to get that first person >> this is al jazeera america. live from new york city. i'm michael reeves with a look at today's top stories. the first patient diagnosed with ebola in the united states has died. the white house supports screening of passengers arriving into five airport in the u.s. families of 43 students who disappeared in mexico calling for justice and worldwide protests.
>> good afternoon, the first person diagnosed with the ebola virus in the united states has died. thomas duncan passed away in texas succumbing to what has been called an insidious disease. screening will begin at five airport. we wait for the latest of course on ebola concerns. first to ash har quaraishi where duncan was being treated. there was an indication of a slight improvement in duncan improvement, what happened. >> on monday he remained in stable yet critical condition.
he was undergoing treatment with that investigational medication. his liver levels had improved. they declined over the weekend. but that could truck wait they said. his vital signs were getting better. the fever was down. they had a plumber of hope that things were taking a turn for the better. he passed away around 7:51 p.m. local time. we spoke with a spokesman earlier about what might have gone done. >> it's likely that the organs were not keeping up with the infection. you know at the end it's very tragic as to what has happened. >> reporter: michael, one of the big questions unfortunately is what will half to the body of duncan. how will it be handled? the cdc said in these situations it does not look like an autopsy will take place. they recommend that the body be
handled in a cremation. the family was not given an option. basically duncan's remains will be cremated. >> there will be heightened security screenings at five u.s. airports. what can travelers expect when new measures are implementedment. >> cdc announced five airports will begin enhanced ebola screenings. they'll start this weekend. and there will be new tracking for all people entering the united states from ebola infected countries. those five airports, we expect to see cdc staff members also manning posts along inside these airports to conduct screenings, taking temperatures, observing the behavior of people and getting more information about where they've been and who they may have been in contact with. 90% of travelers will be coming through these five airports which the focus is there. we heard more about this from
the cdc. >> the thing to understand is that we continue to have a lot of confidence in the screening measures that are in place. by far the most effective screening measure in place is not any screening that takes place in the united states. it's the screening that takes place in these three countries in west africa where they're experiencing this outbreak. >> and michael, one of the critical issues they'll be dealing with is monitoring those 48 people who have been identified to having possible contact with duncan and seeing if cases emerge from those people. >> right now we'll take you to the cdc headquarters in atlanta for this live event. >> good afternoon. today we're deeply saddened by the death of a patient in dallas. despite maxal interventions we
learned today that he passed away. our thoughts go out to his family and friends. he is a face that we associate now with ebola. since the start of the epidemic, 3,742 neighbors west africa are documented to have died from the disease. we don't have their faces as prominently in front of us, and we know even more people have been affected. we think about this, and we remember what a deadly enemy ebola is, and how important it is that we take every step possible to protect americans and stop the outbreak at its source in africa. >> one of the things that we do to protect americans here in the united states is to improve our preparedness in our healthcare system. that three key steps are first that iing about the possibility of ebola and identifying who may
have the disease so that second they may be rapidly tested, and third effectively isolated. that's trucial for our response. and identification diagnosis, and safe care for anyone who may have ebola need to be top of mind right now for healthcare providers throughout the country. at cdc we do quite a bit to support healthcare workers in addressing patients. we will provide detailed information about how to address a patient who may have ebola. anyone with fever should be asked if they've been in west africa specifically guinea, sierra leone, and liberia in the last 21 days. and if so, if appropriate tested for ebola.
we've providing is called health alert networks which have reached hundreds of thousands of healthcare workers. we reach out to professional associations, hospitals, emergency associations, medical associations and many others so we can insure that the available information is up-to-date and useful. >> right now the bottom line of what we're talking about today is that we're stepping up protection for people coming in to this country and for americans related to travel. we will continuously look at ways that we can increase the safety of americans, and we do that at many different levels. we do that in dallas where officials there are working intensively to monitor every person who might have had contact with the index patient to ensure if they do develop fever they're immediately isolated and the train of transmission may be broken.
we do that in our healthcare system with the kind of outreach i've described so that patients will be rapidly diagnosed and if found to have ebola, to be effectively isolated. we do that at the source understanding that until this outbreak is overin west africa, whatever we do can't get the risk to zero here in the inter connected world that we live in today. and we do that through entry and travel programs including the efforts that we under take in west africa and some that will be described in more detail later in this briefing. i think before turning it over to deputy secretary alejandro mijorcus i would like to look at interventions. we continue to evaluate ways to protect americans. protecting americans is our
number one priority. second, we make sure that whatever we do is something that workers, that we evaluate, and that we can think of ways to continuously improve. third, we recognize that. whatever we do until the outbreak is over in west africa we can't get the risk to zero in this country. that's why we continue to surge the cdc response in west africa and the whole of u.s. response in west africa and the international response where we see hundreds of healthcare workers, hundreds of millions of dollars and intensive efforts deployed in the areas heavily affected. and finally as we say in healthcare, above all do no harm. we have to make sure that whatever we do we will to make sure that we don't increase the risk.
the sars outbreak cost the world $40 billion, but it wasn't to control the outbreak. those were costs from unnecessary and ineffective travel restrictions and trade changes that could have been avoided. what we want to do is to insure that we don't undermine our ability to stop the outbreak at its source and unintentionally increase our risk here. so to outline some of the new measures being taken and review some of the measures that are already taken i'll turn it over now to deputy secretary mijorcu. >> thank you very much, dr. freidan. the department of homeland security is focused on protecting the public and taking steps to screen medical personnel. we have implemented a range of
measures to insure a laird approach. to date the existing measures in place include issuing do not board orders to airlines if cdc and the doesn't of state determining passenger is a risk to the traveling public. providing information and guidance about ebola to the airlines. three, to raise awareness about ebola, and four, providing a health notice mondayly referred to as a care sheet to travelers entering the united states that have traveled through the infe infected countries if there is concerns of possible ininfection. we are announcing--we have
announced today enhanceed measures, specifically the enhanced screening will consist of targeted questions, temperature checks, and collection of contact information of travelers from the three affected countries entering the united states through five airports jfk, newark, dulles, chicago o'hare and atlanta. customs and border protection officers,s cdc officers observe all passengers for overt signs of illnesses, through visual observation and questioning as appropriate for those entering the united states at all ports of entry. in addition, moving forward all travelers moving through the five airports identified in the united states through liberia, sierra leone and guinea will
undergo enhanced screening measures. they will be asked targeted questions whether they've had contact with ebola patients. we'll correct additional u.s.-base contact information should cdc need to contact them. and finally we will take their temperature with a non-contact thermometer, which can be a key indicator of potential infection. we're taking these additional measures with dynamic environment to insure a layered approach and we take the security measures needed right now. with that i'll turn it back. >> thank you, and we'll open for questions. we'll just recap at starting at jfk on saturday, and at the four other airports that were mentioned in the following week, that was dulles, newark, chicago
and atlanta, these five airports represent 94% to 95% of the 150 travelers per day who arrive from these three countries. the department of homeland security, cdp and customs will be developing a questionnaire as well as temperature taking and providing information to each traveler. if any travelers are found either to have a fever or have a history of contact with ebola then the on sight center for disease control prevention public health officer will further interview that individual, assess the individual and take additional action as appropriate. now i want to really emphasize that this is stepping up protection. it's going to find people with fever or contact who don't have
ebola. in fact, we know that over the past couple of months about one out of five passengers had a fever. most of those have been malaria. we do expect to see people with fevers, and that will cause obvious concern at the airport. i would like to spend a minute just talking about malaria because it is so important to understand how it's relevant here. malaria is spread by mosquitoes. you can't get it from somebody else. malaria is a disease within west africa is extremely common. it is also a disease which traditionally has been known in healthcare as a fever that comes and goes.
so it may come and then go away in cycles every two to three days. the species of malaria in this part of the world comes back every two to three days. it would not be surprising if we saw individuals with malaria have the fever after coming back here. that might be common presentation among those who have fever that's yes we strongly encourage people who travel to different areas of the world to take preventive medication which is highly effective. if appropriate we would hand this individual off to a local healthcare system who may need to assess and test that person or to local public health system which the person has contact to
give appropriate action at a minimum and insure that their temperature is taken every day for 21 days after the last exposure. just before taking questions i would reiterate what we're doing is stepping up protection. we would evaluate the new measures and start them on saturday at jfk and over the coming week at four other airports mentioned. we would evaluate the experience. we're always looking for ways we can better protect americans. thank you, and we'll start with questions in the room. >> even with these enhanced efforts that people will fall through the seams. that it won't be enough will these efforts be enough? >> what we're doing is putting in additional protection. we've been very clear as long as ebola continues to spread in africa we can't make the risk
zero here. we wish we could. i understand there have been calls to ban all travel to west africa. the problem with that approach is that it makes it extremely difficult to respond to the outbreak. it's hard to goat health workers in because they can't get out. if we make it harder to respond to the outbreak in west africa it will spread not only in those three countries, but will ultimately increase the risk here. that's why the concept above all doing no army i harm is important. >> how effective is this at finding sick people? >> we've looked at different screening.
particularly disruptive to large numbers of people. we think its manageable. there are legal authorities and there is a way to protect the public. mr. narrowk narrow mayorkus. >> i can deed, we have the authority to take measures with u.s. citizens as well as non-citizens. to insure that the public safety where security is not threatened that is in the public health arena just as it is in the national security arena. thank you. >> we'll go to the phones to the next question. we'll take a few from the phones and then come back to the room.
>> our first question today is from cbs news. >> hey, tom, the cdc has said really all we need are face masks adequately protected. then you see these big hazmat suits and i wonder if any consideration has been given to these clunky suits are increasing the risk of inadvertent contamination because in taking them off someone could become contaminated. >> thank you. there is definitely a balance here. the more cumbersome the equipment the greatest possibility there is a problem. in west africa we've seen needle sticks with clean needles through potentially contaminated gloves. it's difficult to work in
cumbersome equipment. that's why we're looking at as many practical approaches that will still be safe. we recognize that there is understandable concern with the infection in spain, with the infections in west africa, to make sure that our healthcare workers are safe. that's why cdc has infectio infection experts who work intensively can any facilit with any facility who has any concerns with infection from ebola. >> our next question. >> thank you for taking my call. the question, doctor, you may have explained this in a previous conference call, explain to us whether thomas duncan was eligible to receive blood platelets from dr. brantley. >> the care of the patient in dallas would have to be referred to the hospital there.
i would remind us that ebola is fatal in a high proportion of cases. we encourage rapid and early diagnosis. the earlier a person is diagnosed the likelier they would be to survive. >> what information can you tell us about a possible second ebola patient in texas? do you know if this person was in contact with mr. duncan? was he one of the people you've been watching, or was he recently in west africa. >> my understanding, and this is recent information, but we will get definitive information in the next few hours is that there is someone who does not have either definite contact with ebola or definite symptoms of ebola who is being assessed. we expect as people are more concerned, as there is a higher index of suspicion that people
will be assessed. there will be rumors and concerns and that is as it should be. we should keep it in perspective. right now there is only one patient who has ever been diagnosed with ebola in the u.s. and that individual tragically died today. we're tracing the other 48 people, ten can definitely, and 38 with possible contact. none of them as of today has had fevers or symptoms suggestive of ebola, but we're not out of that 21-day waiting period. we're at the peak of 21 days so it's certainly a time that we're anxious and carefully assessing. my understanding he had neither definite contact or symptoms suggestive of ebola.
next question. >> hi, "l.a. times." given the demand for manpower and supplies in west africa are there critical resources being diverted for the screening process that could be better utilized on the ground in west africa or elsewhere? >> the screening program here is not diverting from or in any way undermining our efforts in west africa. the temperatures will be taken under the supervision of customs and border protection. cdc already does staff quarantine stations. we'll need to add a small number of additional staff to provide coverage at these five airports, and it is no way going to make it more difficult for us to stop the outbreak in africa. in the room? >> when screening for fevers, if
symptoms don't show up for 21 days how will that help? >> we're assessing for different possibilities that can be done. one of the things that is important is on from travelers here through cvp entry station, information of individuals entering through here. that will be looked at closely in the upcoming days. >> can you explain where this came from? the cdc or the white house first? i ask because i know you were critical taking this step a week ago. and second, can you tell us a little bit more about the quarantined facilities? will they be at each of these airports? will the staffers testing temperatures and asking these
questions, will they be wearing protective gear? >> i'll start and ask deputy secretary mayorkus to condition. i have said consistently we'll do whatever is effective to protect americans. this is a whole of government response. this is whole of government response in africa, and it's a whole of government response here. we look carefully to see what we can do and what we can do most effectively to protect americans. >> i would echo, thank you. i would echo dr. freidens remark. this has been a collective effort across the administration to respond to this outbreak of ebola in west africa. the individual custom and border protection officers will not be wearing masks. that has been the medical assessment of the need right n now. thank you.
>> you said we will not be able to eliminate the threat overseas. what is the resource situation there? and what has to happen to stop the out break that is not happening? cdc is reaching out to the counties and districts within the countries. these are three countries with three epidemics. liberia has had the most extensive epidemic so far. there have been in some areas of liberia, some decreases in recent weeks, we don't know whether those will hold. in sierra leone we'll continue to see increases in cases that are very concerning. we've seen increases and decreases and we're monitoring that very closely. we've seen a greatly
strengthened response, we've seen many other countries stepping up including the united kingdom. if you look in sierra leone and if you look at our efforts just as an example to do laboratory work, cdc operates several of the essential lab tears in these countries. in addition the united kingdom, south africa, russia, china, canada, the european union, and i'm probably leaving out a few also do laboratory work. there has really been a strong international response. the challenge is how rapidly the disease is spreading. we are seeing in west africa some signs of progress. for example, we're seeing more state burials in liberia. a contract with an organization that is expanding across the country for safe burial services. we're working with communities to do that and increase
isolation in treatment capacity. i think we're beginning to see that kind of surge response having an impact on the front lines, but it will be a long-hard fight. in west africa we're far from being out of the woods. >> there has been a major effort. we hope to see more resources coming in from countries around the world matching the kind of leadership the u.s. is showing. we'll go to the phone with a few questions. >> thank you very much. i wanted to ask about the situation in dallas. dr. freiden. you said they have not had definitel definite fevers or
symptoms. have they been tracked and are they involved in this case? >> i would really have to refer you to dallas. often in situations like this information would change from minute to minute. we don't have a concern for symptoms up to , which is the information i've received up to a few minutes ago. >> my question is regarding air travel. the new procedures for the five different airports. is there special procedure or any guidance given to the airports when thinking about just arriving from west africa. is that a necessary precaution to take? if so, can you tell us what should be required? >> cdc has detailed guidelines and works very closely with the
airport industry. there are guidelines specifically for ebola for enhanced cleaning dr. mayorkas, is there anything else you wou d like to add? >> no. >> other questions? >> what is the communication failure was in dallas. how can americans be confident that other hospitals won't make the same mistake. >> i can't comment on what happened with the individual patient, but one of the things that we're working hard is ensuring that nurses, pharmacists, throughout the
healthcare system think ebola. and ask whether they have been in west africa i. that's really important. that will help us insure that if there is another patient who arrives they're rapidly identified for their own sake and their own care and for the community's sake to isolate them promptly. >> cnn. just following up on maryland's question a bit. we've heard a little bit about who this person, clarify the people who contact a high or low risk are all 48 of those, are they being monitored in the person check. if this person was not one of them they would not be getting those checks. is that fair to say? >> in texas very intensive work has gone on to identify everyone who has appeared to have had contact and everyone who might have had contact with the index
patient. we've identified ten people with definite contact. for those 48 people they have all been identified, monitored every day with someone from the public health system measuring their temperature with an accurate device. there have been rumors and concerns about contact and other cases. none of those have panned out. i understand there is a situation now that is being assessed. the latest information that we have is no definite contact. >> duncan did not have a fever when requested. he lied about his contact can you talk a little bit about what
we're doing to prevent the needless problems today? >> it is true that the patient came in when he didn't have a fever. he had a fever four days after arrival. we're looking at steps that can be taken to increase the likelihood if someone arrives and developed ebola they will be rapidly diagnosed. in terms of the cost of sars many of those costs were related to people canceling travel to trade restrictions or trade that didn't occur. i have spoken with business leaders who emphasized to me that there are so many misconceptions about ebola that they're seeing a reduction of investment in parts of africa
that are not in anyway, shape or form involved in the ebola outbreak. we're worried if we don't take care of those concerns as well, we'll have unnecessary costs as well here. >> next question? >> from huffington post. >> hi, i wanted to ask a question about the difference between thomas duncan and kent brantley, but i think you're referring all questions to the hospitals, is that correct? >> i would like to comment that each patient's condition is different. zmapp, a promising but unproven experimental treatment for ebola is not available. it takes a long time to develop. other medication that is up to
the treating physicians and the family whether or not to use, so that's all i would have to say. next question on the phone. >> frommel wall street journal. >> is this the extent of the new screening protocols, or are there more to come, further screenings for those travelers or other ports in the u.s. >> first of all, screening of outbound travelers is already under way. every person leaving is monitored for fever. we've identified 70 with fever and three others with fevers that resulted with them not boarding the plane. travel is being monitored now. we're always looking at all of
the implements to see how they can be person and more effective. thinking about what else can be done as we continuously work to protect the american people. >> thank you. i know you've done screenings on outbound travelers, but you mentioned in strengthening those outbound screenings. one quick follow-up, how will these passengers be identified? particularly if the original flight is a separate booking that it will not show up on the itinerary. >> deputy secretary mayorkus, would you like to respond? >> thank you very much. >> if i could add something in response to the immediate
questions. we'll continue to assess the risk of the red of ebola in the united states and take additional measures as necessary to protect the american people. i think its important to emphasize the points that dr. freidan has made. we'll take the measures we deem necessary. the point of depackture and point of origin so we can identify the full journey of the individual arriving in the united states. thank you, doctor. >> in the room?
>> my question to you is the goal has always been to stop the outbreak at the source. we're seeing that is not the case any more. what can you tell us, is this a new day for the u.s.? is ebola here in essence as one of our yo diseases we'll need to keep an eye on? >> we've stopped every ebola outbreak but this one. this is an unprecedented outbreak in west africa. we're surging with response from the whole of government in the u.s. and globally. this will be a long-hard fight but we believe we can contain the outbreak in west africa. as of today the only patients in ebola u.s. are in hospitals.
and it is important to put in perspective what the risks are. ebola is scary. it's a deadly disease, but we know how to stop t and we're stopping it in west africa community by community. dallas is doing an excellent job of tracing contacts to stop it there, and healthcare workers throughout the u.s. need to think ebola in people who have fever and have returned from any of these three countries in the past 21 days. two more questions, and then we're going to stop. >> cdc set out strict guidelines from ebola patients. can you expand on those guidelines, and will the cdc be involved.
>> the way ebola works is if you're exposed but not sick you have no ability to pass it on to others. as you begin to get sick, you have a fever you may be able to pass it to others. the sicker you get, the higher amount of virus in your body. when people die of it, there are high quantities of virus. we've worked very closely with shorts in section to insure that respectfully and the ability of the family to view the body, the patient who died earlier today, his human remains will be safely removed and safely handled so that they will not present a risk to anyone in the family, to anyone in the healthcare system or get anyone who is participating in the process. >> we may know the to patients
earlier, but there was a patient brought here a month ago. what happened to that patient, and can you tell us who it is? >> we don't reveal consultation. earn patient who migh might have ebola to insure the care available here. just in wrapping up i would like to thank all of you for your interest. i would like to thank the department of homeland security,
deputy mayorkas, and we're stepping up efforts to protect americans. we will always look at what works. we'll continuously evaluate it and consider what more we can do to keep americans safe, understanding as long as ebola is spreading in africa it will remain a risk here. i think we can stop it at the source and protect americans here. >> that was dr. freidan in in atlanta. they talked about the increased screenings that will go in affect at five airports, jfk, newark, washington dulles,
atlanta. that's why those five airports have been deemed critical. and they talked about the enhanced screening which will include fever checks, targeted questions in terms of who they've been in contact with, and u.s. contact information here in case they need to get in touch with those patients. we heard from dr. freidan in the dallas area who may be looked at for symptoms of ebola. as of right now this patient had not had any direct contact with ebola or showed definite symptoms of ebola. that patient has been admitted to a hospital. ash har quaraishi is still standing by. when do we know as of this point about this patient who now has been admitted to a hospital? >> well, michael, there were two incidents this afternoon that may be connected. some reports that they are connected. we heard from the hospital this
afternoon saying that they can confirm say that the patient has been admitted to the emergency room after reporting possible exposure to the ebola virus. they're trying to determine, we're also getting a statement from the dallas county sheriff deputy who is telling us that they have expressed concern. that was directed at the health and human services and now is being looked at. some reporting this is the same case, and that patient has now been looked at from the hospital obviously they're taking very careful precautions here. they're treating everything seriously. you heard in that news conference there were be days where they've been identified as possibly been exposed to ebola when they were, in fact, were into the.
there were concerns and claims that this patient may have been in contact with duncan, they're taking it very seriously. >> let's go north of dallas where a news conference is being started just right now. >> we're training for this type of event since the youth break of ebola in west africa some weeks ago. we said the appropriate response would to include our medic unit, two or three field supervisors, and members of our hazmat materials team who are equipped to deal with patients who not only have ebola but others with infectious diseases.
we made contact with officials and their positions and their staff members. our medical directors, the medical director of the fire department, based on consultation of staff we transported the patient to texas health resources in dallas they had some contact with family members. i would like to emphasize they had not had contact with the patient, while they had been in th the apartment. we have members from the county public health department
epidemiologists and center of disease control, they're advising on the property decontamination procedure, at this pine i would like to introduce our mayor for comments. >> i'll keep my comments very short. as you're all aware you have most of the information that we have currently, and while we a the risk is minimal we're taking several actions to ensure that the public safety and welfare is protected. we'll communicate information as soon as we receive it, again we're being toldol by the arab both the pole kinds, state and federal health agencies that the risk is minimal, but again we're taking all precautions. we'll take some questions we'll answer answer questions that you
may have. >> as the mayor said earlier a lot of this information is coming in quickly. we have three hours of post call. i think it was just based upon this screening criteria. [ inaudible question ] no, we do not have that information. i do not. that's also information that we don't have right now. it's the signs of ebola, nausea, vomiting headaches. this patient was not experiencing all of those symptoms. just a few.
the treatment tend to be based a little bit more conservative at first. that's certainly a call that patients have to make. we really don't have that information. it's our understanding that this person was not in. on the scene we have public health officials and epidemiologists from the then county health department based on the low-risk nature in their opinion of the patient, all hospital staff, a doctor, several nurses and people in the waiting room have been released.
they've been released, and it's our understanding that care now is open. >> the fire department always has to be prepared for any type of emergency. we train for it. the firefighters are prepared for whether it's this type of call or whatever the call may come in next. they're used to dealing with the expected an unexpected. >> there is always a hidenned awareness. they come in to do their job. they are dedicated professionals, they respond and they take their job seriously. there is a heathenne heightened
awareness, but we do a lot of calls that are high risk. i we're on the response end of it it's our understanding that it's a 48-hour time frame at this time the patient is currently at text health resources in dallas. i do not know the residency or the occupation. we have calls in to the center for disease control. we're also working with our public health officials here we
have recommendations, i would like to mention, and i understand the nature of the ebola, but we deal with a lot of infectious diseases on a pretty continuous basis. we decontaminate thes these units. we'll wait for the recommendation. i can't speak to what he was talking about. i know that the hospital staff felt that they had followed guidelines. right now we're dealing with about 14 people. that includes the physician and
nursing staff as well as people who were in the lobby and some of the other patients in the other rooms for treatment. [ inaudible question ] >> it's our understanding that they are not. we're told that this patient is not of the 48 persons under public health surveillance for the dallas patient. [ inaudible]
opportunity to drill down into that. it's information that we do not know. it's my understanding, again, the information is preliminary, it's my understanding that family members had contact with. it's my understanding that he was inside the apartment. we're working with all public agencies. our regional representatives from the regional department with the state of text. both local and state resources have contact about our event.
that's correct. we've been in consult with the cdc on the scene. we were in in contact with centr disease. i'm not going to go too bai--he had several but not all five or six. he exhibited some. he exhibited enough to trigger the preliminary screening. the important thing to note is that once you go more in debt, and you talk to the patient then you're able to rule out some of the risks.
[ inaudible questions ] i would new jersey anyone to call us any time they feel they need us. i think that is good counsel. if you think you're an at-risk patient call us and we can respond. you know. >> you were just listening to the fire cheap from frisco, texas, north of dallas. according to the fire chief this patient may have had contact with family members of thomas duncan, he did not have any
direct contact with duncan himself, and they believe the risk is minimal but being overly caution. we'll have more information coming at 6:00. "inside story" is next. it's been speculated this midterm election could be the lowest turn out ever. if they wanted to increase voter participation could they do it? that's the "inside story."