoretically possible that you might have some virus present in something that someone would cough. But the levels of virus are so low.

BURNETT: They are not that high.

LIPKIN: That the odds are so high against it.

BURNETT: And doctor Yasmin, we know five students at four schools, at least these are the numbers we have now had contact with the Ebola patient. Is there extra concern for kids? YASMIN: So residents here are concern. The messaging again, though,

is that children exposed to Ebola are monitored in the same way as adults. The incubation range is the same in adults as in children. And that will be monitors for the same symptoms. We now know they did have direct contact with him. But so far, all five of those children are healthy and showing no signs of Ebola.

BURNETT: All right, thank you very much all three of you. And for more on OUTFRONT Ebola coverage, go to You can see it all there as we've been covering this over the past six months.

OUTFRONT next, the Ebola patient took multiple flights to get to Dallas. He was screened leaving Liberia, allowed to enter the United States. How the process failed both the passenger and the public.

Plus, 3,000 Americans will soon be going to the hot zone. What happens when they return to the United States? Is there any plan at all?


BURNETT: Breaking news, we have learned the first Ebola patient diagnosed in the United States, Thomas Eric Duncan, flew on two United airlines flights, a flight from Brussels to Washington Dallas airport and then a flight from Washington to Dallas. Thomas Eric Duncan is in isolation in a Dallas hospital. Tonight, United, sagging the CDC says there is zero chance anyone contracted Ebola on those flight. We are going to ask the CDC spokesman about in just a moment.

But first, Rene Marsh is OUTFRONT.


RENE MARSH, CNN AVIATION CORRESPONDENT (voice-over): The Liberian government tells CNN the infected passenger Thomas Eric Duncan stopped in Brussels on his way back to the U.S. We now know he boarded United Airlines flight 951 to Washington Dulles, connecting to another flight, 822 to Dallas.

Local governments and Ebola hot spots screen passengers with temperature scanners and look for obvious signs of illness.

DR. THOMAS FRIEDEN, CDC DIRECTOR: We made sure that every traveler who leaves that country is tested to see if they have a fever before they get on the plane. If they have a fever, they don't get on the plane.


MARSH: CNN medical correspondent Elizabeth Cohen and her crew were checked at the Liberia airport as they were prepared to leave. And when passengers arrive on U.S. soil, Customs and Border Patrol officers are supposed to question their whereabouts and visually scan for symptoms.

But Cohen was surprised there wasn't more thorough checks. She says one officer was unsure what symptoms she would experience if she was infected.

JOSH EARNEST, WHITE HOUSE SPOKESMAN: To bolster that screening effort, the CDC has been involved in training CBP officers who are on the front line of this, to make sure they understand and they have been trained on the symptoms of this illness.

DR. WILLIAM SCHAFFNER, INFECTIOUS DISEASE EXPERT: The most important thing to do is ask every patient with a fever, have you traveled? And if so, where? And if they tell you they've just come from West Africa, put them in isolation immediately.

MARSH: And while Duncan was not showing symptoms, which experts means he was not contagious, "The New York Times" reports he had just helped a pregnant woman who died of Ebola hours later.


MARSH: Well, the way it works is the customs officer flagged the potential passenger and the CDC is actually present at most international airports and takes over from there. A CDC official says that CBP, Customs officers, will be handing out this flier to passengers arriving to the U.S. from Ebola-affected countries. It essentially details the symptoms and incubation period for Ebola.

In the meantime, Erin, we know that the U.S. government is not advising that airlines not fly to countries impacted by Ebola. That said, the CDC is putting out travel notices, essentially warning travelers about the potential danger -- Erin.

BURNETT: Renee, thank you so much for that reporting. We have a lot of questions now for the spokesperson from the CDC, David Daigle, who is with me now.

I want to start with you with what's happening here on the U.S. side. You just heard our Rene Marsh reporting, our Elizabeth Cohen was actually just in Liberia four days ago and when she came back, her team was direct with Customs and said, look, we were in Liberia and covering the crisis for CNN, and one crew member said the response was welcome back to the United States and was sent right on his way. Another one was asked whether he had mud on his shoes.

This is pretty shocking. Is this going to -- stop right now or is it going to take time?


You know, I don't know about Elizabeth's particular experience but I can tell you that when I returned from Nigeria, I went through screening in Lagos and when I arrived in Atlanta, I thought it was a very good questionnaire and they did ask me about my travel history and where I came from. So, my experience was different I guess.

BURNETT: It might have been. But given that this happened, is there any other communication from CDC, anything to Customs or Border Control to make sure it is consistent and they are doing the right thing. DAIGLE: You know, we do work with the customs and border control

at 20 different embarkation places in the U.S. and I heard the mention, if you think back to SARS, the yellow carbon dioxide cards handed out where the outbreak was occurring. So it sounds like there is ongoing coordination and they are working together on I guess escalating different steps to warn people.

BURNETT: So, I want to ask you about flights from West Africa and from Liberia. You just heard Rene reporting.

If Thomas Duncan survives, it is going to be probably because he came to the United States and he got the medical care here. "The New York Times" is reporting days before he got on that flight, he helped a pregnant woman that died later and others who had contact with her has died. He knew she died when he had gotten on that plane.

Is it possible that if he survives, given the death rate in Liberia, you're going to have other people purposely getting on to planes trying to come to the United States so they might live?

DAIGLE: You know, I apologize, Erin. I don't know -- and I haven't seen "The New York Times" report and I don't know about the flight history coming to the U.S. So, I have been immersed in what we are doing here in Dallas, so I really don't -- I can't feel like I can go into that.

BURNETT: All right. I understand that.

But if he does survive, are you then worried that other people from Ebola-stricken countries will have incentive to come to the United States, because as we know there is not the medical care there that they need.

DAIGLE: Yes, that certainly would be a concern. But once again, I don't know a lot of the details for this particular case.

BURNETT: I understand. Got it, got it. But, of course, it is a concern. I understand.

But from what we know right now --

DAIGLE: Certainly.

BURNETT: -- the patient in Texas was screened at the airport in Liberia, at least, you know, for a fever. Now that failed for whatever reason. Questions weren't asked, for whatever reason. That didn't work and he came into the United States.

Is it something you will consider recommending that flights from these countries should no longer be coming to the U.S.?

DAIGLE: No. I don't think so. And that is certainly not -- I'm not even sure if that is a CDC call.

BURNETT: Right, I understand. But now, we know that there are risks for people getting on those planes and come to the United States. Does that change the thinking?

DAIGLE: I think he got on the plane asymptomatic, without any symptoms whatsoever. So, I mean, with the fever -- the symptoms occurred after he landed or arrived in the U.S. So, it is very difficult to prevent that. I mean the viruses don't respect borders.

BURNETT: Right. And I'm agreeing with you. But I guess I'm saying is given that there is this period that you get on a plane and not know you have it, and then you can land in the U.S. a few days later, does that mean flights should be stopped to prevent that from happening again?

DAIGLE: No. We have a good application for the screening here and in West Africa and working with customs and border control and I think we can escalate it with warnings. So I think we can stop it before it is serious.

BURNETT: And before we go, one quick question on -- we keep hearing zero chance, you know, that anyone who's on those planes could have contracted it, because he didn't have symptoms at the time. When you say zero chance, he didn't have symptoms. Does the CDC know at what instant a person goes from not having symptoms to having symptoms?

DAIGLE: You know, I'm not sure I understand the question. Do we know on what day or what exact time you go from --

BURNETT: The whole thing is there is no chance it could spread if you don't have a symptom. But do you know exactly when a symptom is a symptom and when a person can become contagious.

DAIGLE: I think we know it can occur typically between the 22nd and the 21st day, but we typically see it around the eighth day, from the exposure.

BURNETT: All right. Thank you very much, I appreciate your time tonight.

And OUTFRONT next, thousands of troops will soon be battling Ebola in the hot zone. What are officials doing to keep them safe and bring them back to the United States healthy?

Plus, this is the second time Ebola has hit American shores. How scientists fought back the last time.


BURNETT: Breaking news, the U.S. military is watching the Ebola situation in Texas very closely tonight. Already, the first of 3,000 American troops have deployed to Liberia to help fight the outbreak there. More than 1,800 people have died. When happens when those troops come back to the United States.

Barbara Starr is at the Pentagon tonight.

And, Barbara, you know, we hear day in and day out from military officials about the fight against ISIS, but the fight against Ebola is high on their list there. There are more being deployed to West Africa right now than to Iraq and Syria.


Absolutely right. The chairman of the Joint Chiefs of Staff, General Martin Dempsey, now we are told making this Ebola issue one of his top priorities, even as that fight against ISIS goes on.

We have learned tonight that General Dempsey a couple of weeks ago privately called into his office a series of experts, health medical experts on Ebola, to get a personal briefing about what is going on here and what the risks are, what the situation is.

We are told the concern is not just about keeping the troops safe but the humanitarian crisis obviously in West Africa and concerned the rate of infection could provoke a security crisis across Africa. Some of the concerns of the chairman as he works on plans to send the 3,000 troops to Africa and exactly how to keep them safe and healthy -- Erin.

BURNETT: Well, Dr. Lipkin, director of the Center for Infection and Immunity, who was just here, told me he thinks it may be 1.2 million people who may die of this before this is over, to give a scale of what Africa is dealing with.

Barbara, those 3,000 American troops that are heading to that zone, what happens when they come home?

STARR: This is the key question even as we stand here tonight, Erin. The Pentagon acknowledges it doesn't have an answer to it. The Defense Department and the military, the joint chiefs trying to work out a solution to that problem.

We are told tonight by a top defense official, it is very possible the rules will require that the troops be put in some sort of isolation for some period of days upon their return from Africa, that they would not be allowed directly to go back to their families and to their bases until a period of days pass and everyone is absolutely sure that they are healthy. What if some of the troops become ill with Ebola?

The hope is that they won't. That they will be able to keep them away from people who are ill. But there is very limited evacuation -- air evacuation capacity out of Africa. As we tonight, they are looking at the possibility of converting some military transport aircraft to have those isolation chambers so they can fly ill troops home if it comes to that -- Erin.

BURNETT: Barbara, thank you very much.

And OUTFRONT next, Ebola has hit the United States before. It sparked fear and panic but doctors and scientists fought back.

Plus, the Iraqi army, its soldiers massacred, unable to stop the advance of ISIS on Baghdad. Can the president keep his promise of no U.S. boots on the ground?


BURNETT: Now, let's check in with Anderson with a look on what is coming up on "AC360".

Hi, Anderson.


The story you've been covering this hour about the Ebola patient Thomas Duncan, clearly a lot of concern about the disease's transmission and we're going to get to that with our medical experts, but also a lot of questions about the way this was handled. Why was Mr. Duncan released by the hospital, why was it his friend and not hospital who first call the CDC. We'll get to all of that.

And for the first time, you'll hear from one of only two known Americans who survived the disease. You'll hear what Nancy Writebol went through, and also hear the powerful message she wants to deliver to Mr. Duncan.

All that, plus new allegations about another alleged sexual assault incident involving Jesse Matthew, the suspect in the disappearance of Hannah Graham. "360" is two hours tonight, 8:00 and 9:00, live edition. A lot going on, starts at the top of the hour, Erin.

BURNETT: All right, we'll see you in just moments. Thank you, Anderson.

And our breaking news coverage continues: health officials in Dallas are monitoring at least five school age children who came into contact with Thomas Duncan while he was contagious with Ebola. Tonight, CDC investigators are scrambling to locate anyone who came into contact with him -- sorry, the first time the U.S. responded to an outbreak. Here is Athena Jones.


ATHENA JONES, CNN CORRESPONDENT (voice-over): The announcement from the head of the Centers for Disease Control was chilling.

DR. THOMAS FRIEDEN, CDC DIRECTOR: An individual traveling from Liberia has been diagnosed with Ebola in the United States.

JONES: Until yesterday, Ebola had been largely confined to West Africa. Now, it's here and it's not the first time.

UNIDENTIFIED FEMALE: A mutated strain of the killer virus struck a research facility outside of Washington, D.C.

JONES: In 1989, an airborne strain of the virus quickly spread through monkeys at the Hazelton research facility in Reston, Virginia, creating fear and panic just outside the nation's capital.

Richard Preston chronicled the outbreak in his best seller "The Hot Zone".

RICHARD PRESTON, AUTHOR, "THE HOT ZONE": The monkeys were dying with nose bleeds, there was blood all over the place. And it was clearly a highly potentially infected environment loaded with Ebola virus.

JONES: Dr. Jerry Jaax was in charge of the Reston facility when the outbreak occurred.

DR. JERRY JAAX, FORMER ARMY CHIEF OF PATHOLOGY: We had one event where the monkey got loose in one of our rooms. The monkey didn't want to get caught, he was smart about it. You know, we had a hard time catching him.

JONES: In the end, the particular sub species of Ebola species dubbed the Reston strain, proved fatal only to the monkeys. But that didn't stop the fear that an outbreak could happen here, like the one depicted in the movie "Outbreak".

UNIDENTIFIED MALE: If one of them has got it, then 10 of them have got it.

UNIDENTIFIED MALE: We can't stop it.

JONES: The threat of Ebola spreading in the U.S. may have been low at that time, but the concerns about an epidemic were real.

UNIDENTIFIED MALE: The most optimistic projection (INAUDIBLE) is willing to make for the spread of the virus is this: 24 hours, 36 hours, 48 hours.

JONES: Professor David Heymann helped to investigate the first Ebola outbreak in Africa in 1976.

PROFESSOR DAVID HEYMANN, LONDON SCHOOL OF HYGIENE & TROPICAL MEDICINE: Ebola is a disease which is fairly easy controlled but at the same time, it's a disease which is very terrifying to people and which causes great human suffering and death.

JONES: The current Ebola patient being treated in a Dallas, Texas hospital is in serious condition. Health officials are working to contact and monitor anyone who may have come into contact with him. Once again, the concerns are real.

GOV. RICK PERRY (R), TEXAS: We wish it were somewhere else, but the fact is, it's here.

JONES: Athena Jones, CNN, Washington.


BURNETT: And OUTFRONT next, the Iraqi army, desperate for troops, offering amnesty to deserters who return. Will that Army be able to stop ISIS?

(COMMERCIAL BREAK) BURNETT: Breaking news: mortars heard in Baghdad's Green Zone.

American forces continuing to pound is targets in both Iraq and Syria. While Turkey, which is a crucial player because it shares a border with both Iraq and Syria has finally agreed to join the fight.

But the man tapped by the Obama administration to coordinate the international fight against ISIS tells our Elise Labott exclusively today that the war won't be fast, training Syrian rebels which is apparently the key to fighting the terror on the ground, according to the U.S. administration, is going to take a long time.


GEN. JOHN ALLEN, MARINE CORPS (RET.): Over the long-term, the intent is to build credible forces, vetted forces, credible forces with --

ELISE LABOTT, CNN GLOBAL AFFAIRS CORRESPONDENT: It's going to take a while though.

ALLEN: Well, it is, yes, and we have been saying it all along. It's going to take a while. It could take years. And so, we have to manage our expectations.


BURNETT: As for Iraq, it doesn't look like the fight against ISIS will end soon any time either.

Tom Foreman is OUTFRONT.


TOM FOREMAN, CNN CORRESPONDENT (voice-over): Military bases overrun by ISIS, convoys decimated, towns occupied, all amid troubling reports of Iraqi troops being slaughtered, dropping their weapons and running. In Washington, even the president is now admitting his team thought the Iraqis were more ready to fight.

BARACK OBAMA, PRESIDENT OF THE UNITED STATES: That's true. That's absolutely true.

FOREMAN: And why not? Twenty-five billion coalition tax dollars, years of training, and more than 4,400 American lives were spent to dismantle a dictatorship and set up a quarter million troops as the Iraqi army, amid much hope.

GEORGE W. BUSH, FORMER PRESIDENT: We're coming closer to the day when they can assume responsibility for defending their own country.

FOREMAN: But then as the bulk of U.S. troops withdrew in 2011, many Sunni members of the military felt that Prime Minister Nouri Maliki, a Shia, was pushing them out of power.

Retired Lieutenant Colonel James Reese saw the divisiveness firsthand. LT. COL. JAMES REESE, CNN MILITARY ANALYST: The Sunni soldiers

are not fighting for Iraq. The military literally is fractured between religious lines. You have Sunni leadership. You have Shia leadership. Again, if we could guess rid of that factor, the religious factor, you've got some very good soldiers.

FOREMAN: Which brings up another problem. Analysts say many, perhaps thousands of the good Sunni troops trained by American soldiers now appears to have crossed over to the ISIS side. And half the troops that are left can't be counted on as partners. Now, the chief of staff is facing hard questions even as talks swirl of more training.

SEN. JOHN MCCAIN (R), ARIZONA: You think the people you're training will only go back and fight against ISIL, do you really believe that, General?

GEN. MARTIN DEMPSEY, CHAIRMAN OF THE JOINT CHIEFS: We do not have to deal with it now.

FOREMAN: The Iraqi army is so desperate for more troops, it is offering amnesty to deserters if they'll just rejoin the fight. But if not, what then?

BURNETT: The president has been categorical. There will not be American boots on the ground. Is this a promise that can be kept?

REP. PAUL RYAN (R), WISCONSIN: I don't think so.

FOREMAN: Most voters do not want that. But right now, American wishes may depend on the Iraqi will to fight.


FOREMAN: In the end, Erin, when you think about what you had just a moment ago, that question that Elise Labott asked, can this be done? And we're told it could take years. It could take a lot of training. The problem as we see right here is even with years, even with a lot of money, even with a lot of training there is no guarantee of results, because certainly the Iraqi army has been set up to be ready for this fight today and they're not.

BURNETT: That of course is the unfortunate truth.

Thank you very much, Tom Foreman.

And thank you all so much for watching. We'll be back here again same time tomorrow night.

"AC360", though, begins right now.