>> in the fall of 2014, significant aid and manpower finally started arriving in the region. in liberia, there were contingents from france, china, cuba, germany, sweden and the united states. >> this is an extrapolation. >> exactly. >> it was chaotic and coordination was often difficult. but makeshift etus were finally replaced with purpose-built field hospitals. >> i communicated with the ministry that jfk should close down. so just transfer them from jfk.

>> you need to scrub and clean my office. i created something called a coordination team. good morning. yesterday i started getting complaints. there were two patients that were brought to triage and they were lying in triage for more than an hour. i mean every patient that comes here think about your relative being in that position, you don't treat patients like that, you can't have patients waiting in triage for one hour before they get care. we need to be vigilant about it. i have seen so many people die and sometimes i'm afraid being a medical doctor.

one laboratory technician working for us at jfk got infected. and my hygienist got into a physical fight before the patient became infected. then two securities got infected at home. after i joined jfk, three intern doctors came and dr. scott land. dr. scotland wanted to work alongside me. and every time i was working for four or five hours, it was scotland that would stay, he was a perfect friend, a perfect colleague. one day he took the day off, and then that evening i called him

to see how he was doing. he said, o doc, you know what? i have fever and chills. i said keep it calm, come to the unit and we'll take a sample. that night his first inclination was to call me. he said doc, my results came back positive. he started to cry, he started to shed tears. and i told him, i will do everything in my power to make sure you're okay. i will get an ambulance. and then i ask him to receive him and put him in and did everything i could do for him, i kept calling all through the night, i didn't get him, he didn't talk to me. the following morning, he just dropped and died. he just dropped and died.

he just dropped and died. yeah. up until now, when i think about it, i feel like i've done nothing.

>> my whole family got ebola. eight died, two survived.

after i survived, i voluntarily decided to give care to these children. hello, everybody. lunch is ready, we're going to have our lunch. these children are here because they have lost everything from ebola and the community has a responsibility to take care of them. in taking care of these children, they are risking their lyes. since we are survivors, we cannot infect them and we cannot get infected by them. so these children are brought here to be under quarantine. in entering the home, they can really, really be afraid. not wanting to talk to anybody,

not wanting to share their problems. they don't know who to trust. by time goes by, while talking to them, one-on-one, they start talking back to us. >> when ebola ends, every day is going to change, families are apart for good. my daughter is 4 years old. i called on my best friend in life, and my son is also very brilliant. because i was so afraid of them becoming infected, i had to stay away from them for a long while. people only see the deaths, but the consequences are far more

than that, in africa, we drink together, we drink from one cup, we share from one spoon and we eat from the same plate. see, ebola is not only killing us, it's destroying all of our cultures and traditions and reducing our hope for the future. >> i know we are talking about the prevention of the emerging virus, it's three factors, early identification, precision of diagnosis and immediate action. >> we're trying to find some small molecules or some

anti-bodiies that inhibit the ebola virus to enter the cells. >> the 21st century can be characterized by the advances, our only chances of winning the race is to use 20th century tools to fight heepidemics or ideally even to prevent them with vaccines. >> viruss are bad, but in terms of research they provide the critical tools for our cells. they have been with us through millions and millions of years of evolution. if we can ask the right questions, maybe we can find out some useful information. we have surveillance projects, we have viruses from humans,

from animals, from twine, that birds, finding out what are the mechanisms for spread. >> when you are talking about vaccine development, we knew even less for flu than we knew for the ebola. so we need to have a universal flu vaccine soon, so everybody's working on that. >> can you tell me the slice that you have prepared? >> this is the slice. >> oh, yeah. >> currently we create a new flu vaccine every year, adjusting it to match the circulating streams of flu. it takes months to make that vaccine. >> yes, it looks quite nice. >> what scientists are trying to develop is a universal flu vaccine, one that could work against all strains of flu, seasonal and pandemic. >> right now it takes at least nine months to develop a

vaccine, that's too much time. >> if there's a pandemic, a lot of people will die before a vaccine is ready. >> go this way? okay, goodbye, hope to see you soon. the problem is not just vaccines, we also need better diagnosis. >> better diagnostics are critical to preventing outbreaks from becoming e 2kee ining hele misidentify ebola. we lost valuable time to contain them. >> thank you, you have been identified. >> this is the area where we have a lot of the diagnostic machinery that we're working on. so the general idea is, your

sample is going to get placed in here, and it will run across a chip. you close it up and then the cartridge can sit right here. right now the run time is somewhere in the order of half an hour. so what you can see on the screen here, this is the intact virus, maybe it's ebola, maybe its influenza, maybe it's zika. you can imagine it being useful in your doctor's office, or in an airport, or you can imagine someone wanting to bring it to a triage site if there's some disaster or some outbreak. >> we are losie ingwe. >> today the president of brazil gave public health officials the right to enter any home of business to try to eradicate mosquito breeding grounds.

>> zika virus has been reported in chili. >> scientists are still trying to understand the full range of neurological effects zika causes in children and adults. >> zika virus has been detected in the miami area. >> can you imagine colleagues, the fear and anxiety in this chamber if these 100 mosquitoes were outside this jar not inside this jar. >> zika is a serious threat to americans. >> zika is spreading rapidly afternoon the world.

>> we're already seeing mosquitoes transmitting zika in the united states. it's really just a question of how many states, how widespread, and how many people will acquire infection as a result? we are not prepared for zika. every outbreak, we go to the capitol hill folks and beg, and every outbreak it becomes very political. in the united states, there are a patch work of laws that guide health. there's no consistency and allows the public health department to go on your lawn, in your property to spray

insecticide? in some cities yes, in some cities no. can i compel you to remedy a swamp like condition in your yard because it's bringing mosquitoes? again, there's no consistent law. must public health is a two-way trust, i have to trust that government's going to do the job. but government can't do the job of public health unless the public is engaged. if government says mosquitoes are here, and they're carrying a really dangerous disease, we need to come on your property, we need to have access to ways to eradicate those mosquitoes and you say i believe in the second amendment, nobody's coming on my property, then there's no trust. and there's no public health. and similarly, if there's an epidemic, that involves a vaccine, government doesn't line

your children up, you line your children up. and if you're not willing to do so, then you're not part of the trust that is the basis of public health. if there's one hallmark of my lifetime on this planet, it is the erosion of trust in government. and public health is paying the price at every level for that erosion of trust. >> each year terry gets the vaccine. i don't get it. and we gave shannon the choice, and she chose not to. i'm trying to understand the flu vaccine because i want to know if we got shannon vaccinated if

it might have saved her life. there's so much information on the internet, i can go to 30 different websites and get 30 different answers. you don't know who to trust. >> there's something about the flu vaccine that conjures confusion. while not currently a perfect tool, and varying in effectiveness from year to year, over the last decade, the flu vaccine reduces the risk of getting the flu by 50%, it also reduces hospitalizations and deaths. >> a little over a year ago, a mom that lost a little girl put together a facebook page and she titled it flu moms. and when she hears of another mom or somebody finds us, they join. here's a mom, she had a booth at a fair and all of our children

were pictured. there's shannon. and when children came to the booth to get their faces painted, then the parent stachbtistachbt i standing there waiting would be told about these children who have died and the importance of vaccination and that kind of thing. we have a new mom. julia. how wonderful to be part of a flu mom group. but it's great that we all are here for one another. shoot. we'll learn her story pretty soon. >> there's a huge amount of parents who are just utterly

confused. and that's a big communication challenge when it comes to the vaccine. the question is does she have anything now? >> yeah, she does. >> vaccine hesitancy is something we observe to be on the rise, which is quite alarming. influenza is possibly preventible with a vaccine, that's great, but nobody uses it, that's not great. one of the most common misperceptions about the flu vaccine, say, you know, i'm healthy, i never get sick. the potential of me giving something to somebody that may be serious to them, even if it may not be serious to me at this moment. and i may very well sit in a subway next to somebody who has a very weak immune system. and they may not know it and i may not know it, but i may very

well give somebody the flu. so there's the question of the common good versus the individual good. if we want any effectiveness of a vaccine, we need to get vaccinated. the grea >> the great influenza of 1918, that virus was said to have gone around the world four times without an airplane. that's 100 years ago now. at the end of the great influenza, 50 million or 100 million have died. that's against a global population at the time less than 2/7th of what it is today. multiply 50 mill on or 100

million by 3, you're talking about a number of deaths that's catastrophic, a hit to our economy that's unimaginable. in 2006 i brought the top thinkers from all over the world together. the vast majority felt that in the next 20 years, 30 years, there will be a pandemic, and it will have the potential to bring humanity to its knees. >> new strains of influenza are already affecting birds in nearly 75 countries and the way we're interacting with the animal world is putting us at risk. we encroach on wet lands, so wild birds mix more frequently with domestic poultry, our food trade is completely globalized and our factories and farms are

growing in scope and size. >> with all influenza, there's a critical moment when a virus is circulating in one species, let's say birds, manages to mutate in a form that allows it to get into, say, pigs, and then from there to spread easily between people. we have seen this over and over, it's going on all the time. right at this moment. here's what a truly horrible worst-case scenario pandemic would look like. first there would be a jump from some animal species to humans. the first humans would be the people close to those animals. and then their families and the kids in the schools, and it would not be regionally confined for long at all. days, that's it. and let's assume that it kills

5% of the people it infects. well, 5% would be hundreds of millions of human beings. >> pandemic flu will soon reach this country. >> if you become sick while traveling, contact -- >> once the epidemic has really begun to spread, you can't even begin to imagine the scale of this. >> you want to be as far away from the city as possible. >> huge numbers of people that are not coming to work, and that includes jobs we consider essential for public safety, like the guys that turn water systems on and off, the police, the fire department. then people start blasting their conspiracy theories out about where this disease came from, who caused it, why is it here? you will see a whole wave of shortages of goods and services all over the world, the

stockouts of every single kind of drug, the overcrowding of hospitals, the overcrowding of the mortuaries, the sheer numbers of both sick and dying. what a really severe influenza pandemic would look like is something close to social collapse. >> when not effectively prepared as a world for a pandemic, we don't have effectiveness coordination and response, but the biggest thing is that the underground preparation and preparedness is full of holes. there's a pattern here of responding to an outbreak rather than investing in preparedness. preparedness is so much cheaper, so much more cost effective than

responding after the event has happened. >> major nations around the world currently spend 10 to 25 times less on biosecurity than they do on homeland security, in spite of the likelihood of an epidemic causing even greater loss of life. we are overdue for afternoon in za pandemic, a lesser influenza pandemic would likely kill up to 2 million people. and influenza pandemic like 1918 could kill 200 million people, more than the entire population of germany, great britain and spain combined. to prevent pandemics, we need to do a much better job of controlling outbreaks.

i think when a dart strikes a country, you do see that people care. >> people are dying, we have to do something about this, we have something in development so we'll accelerate. it, i think it was really necessary for people, companies to step up and try to do something about this, because it was obvious, i think, to, well to the experts that this is not going to be just this outbreak, there's going to be more. biggest lesson really was that

epidemics will come back, right? it will be ebola, it will be something else. but there will be another one. and so i think what the world has learned is that they have to be better prepared. i think you need the right players from the start. i think you need to have the public sector working very closely together with the private sector. we need to join forces, really u from the sport to make things happen very, very quick. i care. and i think, yeah, i mean many people care, i mean we saw many people there that -- many women that were going to sierra leone to help in the fight. that was amazing to see that response from the world towards

sierra leone. there's a huge sense of accomplishment when you do the right thing, when you see that what you do can potentially make a difference for those people. good morning. we're seeing few patients now. the staff are better prepared now to work. they're more trained. i think if we're this prepared before august or september, we will be better.

in december, we had 16, 17, patients admitted on the conf m confirmed ward, and 14 of the 17 will go home soon. hello, baby. are you all right? how are you doing today? so with time we got better. no sick or anything? no, you're ready to go today. how are you feeling? any vomiting? nothing. go home tomorrow. it's like a miracle, you see a patient and the patient is dying sick, and then two or three days onwards, the patient starts to regain strength, trying to grow and get stronger each day.

and then the most exciting thing is that you put the patient out of the ward and you remove the tyvek and the patient sees you. the patient knows dr. moses as saved a person, but doesn't know the person, and some of them start to cry. and i say, wow. it gives me joy. yeah. it gives me joy. ♪ ♪ ♪ . >> good morning. every time we are able to help one person to stay alive and

leave this hospital zone, they go home. now if this doesn't stop here, staying alive is a continuous challenge. so these certificates are so that you can go home and people in your community who are afraid to come around you thinking you still have ebola, give this to you, this is some evidence from the minister of health, that you were tested and treated and now you are cured. okay? on behalf of the ministry of health, this certificate says that you have successfully undergone care and treatment related to ebola virus disease and after post treatment assessment, you are now declared free of ebola. you have been examined and confirmed in a negative laboratory test in 11th day of

december, 2014. and it's signed by me on behalf of the minister of health. >> i want to present this certificate. emma. please talk to me. this is for you. take it from me now, baby. it's for you, yeah. >> when i see patients, i remember them. yeah. especially those that are sick that were really sick, i remember that. there's something in each individual body that makes that person survive and another person won't survive. because you see one patient is so sick and that patient lives, you see another patient who is not so sick and that patient

dies, you say why? what's the difference? i give them the same treatment, the same feeding, the same care. why?

>> when an outbreak catches hold, it affects every part of our lives. business and government, trust and freedom, equity and security. the fight against epidemic s ca only be won if each of us does our part, it turns out we're all the front line. >> i think it goes on your left side. >> what if that's not where i want to wear it? >> tell him i got it. >> i created a procedure so that when people look themselves in the eye -- >> it was in this hall, 52 years ago that my life was forever changed, i felt i had been drafted into a different kind of army, the fight for human rights. in 1980, smallpox was declared eradicated from the world and so far it's the only human disease

ever eliminated by a public campaign. can we stop hiv aids, sars and mers and never become a pandemic, i don't think it's hard or complicated, but we have the tools, and we know what to do, it's merely the application of public will, go out and change the world. >> one thing this outbreak has taught me is that to help people to really make an impact, you need to be more than one. i really would love to learn and plastic health system management. i believe that the health system can be better than what it is.

you know i'm going away, i'm going to a different country, for one whole year, but i will call you every day. you know papa loves you, he yes? also everybody needs to learn when it comes to health emergencies, until the entire world is safe, nowhere is safe. good morning. >> how are you? >> fine. >> good to see you. what keeps me awake at night now is that we will deliver on our promises to the people of west africa. that we will support this country to build the systems, to make sure that when there's another case of ebola, which will happen, that it doesn't give rise to a big epidemic. the time is gone that we lived

on islands or that we were protected. and there's no way to stop that. because fighting aids, or fighting the flu and sars in asia benefits people in europe and in north america. so we need to go beyond the boundaries of our own countries. >> the networks that connect us accelerate everything, the spread of ideas, conflict, people, and microbes, there is no running away. there is no wall high enough. >> what's absolutely missing, just not there, is trust. and so coming up with preparedness that looks like it could stand up to the microbes when an attack comes, it's really about each country

carrying their own weight, yes, we always need to be watching, vigilance is mempl innocent. >> the hallmark of the 21st century is that our world is simultaneously more connected and more fraught. epidemics are a test of who we are. we can use our connections for good, to make the world safer and healthier. or those connection also turn on us in an instant. >> we cannot just continue to be responding to every outbreak as it occurs. >> if we do not invest in prevention, we're setting ourselves up for help zem democraticses and pandemics that will cost both lives and money.

>> i can't some fatales say pandemics are inevitable so don't work it on it. pandemics aren't inevitable. outbreaks are inevitable, it's our option if we will be lazy, our it's option whether we will deny the risk, it's our option whether we will refuse to face the consequences. >> we have a chance to stop something that otherwise could be horrific, but it's going to take all of us.

. hello and welcome to this special post edition of "unseen enemy" and questions if the world is equipped to deal with it if it ever happens. we have the director of the film you just watched, dr. sanjay

gupta, our medical correspondent and dr. anthony facci. and the author of the book, why we're at risk. let's explain some terms, sanjay, there's outbreak, epidemic, pandemic, endemic. >> outbreak is usually when you see some sort of eruption of an infection that you wouldn't otherwise expect to see. so even if it's a single case of something that's brand-new, that could be an outbreak. epidemic is when something starts to spread rapidly among the population, pandemic is when it's spreading around the world. endemic is when it becomes sort of entrenched in a particular place, malaria for example, that started off in these first sort of stages but is now endemic within certain parts of africa. >> just in terms of risk, you say you can't prevent outbreaks,

you can't prevent the emergence of a new infectious agent, but you can prevent how it spreads? >> that's the whole point, microbes merge and re-emerge, there's nothing you can do about it, but you can prevent an outbreak from becoming a pandemic or an epidemic, with vaccine development, you can plenty that spread. people think, well, prevent an outbreak. you're just not going to do that. there will be emergence, for instance when we had ebola in west africa, it started off as a single case that then spread to a few, and because of a number of circumstances and missed communities, it just exploded in west africa. if the right public health measures had been taken early on, we would not have had an

epidemic in west africa. >> there had been isolated outbreaks in uganda, angola -- >> this of them actually, between 1976 and the current one, there's about two dozen of these outbreaks. >> this outbreak was very different and obviously affected a much greater number of people. >> it was a perfect storm, and the perfect storm was that you had three countries with porous borders, guinea wraps around the map of sierra leon. they had never before seen ebola or knew how to respond to it and other cultural things,a otherwise would be beautiful things, how you care for the sick, how you bury the dead, all that is sinner jasinner jazzed make it work. you put all of those things together and that's the perfect

storm. >> you actually started working on the film before ebola, how did ebola kind of change the -- >> we thought we were doing a thing about the past like sars and influenza and we were going to look at the future and suddenly the present interscreened. we wept to west africa and we were there for a couple of months and we were there and working on inflew wu weenza and zika happened. >> you were in west africa during the ebola crisis, i just want to play this for our viewers. >> reporter: it only takes a small amount of virus anywhere on your skin to cause an infection, and as i learned, no precaution is too small for the doctors who treat these patients. tim is one of the doctors without borders, he's from canada, he comes into these settings for weeks at a time. he is not married, he has no children, that would be a job

liability he tells me. multiple pairs of gloves and masks, the head is completely covered, a multi layered gown, boots, absolutely suffocating in the hot weather. >> it just shows the preparations, we're talking about are we pre-paired, that's one of the difficulties we're preparing. >> ebola was not particularly contagious, but it's highly infection, if you have a small cut on your hand, we all have them on our hands, you could potentially get the ebola virus in your blood stream. >> you said the worst problem is being unprepared. >> there's much larger issues to

worry about, including is there a health care system to deliver the goods to take care of people and to get diagnosed early. in countries where there's limited medical resources, it's one of those factors that allows for rapid spread of the disease, in an environment where it's very difficult to do anything about it, particularly at a time when we don't really have the vaccines yet, other than try doing contain the spread and treat people when they get sick. and put people in a bad situation. >> can you predict where the next hot spot is going to be? >> you know, you can't. you can keep your eye on something that's suspicious, right now as we speak, there's a virus, that's bird flu, thankfully it doesn't spread easily from human to human, so when you have enough cases it would evolve to do that.

so we're focusing very intently on areas in china, where we're having these bird flu infections. >> so much depends on where something like this happens, is it an area where there's a lot of air travel, is it a the way it spreads, unlike ebola, they could be sharing the virus for 24 hours before they know they are sick. when you a respiratory illness that's why it is dangerdangerou. >> you can see animals an humans coming in close contact but you could also have a circulating virus, something we have already seen in the world that undergoes a massive mutation, a reasso reassortme

reassortment. it becomes a novel virus, a new virus we have not been exfopose to and can cause this sort of pandemic flu. >> and they aren't isolated anymore. there is more and more international travel. even an outbraeng that occurs in a very remote village will pry grate to the capital. you go to a capitol with people that are infected and the capability of it being transmitted to lots and lots of people. those people leaving and going to other countries. >> and even animals that normally we might not come in contact with because the growth of populations that want exotic meats, the world is much smaller. >> which makes containment really difficult at this point. >> you talk about influenza. i think people don't think about the danger of influenza. it seems like everybody knows about the flu, people get shots for it.

>> and 36,000 people a year die from it. big deal. >> in the united states. >> it's fair to distinguish between seasonal flu and pandemic flu. seasonal flu mu tates a little bit every year. you are some protection against it. pandemic flu with highly lethal pandemic flu, it is mu tated so much that we don't have immunity to it. it effects babies more because they don't have immunity. that's part of the concern. >> and her case was just shocking. i mean within a week -- >> yeah. she was dead and her mother was doing mouth to mouth resuscitation to keep her alive, which is every parent's worst nightmare. there should be fmore awareness.

i doesn't always kill the immune compromised and elderly. we absolutely need to support the research to get to a universal flu vaccine. >> if she hadn't gotten a flu vaccine would it have made a difference? >> i think it would have. that's the issue. there is lot of reluctance to take immunizations in general. now we are insisting from a messaging that everybody needs to get the vaccine. i think all of us would agree needs to happen. >> you can't get the flu from a flu shot. i know everyone here knows that but it bears repeating. i hear it all of the time, the flu shot gave me the flu. you can't get it. it causes an immune response. your body may feel miserable far little bit. it is doing what it is supposed to do. it's not the flu.

that's one of those myths i think really makes a lot of people not get the shot. >> are we overdue for an influenza pandemic? can one say that? >> you can't. people say it occurred about every 20 years. pandemics, the only thing predictable is that it is unpredictable. we had the horrible one in 1918. we had another one in 1957 and another one in 1968 and one in 2009, the h1 n1. we have to have a different kind of preparedens and ness and we on a vaccine that would be effective against any it ration of flew. it is when it's a major clang or

shift in the flu. little changes are called drifts and big change called a shift. i think that's one of the most important goals in vaccine research that we can possibly have is to develop a universal flu vaccine. >> we are facing cutbacks at the worst possible moment. they are always called wake up up calls. they turn out to be not so much wake-up calls but more like snooze alarms. we kind of at some point hit that snooze button and drift back off. we do it with pandemics. it's the same sort of pattern. we are standing in the flood waters and then onto something else. i think that's a problem. you know, we really do need to focus on doing things that he thinks we need to do, which is

starting with universal vaccine for human kind really. >> what would it do? >> it would induce an immune response that would be protected against every form of influenza. i don't think we'll get a perfect universal flu vaccine. you can start off getting to the ultimate goal so you can give a vaccination once every five to ten years that would give you enough background protection that even when you encounter a brand new pandemic virus there would be enough with that particular vaccine that you would be able to protect people. that's the ultimate goal. >> it is extraordinary. you know, when you look at h hiv and how for many people where they have access to drugs it is a condition that people can live with as opposed to a death sentence.

>> well, the hiv development of drugs and treatment is an extraordinary success story of the relationship between fundamental research developing an intervention that's highly effective. i have been taking care of hiv infected individuals for the last 35 years. the first several years virtually all of my patients died. they would come in and we didn't know what the virus was and we didn't have therapy. now we have therapy. if you put them on a combination of three drugs you can look that person in the eye and say if they take their medications regularly they could live an additional 50 years. >> and if they take it regularly they could not pass on the virus. >> it's called treatment as prevention. you bring down to below detectable level. >> i don't think a lot of people understand that. they have done where one person

is positive and one person is negative. as far as i understand there is no cases of people transmitting -- >> if they take the medication it is almost impossible. you never want to say impossible. >> and hiv is also an example of it was an outbreak then an epidemic then a pandemic and now endemic. is that fair? it did go through all of those stages. >> what do you hope people come away with the film with if. >> i think i could have the flu and i could give it to her and i could kill her and i would never know. i never thought that before this. >> it's that simple. >> yeah. it's that simple. we can all make a difference. we need really good doctors. we need good governments and companies but it is also about what do i do? >> it is not just about the

technology and science but the rest of the system has to be in tact. we have to have a good health system globally. if this is clearly now a global challenge that we are all faces but if we don't have the public health, the right medical systems, the right ability and knowledge of how to communicate to people to have them comply these are kinks in the armory here. if we can't deliver it or have a health system to deliver it we won't be not as much progress as we thought we might have. it all fits together. i think it came across powerfully in her film. >> thanks for being with us. if you want to learn more about outbreaks go to cnn.com/unse cnn.com/unseenenemy.

you can explore other topics. that's it for us. thanks for watching. good evening. tonight everything we wanted to know but could not possibly know this time last night when crews missiles were flying. there is late word on what was and what was not hit. there is also troubling new reports about possible russian involvement and covering up the syrian attack that triggered this. also a new look at president, cabinet members being briefed about 9:15 last night in a makeshift information