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Newsroom/World View

NEWSROOM for September 20, 2000

Aired September 20, 2000 - 4:30 a.m. ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

ANNOUNCER: Seen in classrooms the world over, this is CNN NEWSROOM.

ANDY JORDAN, CO-HOST: Welcome to the show. I'm Andy Jordan.

RUDI BAKHTIAR, CO-HOST: And I'm Rudi Bakhtiar. We have something special planned for your Wednesday NEWSROOM.

JORDAN: We're headed "under the microscope" for a virus encounter. Here's the rundown.

BAKHTIAR: From E. coli to the common cold, today's show is a crash course in infectious disease.

JORDAN: "Business Desk" asks if normalized trade relations means a positive prognosis for U.S./Chinese relations.

BAKHTIAR: We're feeling no pain because "Worldview"'s hanging out on the beaches of Jamaica.

JORDAN: Be sure to take notes in top story because it's brain teaser time in "Chronicle." Good luck!

BAKHTIAR: In today's top story, waging war on microscopic enemies. Are we winning or losing the battle? From small pox, to malaria, to AIDS we focus on infectious disease. For some diseases, we've discovered the cures. For others, such as AIDS, the antidote is elusive.

Micro-organisms, or sub-microscopic germs such as viruses and bacteria, are among the agents of infectious disease.

Holly Firfer has more.

(BEGIN VIDEOTAPE)

RYAN BOZOF, EVAN'S BROTHER: This is the funeral.

HOLLY FIRFER, CNN CORRESPONDENT (voice-over): April 20th is a day Ryan Bozof will never forget. It's the day his brother, and best friend, died.

BOZOF: He was just a real enthusiastic kid, energetic, a real loving brother. He'd do anything for me and I'd do anything for him. He was my best friend, for all my life and I miss him greatly.

FIRFER: He would do anything, but he couldn't help save his life. His brother, Evan, a college junior, was a healthy athletic 20- year-old, star of his baseball team, studying to be an orthopedic surgeon. The picture of health and strength, Evan woke one morning with a headache. By that evening he was nauseous and vomiting. He rushed to the emergency room. He never left the hospital. Three weeks later he was dead.

LYNN BOZOF, EVAN'S MOTHER: They suspected he had bacterial meningitis.

FIRFER: An infectious disease that's spreading. In fact, according to the CDC, up to 300 students like Evan will contract meningitis this year alone, an increase of 50 percent since 1990.

DR. JAMES TURNER, UNIVERSITY OF VIRGINIA: Living in crowded conditions such as dormitories would appear to increase risk. College students, as you know, tend to be stressed out, stay up late at night, either partying or studying and that puts them at risk.

FIRFER: Meningitis, like many infectious diseases, was identified first in Africa and Asia and has worked its way around the globe.

DR. JEFFREY KOPLAN, CDC: The boundaries that we live in are no longer the counties that we are in or the neighboring cities, but they are as far away as different continents. That is due to shipping, due to air transport, due to travel by people coming here and our people going elsewhere.

FIRFER (on camera): We have known infectious diseases since recorded history. In 212 B.C. historians first noted an illness, that scientists believe was influenza, or the flu; 200 years later, Hippocrates documented the first influenza outbreak in history. Jump to 1300 and to China, where the deadly bubonic plague was festering.

(voice-over): At the time, China was a major trading post. Merchant ships from Asia traveled across the seas to Europe, carrying imports, exports and this deadly disease.

Within five years, the bubonic plague, also called the "Black Death," had spread throughout the European continent taking the lives of 25 million people and soon, one-third of all of Europe was gone, a turning point in medical history.

DR. SUE BINDER, CDC: It took months to years to spread across the world. Today an epidemic could potentially spread in days to weeks.

FIRFER: Throughout the centuries, history has continued to record the battles against infectious disease. In fact, your great grandparents might have remembered 1918, when the flu killed more people than World War I. Your parents might even recall the 1968 Hong Kong flu epidemic, which claimed 700,000 lives worldwide. But we haven't been sitting back and watching nature take over. Armies of doctors and scientists have marched into labs to develop vaccines and antibiotics to fight these deadly diseases.

A great example is one of the most remarkable medical discoveries of our time. It was 1921, polio, a virus that attacks the nervous system and leaves its victims paralyzed, was racing through America, affecting young and old; even one of our presidents, Franklin Delano Roosevelt.

Then, a breakthrough. In 1952, Jonas Salk created the polio vaccine. And now, today, in the Western world, it is practically non- existent. But scientists warn, it is just a plane ride away.

DR. DAVID HEYMAN, WORLD HEALTH ORGANIZATION: The only infectious disease that has really been wiped out has been small pox. Through a global effort between 1967 and 1980, the vaccine that was very effective, was used effectively and the disease is now eradicated from the world.

FIRFER (on camera): As quickly as we stop some diseases, new ones develop. In the past 20 years, 30 new infectious agents have been identified.

BINDER: There are a lot of reasons that infectious diseases emerge, some of them relate to things that we do, and ways that we alter the ecology around the world so that we change the habitats in which organisms are living.

FIRFER (voice-over): In 1999, 65-year-old Robert Benson (ph) learned that the hard way. After a month in the hospital, with a 105 degree temperature, and two weeks on a respirator, doctors couldn't figure out what was wrong with him.

UNIDENTIFIED MALE: We went to Africa, you know, several months ago, and they thought it might have be a latent case of malaria.

FIRFER: Turns out, Robert was suffering from West Nile virus, an entirely new strain of disease for the Western Hemisphere, working its way across America.

DR. BETH LEVINE, COLUMBIA UNIVERSITY: We don't know exactly what this strain is.

FIRFER: Childhood immunizations have effectively protected children in the U.S., Europe and parts of Asia from diseases like measles, mumps, and whooping cough, among others. But just when scientists began to feel triumphant over these infectious diseases in the industrialized world.

DR. DONALD GAMEN, HOWARD HUGHES MEDICAL INSTITUTE: Around 1981- 82 a new disease arrived virtually simultaneously in America, in Europe and throughout Africa. A terrifying disease characterized by immune deficiency, opportunistic infection, and even tumors occurring in young men. FIRFER: Doctors realized that people, no matter who, how healthy or where they lived, were not safe. There was a new disease, one they knew very little about, and one they could not stop from spreading.

(BEGIN VIDEO CLIP)

MAGIC JOHNSON: Because of the HIV virus that I have obtained, I will have to retire from the Lakers.

(END VIDEO CLIP)

FIRFER: Today, doctors know more about AIDS, but they still do not know how to stop it. Although messages of healthy living have helped slow the progression of the disease in the U.S. and Europe, AIDS has already left more than 10 million orphans in Africa behind.

GAMEN: We can never get away from infectious disease. We can triumph over individual infections diseases, but the concept that we are going to free of infection, as a species, is a ridiculous one.

FIRFER: Most scientists say we are actually as vulnerable as those who lived in the 14th century. They predict the future.

DR. STEVEN MOSTOW, UNIVERSITY OF COLORADO: We are very worried that we'll have what's known as a worldwide pandemic of influenza that will effect, probably, 40 percent of the world's population and could lead to epidemics of mortality that occurred in 1918.

FIRFER: But experts can't predict exactly when this, or other disease outbreaks might occur. They sum up the problem this way: The clock is ticking, but we don't know what time it is.

That is why scientists are constantly working on new vaccines, and antibiotics to protect us wherever we are.

(END VIDEOTAPE)

JORDAN: Well, as scientists work to treat infectious diseases, they also try to understand how they evolve. Next, in our look at the germ world, the difference between a virus and bacteria, and how they're transmitted. To do that, a little detective work is in order.

(BEGIN VIDEOTAPE)

FIRFER (on camera): Hello, I'm Holly Firfer, from CNN's medical unit, and I need your help. About 30 local high school students got sick after eating lunch yesterday. I need to figure out what happened.

Can you help me get to the bottom of this? This is your mission if you should chose to accept it.

(voice-over): To solve our mystery, let me give you the facts. About 6:00 p.m. yesterday, 20 students complained of stomach cramps, diarrhea and some were vomiting. About 10 more said they felt like they had a fever and an upset stomach. All 30 of them ate lunch in the cafeteria that day. By this morning, many of them were taken to the hospital.

Doctors say, it's an infectious disease. What happened?

Now, to start our mission, there are some things you need to know. Infectious diseases can be spread through the air, by direct skin contact, sexually, through insects, food or water.

Let me give you an example, You're playing hackysack, the hackysack is a germ, you pass it over to your friend, and now he plays, and passes it over to another friend. All three of you have touched the germ, really the hackysack, but now all of you have been exposed and infected. It can be that easy.

DR. BRETT FINLAY, HOWARD HUGHES MEDICAL INSTITUTE: In North America, United States and Canada, infectious diseases are the third leading cause of death.

FIRFER: It is the number-one killer throughout the rest of the world. This year, it's estimated that 17 million people will die from an infectious disease. According to the World Health Organization, every three seconds a child dies.

(on camera): So, as you can see, infectious diseases can be deadly, and easily transmitted. So, I've enlisted the help of some experts, folks who track disease outbreaks, like the one we see with our students, to see if we can crack this case.

(voice-over): First off, we need to do some laboratory testing to figure out what we are dealing with.

BINDER: Make sure that the appropriate specimens were being collected, as people were coming to the hospital, because a lot of times we can make a diagnosis on a sample of blood or a sample of stool.

FIRFER: There are two main types of germs that cause most infections, viruses and bacteria. Viruses cause colds and flu, most coughs, and sore throats. They are also responsible for causing chickenpox, herpes, hepatitis, measles and AIDS.

Bacteria can cause ear infections, some sinus infections, and strep throat, as well as salmonella, E. coli, tuberculosis, gonorrhea, and typhoid fever.

(on camera): Well, our labs tests are back and the scientists tell us that our students were exposed to a bacteria called E. coli 0157.H7. This is important to know.

DR. DAVID BELL, CDC: When we have illnesses like the cold, like colds and the flu, viral illnesses, antibiotics offer no benefit for these illnesses.

FIRFER (voice-over): For bacterial illnesses, antibiotics can work. So at least our students can get treatment. Our case is going to be tough, because, believe it or not, our bodies are covered with bacteria or microbes and they are literally everywhere. Scientists say, we are actually more microbial than human. Microbes outnumber human cells on our body 10-1. And they can multiply very quickly.

DR. ANTHONY FAUCI, NATIONAL INST. OF HEALTH: Unlike humans, which have generations measured in 15 to 20 to 25 years, microbes do that 100s of times over a period of days and weeks, and thousands of times over weeks to months. So they can really adapt themselves very, very, very easily.

FIRFER: Not all of these microbes are dangerous, in fact, many of them help us to stay healthy. Some aid in digestion, some produce vitamins to assist our growth, and some actually protect against pathogens or the bad bacteria trying to invade our bodies.

BINDER: To paraphrase Madonna, we might say that were living in a bacterial world, and a fungal world, and a viral world, and a parasitic world. We have organisms living around us, on us and in us.

FIRFER: Get this, in our mouths alone, there can be up to 300 pathogens. So these bacteria we carry can actually help prevent those pathogens from causing cavities.

DR. DAVID HEYMAN, WORLD HEALTH ORGANIZATION: Some bacteria cause disease, but sometimes, not always. They pick on people that are sick, if they have weaker immune systems, for example. If they are young, if they are old, if they are starved. Those are the people that are most susceptible to bacterial diseases.

FIRFER: The most common infectious diseases worldwide are pneumonia, tuberculosis, diarrheal diseases, malaria and HIV. But since we know our case involves bacteria, we can narrow it down. Now, comes deductive reasoning.

BINDER: We would be taking the information about the foods that might have been served that day and putting it into a questionnaire format, and then asking everybody who was sick what foods they ate.

FIRFER (on camera): The experts say, after talking to all of our students, they found out they all had hamburger for lunch.

(voice-over): Oftentimes food or water can become contaminated with dangerous bacteria like E. coli 0157.H7, or salmonella. If food is not cooked or water not chlorinated properly, these bacteria will survive, and end up making you sick.

There are other reasons infectious diseases reach so many.

HEYMAN: We are going deeper into jungles, where diseases like yellow fever are present, which then enter into human populations. We're changing our habits in food preparation, and in so doing, we let infectious agents pass through, such as happened in mad cow disease.

FIRFER: You can hop on a plane and within 24 hours, be on the other side of the world. With global travel, diseases are being spread to every corner of the Earth. BINDER: For example, we are used, now, to walking into a grocery store, and we expect to see mangos and papayas and kiwis, no matter what time of year it is. These aren't coming from the United States. We no longer have our local farmer providing us with produce, and if these are contaminated with organisms that are endemic, or very, very common in these other countries; we are eating them.

FIRFER: I think we are getting close to solving our case. Let's revisit our facts, 30 people are sick. Symptoms are stomach cramps, diarrhea, vomiting and fever. They all were sick after eating the same meal, at the same place, at the same time.

After lab tests, our scientists tell us it is a food borne bacteria, called E. coli 0157.H7, which we know can multiply thousands of times and if it is not killed, can spread quickly.

Can you figure out what has happened?

BINDER: That really implies that there was a problem at the school, and how the hamburger meat was handled, how the food was prepared, or something related to service.

FIRFER (on camera): Did you solve the mystery and complete the mission? If so, we might be coming to you, future scientists, to track all our infectious disease outbreaks. Well done all and thanks.

(END VIDEOTAPE)

JORDAN: Hang tight, there's more to come. Until then, see if you can answer this quiz question: "If I feel like I have a cold, I should insist my doctor prescribe antibiotics?" True or false? The answer's coming up in "Chronicle."

BAKHTIAR: On to other news in our "Business Desk." Today, a major coup for proponents of improved trade relations between the United States and China. The Senate has passed permanent normal trade relations.

Congress has had to approve China's trade status annually since 1979. U.S. President Clinton is expected to sign the deal soon.

(BEGIN VIDEO CLIP)

WILLIAM J. CLINTON, PRESIDENT OF THE UNITED STATES: In return for normal trade relations, the same terms of trade we offer now to more than 130 other countries, China will open its markets to American products from wheat to cars to consulting services.

(END VIDEO CLIP)

BAKHTIAR: One business with a close eye on China: passenger and freight airlines. They're competing to be the one U.S. carrier Beijing allows 10 round-trip flights per week to China starting in April. The U.S. Transportation Department will decide which one in the next few weeks. JORDAN: As China celebrates the Senate vote, business people prepare to travel to that Asian nation. But business is only one reason for travel. In "Worldview," we spotlight another: soaking up the culture of a country. We spin the globe and land in the Caribbean.

SHELLEY WALCOTT, CO-HOST: Time to revisit Jamaica, an island nation in the West Indies. More than 90 percent of its people have black African or mixed black African and European roots. More than 80 percent are Christians. Jamaica's capital is Kingston, a commercial seaport with many old buildings. But since it was founded in 1692, it's suffered from fires, hurricanes and earthquakes.

Despite these setbacks, Jamaica is a haven for tourists and it offers visitors an opportunity to meet its people up close.

Carolyn O'Neil explains.

(BEGIN VIDEOTAPE)

CAROLYN O'NEIL, CNN CORRESPONDENT (voice-over): Out of many one people is the national motto and describes this melting pot of world cultures from Africa, Europe, India and China, which has become today's Jamaica. And while agriculture is still key on this, the third largest island in the Caribbean, the Jamaican economy bustles with the business of tourism.

The island's beauty is the lure, but there's a lot to discover beyond the resorts.

BRIAN DREW, GRAND LIDO NEGRIL RESORT: We promote that quite a bit because I think you're missing Jamaica if you don't have an opportunity to see all its beauty because there's so many activities here in Jamaica.

O'NEIL: This party spirit, from limbo contests to cliff diving has built Jamaica's reputation as one of the places to play and hang with the friendly locals.

Sensible advice for any traveler in search of local flavor, however, is to be careful when and where you choose to interact with strangers in any country. That's one of the reasons the Jamaica Tourist Board created the Meet The People program.

IVA: Hi.

O'NEIL (on camera): Hi.

IVA: Welcome to our home.

O'NEIL: Thank you. I'm Carolyn O'Neil.

IVA: I'm Iva.

O'NEIL (voice-over): On this night, we joined a Meet The People party at Iva Walter's home in Ocho Rios. IVA: I think it's a fine example of really meeting Jamaicans one to one, right? Like here this evening I would have invited some other Jamaicans and my sister is here from London visiting with me as well. So it's just a nice way of interacting with local people.

O'NEIL: And while listening to the steel drum beat of island music, guests dined on traditional Jamaican food such as jerk chicken, aki (ph) and salt fish, even curried goat.

(on camera): Oh my gosh, this is quite a spread.

(voice-over): All served under a brilliant Caribbean moon.

UNIDENTIFIED JAMAICAN: You only get that moon in Jamaica, only.

O'NEIL: Meet The People began over two decades ago, a free program matching local volunteers with visitors.

IVA: Jamaicans love to entertain, you know? And we love to invite people home and this is one way of doing it.

O'NEIL: This honeymoon couple from Ohio found out about Meet The People on the Jamaica Tourist Board's Web site.

(on camera): Why did that sound like something you really wanted to do on your honeymoon?

UNIDENTIFIED TOURIST: Well, one thing, when you go out of town, it's different you staying at a resort. But you get a chance to, I wanted to actually go and be nosy, go see how other people live other than myself.

IVA: And when somebody calls and we tend to match up people of mutual interests, you know, because people like to know more about Jamaica. They want to know more about our culture, our history, our people, everything.

UNIDENTIFIED TOURIST: And what I thought about it was really wonderful, you know, to get out to meet people, to meet somebody else other than where you're from, you know? I mean it's wonderful.

O'NEIL: Lasting friendships have developed through the program and it certainly provides a valuable view of the real Jamaica.

UNIDENTIFIED TOURIST: Thank you very much. Bye-bye.

O'NEIL: Or as Jamaicans say to a departing friend, walk good so you can come back soon to visit again.

(END VIDEOTAPE)

BAKHTIAR: We're back to infectious diseases in "Chronicle." By now, you pretty much get the picture that there's a lot we know and a lot we don't. Let's test you're infectious disease I.Q. True or false? "If I feel like I have a cold, should I insist my doctor prescribe antibiotics?" We turn to Holly Firfer again for the answer.

(BEGIN VIDEOTAPE)

FIRFER (voice-over): When he was 11 years old, Damion Heersink (ph) ate an undercooked hamburger that was tainted with the bacteria E. coli 0157.H7. He almost died.

Four years ago, Haylee Bernstein (ph) had a salad for lunch and ended up in the hospital for 14 weeks. She, too, had been infected by the E. coli bacteria. On average, 20,000 Americans die each year from complications related to the flu. In Africa, one-fourth of all pregnant women are HIV positive. Of those, more than 25 percent will pass on the virus to their children.

Damion and Haylee didn't have to get sick. People don't need to die from the flu or the AIDS virus. All of these situations are preventable.

(on camera): With just one ounce of effort, prevention can keep you, and those around you safe. So, let's see how much you know about staying healthy. Ready to take a quiz?

OK, question number one: If I feel like I have a cold, I should insist my doctor prescribe antibiotics? True or false?

Well, the answer is false.

DR. HARRY KEYSERLING, PEDIATRICIAN: Most colds are due to viral infections and antibiotics have no benefit at all in that situation.

FIRFER: Doctors add, each time you take an antibiotic bacteria are killed. And if you use an antibiotic unnecessarily, the bacteria can mutate and learn to outsmart the drugs and the next time you really might need those drugs they won't work.

Number two: When I feel better, I don't need to take any more medication, like antibiotics? True or false?

KEYSERLING: That's false. It's really important, even though you feel better after a few days, to complete the entire course of therapy and that is so the infection won't come back.

FIRFER: Moving on: If I find a dead animal, since it is dead, I can't catch a disease from it? True or false? The answer is false.

KEYSERLING: Often animals that have infections may die and you could become infected just by touching the animal.

FIRFER: Staying in the animal kingdom, most of you have heard that animals foaming at the mouth could be infected with rabies. If a wild animal is not foaming at the mouth, well, then it is not dangerous to me. True or false?

KEYSERLING: That's false. A wild animal doesn't have to be foaming at the mouth to have rabies. It is not a good idea to try to pet a wild animal.

FIRFER: How many people have been infected with HIV worldwide? is it 4 million, 10 million or 42 million?

KEYSERLING: The answer to that would be about 42 million, and most of the disease is in countries that are developing, particularly in Africa and in Southeast Asia.

FIRFER: Do you know what the number-one global killer is? is it heart disease, infectious disease or cancer?

KEYSERLING: The number-one killer in the world is infectious disease. The two very common worldwide problems are malaria, which we don't see in the United States, and this particularly is a problem for young children, and tuberculosis for adults.

FIRFER: Here's another: I don't need to get any more immunizations if I had them when I was a baby? True or false? Sorry everyone, the answer is false. There is no outgrowing shots.

KEYSERLING: We need to have boosters against diphtheria, and tetanus about every 10 years.

FIRFER: Doctors also recommend a yearly flu shot, and for college kids an immunization for meningitis.

OK, let's get to a popular topic, food. To properly defrost my hamburger meat I should: A) put in the refrigerator; B) put it in the microwave; C) set it out on the counter?

Well, this was a trick question, the answers are A and B.

KEYSERLING: The problem about setting it out on the counter is that if the hamburger meat is contaminated, the bacteria, as it gets to room temperature, the bacteria start growing and can taint the meat.

FIRFER: Now, before handling any food you should: A) rinse your hands in warm water; B) scrub your hands with soap and warm water; or C) wash my hands?

The answer is B.

KEYSERLING: If your hands are not clean, you could contaminate the food. But it is actually even more important to wash your hands after you finish preparing the food.

FIRFER: This is so you don't contaminate other foods, especially those foods that don't get cooked and where bacteria wouldn't be killed.

Time to make the burgers, but how much do they need to be cooked: to 120 degrees, to 165 degrees, or if it looks cooked it is fine?

KEYSERLING: One hundred and sixty-five degrees would be the right answer. You really shouldn't eat hamburgers that are raw or medium rare.

FIRFER: Those burgers could have bacteria on the inside that wasn't killed. So be sure that it's not pink in the middle and the juices run clear.

O.K., the last question: Which of the following is safe to eat, raw cookie dough, pancake or waffle batter, or sunny side up eggs?

Well, guess what, none of those are safe, sorry!

KEYSERLING: All those foods contain eggs, so we can never really be sure that the eggs weren't be contaminated with salmonellas is one of the bacteria that causes problems.

FIRFER: So how'd you do? Did you get all of the answers correct? If not, now you know.

(END VIDEOTAPE)

JORDAN: Well, I don't know about you, but I am going to go straight home and I am going to gargle and wash my hands.

BAKHTIAR: Wash your hands and wash your hands, wash your hands. And that does it for us.

JORDAN: See you back here tomorrow.

BAKHTIAR: Bye.

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