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Legal View with Ashleigh Banfield

CDC: Ebola Not Airborne; An Ebola Q&A; First Enterovirus Death in Rhode Island

Aired October 01, 2014 - 12:30   ET

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

(COMMERCIAL BREAK)

ASHLEIGH BANFIELD, CNN ANCHOR: The Centers for Disease Control, very, very clear on one point regarding Ebola. You cannot catch it necessarily from the air. It's not airborne. It doesn't really behave like a cold or the flu.

You have to have actual contact with the bodily fluids of an infected person. That is a bodily fluids issue.

I want you to watch very carefully. This is a very real case of how one person, one infected person, spread the virus to many others.

(BEGIN VIDEO CLIP)

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: A woman in Uganda didn't know she was sick with Ebola. She was in close contact with six people.

Her baby and father-in-law, they both got sick. The baby then got his grandmother sick, and she had contact with two more people as well. The father-in-law had close contact with 12 people.

Out of that, his brother and cousin both got sick. The brother then had close contact with four more people. And the cousin had close contact with five more people, including another brother who used his blanket and also got sick.

(END VIDEO CLIP)

BANFIELD: The voice you just heard was Dr. Sanjay Gupta, our chief medical correspondent, who is outside of the Centers for Disease Control right now, and also with me live here in New York is Dr. Ian Lipkin, an infectious disease specialist from Columbia University.

Sanjay, first to you, if I could, how delicate is this virus? How resilient or how delicate is it, meaning, if I sneeze on my hands and then I touch a door handle, how long will it last on that door handle to when the next person touches the door handle and then ultimately could be infected?

GUPTA: Well, we know this virus can live outside the body, first of all, and it can live probably for several days. It's a little bit dependent on if there's sunlight, for example. Even simple UV light can start to deactivate the virus. Obviously, if someone cleans the door handle, that can deactivate the virus.

But, to your point, it can live on surfaces. It's not common for it to have significant virus when someone sneezes as compared to blood, for example. There could be a hundred-fold more virus in blood versus with somebody sneezing.

But it is theoretically possible but unlikely that someone could become infected in the way you just described, someone sneezes, they touch a handle, someone else comes by, touches that handle and touches their nose, mouth, eyes and gets infected, theoretically possible but not likely.

BANFIELD: I'm sure it's something a lot of people are wondering just how susceptible could they be.

And for the rest of the hour, Sanjay, I also want to remind our viewers that you're going to stick with me, because here on CNN, we're going to answer your viewer questions. And we invite you to tweet us with those questions. The hash tag is #EbolaQandA, hash tag #EbolaQand -- and the word "and" -- A. We are also taking anything that you post on your Facebook page as well.

Dr. Lipkin, if I could ask you as well, this is typically flu and cold season, and so many of the symptoms are similar.

Are we in the general public supposed to be able to determine the difference, or is this really up to the medical community to determine that someone in their midst has something more than the flu and cold that they're likely going to get inundated in the E.R.s in the coming months?

DR. IAN LIPKIN, DIRECTOR, CENTER FOR INFECTION AND IMMUNITY: In the early phases of Ebola, people can have very mild illness, but it rapidly progresses to something more severe, so it's not going to look like your average cold or cough.

If you have a travel history or contact with somebody who has a travel history that's suggestive --

BANFIELD: That you know of.

LIPKIN: That you know of. But this is, for example, the way we ultimately controlled SARS. We found evidence of travel history, and it's the role of the public health departments and the Centers for Disease Control to help us do that track tracing.

So I think, as Sanjay said, it's possibly theoretically to become infected via a cold symptom associated -- not an aerosol but saliva or whatever might come out of your nose, but that's much less likely.

The more common route for transmission is that somebody comes into contact with vomit or blood or something else which is truly dangerous.

BANFIELD: OK, but when you say "in contact," the person who's coming into contact, do they have to have an open wound on their skin or just simply touching it or being near to it? What's the actual transmission path?

LIPKIN: We are continuously touching our face, the mucous membranes in our mouths and our eyes, so yes. And we have open cuts on our hands that we're not aware of.

So it's possible for somebody to come into contact with vomit or blood or something like that and become infected.

BANFIELD: And not even realize that --

LIPKIN: And not realize it, but again --

BANFIELD: And they're clearing their eyes.

LIPKIN: This is really well-contained at present. We're talking about a single case at present in Texas.

And even if it spreads to be two or three more -- God forbid it does, but even if it did -- it's not what we're looking at in west Africa.

BANFIELD: Sanjay, just quickly before we go to break, I want to remind people. You have reported in the past -- I can't remember the number but it was astounding, the number of times we actually touch our faces in one 24-hour period. I think it's something like -- was it a thousand or so.

And the reason I ask you for that statistic is because, is this a circumstance where a lot of good hand washing is advised for the public out there that might be nervous or is it really beyond that?

GUPTA: I think that's always a good suggestion, certainly for all sorts of different viruses. We touch our hands to our face, eyes, nose, mouth several hundred times a day without even realizing it, and that's oftentimes how these viral diseases are transmitted.

But I will say again, when it comes to Ebola, typically, you're talking about a very small number of people, and the idea that it's sort of out there on surfaces, I just don't want to leave people with that impression.

It's always good to wash your hands. It's always good to avoid touching surfaces for all sorts of different reasons. But that's just not -- there's a lot of places where we should focus our attention in terms of curbing Ebola, and certainly we should do that, but there are much more important things.

What's going on in west Africa, curbing that is going to make a huge impact over here in the more near-term future.

BANFIELD: OK, well, Dr. Gupta and Ian Lipkin, stay with me if you both would, plenty to talk about with you because we're answering your questions, viewer questions, about Ebola.

Tweet them out at the hash tag, #EbolaQandA. And one of those questions is this, can the Ebola question -- can the Ebola issue -- can Ebola become airborne? We're going to have that answer, coming up. (COMMERCIAL BREAK)

BANFIELD: So in light of the first case of Ebola being diagnosed in the United States, CNN is answering your questions about the killer virus. If you have a question, you can tweet using #EbolaQandA.

And joining me to answer your questions is Dr. Ian Lipkin, and we're also joined by CNN's chief medical correspondent, Dr. Sanjay Gupta.

Dr. Gupta, if I could start with you, we talked a little bit about this notion, there's a question from a viewer, what if an Ebola patient sneezes on you. It's not always that simple.

Say if you're sitting on a bus and someone sneezes beside you, should we be concerned because we've heard it's not airborne?

GUPTA: Right. It's not airborne. And what we're talking about is this idea that did bodily fluids from this person who is sick with Ebola -- and I only bring that up because people sick with Ebola may be unlikely to take a bus ride. They're usually pretty sick. They're usually at home in bed or in the hospital.

But say someone was sick with Ebola and on a bus, and they sneezed on the bus but did not get bodily fluids onto the passenger next to them, unlikely that person could potentially become infected.

It doesn't linger in the air so someone else in the bus could potentially become infected. That's typically what people mean by airborne, that it's hanging out there and can get more and more people infected. It's unlikely.

Ebola typically isn't associated with a lot of sneezing and coughing. It doesn't behave that way. It's not that kind of flew and there's usually not a lot of the virus in what you sneeze or cough. There's about 100-fold more virus in your blood, for example, than that. So it's possible but unlikely.

BANFIELD: Thanks. We have another question, why don't we shut down flights from Africa? I know that sounds pretty egregious in terms of trying to put up the barrier, but is that -- let's say -- we've got one patient now, but let's say there is a bigger problem in the future.

Is that something that has been done in the past or could be done?

LIPKIN: It's something that could be done, yes. It's not something that we anticipate at present. What's more likely is that we'll try to emphasize through education. As people leave planes, you pass out landing cards and explain to them they need to report to local health authorities if they become ill.

But, yes, it's theoretically possible that we could shut down airports. WHO, for example, in 2003, shut down specific cities, basically said, there will be no travel. There are embargoes on travel to specific areas.

So that can happen. We're hoping that that's not going to happen.

BANFIELD: This patient flew, you know, an indirect flight through Brussels.

LIPKIN: Yes.

BANFIELD: So you can't shut down Brussels, too?

LIPKIN: No, it's --

BANFIELD: I mean it gets a little bit tricky when you're talking about the (INAUDIBLE) --

LIPKIN: We have to -- we have to take travel histories.

BANFIELD: Yes.

LIPKIN: But I think we have this sort of information anyway as people make circuits as they go from country to country. So we can track them. And I'm sure that what's being done now is that people are trying to track anybody who might have come into contact with him in Brussels, despite the fact that at that point he was not infectious. And I just want to emphasize what Sanjay said a moment ago. In virology, in infectious diseases, we have a very specific interpretation of the term airborne. That means that it does linger in the air. This is not that. If it were so, it would be much, much more worrisome.

BANFIELD: You also mentioned something about the two-meter zone. I mean if someone sneezes within two meters, it could be airborne for a moment.

LIPKIN: Yes, there's a -- it's a -- it's a distance. For example, a small aerosol, which goes, you know, a few inches is very different than an airborne virus which may distribute through several feet.

BANFIELD: OK. Yes, so very significant to note.

LIPKIN: Yes.

BANFIELD: In a very small area, yes, but generally speaking, an entire bus, no.

Dr. Lipkin and Sanjay Gupta are going to stay with me. And, again, if you have questions, you can tweet them. We're using the hash tag all day long on CNN, #ebolaqanda. So just tweet us your questions and after the break we'll have more for you.

(COMMERCIAL BREAK)

ANNOUNCER: This is CNN breaking news.

BANFIELD: Now, we've been talking all day about a patient with Ebola being, you know, detected here in the United States, but we have breaking news about Enterovirus. A severe respiratory illness that has been afflicting a lot of children around the United States. And we're just getting news from the Rhode Island Department of Health confirming that the first death has now occurred as a result of Enterovirus 68. This outbreak that we've been reporting on for weeks. Apparently this is a child and this death apparently happening last week.

I want to bring in Dr. Ian Lipkin and also Sanjay Gupta, who are still with me.

Sanjay, I'll just turn that over to you for a moment because up until now I think most of us were under the understanding that it wasn't necessarily a lethal virus, that you could beat this. And now we're hearing about a child dying.

GUPTA: Yes, I mean I think that was the general sort of thinking about this and we obviously have been talking more recently about the fact that this particular virus was associated with people developing weaknesses or even paralysis in some of the limbs. One of the things that, you know, you've got to keep in mind when you think about this sort of thing is that a child who -- this is obviously a sad, tragic sort of story -- but a child who has Enterovirus 68, you want to know a lot of things about this child. Were there other infections? Was the child sick in some other way? We do know people, for example, who have weakened immune systems are going to be less likely to do well from this sort of infection?

So I think some of those details are still coming in from -- I read the same report from Rhode Island that you did. But, you know, we -- you know we talk about Ebola, we talk about all these different sort of pathogens. You know, you keep in mind, Ashleigh, that regular flu kills some 30,000 to 40,000 people a year in this country and it's sad to think about but that's the reality. And Enterovirus is one of those types of strains that can sometimes lead to death.

BANFIELD: And, Dr. Lipkin, you know, I think that the Rhode Island Department of Health is also releasing that this child apparently was also afflicted with a staph infection. Does that make a lot of sense to you reading that?

LIPKIN: It does make sense. Enterovirus 68 has been spreading rapidly around the world. We began detecting it in some of the work we do in foreign countries two or three years ago. And there have been large outbreaks now. And, of course, there's one in Colorado.

BANFIELD: Leading to death, though?

LIPKIN: Not leading to death, but, you know, whenever anybody is compromised, as Sanjay has said, as a result of an infection of this sort, maybe the child was on a respirator, had a secondary infection with Staphylococcus, it could easily account for this sort of an outcome.

BANFIELD: OK. Well, we're continuing our reporting -- our live reporting as well on the Ebola virus. There is this patient actually diagnosed for the first time in the United States. This patient now in serious condition in Dallas, Texas. And we're answering your questions about Ebola. It is contagious. Highly contagious? No. And that might sound strange to you because it is so infectious. We'll have answer to all of these things. Send us your questions. You can either e-mail or you can tweet us with the #ebolaqanda. #ebolaqanda is the hash tag. Dr. Gupta and Dr. Lipkin are going to answer more of your questions straight ahead.

(COMMERCIAL BREAK)

BANFIELD: So we've got a live picture set up in Dallas/Ft. Worth at Presbyterian Hospital. We're just minutes away from a live news conference with the Texas governor. Rick Perry is going to talk about the Ebola case that has been diagnosed there in Dallas. He's going to do so live at that hospital. And as soon as he steps up to that live microphone, CNN will be bringing that to you live as well.

In the meantime, we've been answering all your questions about the Ebola virus and how people contract it. If you've got questions, you can tweet CNN using #ebolaqanda. And Joining me once again to answer your questions is epidemiologist and infectious disease expert, Dr. Ian Lipkin here live in New York.

It's a great question that comes from one of our viewers. Can insects or animals spread Ebola?

LIPKIN: Well, infects, no. But animals, yes. So, in fact, the origin of many of these Ebola outbreaks is wild -- is people hunting wild game.

BANFIELD: Which happens a lot in Texas.

LIPKIN: So -- yes. Well, but probably not the same kind of wild game we're talking about.

BANFIELD: OK.

LIPKIN: So it's typically people who are hunting primates, inexpensive sources of protein in the jungles. Bats we presume are the original reservoir for Ebola virus. So if you hunt bats, you hunt primates and you're in central or West Africa, that's a dangerous thing to be doing.

BANFIELD: Another question that's come in, doctor, is, when will medicines like Zmapp (ph) become available? That was that very controversial treatment serum that was -- hadn't even been tested on any humans before it was actually used on the first two American Ebola victims who contracted it in Africa before returning home. When is that going to be more widespread?

LIPKIN: So I'm still not certain that Zmapp is effective. We don't really know because those patients got excellent care when they moved back to the United States. So it may simply be a function of the fact that they recovered from the illness and they received the supportive care that they need. There are a whole host of drugs that are now being tested that seem to have efficacy. It -- we're probably months away from being able to use those, however.

BANFIELD: And if not Zmapp, something else? LIPKIN: And something else. There are a whole series of drugs that

have activities specifically against viruses. Zmapp is a series of minicrol (ph) antibodies that are very useful in preventing the virus from attaching to the outside of a cell so it can't get in.

BANFIELD: OK.

LIPKIN: But once it's inside of a cell and it's reproducing itself, you need a drug.

BANFIELD: Last question. Only a couple seconds, if you can do this one for us. Why won't they release this patient's name and transit history, what airlines he's been on, if you're trying to find who he's been in contact with?

LIPKIN: We have very strong regulations on patient confidentiality. So one can't simply release these things. However, the authorities who need to be able to track these individuals with whom he or she came into contact do have that information and they're doing so quite well.

BANFIELD: Dr. Lipkin, thank you so much for being here today and for your information.

LIPKIN: My pleasure.

BANFIELD: So valuable. So appreciate it.

By the way, one of the only two Americans before this particular case to ever contract Ebola, Nancy Writebol, is going to be live with Anderson Cooper tonight on his program at 8:00 p.m. Eastern Time. So be sure you tune in then.

In the meantime, thanks for staying with us for this special hour of LEGAL VIEW. Wolf, my colleague, starts right now.