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CNNW CNN Newsroom October 12, 2014

Nationwide is on your side hello, everyone. Im debra in for fredericka whitfield. We are following a lot of breaking news today. Happening now in dallas. A nurse at Presbyterian Hospital is in stable condition after testing positive for ebola. This is the second ebola case in the United States. However, it is the first known transmission of the deadly disease inside the u. S. The nurse had substantial contact with ebola patient Thomas Eric Duncan wednesday. According to hospital officials, the nurse was considered to be at low risk because she was wearing full protective gear following cdc protocols. The white house says the president boem has been updated on the situation by the secretary of health and human services. Another person close to the nurse is not showing any symptoms, but has been placed in protective isolation. Ed lavedera is covering this development for us. Dozens of people now being monitor for infection because of their contact either with the original patient or in the situation of the nurse. One additional person. Do Health Officials expect to see more cases in the coming days . In the coming days theyre going to be focussing on following up on the contacts that this particular Health Care Worker dealt with and they know of one close person who has already been isolated. They will work up that contact list just the way they did with Thomas Eric Duncan. If you remember, what is interesting about this situation is that there were close to 50 people who were on that official contact list with Thomas Eric Duncan. About ten of those were believed to be high risk. This particular Health Care Worker does not fall underneath that because this was someone who came into contact with Thomas Eric Duncan after he had been admitted to the hospital here in dallas after the second visit. This is someone who hospital Officials Say was part of the team that cared for Thomas Eric Duncan and thats why theyre monitoring the situation very, very closely with her, obviously, and Health Officials here in texas, deb, have been saying that they are not surprised that there has been another case, that they have been putting plans and procedures into place preparing for just this kind of event. Ed, is there a prevailing theory about how this nurse contracted this . There was a breach in protocol. They havent said at what point, whether it was while she was in the room wearing the protective gear or when she came out from wearing the protective gear. Isnt the hospital a little too confident that they could contain any future infections . Theyre describe this particular part of the story as very concerning because they do say that this particular Health Care Worker, of time she had come in contact with Thomas Eric Duncan did wear the proper protective clothing, the facial mask, gloves, and Everything Else that was part of that. Somewhere along the line the Health Care Workers are saying there was some sort of breakdown in the protocol. Perhaps in the way these garments were removed is one possibility. They need to track down where exactly this came from and the director of the cdc talked about just how concerning this part of the story is for them. We dont know what occurred in the care of the index patient, the original patient in dallas, but at some point there was a breach in protocol, and that breach in protocol resulted in this infection. Hospital officials, you know, they talked about how there were close to some 50 people who were involved in the care for Thomas Eric Duncan during his ten days or so here in the hospital. Cdc officials now are saying that theyre going to work on limiting the number of people who were exposed to this particular patient to as few people as possible as they kind of go through the process here and investigate just where the breakdown was and how someone who was supposedly under all of this protective garments and clothing and everything you needed to do, how despite all of that, they still were infected. Yeah. Theres no question. Ed lavendera, thank you. Clearly, Health Care Workers are the heroes in all of this. A number of them have died in west africa. Now one here in the u. S. Is contracted it, and now they say their thoughts are with this nurse. We are breaking medical ground here in the u. S. Not in a good way. In just a matter of days the first person to ever be diagnosed with ebola and now the first ever to contract the virus. Joining me here in the United States, joining me now, dr. Alec anned are a garza, former assistant spaekt for hospital affairs, and Board Certified physician for infectious diseases. Dr. Garza, let me start with you. One thing that the cdc director said was that when it comes to disaster response, you need humility because clearly what theyre dealing with is so dangerous and so deadly. How alarming is this particular diagnosis to you given the conditions as we know them . Yeah. This is a very formidable virus, and so dr. Frieden is entirely correct. You need to have a little bit of fear and a little bit of humility when you are handling both the patients and the virus, and so the news coming out of dallas as well as out of spain with Health Care Workers now becoming infected from helping to treat these patients is a little bit concerning. When we think about when we think about how this did spread, look, you have mr. Duncan was exposed to several people during the point that he was effectively contagious and the contact spread to the contact virus. This Health Care Worker was with mr. Duncan for a much shorter period of time. Those he knew first were not dressed. Those he knew after were in fact, dressed. How do you reconcile those two images as somebody in full protective gear coming down with this . Well, its definitely concerning. What i would emphasize is that when he was taken to the intensive care unit at texas presbyterian, he was getting very hightech stateoftheart critical care. For example, he was intubated. He was also getting dyalysis. These are all procedures that put you at high risk for blood and body fluids because you are putting things into the patients body. For example, dyalysis catheters are a large iv line that needs to be inserted into one of the central veins. Theres a lot of more potential for blood exposure in a hospital setting, and that may be part of it. People can get contaminated on their outside personal protective equipment, and when theyre taking it off, they may contaminate themselves. Thats where we need to really be just as meticulous with taking off the gear as when we put it on. You are suggesting a droplet of blood that may have gotten on some of the protective gear and somehow spread or been touched. Is that one way it could be transmitted . Right. Yeah. When you are taking it off, it could have been some men skul type of amount of blood that was he totally inadvertently got the patient contaminated, and thats why we need to have a second person watching someone take off this gear. A supervisor or the buddy, for example that, weve talked about before. Dr. Garza, how hard is it to be in a hospital setting when you have, as the doctors say, this minuscule droplets of blood, for example. Again, respecting the virus. Get infected with the virus. They have treated thousands of these people. Then doesnt it go to the point that there should be certain hospitals that deal specifically with ebola cases given the fact that, look, you know, its much ease wrer to train, say, 100 people than it is 1,000 or 10,000 people on how to deal with these kinds of protocols. Dr. Garza. I think thats an excellent point that you are making. Its one that is probably taking place now at the highest levels, whether these patients should be treated at these high containment facilities both in atlanta and in nebraska where the people do have the equipment, the knowhow, and the training and now, unfortunately, have the experience in dealing with these types of patients. No question. Everybody getting sort of a crash course. Dr. Alexander garza, doctor. Thank you for your guidance. Isis is making big advances in the province surrounding baghdad. Up next, we will hear why the white house says, well, its not worried. 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Farxiga can cause serious side effects, including dehydration, genital yeast infections in women and men, low blood sugar,kidney problems, and increased bad cholesterol. Common side effects include urinary tract infections, changes in urination, and runny nose. Do the walk of life yeah, you do the walk of life need to lower your blood sugar . Ask your doctor about farxiga and visit our website to learn how you may be able to get every month free. Its not clear in isis is responsible, but the terror group is tightening its grin on an bar province. About eight miles from Baghdad International airport. The provinces leaders are pleading for u. S. Ground troops to defend it against isis. The bhouss in es ins iraqi forces the message from the Obama Administration or have we been seeing hedging on baghdad, whats going on with baghdad, whats going on with nearby an bar province. How do you wrap it you will for us . Deb, there are certainly mixed messages coming from the administration. Just this morning general martin dempsey, the chairman of the joint chiefs of staff, was on abc and he was saying that there certainly will be days when isis can use indirect fire into baghdad. Now, that comes just hours after secretary of defense chuck hagel was saying that baghdad is safe and secure. Listen to those comments. Iraqi Security Forces are in full control of baghdad and continue to strengthen their positions in baghdad. We continue to help them with air strikes with our assistance and our advisors which i have at the direction of president obama added to our numbers there. Now, just the night before on friday chuck hagel was saying how dire the situation is in an bar province as other administonurse uses very brutal tactics, but the other point i would make, deb, is that president obama has said very recently that they have overestimated the iraqi armied forces for five years or so, and those are the very armed forces who are supposed to be securing baghdad. Now, of course, though, there are american troops there in security roles, deb. Are there signs that the administration is getting pressure from the outside, as taking heat for what is going on within iraq . Well, we are essential hearing more and more from republicans who are criticizing the administration and also the situation on the ground, that it is not going as well as planned. I want you to listen here to comments that senator john mccain made this morning. First of all, theyre winning and were not, and the iraqis are not winning, the kurds are not winning, and theres a lot of aspects of this, but there has to be a fundamental reevaluation of what were doing because we are not we are not degrading and ultimately destroying isis. And also, deb, this is becoming a bigger issue in the midterm electrics with more and more republicans saying that the administration has to do more. All right. Aaron mcpike, thank you so much. We appreciate that. Well, let me bring in cnn military analyst Lieutenant Colonel rick frankona. You look at everything that is happening right now. Baghdad apparently is not in danger. Theres no effective strategy that isil has. Can they potentially do enough damage either by choking off the city, by taking control of the airport, pounding it and creating terror within that, in fact, is destabilizing baghdad right now . Yeah. I this i all of the above. What were seeing is isis make a concerted effort to get lowers to the airport, and as the chairman mentioned, baghdad is susceptible to indirect fire. What that means is artillery and mortars . Weve already seen mortars impacting into the green zone, and were seeing a lot of car bombings. These fit isiss tactics very well. What they like to do is surround an area, choke it off, and then send in a bunch of suicide bombers to destabilize it before they do anything else. Were seeing the initial faces of that. Now, i dont think that were going to see a frontal assault on baghdad. Baby is just too big. The military forces there are too strong, and thats where the best of the Iraqi Military is going to be. What were seeing in an bar province, on the other hand, are the lesser qualified units of the Iraqi Military and despite the use of american airpower, they still have not been able to retake any of the cities that isis has rolled up and, in fact, isis continues to take territory from the iraqi army. So when you think about it, the situation that you have just described effectively baghdad is sort of the one city that it seems that the United States has some control inside. Youve got u. S. Advisors who are there. Youve got troops. You have the embassy. When you talk about destabilizing baghdad, how does that change the game . Even if isis doesnt take the city, how does it change the game . Well, what theyre going to be able to do is create terror in thissed the city. If they put enough artillery, mortars, car bombs in the city, that makes it very difficult for this new government to say that its maintaining control or that its able to open up to the sunnis and create this inclusive government that everybody hopes will change the game in the country, and were not seeing that. Isis continues to move around the city. Theyre moving on the north. They already control much of the west, and some of the southwest. If they can actually get more around the city, that puts us in a bad way. I want to underscore what i think Barbara Starr said earlier. That Baghdad Airport is critically important to all of our plans there. There are a couple of hundred american troops there. There are six apache helicopters there. So thats very critical to, you and theyre only eight miles from that. Unless the iraqi army can get its act together and start securing that area out there, somebody is going to have to go do it. I dont know what thats going to be. Lets include the u. S. Who wants to put more force theres or certainly reinforce that airport, but let me just ask you this question that keeps plaguing me. Theres something, like, 30,000 isis fighters. No more than that is the numbers that we were being gin. How is it that they are able to make such ground and hold these different cities and effectively now come so close to baghdad. Yeah, thats a really good point, deb. What theyre doing is theyre amassing their forces where they want to conduct these hitandrun operations, so while the iraqi army has to keep itself spread out to try and protect everywhere, isis moves its forces where it needs them. If theyre going to attack the haditha dam, they will move as many forces they think theyre going to need and overwhelm the forces that are there. Its not the numbers you have in total. Its the numbers you have on the battlefield in any particular spot. Isis is very good about moving people. Just take a look at what theyre doing. Theyre controlling a battle in kobani and almost 500 miles away theyre battling in iraq. Their command and control structure has want been defwraded. Theyre still effectively managing their forces. Meantime, theyre paying people within the cities that they have taken control over to at least have some presence there. Lieutenant colonel, thank you. Appreciate that. Still ahead in the cnn news rm, the first known european case of ebola has a nurses aide in madrid struggling to recover. It has left people in spain wonder if anything their country is also up for the fight. Growi. Getting in a groove. Growth is gratifying. Goal is to grow. Gotta get greater growth. I just talked to ups. They got expert advise, special discounts, new technologies. Like smart pick ups. Theyll only show up when you print a label and its automatic. We save time and money. Time . Money . Time and money. Awesome. Awesome awesome awesome awesome all awesome i love logistics. For over 19 million people. 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