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ByRobertF.Bukaty The Associated Press FORT KENT, MAINE Maine health authorities struggled Thursday to reach a com- promise with nurse Kaci Hickox that would require her to keep her distance from other people, in the na- tion's most closely watched clash between personal freedom and fear of Ebola. Hickox, 33, stepped out of her home in remote north- ern Maine for the second day in a row and went on a morning bike ride with her boyfriend, practically daring authorities to go to court to have her confined against her will, as they threatened to do for days. But by late afternoon, the legal showdown had yet to take place. Hickox, who returned to the U.S. last week from treating Ebola victims in West Africa as a volunteer with Doctors Without Bor- ders, has been under what Maine has called a volun- tary quarantine at her home in this town of 4,300 people. She has rebelled against the restrictions on her movements, saying that her rights are being violated and that she is no threat to others because she has no symptoms. She tested nega- tive last weekend for Ebola, though it can take days for the virus to reach detect- able levels. Her 21-day quarantine — the incubation period for the Ebola virus — is sched- uled to end on Nov. 10. Gov. Paul LePage said a scaled-down quaran- tine that was discussed by Hickox's lawyer and state attorneys would have al- lowed her to go for walks, runs and bicycle rides while preventing her from going into public places or com- ing within 3 feet of others. But around midday, LeP- age said that the hours of negotiations had gone no- where, and that he was pre- pared to use the full extent of his authority to protect the public. "I was ready and will- ing — and remain ready and willing — to reason- ably address the needs of health care workers meet- ing guidelines to assure the public health is protected," he said. Hickox stepped into the media glare when she re- turned from treating Ebola patients in Sierra Leone to become subject to a man- datory quarantine in New Jersey. After an uproar, she was released and traveled more than 600 miles to the small town close to the Ca- nadian border where she lives with her boyfriend. She said she is follow- ing the federal Centers for Disease Control and Pre- vention recommendation of daily monitoring for fe- ver and other signs of the disease. An unmarked state po- lice cruiser followed Hickox on her hour-long bike ride on trails near her home, but police could not take action to detain her with- out a court order signed by a judge. "I really hope that we can work things out amica- bly and continue to negoti- ate," she said. States have broad author- ity under long-established law to quarantine people to prevent the spread of dis- ease. But legal experts said there are differences here that could work in Hick- ox's favor in court: People infected with Ebola are not contagious until they have symptoms, and the virus is not spread through casual contact. In other developments: • Ebola fears infected a medical conference on the subject. Louisiana state health officials told thou- sands of doctors planning to attend a tropical-diseases meeting this weekend in New Orleans to stay away if they have been to certain African countries or have had contact with an Ebola patient in the last 21 days. • Liberia is making some progress in containing the outbreak, while Sierra Le- one is "in a crisis situa- tion which is going to get worse," the top anti-Ebola officials in the two coun- tries said. • The World Bank an- nounced it will give an ad- ditional $100 million to help bring in more foreign health workers. That raises the money it has given to the fight to $500 million. Some states like Maine, New York and New Jersey are going above and be- yond the CDC guidelines to require quarantines. So is the U.S military. President Barack Obama, the nation's top infectious- disease expert and human- itarian groups have warned that overly restrictive mea- sures could cripple the fight against the disease at its source by discouraging volunteers like Hickox from going to West Africa, where the outbreak has sickened more than 13,000 people and killed nearly 5,000 of them. "The volunteers are he- roes to the people they help, and they are heroes to our own countries. They should be treated like heroes when they return," Samantha Power, U.S. ambassador to the United Nations, said in Brussels. QUARANTINE MaineinstandoffwithnurseoverEbolasafeguards ROBERTF.BUKATY—THEASSOCIATEDPRESS A worker from the Centers for Disease Control leaves the home of nurse Kaci Hickox a er a brief visit on Thursday in Fort Kent, Maine. By Lindsey Tanner The Associated Press CHICAGO Fever?Headache? Muscle aches? Forget about Ebola — chances are astro- nomically higher that you have the flu or some other common bug. That message still hasn't reached many Americans, judging from stories ER doc- tors and nurses swapped this week at a Chicago medical conference. Misinformed pa- tients with Ebola-like symp- toms can take up time and resources in busy emergency rooms, and doctors fear the problem may worsen when flu season ramps up. That's one reason why doctors say this year it's es- pecially important for pa- tients to get their flu shots: Fewer flu cases could mean fewer Ebola false alarms. "The whole system gets bogged down, even if it's a false alarm," Dr. Kristi Koe- nig said during a break at the American College of Emergency Physicians' an- nual meeting. Since the first Ebola diag- nosis in the U.S., on Sept. 30 in a Liberian man treated in Dallas, doctors say they've had to reassure patients with many fears but none of the risk factors. Examples shared by those attending the meeting in- clude: • An Ohio patient who thought she had Ebola be- cause her husband had worked in Dallas, but not with the Ebola patient. • A New Mexico woman who sought ER testing for Ebola because she had vis- ited Africa two years ago. • Two Alabama patients who worried they were infected after traveling through an airport in At- lanta, the same city where Ebola patients were treated. Those Alabama patients had intestinal symptoms but no contact with Ebola patients nor recent travel to Ebola-plagued countries in West Africa, and they were sent home after doctors con- sulted with the federal Cen- ters for Disease Control and Prevention, said Dr. David Pigott, an emergency medi- cine specialist at the Univer- sity of Alabama at Birming- ham. Flu and other airborne diseases can be transmitted by indirect contact with in- fected people. By contrast, the only way to get Ebola is through direct contact with blood, vomit and other body fluids from Ebola patients, experts say. WhileEbolacanbequickly ruled out for many patients by asking about recent travel to West Africa and contact with Ebola patients, "there's still some concern about any- body with symptoms that could be Ebola because it's so much in the news right now," said Koenig, director of pub- lichealthpreparednessatthe University of California in Ir- vine. That means a patient with the flu could trigger a full- court press in the ER, includ- ing isolating the patient and ERstaffgrabbingthehazmat suits until Ebola is ruled out. Ebola was among hot top- ics at the meeting, and hun- dreds packed sessions on how to handle a disease they most likely will never have to treat. Only four people have been diagnosed with Ebola in the United States, and ex- perts doubt that Ebola will become widespread in this country. But if more Ebola cases do occur, getting vac- cinated against the flu now "would make the screening process a lot easier," said Dr. Daniel Bachmann, an emer- gency medicine physician at Ohio State University's Wexner Medical Center. So far, flu activity is low nationwide and only one death has been reported, in a child earlier this month. But unlike Ebola, flu con- tributes to thousands of U.S. deaths each year and many more hospitalizations. And unlike Ebola, there's a vac- cine to protect against the flu, recommended annually for adults, teensand children starting at 6 months of age. So when patients express fears about Ebola, Bach- mann tells them, "Go get your flu shot." HEALTH Amid widespread Ebola fears, doctors recommend getting a flu shot By Roxana Hegeman The Associated Press WICHITA, KAN. A small plane lost power after takeoff and crashed into a flight-training building while trying to return to a Kansas airport Thursday, killing four people, injur- ing five others and igniting a fire that sent up tower- ing plumes of black smoke that could be seen for miles around Wichita, officials and witnesses said. Three of the dead were inside the building when the plane crashed into it at the city's Mid-Continent Airport, and the fourth was found on the roof and is be- lieved to be the pilot, Wich- ita Fire Chief Ronald Black- well said Thursday after- noon. Five others were injured in the crash, and one was in serious condition at a hos- pital, Blackwell said. Offi- cials said that only one per- son was on board the plane and that everyone who was in the building had been accounted for. Identities of the victims were not imme- diately released. "We understand that this is a very difficult time, es- pecially for folks who have family members who are working out here and they don't know," Wichita Fire Marshal Brad Crisp said. The plane, identified as a twin-engine Beechcraft King Air, crashed into a building that FlightSafety International uses to train pilots to fly Cessna planes, company spokesman Steve Phillips said. The FAA said it crashed after losing en- gine power and trying to re- turn to the airport. It appeared to strike the top of the building and ig- nite what Blackwell de- scribed as a "horrific" fire. Jeff Papacek, 39, of Wich- ita, said he saw a "giant fire- ball" as he was heading to his engineering job at Lear- jet, which has a testing fa- cility at the airport. He said he didn't see the crash be- cause there were too many buildings in the way, but he said the plane caught his at- tention beforehand. "We are used to planes flying straight with the runway and this plane just didn't look like it was lined up and was way too low for the direction it was going," Papacek said, adding that he drove to the crash site to see what was happening and saw the building fire raging. WICHITA Plane crashes at Kansas airport; 4 dead MIKE HUTMACHE — THE WICHITA EAGLE Firefighters try to put out a fire at Mid-Continent Airport in Wichita, Kan., on Thursday shortly a er a small plane crashed into the building. By Lolita C. Baldor The Associated Press WASHINGTON The Pen- tagon is considering ways to bring the Sunni Arab tribes of Iraq's Anbar prov- ince more fully into the bat- tle against the Islamic State group, the top U.S. military officer said Thursday. Gen. Martin Dempsey, chairman of the Joint Chiefs of Staff, told reporters that expanding U.S. train-and- advise efforts to include the tribes is one of three key el- ements of a strategy de- signed to roll back IS fight- ers in northern and west- ern Iraq. The other elements are advising and assisting Iraqi government troops and creating so-called na- tional guard units as a sort of quasi-military force that must first gain legal ap- proval from the Iraqi gov- ernment. "You need all three of those eventually," Dempsey said. However, a condition for training and advising the tribes would be the will- ingness of the Iraqi govern- ment to arm them, he said. Speaking alongside Dempsey, Defense Secre- tary Chuck Hagel agreed that the tribes are an im- portant component of the strategy. "The Sunni tribes are going to have to be part of this," Hagel said. Enlisting the help of An- bar's tribes was critical to the success of U.S. efforts to stabilize Iraq in the lat- ter stages of the Iraq war in 2007-2008. Since that period, the tribal leaders have grown disillusioned with the Shiite-dominated government in Baghdad, although Washington has staked its hopes on a more inclusive approach to the Sunnis and Kurds by new Prime Minister Haidar al- Abadi. Dempsey said the U.S. strategy's first focus is on Iraqi government and Kurdish regional fighters. But the tribes could be an important complement to those. IRAQ US c on si de rs em po we ri ng S un ni t ri be s Select"Subscribe"tabinlowerrightcorner Complete information for automatic weekly delivery to your email inbox That's it! 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