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New Day

First Ebola Diagnosis in U.S.; Graham Suspect May be Linked to Other Cases

Aired October 01, 2014 - 08:30   ET

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

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MICHAELA PEREIRA, CNN ANCHOR: Good to have you back with us on NEW DAY.

The first case of Ebola has been diagnosed in the United States. That patient's being treated in Dallas after flying back to the U.S. from Liberia. Now, how big is the risk that it spreads and what are officials doing to prevent the spread? We are going to get perspective from a trifecta of astute medical professionals, Dr. Anthony Fauci, he's the director at the National Institutes of Health. Good to have you here. Beside me, Dr. Alexander van Tulleken, a senior fellow at Fordham University. And, of course, CNN's chief medical correspondent, Dr. Sanjay Gupta.

And for those of you that didn't miss - that missed it last hour, Dr. Gupta and I had a very interesting conversation with Dr. Tom Frieden, who is the head of the CDC.

And, Sanjay, I think we need to clarify here, do you get a sense that a CDC has a strong understanding and a strong grasp and is giving strong guidance on how Ebola is being transmitted?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Well, you know, I think the science, you know, around this is fairly clear in that, you know, someone, first of all, has to be sick, does not have symptoms before they can start to spread the virus. That's when the virus starts getting into the bodily fluids. I think that part of it's clear.

I think what is less clear and I think very important to clarify now is when someone should be tested. You know, this particular gentleman comes back from Liberia on the 20th, on the 24th he starts getting sick, on the 26th this person goes to the doctor, to the hospital and at that point we know the person is sick, we know the person has just returned from Liberia, and the person has some concerns about an exposure to Ebola. And despite all that, the person is sent home, not tested, not isolated. Two more days go by before the person comes into the hospital and is confirmed to have Ebola. Those two days are crucial and important.

PEREIRA: Yes, they are. They are.

GUPTA: It's exactly what we're trying to do here, prevent this disease from spreading. How many contacts did that person have during that time period? So important. And I think that when it comes to the guidance, you know, what the CDC is saying, what local public health departments are doing, the coordination between them, are we crystal clear on who should be tested? And I don't think that we are. And I think that that's a problem. Even when you look at the guidelines, Michaela, they still say interim guidelines.

PEREIRA: Right.

GUPTA: That suggests that they're still evolve and changing.

PEREIRA: Let's bring in Dr. Anthony Fauci with the NIH.

I mean I think this is the concern right now, Dr. Fauci, that a ball seemingly was dropped in Dallas. Fair enough, except for the fact that this is an infectious, a highly infectious disease. How do we make sure the guidelines are clear to health care professionals across the U.S.?

DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTES OF HEALTH: Well, from the health care professional, the CDC has been putting out announcements about the fact that when someone comes into an emergency facility with symptoms that are compatible with Ebola, an important thing to do is a very simple travel history.

And they are -- they have been continually emphasizing that and doing, I think, a good job of it. We, obviously, need to continue to do that. So if someone comes into an emergency facility, I mean that happens thousands of times a day throughout the country. But what we need to get the word out even more is a simple travel history. So if the emergency room physician had asked this person, do you have any recent travel outside of the country, and if the person said, well, I just came back from Liberia, that would have been an enormous red flag for anybody given the publicity that we have.

PEREIRA: Right. Right. Sure.

FAUCI: So that's really the issue, to make sure that physicians are aware that we have a problem, that there is an outbreak in West Africa and people will be coming to the United States who will be without symptoms. I think the issue that Dr. Frieden said about the plane was quite correct, the person had no symptoms during the plane trip.

PEREIRA: Right, on the plane. Yes.

FAUCI: So the danger of that is not a problem. Once the person began to have symptoms, that's when you've got to take a travel history.

PEREIRA: But here, again, is an issue. There are so many steps and so many levels. Dr. van Tulleken here in the studio with me. This is a management issue because you have to manage from the flight departing Africa, the arrival in the U.S., because at that time they can start showing symptoms, thus infect all the people on the plane or people that come in close proximity. Not all of the people. Don't want to cause unnecessary panic. But then they're on the ground. This person self-reported. Essentially said, look, I just came back from Liberia. I'm feeling poorly. Went to the hospital and was released. That is concerning.

DR. ALEXANDER VAN TULLEKEN, SENIOR FELLOW, FORDHAM UNIVERSITY: I think that's absolutely right. What you have to do here is give doctors permission to admit people who aren't very sick, with low risk.

PEREIRA: Better to over react is what you're saying?

VAN TULLEKEN: Yes, I mean, ordinarily someone comes back from West Africa with a fever you say, look, you know, you'll probably be OK.

PEREIRA: We'll take a look.

VAN TULLEKEN: We'll take a look at you. We can send you home. And so to put them -- to occupy a whole room to isolate them, to out -- roll out this big bunch of tests and big set of procedures, that's a difficult step for physicians in Dallas who aren't used to dealing with this to take. So you really need to have protocols in place. So it isn't -- the doctor isn't going, well, maybe, what's the risk here. You need to have an absolute clear decision that is just a binary outcome. You got off the plane from West Africa, you've got a fever now, you're isolated until it's proven that you don't have Ebola.

PEREIRA: So we're talking about the first steps here as we know what's going on overseas. We know the fight continues in Africa. We know some testing is going on before people get on a plane if they have a fever. Now we need to tighten things up here stateside, Sanjay, it sounds like, to make sure that those messages are getting out.

One of the other things I want to talk about is this notion and I - and I want to keep repeating this because I think this is where the mistake is coming in from some people's understanding. Highly contagious versus highly infectious. Explain that -- I know it's rudimentary, but I think it is worth repeating.

GUPTA: Well, what that basically means is that, look, when you think about something like the flu or something that's highly contagious, that can be airborne, spread easily through the air so someone could infect lots of people around them without having direct contact with them. Ebola is not highly contagious, but it is highly infectious. And what that means is that once somebody gets sick with Ebola, they are starting to excrete the virus in their bodily fluids. And even a small amount of that bodily fluid, if it were to get on somebody else, it could cause an infection. That's what it means to be highly infectious. It's very infectious in that regard but it's not going to spread easily through the air.

And I think that's a very important point. And again this idea that people don't spread it until they are sick -

PEREIRA: Right.

GUPTA: Becomes crucially important.

PEREIRA: That's right.

GUPTA: And I can't imagine someone's walking through an airport shaking hands and indiscriminately spreading Ebola, that doesn't happen.

PEREIRA: Right.

I want to look to the future a little bit with you, Dr. Fauci, because we know that the NIH began trials of an Ebola vaccine in humans. How is that testing going along. And is there hope that more of these experimental serums, Zmapp, and there's another company in Canada that's producing another one as well, that there will be more of those made available and used.

FAUCI: Well, I think we better make sure we understand that all of these vaccines and therapies are still quite experimental. So when you see "being made available," we've got to emphasize available within the context of a clinical trial to determine if they actually work or possibly, and we hope that's not the case, they might paradoxically actually harm people. So I know everyone is very anxious to get interventions out there, but they really need to be done in an orderly fashion where you get them to people as quickly as possible but under the auspices of a clinical trial.

The vaccine that we're testing at the NIH, we've already injected the 20 people that are part of the phase one trial. We'll now observe them for a couple of months until probably the end of November, early December. And if it looks like it is safe and the fact that it induces the kind of response that you want, then we'll do a much larger clinical trial in the setting of West Africa where you can actually prove or not whether it works. And if it works, then you'd want to widely distribute it. And if it doesn't work, or is actually dangerous, you wouldn't want to do that.

PEREIRA: Well, we know there's urgency there for sure.

Last question to you, Dr. van Tulleken, as you're here. This is not a highly contagious disease, as Dr. Sanjay Gupta pointed out. Do you feel comfortable that the United States is prepared should a highly contagious disease come to our shores?

VAN TULLEKEN: I think the fact that we're seeing cases of Ebola arrive here now, we're reaping the rewards of not doing very much over the last few months. Basically one charity, Doctors Without Borders, has done the bulk of the work. For an international system, that's unacceptable. So if we want fewer cases coming, we want no more cases coming, it has to be controlled in West Africa. The administration stepped up now to do that, but every other country needs to be putting resources in there as well.

PEREIRA: A call to action right there from Dr. van Tulleken. Dr. Sanjay Gupta, Dr. Fauci, thank you so much, the three of you, for joining us. A really important conversation to be had. And it, of course, it will continue here on CNN.

We turn to another story that is of great concern. The man being held for the disappearance of Hannah Graham under the microscope. Will this man, Jesse Matthew, be linked to other unsolved cases in Virginia? We have new details for you ahead.

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BERMAN: It is time now for the five things you need to know for your NEW DAY.

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BERMAN (voice-over): Number one, for the first time a patient in the United States has been diagnosed with Ebola. Now the race is on to find people who had contact with this man as his symptoms emerged following his flight to the U.S. from Liberia.

Another security breach plaguing the Secret Service. The agency really unable to explain how a CDC contractor managed to get on an elevator with the president while this guy was carrying a gun without being cleared.

Tuesday marked the biggest day of U.S.-led coalition air strikes against ISIS in Syria and Iraq. They came as the terrorists moved closer to crucial cities in both countries. Meanwhile, the Turkish parliament is debating whether to send ground troops in to help fight ISIS.

Congressional leaders holding a hearing this morning on Sergeant Andrew Tahmooressi. He's the U.S. marine jailed in Mexico. Lawmakers are calling for his release so that he can receive treatment for PTS.

And the Kansas City Royals, mounting an improbable comeback. Actually, had, like, three of them in one game. They defeated the Oakland A's 9- 8 in 12 innings, a classic wild card match-up. The Royals now face Mike Trout and the Angels in the division series.

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BERMAN (on camera): We're always updating the five things to know, so go to newdayCNN.com for the latest.

So, the man being held in Hannah Graham's disappearance now under investigation for connections to other missing person cases. This as the mystery unravels, why wasn't he stopped before now?

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BERMAN: So, Jesse Matthew, the man charged with abducting UVA student Hannah Graham is now being investigated for connections to other unsolved crimes in Virginia. Matthew has already been linked by DNA, or forensic links we should say, to the 2009 murder of Morgan Harrington.

The question now is, have authorities maybe fallen upon a serial killer here? We want to bring in CNN commentator and legal analyst Mel Robbins, as well as forensic scientist Lawrence Kobilinsky.

So, Mel, one of the things that's fascinating here is this guy initially goes into the police voluntarily.

MEL ROBBINS, CNN LEGAL ANALYST: Right. BERMAN: Walks in with no lawyer. Now, ten days later, it seems like investigators of Virginia are emptying file after file, all their case files, finding possible links to him. How do we get from one place to another?

ROBBINS: Well, basically he was wanted for questioning. He wasn't a suspect yet, because he was the last person seen with Hannah Graham. And so he goes into the police station, John, as you said, and presumably for questioning and says hey, I want a lawyer.

And they made a decision at that point, because the D.A. was there when he walked in, that they didn't want to question him because they wanted to make sure that if they heard anything they could use it in court.

Now, see, I think they him walk out, personally, because they thought maybe if they followed him, he'd lead them somewhere, and then they lost him in the chase. And now, here we are, and he's implicated in a string of crimes that span 12 years.

Larry and I think that this is just the tip of the iceberg, quite honestly.

BERMAN: You think its the tip of the iceberg. Now, in terms of implicated, the actual only link that they have told us yet, and again, a lot of this is based on leaks that we're all getting from the investigators here. So, just be aware of that, take that into account. But the only forensic link right now is between the Hannah Graham case and this case of Morgan Harrington.

When we hear that phrase forensic link, what does that mean?

LAWRENCE KOBILINSKY, FORENSIC SCIENTIST: It probably means DNA, that's what we're beginning to hear now. I think what's breaking this case is the legal decision to have a search warrant of Jesse Matthew's home.

BERMAN: So, what do you think they found in there?

KOBILINSKY: I think they were taking toothbrush, hair brush, clothing, looking for trace evidence. Because by getting those items, especially a hair brush, you could then compare the DNA evidence that they get from the home with the body of Miss Harrington. I mean, there's obviously something there on the body or on the victim's clothing that can be linked through DNA. That's the linkage.

BERMAN: How long does this last, thought? How long does DNA last before it starts to degrade?

KOBILINSKY: Well, we're talking - -remember Harrington was in the field for three months so that only certain types of DNA would still remain intact and able to be tested. And so there very well might be semen on clothing or there might be DNA under fingernails. That's the kind of evidence that the police need that to establish the linkage

ROBBINS: But they might have also found her DNA at his house. I mean, we don't know yet. See, what they're going to be doing now is they're going to comb his house for any kind of trace evidence, any kind of DNA that links the women back to him in any way.

So, there may be female DNA back at his house that they find that connects him to these cold cases. There may be his DNA at crime scenes. You also have to remember, in all these cases, John, we don't have any women.

We have women that have gone missing, not women that have been found like Morgan, and so there may not be much evidence to try to link him to those cases. They're also going to take a look, John, and run his DNA through the national FBI database on cold cases on missing persons, and one of the things to keep in mind is that if we know that this started presumably in 2002 with the alleged rape of the Liberty University student, and it ends with Hannah Graham, that's 12 years of crimes.

BERMAN: That's a long time.

ROBBINS: That's a very long time.

BERMAN: You mentioned Hannah Graham, but of course this case, right now at least, is about Hannah Graham, who is missing. If you're the investigators right now, if you're the police, how do you leverage now all this information to help find Hannah Graham?

ROBBINS: Well, if I'm the D.A. in this case, I'm hammering that defense attorney saying your window of time to get a deal that saves your client from being fried in the electric chair is narrowing with every day. You get your defendant to talk, you get him to come clean on the other victims, on where people are, on what happened to Hannah Graham, and maybe we'll cut a deal.

And then you hope that what the defense attorney does is leverage this guy's family, that he appeals -- this was a guy that remember has two personalities, presumably. He's involved in a church, he's involved in football teams, he is, you know, by people that know him said he was a teddy bear. You appeal to that side of him, but who knows?

KOBILINSKY: They're going to have to break him to find the body of Hannah Graham.

BERMAN: Let's hope this leads to something, to some peace for the family. Lawrence Kobilinsky, Mel, thanks so much for being with us. Really appreciate it. Chris?

CHRIS CUOMO, CNN ANCHOR: Good discussion, John, thanks for having it.

Another big question this morning is how can officials make sure that Ebola in the U.S. remains an isolated case instead of an outbreak? The very latest on that situation and other news going on in the "NEWSROOM" with Carol Costello right after the break. Please, stay with us.

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