Return to Transcripts main page


Obama Says Ebola A Top National Security Priority; Interview with Thomas Frieden; Partner of Ebola Patient Speaks Out; Interview with Mayor Mike Rawlings; ISIS Battles Along Syria-Turkish Border; U.S. Choppers Hit ISIS Targets; 4-Year-Old Enterovirus Victim Died in His Sleep

Aired October 6, 2014 - 20:00   ET


ANDERSON COOPER, CNN ANCHOR: Good evening. We begin tonight with breaking news in the growing Ebola outbreak.

For the first time a person has contracted the virus outside of Africa. A nurse's assistant in Spain has tested positive for the virus after helping to treat two Ebola patients who returned to Spain with the virus and have since died.

There are also new developments for the Ebola patient in Texas and now Nebraska. In Dallas, Thomas Eric Duncan is in critical condition. In a moment, you're going to hear from the woman he traveled from Liberia to see, Louise, who is still in quarantine, the woman he stayed with, along with her son and two nephews. She's scared, she's worried and she's begging for help.

Tonight a freelance cameraman who contracted Ebola while covering the outbreak in West Africa is in isolation in Nebraska Medical Center. He arrived for treatment just today.

Also today President Obama said he considers Ebola a top national security priority and an issue of safety. He says the chances of an epidemic in the United States are extraordinarily low if everyone does what they're supposed to do.


BARACK OBAMA, PRESIDENT OF THE UNITED STATES: This is an extraordinarily virulent disease when you don't follow the protocols. And so the key here is just to make sure that each step along the way, whether it's a hospital admissions desk, whether it is the doctors, the nurses, public health officials, that everybody has the right information.

If they have the right information, and they're following those protocols, then this is something that we're going to be able to make sure does not have, you know, the kind of impact on the security of the United States that a lot of people are worried about.


COOPER: Well, if you've been following the case of Thomas Duncan at all, you're likely aware there's been a serious, serious breakdowns in communications, to say the least, along the way. In fact the hospital that originally blamed a glitch in their electronic health record for the reason they failed to admit Mr. Duncan even though he was showing symptoms with Ebola and had traveled from Liberia, that hospital finally admitted over the weekend all the records were available and they should have admitted Mr. Duncan immediately when he first came to that hospital.

That was one of a series of missteps that has left many wondering if this country can handle even the bigger outbreak.

I spoke with CDC director Thomas Frieden just a short time ago.


COOPER: Dr. Frieden, first, can you tell us how Thomas Eric Duncan is doing? Is he still in critical condition?

DR. THOMAS FRIEDEN, DIRECTOR, CDC: I'm afraid the patient in Dallas is still critically ill. And we're really hoping for his recovery. That's very much on our minds these days.

COOPER: A federal official confirmed to CNN that Duncan is receiving an experimental drug and Duncan's nephew who is also getting regular updates from the hospital identified it as a drug called brincidofovir? Is that true?

FRIEDEN: The actual treatment of the patient, that's really up to the patient, the patient's family and the hospital to release. I will say that we know that the medicine could have been used before have not been used here. There are other medicines like brincidofovir that have been showing some promise in a test tube. Whether they would help or not, we don't know. But certainly we would want everything possible done to try to ensure his recovery.

COOPER: The medicines before that have been used which you referenced ZMapp, which was used on the two American missionaries, is there -- just to confirm, is there no more of that currently available?

FRIEDEN: That's my understanding. There's no more ZMapp and kit takes a long time to make. The other one, Tekmira, is difficult to use and in critically ill patients may not be safe to use.

COOPER: On Thursday I spoke to a woman, Louise, who is the woman who was at the -- whose apartment Thomas Duncan was staying at and also took him to the hospital. I also spoke to her earlier as well. We're playing some of that in our broadcast tonight.

As you may know, I mean, she says that the towels that he used were still in the apartment when I talked to her last week, the sheets were still on the bed. And no one had really told her exactly what to do with it. The fact that they were left there days after it had been announced that he had Ebola, why wasn't that more of a priority to try to clean up that apartment?

FRIEDEN: I think there are things that we're learning from this case. We know that the hospital didn't identify Ebola the first time he went in. It took far too long to get all of the things together, to clean up the apartment, and ultimately get the family out as that was the decision that was made locally. These are things that we'll look at for future responses, but I think you have to look at the bottom line here, of how we stop Ebola from spreading.

That bottom line is to find every person who was exposed to the index patient, make sure that they are tracked for 21 days after exposure and the moment they develop fever or other symptoms get them promptly isolated so they don't spread it. That's how we stop Ebola. That's how you break the chain of transmission. That's the bottom line. And the most important thing to focus on.

And the folks in Texas are doing a terrific job with that. They've identified 10 likely and 38 possible contacts and every single one of them is without fever, without symptoms and is being checked daily. That's how we've stopped every Ebola outbreak until now and that's what we're trying to ramp up in Africa as well so we can bring that under control and make us all safer.

COOPER: You're saying the folks in Texas did a terrific job. You're not including the hospital who turned Mr. Duncan away after they've been told twice that he had come from Liberia, are you?

FRIEDEN: No, I think we're looking at hospitals, emergency departments and doctors and nurses to really take a travel history. And anyone who's got a travel history of travel to Liberia, Guinea or Sierra Leone, in the past 21 days, they have fever or any other symptoms, by all means, immediately isolate, evaluate that history, consult us at CDC. And we'll get that patient promptly tested.

COOPER: But also having the sheets that this man sweated on, that he used, and the utensils that he used, the towels that he used, I mean, having this woman Louise be the one to bag them up into a plastic bag and live with them for several days, didn't that expose, continue to expose her potentially to the virus?

FRIEDEN: Once things are bagged, they're not going to get out of that bag, but it is concerning, and we need to ensure that we take maximum care of those around the patient so that they're monitored for signs and symptoms of Ebola and promptly treated if that develops.

COOPER: There were some video that we shot at the apartment today, the hazmat crews are power washing the apartment. There's mist traveling through the air. Kids are close by. Reporters on the ground say that others in the complex say that they haven't been told anything by health officials about what to do.

Do you believe anybody else in that complex is in danger?

FRIEDEN: No, we've done detailed interviews and retraced the index patient's steps between the 24th and the 28th between the time he first had symptoms and the time he was isolated and we've identified everyone who even potentially had contact with him.

COOPER: Has anymore decision -- I know you're at the White House today. Has anymore decision been made about greater screening of people coming from Ebola-stricken countries?

FRIEDEN: We're looking at all of the options. Nothing is off the table. The key is to make sure that what we do improves the safety of the American people. That's the number one goal of the president. That's the number one goal of the whole of the U.S. government and of course at CDC. Our number one priority is keeping Americans safe.

COOPER: Do you know when a decision will be made, though? I mean, isn't a clock ticking on this?

FRIEDEN: Well, we'll be looking at things closely over the next few days. And I think you will see some new things in the next few days. But what we want to do is make sure that what we implement works is workable, and you have to understand that the bottom line is that as long as this is spreading in Africa, whatever we do, there will be some risk here. We can't get that risk to zero until we have it controlled in West Africa. So we have to make sure that whatever we do doesn't undermine the efforts there.


COOPER: That was Dr. Thomas Frieden, the director of the CDC. Now 360 one-on-one exclusive with Duncan's partner, a women we're identifying only by her first name Louise. When I first spoke with her late last week, she was understandably upset, frustrated, confused. Duncan was staying with her when he first became sick. She took him to the hospital. She went with him to the hospital the first time. Took him home when doctors mistakenly discharged him.

She, her son, and two nephews were all quarantined in the apartment where Duncan became ill. She bagged up the sheets and towels he used as I mentioned, but then they sat there for days. And Louise didn't know what to do with them. The bags now finally gone, the apartment as you saw is being cleaned but there are more troubling developments on that front, which we'll have later in the program.

Louise and the three young men are still in quarantine. Now moved to an undisclosed location but the fear has followed them. Here's part of the latest conversation I had with Louise.


COOPER: So, Louise, what are you hearing about Thomas' condition?

LOUISE, PARTNER OF THOMAS ERIC DUNCAN: They say it's elevated from critical to worse. And that's why I really want to go on the air to ask the American government to please help me. I want him to be saved, for them to save his life.

COOPER: Did they tell you that his condition had worsened? I understood that you heard his condition had worsened from a reporter.


COOPER: When was the last time you had talked to him? LOUISE: Two days ago. Two days ago, when they put a tube in his

mouth. He could hardly speak. So I told him, "OK, I will call you back later." And I have not heard from him anymore.

COOPER: You must be very worried.

LOUISE: I am worried. I am sad. You don't know how frustrated I am. And I'm just asking God and asking the American government the same medicine they they're giving the people that came from Liberia, the Ebola people that came, the people with Ebola that came in Atlanta then. And please help him save his life. He is too young to die.

COOPER: Were you there when they -- when they came? I believe it was on Friday they finally came to clean the apartment where you were in. Were they -- were you still there when they came?

LOUISE: Yes. I was there when they came.

COOPER: How did that go? What happened?

LOUISE: They said that they were -- I should allow them in. They were coming in to come and clean up the room. And so they came in there and they started cleaning up, and just changing things and took out of there.

COOPER: And the sheets that were on the bed, the towels that you had put in a plastic bag, they took all of that?

LOUISE: Yes, sir.

COOPER: The president of Liberia, as you know, she has made a statement saying that she's very angry at Thomas.

LOUISE: I am so, so angry at her. This president does not care. She does not care.

COOPER: You're saying she's not doing enough to combat Ebola in Liberia?

LOUISE: She's not doing -- no, she's not doing anything. And I'm saying, I have my three boys over there. They better not go after them. They better not go after my family.

COOPER: When Thomas came, there are people in Liberia who are saying that he -- he was a driver, that he drove -- helped his sister-in-law, who was pregnant, try to go to a hospital after she tested positive for Ebola, and that maybe that's how he got in contact with it.

Is that true? Did you know -- did he know -- did he have a sister-in- law?

LOUISE: No, I don't know anything, but that -- no, I don't know. I don't know anything about that.

COOPER: And when -- when you found out that he was positive, did he say anything to you about how he might have got -- come in contact with Ebola?

LOUISE: There was no discussion because he started losing his voice. And every time he goes and to talk, you know, he would be getting short of breath. So he and I had not discussed anything about it. I just -- I just want him to be well.


COOPER: We're going to have more of my conversation with Louise in the next hour of 360, when we're live.

And joining me right now live chief medical correspondent Dr. Sanjay Gupta. Also Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University. And David Quammen, author of many books including the upcoming "Ebola: The Natural Human History of a Deadly Virus."

Sanjay, this new treatment that Duncan is getting, can you explain what it is, how it's different from ZMapp which apparently there isn't any more supply of right now?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Yes. Brincidofovir, it's a -- it's an antiviral medication. You have antibiotics which help treat bacterial infections. This is an antiviral. There's only a few antivirals. This is one of them.

It basically prevents a virus from duplicating itself. The reason people get sick is the virus starts to duplicate itself, replicate, get into various bodily tissues, and that's what really makes people sick. This prevents that process according to just test tube studies.

Like most of these medications, Anderson, this hasn't been tested in humans. So this is something that they're basing it on laboratory studies. ZMapp works kind of the same way except to prevent cell -- it prevents the virus from getting into new cells. That's an injection. This one is just pills.

COOPER: Doctor Redlener, obviously, Louise was talking about ZMapp, saying why doesn't she -- why doesn't, you know, Thomas Duncan get it when those missionaries did. The U.S. government is saying there is no more of this. But who decides who gets what medication?

DR. IRWIN REDLENER, COLUMBIA UNIVERSITY: Well, in a situation like this where we have extremely limited supplies of the things that we know would probably work the best, hands are tied at every level. But what would happen in a situation like this new antiviral agent that Sanjay was just talking about, is the manufacturer would go to the CDC, and say hey, we -- I think we have something that might work. It'd be worth a try.

And then the CDC and the government would authorize this drug, even though it's experimental and authorize it to be used in a clinical setting, in this case in Dallas with this guy.

COOPER: You also made an important point before in the program to me is that we all think about well, the CDC is doing this in Texas and stuff, but it's really the CDC is a federal organization. It's really local and state health officials on the ground in Texas dealing with this.

REDLENER: Exactly. And I think it's important for people to understand that. We have a tremendously potent, brilliant, competent Centers for Disease Control, including under the leadership of Dr. Frieden. But the actual delivery of the public health procedures from cleaning up the apartment, to making sure that the infection doesn't spread, to making sure that procedures go as -- they should go in the hospitals, that is part of the local health infrastructure. Both the public health and the hospital.

COOPER: So the CDC makes recommendations.


COOPER: And tries to help out when they can but it's really state and local officials.

REDLENER: Exactly. That's where the actual (INAUDIBLE) sort of hits the road. That's where it needs to happen.

COOPER: And David, there are a lot of people, politicians, people in the media, calling for the U.S. to close the borders, to suspend flights from infected countries. Not only aren't there many direct flights from infected countries but you believe that would actually be counterproductive. How so?

DAVID QUAMMEN, AUTHOR, "EBOLA": Well, I agree with Dr. Frieden on that. He said several times in the last few days that the notion of closing airports entirely, closing borders entirely, closing off countries would probably, first of all, be impractical. It wouldn't succeed. You couldn't keep those borders completely closed. And secondly it would be counterproductive because it would allow the outbreak, the epidemic to continue to grow in West Africa.

And as he has said, no one is safe in America, no one is safe anywhere else, until that outbreak in West Africa is gotten under control and stopped.

COOPER: Sanjay -- go ahead.

QUAMMEN: Screening people as they come in is a different question.

COOPER: Yes, and that clearly seems like something that the U.S. is going to be trying to do more of, at least -- whether it's actual physical testing of it but most likely just trying to screen as best they can, right?

QUAMMEN: That's right. And it seems as though there are big improvements that need to be made and can be made and how that is done, how rigorous the screening is coming into the U.S., coming back to the U.S. if you're a U.S. citizen.

I mean, your reports from Elizabeth Cohen have made that really vivid about the fact that U.S. Customs and Border Protection probably needs to be a little bit more well informed and vigorous about screening people on the way back in.

COOPER: You agree with that, Dr. Irwin?

REDLENER: Well, I agree. It was a very interesting thing we saw just the other day in Newark. So an airplane lands and there was a guy who got sick and just came from a West African country, suspected of potentially being an Ebola patient.

What we saw there was a tremendous amount of confusion and delay and who is in charge here kind of thing. So we have the principals down path that we know that we need to separate these people, get them tested but the actual processes that have to be deployed by the airlines, by the local health officials, et cetera, that's where we're still stumbling around trying to figure out what are the things we actually need to do at any given scenario.

COOPER: And when David Quammen was referring Elizabeth Cohen was on the air last week and talked about when she got back from Liberia, from reporting on Ebola, customs in the U.S. basically really didn't know how to deal with her. The guy was like, yes, I think I received a memo or something about that, I'm supposed to ask you, but basically there wasn't really much rigorous testing.

We're going to have more from Dr. Sanjay Gupta, Dr. Irwin Redlener, David Quammen. Thanks very much for right now.

A quick reminder, make sure you set your DVR so you can watch 360 whenever you want.

Coming up, how do you clean an apartment that an Ebola patient lived in? That has been happening all weekend in Dallas. That finally started happening last week with kids and other neighbor watching very close by.

The question I ask the CDC, are they in danger? Gary Tuchman is there. His report when we continue.


COOPER: Welcome back to breaking news tonight. For the first time in this latest Ebola outbreak, a person has contracted the Ebola virus outside Africa. A nurse in Spain today was diagnosed with Ebola after treating two Spanish aid workers who had returned home for treatment. Both of those people have since died.

Now back here in the U.S. hazmat crews today finally finished the process of cleaning the Dallas apartment where Ebola patient Thomas Duncan stayed. He is now in critical condition. For days the towels he soiled and the sheets he sweated lingered in that apartment, they've now been removed. Now there are new questions about the way the apartment was cleaned. You can see there's a mist from the cleaning which is troubling, which (INAUDIBLE) something to the father of the freelance journalist who got Ebola said.

He said his son thinks he may have been infected by some of the spray that came back when he was disinfecting a car that someone had died in. We don't know for certain that's how the journalist who's being treated in Nebraska contracted Ebola but it's raising some troubling questions.

Gary Tuchman is in Dallas. Here's what he found.


GARY TUCHMAN, CNN NATIONAL CORRESPONDENT: What you are looking at is the first time in American history a hazmat team has worked an Ebola cleanup scene. Men dressed like astronauts who work for a Texas company, destroying everything in the apartment Thomas Eric Duncan was staying in that could still have the living Ebola virus.

Brad Smith is the vice president of the company.

BRAD SMITH, VP, CLEANING GUYS: Anyone that can give us advice from this, we've taken it and we've gone a step further in our own training and taken care of it.

TUCHMAN (on camera): This is kind of a surreal spectacle. You see the workers going in, in protected hazmat suits doing their job, while parents and children wander around on nearby balconies.

(Voice-over): Look closely, you see mist from whatever is being sprayed in the apartment. For much of the time the door of the home is open while the spraying is taking place. And look right next door, a child on the balcony who can't be more than 40 feet away. The apartments on both sides were occupied the entire time the apartment was being cleaned. People from all over the world live in this area, very little English is spoken.

Lorenza Cardia (ph) has seven children and lives in the complex next door where she can watch what's going on. She has no idea if it's safe for her or her family to be there. No official has told them anything.

She tells me, "I am scared of what's happening. It's bad because we don't know anything. We don't know if it's going to spread. I keep my kids inside the apartment."

Joseph Thomas lives even closer. He's been told nothing either. But is resigned to fate.

UNIDENTIFIED MALE: I'm trusting my god. I'm trusting my god. He will protect me. If he don't want me, I am ready to die.

TUCHMAN (on camera): Brad, the neighbors here, the neighbors here are all coming out the balcony watching. Your people are going in with their hazmat suits and they're just wandering around 30 feet away. Is that safe for them?

SMITH: I don't want to comment on that. That's not my expertise.

TUCHMAN: But that's not your job to tell people maybe they should leave this apartment complex?

SMITH: No. Absolutely not. I can't say I'd leave my family here.

TUCHMAN (voice-over): The CDC says there's virtually no risk of Ebola being spread to these neighbors during the cleaning. Ebola does not spread through the environment. But even if it's just to play it safe, it's not clear which local officials would be responsible for giving the residents information and/or temporarily moving them out.

A spokeswoman for the Dallas County Health and Human services department says, we perform contact tracing, investigations and public health follow-up. We will not comment on something that is not in our purview.

The spokeswoman said get in such with the spokeswoman for Dallas county. But she hasn't responded to us as of yet.

The work has taken over three days and now the job is finished. The hazmat trucks start driving off to an undisclosed location.

SMITH: We've totally cleaned the apartment, from the ceilings to the floors, removed everything out of the apartment, carpet, drapes, blinds and then obviously put a final decon on everything to make sure nothing is living in there. And it's all been removed.

TUCHMAN: The hazmat team is now gone but it appears that most of the neighbors never left.

Gary Tuchman, CNN, Dallas.


COOPER: Joining me now live is the mayor of Dallas, Mike Rawlings.

Mr. Rawlings, thanks very much for being with us. So I know you heard Gary's report there. He had kind of a tough time trying to get an answer on who should be keeping neighbors in that apartment complex informed. What's the answer to that? I mean, is there an answer?

MAYOR MIKE RAWLINGS, DALLAS: Well, we're in charge of keeping them informed and we've been doing that. We have gone door to door, talked to everyone. We have had reverse 911 calls. We've handed out brochures. We've had apartment meetings and talked to people. So while I really understand how scared these individuals are, I think it's natural, I believe the job of communication has been done and done well. But, you know, people are going to remember what they remember.

COOPER: From -- you know, I talked to Louise a couple of times now.


COOPER: The woman who lives in that apartment. And when I first spoke to her on Thursday, you know, I think a lot of people are surprised to learn the sheets Duncan slept in were still there, the towels he'd used, other items were still in the apartment.

I know you've said that dealing with five major jurisdictions has slowed down the process somewhat of dealing with her and her family.

I'm just wondering how so? And what's been the most difficult part and at this point, is it clear to you who is in charge of dealing with all the people Duncan came in contact with?

RAWLINGS: Well, yes, on the last question. I think we have 40-some people. We've got a couple of dozen individuals that are all assigned to people and we're meeting with them every day. We're taking their temperature twice a day. So I think we've got that worked out.

It is difficult. And frankly, I would like to have moved a little faster with the Duncan was -- we were told that he had Ebola on Tuesday. The team got on the ground on Wednesday. We moved her on Friday. I wish we'd had it 24 hours earlier. But you know what, we're dealing with the safety of Dallas. And we've got to make sure that every step is thought about and the procedure is cracked.

We've got it to a safe spot. And in the long run we're going to see whether that 24 hours made a difference or not. Knock on wood right now she has not shown any symptoms. We just had her pastor out to meet with her today. She's in good spirits and hopefully she will stay that way.

COOPER: Mr. Duncan's stepdaughter who came in very close contact with him, she was there, she called 911. Got him to the -- or called the ambulance when he was taken to the hospital for the last time. She told "The Washington Post" that the CDC told her she no longer has to isolate herself and her family.

Do you know, A, if that's true and why that might be? Because according to Louise, she was the one who was there giving Duncan tea, realized he was badly ill and called the ambulance.

RAWLINGS: We categorized people in high risk and low risk. And I don't know exactly -- folks know exactly where she is on that list. Not everybody needs to be isolated. They need to check and monitor this. Remember there's zero chance of you being able to get this disease unless you are in contact with an individual that is showing symptoms. And none of these people are showing symptoms. So they cannot give the disease out.

So we're not keeping everybody in a lockdown situation. But we are making sure that they're safe and secure, but it's interesting. I mean, you literally are at least five -- you got the feds, you got the state, you got the county, you got the city and you got a privately run hospital. And we're all trying to coordinate. And I think we're working well together. I like to have got it done 24 hours earlier.

COOPER: Yes. The -- I guess the positive thing on this, if anything, is that at least it's kind of a trial run for something other -- you know, inevitably this will happen somewhere else down the road. Hopefully lessons are being learned that each time it gets better and better.

Mayor Rawlings, I do appreciate your time tonight. RAWLINGS: Yes. It does and I think it's an amazing thing that we've

got the kind of mathematical chaos theory working here in the United States and we've got to be as prepared for it because you never know where this is going to -- strike. And hopefully there's learning that comes from us and I'll be glad to give anybody the learning I know.

COOPER: Yes. And I also just want to repeat what you said which we've been repeating every time we report on this, that unless somebody is actually showing symptoms they can't pass the virus along. So even if you're on a plane with somebody who's positive, as long as that person is not showing symptoms and takes as much as 21 days to show symptoms, that person cannot pass it along.

Mayor Rawlings, appreciate your time tonight. Thank you.

RAWLINGS: Great. Thank you.

COOPER: As always you can find out more on this story and others at

Just ahead, airstrikes against ISIS have battered the group's home bases in Syria but they have not stopped ISIS from gaining even more territory.

The question is, is the war on ISIS making any difference at all? Has the U.S. military crossed the line into direct combat in Iraq? We'll tell you why when we asked the question next.


COOPER: New questions tonight about whether U.S. airstrikes against ISIS are making any difference at all. In Syria, tonight ISIS is closer than ever to capturing Kobani near the border with Turkey.

ISIS fighters have planted flags on a hill top and a building in the city. They've managed to close in on Kobani despite ongoing airstrikes by U.S. as well as its allies.

Meanwhile in Iraq ISIS is moving closer to Baghdad, the west of Iraq's capital. The Iraqi army is trying to hold back ISIS fighters. ISIS has gained control of more Iraqi cities since the airstrikes began.

In Anbar Province, the U.S. military has begun using Army Apache gunships attack helicopters against ISIS targets. To some people that sounds a lot like combat, something President Obama has ruled out in Syria and Iraq.

Chief national security correspondent, Jim Sciutto, joins me now. So first of all, situation in Kobani, northern Syria, what's the latest?

JIM SCIUTTO, CNN CHIEF NATIONAL SECURITY CORRESPONDENT: It's not good. Kobani is a city fighting for its life now. The Syrian-Kurdish fighters there lock in street battles with ISIS fighters as ISIS has moved in. ISIS holds the high ground above the city.

It's been shelling with artillery and tanks. There had been a handful of U.S. airstrikes around Kobani, but really hasn't changed the calculus on the ground. Many officials say that the real key there would be Turkish intervention because Kobani is just along the border with Turkey here.

COOPER: So the airstrikes, have they been having much effect? It doesn't seem like it certainly with Kobani.

SCIUTTO: You look at the map and really nowhere do you see an obvious effect. Let take a look at Iraq here. So this is Iraq before the start of the U.S.-led campaign. At the time ISIS controlled 13 cities. So here's 59 days ahead today.

After 59 days of U.S. airstrikes, they now control 14 cities. They added hit here just to the west of Baghdad. They're also now contesting for Ramadi. If you look at Syria, you don't even need, Anderson, a before and after photo because before the U.S. air campaign started ISIS controlled ten cities.

Now 14 days into that campaign, they still control ten cities and, in fact, they're getting closer to taking control of Kobani. Looking at this map here on the ground you can't see any measurable effect.

COOPER: Let's talk about the U.S. apache helicopters engaging in combat. Even the Pentagon spokesman, Admiral John Kirby, who I'm going to speak to in our next hour, acknowledges that's a form of combat. That is a significant development.

SCIUTTO: A lot of commanders were saying that even about the high- flying aircraft when the air campaign started, jets, bombers, et cetera, because they're in danger. They're flying combat missions. But really when you get down close to the ground with an Apache helicopter.

It's much slower flying at a much lower altitude, which makes it more vulnerable to ground fire. That certainly puts those pilots in danger. They're not ground troops, per se, but they're closer to the fire fights at this point than any U.S. forces have been in this campaign.

COOPER: I'll talk to Admiral Kirby in the next hour, but what happens if one of those Apaches goes down? Who rescues that crew? Is that U.S. personnel or do we rely on Iraqi personnel? Talk to him about that. Jim Sciutto, thanks.

I want to bring in CNN's Ben Wedeman now. He's in Baghdad tonight. He has been talking to members of the Iraqi army who are battling ISIS. Also joining us Retired Lt. General Mark Hertling, who commanded U.S. forces in Iraq in 2007 to 2009.

So General, let's talk about Kobani. I mean, the fact that it's close to being captured by ISIS, what does that say about the effectiveness of airstrikes?

LT. GENERAL MARK HERTLING, COMMANDER, U.S. FORCES IN IRAQ 2007-2009: I don't think it says much about the effectiveness of airstrikes, Anderson, because we're talking about two different types of targeting. You're talking about precision targeting, which is what the aircraft that have been launched against Syria had done.

They're looking at main targets that they can hit. What you're talking about in Kobani is an infantry force, a group of individuals on the ground. You are not going to fly over those forces and drop precision weapons on top of one individual after another.

So we knew from the very beginning, I believe, that airstrikes in Syria were not going to countermovement except movement in vehicles and in large formations by ISIS.

And what we've got right now is house-to-house fighting, street-to- street fighting in Kobani and airstrikes are not effective in that kind of an operation. It takes ground forces to don't counter ground forces when you're talking about urban combat.

COOPER: General, how significant then is the -- I mean, Jim Sciutto mentioned artillery from high ground that ISIS has being fired into the city. Is that significant in this battle? And if so, I would assume those could be targeted.

HERTLING: Those are certainly targets. I think what Admiral Kirby will likely tell you is they're searching for those kind of targets to counter the heavy equipment, the artillery pieces, the very limited number of tanks that ISIS has. Those are obvious targets. But once you get inside the city, I think that's where we see the hand-to-hand fighting going on.

COOPER: Ben, you're in Baghdad. You've been talking to Iraqi military. Obviously a lot of questions about their readiness. What are you hearing and seeing in terms of how well they can actually protect Baghdad itself?

BEN WEDEMAN, CNN SENIOR INTERNATIONAL CORRESPONDENT: Well, Anderson, just today, we were at the western perimeter of Baghdad's defenses with Iraqi soldiers and officers, and what we saw was they seem to be holding the line.

But the situation they described was one of basically that ISIS is taking pot shots with snipers on their positions. They've tried a few hit and run raids, but it appears that they're not really focusing on that area at the moment.

They're really focusing on towns like Ramadi and of course, Hitt, which they were able to take over a few days ago. So it's really a question of concentration. And of course, the area we were in to the west of Baghdad about to 20 miles is not far from Baghdad International Airport.

So that's fairly highly protected, but the area itself of Abu Ghraib is largely a Sunni area. One person told me, yes, the army controls this area by day, controls the roads by day, but at night they pull back to their bases and ISIS takes over.

So the hold on the capital is tenuous at best, but of course, you need to keep in mind that ISIS until now has been most successful in taking over, controlling areas where there's a Sunni majority. Baghdad does not have a Sunni majority. It's a Shia majority.

But there are areas around the capital and in the capital with Sunni populations some of whom are sympathetic to ISIS. So when you speak to Iraqi military and security officials, they say their real worry at the moment is the possibility of more car bombs, more bombs within the city.

In addition to sort of this looming threat on the western side and the southern side of this city. So it's a very complicated security picture and many people wonder if the Iraqi army is up to the task.

COOPER: General Hertling, just very briefly, how close would they have to get in order to be able to strike the airport? I mean, do they have equipment, ISIS, do they have artillery that can actually shoot a plane out of the sky?

HERTLING: Well, I'm not sure they have equipment that can take down an aircraft, Anderson, but they certainly do have equipment that could potentially launch artillery into the Baghdad airport.

There are two towns close by that have always been Sunni strongholds, Iscanderia and several others actually. And I think they are controlling the entrances to the western side of the city.

But as Ben pointed out, it's not so much that that is worrisome to the Iraqi security forces. It's actually the guerrilla warfare inside the city. I would guarantee you are going to see an uptick in car bombs and a lot of both kind of things especially in the Shia neighborhood.

COOPER: Which we even saw, I mean, last time, I was there when ISIS was starting to make advances. General Hertling, good to have you on. Ben Wedeman as well, be careful.

Just ahead a 4-year-old New Jersey boy who died in his sleep in his own bed is the firm confirmed fatality in the enterovirus. Outbreak that is sweeping the country. His parents say there were no signs that he even had the virus. What you need to know ahead.


COOPER: A nasty strain of common respiratory virus that's hitting children especially hard this year, Enterovirus D68. A 4-year-old New Jersey boy is the first confirmed fatality. Authorities say that Eli Waller was killed by the virus even though he reportedly had no symptoms at all. No trouble breathing. No cough. No fever.

The virus has sickened hundreds of kids across the country. Some have ended up on ventilators in ICU units. It's also been linked to paralysis in some kids. Now the death of Eli Waller has raised a new terrifying pros prospect, what if the virus can kill with no warning? Susan Candiotti reports.


SUSAN CANDIOTTI, CNN NATIONAL CORRESPONDENT (voice-over): His parents call Eli Waller, the youngest in the set of triplets, Little Buggy, comparing him to a shy puppy who loved to make people happy.

JEFF PLUNKETT, HAMILTON TOWNSHIP NEW JERSEY HEALTH OFFICE: Always told his dad, do I make you proud? And the father always would say, yes, you do. He just was precious.

CANDIOTTI: Apparently without warning, 4-year-old Eli went to bed 12 days ago and never woke up. A victim, the CDC says, of the enterovirus.

(on camera): Did he have any underlying conditions that might have caused this?

PLUNKETT: None whatsoever. He was asymptomatic when he was put to bed that night.

CANDIOTTI (voice-over): That's what makes Eli's death so mysterious. There's no explanation for how he got sick. None and that's stunning.

PLUNKETT: It's hard to believe, if you think about it. But it is the nature of that virus.

CANDIOTTI: While he usually attended pre-K with his sisters in Hamilton Township, New Jersey, Eli's mom kept him home that day because of a slight case of pink eye.

PLUNKETT: Went to sleep and when she went to wake him up in the morning, he had passed.

CANDIOTTI (on camera): That quickly?

PLUNKETT: That quickly.

CANDIOTTI (voice-over): His sisters are not sick. Of nearly 600 confirmed cases in 43 states, the CDC says Eli's death appears to be the only one of four fatalities blamed entirely on the enterovirus.

(on camera): Is there anything that Eli's parents could have done, could have foreseen to prevent this?

PLUNKETT: Absolutely not.

CANDIOTTI (voice-over): Before the CDC confirmed Eli died of the enterovirus, as a precaution, the school scrubbed down the pre-K classroom where the children have all their activities.

UNIDENTIFIED FEMALE: The students are having to do a lot more hand washing than they're used to in the day. And I come on and say do the hand wash cha-cha.

CANDIOTTI: Eli's school honoring him with blue ribbons and his name on a sign for everyone to see.

UNIDENTIFIED FEMALE: When you see photos of little Eli, his personality leapt off the page.

CANDIOTTI: His parents setting up a foundation to support special education, offering a statement reading in part, he was a beautiful mix of eagerness and hesitancy, need and striving, caution and surprise, all of which were grounded in a pure, unconditional love. From a 4-year-old who loved soccer, dancing and making his family proud. Susan Candiotti, CNN, Hamilton Township, New Jersey.


COOPER: So hard to believe. Understandably many parents across the country are extremely worried about this virus.

Joining us again, CNN chief medical correspondent, Dr. Sanjay Gupta. So he wasn't exhibiting symptoms when he went to bed. What happened? How does that happen?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Well, you know, we don't know for sure. I mean, this is a virus that can cause very rapid illness. I mean that's one thing we know about Enterovirus 68. There are several different strains of enterovirus, but this is the most dangerous form.

Typically kids who had breathing problems in the past will be most susceptible. They know for sure. I've read the reports that this is really unfortunate sad death was caused by enterovirus in the fluid surrounding his brain and spinal cord. So it is just really sad. It moved really fast in him.

COOPER: I understand this is actually a pretty common virus. What's making this strain so dangerous particularly for kids right now?

GUPTA: Well, you know, for kids there's lots of different enteroviruses out there. We get exposed to enteroviruses throughout our lives. Most times it doesn't cause much illness if any at all, but it does build up a little immunity in us each time we get exposed.

Kids just because they are younger, they haven't been on the planet as long, they don't have as much exposure and therefore, they don't have as much protection.

When a bad strain like this suddenly starts circulating, it's circulated before, but when it starts circulating again like now kids end up being the most vulnerable.

COOPER: Why do some kids get paralysis or limb weakness?

GUPTA: We know that there's been 11 children in Colorado and I think four children in Boston may have similar type symptoms. The enterovirus may be getting into the fluid again surrounding their spinal cord. Only half the kids tested positive for enterovirus.

But it could mean that the test just came too late and they didn't find the virus. That's what happens, it gets into the fluid around the spinal cord and causes damage to spinal cord, which they've seen on MRI scans.

COOPER: All right, it's so sad. Sanjay, thanks very much. Up next authorities have allegedly found a letter written by Eric Frein, the man on the run accused of shooting two Pennsylvania State troopers and killing one of them. Details ahead.


COOPER: Following a number of other stories tonight, Susan Hendricks has a 360 News and Business Bulletin -- Susan.

SUSAN HENDRICKS, CNN CORRESPONDENT: Anderson, the U.S. Supreme Court has refused to take up challenges to loss legalizing same-sex marriage in five states. This means same-sex couples can soon marry in Utah, Oklahoma, Wisconsin, Indiana and also Virginia bringing the total number of states allowing same-sex marriages to 24 with more states expected to follow.

Two senior law enforcement sources say a handwritten letter believed to be written by the suspect wanted for ambushing two Pennsylvania state troopers details how he shot the officers and got away, but the officials say the letter found during the manhunt for Eric Frein offers no motive for that attack.

And USA swimming has suspended 22-time Olympic champ, Michael Phelps, for six months and says he won't compete in next year's world championships because Phelps violated their code of conduct when he was charged with dui a week ago. He has taken a break from swimming to attend a program to, quote, "better understand himself."

A marriage proposal didn't go as planned. The couple was riding in a hot air balloon that was forced to take a dip in the Pacific Ocean. Surfers grabbed the rope and help lifeguards pull the balloon to shore. All people on board made it to shore safely. One couldn't even swim. She did say yes, though, by the way to the marriage proposal.

COOPER: Wow, if they can survive that, they can survive anything. Susan, thanks very much.

In the next hour, a friend of Dallas Ebola patient, Thomas Duncan pleads for help for him. Why she feels he may not be getting the same treatment as others in America. That ahead.