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HOUSE CALL WITH DR. SANJAY GUPTA

Flu Season Surprises

Aired January 29, 2005 - 08:30   ET

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


TONY HARRIS, CNN ANCHOR: Two bomb attacks killed eight people this morning in the Kurdish town of Khanaqin. Final preparations are being made for the election with the polls scheduled to open at 11 p.m. Eastern time. The latest security measure is the closure of bridges in Baghdad.
Snow, sleet and freezing rain zap the southeast with smash-ups blocking Atlanta area expressways and icy runways delaying flights. It could get worse before it gets better. Power outages are expected as the ice brings down tree limbs and electrical lines.

Yet another conservative commentator has been paid to help implement Bush administration programs. The Department of Health and Human Services said Mike McManus received $10,000 to train counselors for its marriage initiative. McManus has yet to comment. Conservative pundits Armstrong Williams and Maggie Gallagher have admitted accepting government money.

I'm Tony Harris in Atlanta. HOUSECALL begins right now.

SANJAY GUPTA, HOST: Good morning, and welcome to HOUSECALL. Checking medical headlines, researchers found the avian flu can be spread between humans. The avian or bird flu is typically passed from infected birds to humans, but investigators worry the deadly virus could mutate and begin passing more easily from person-to-person. We're going to talk more about that later in the show.

Also obese moms often make for obese kids. A new study finds the children of overweight mothers are 15 times more likely to be obese than children of lean moms. These signs of kids becoming overweight start as early as age four.

And we know baked is generally considered healthier than fried. But when it comes to your risk of stroke, it can make a real difference. A new study finds eating broiled or baked fish lowers the risk of eskemic (ph) stroke by 28 percent. But get this. Eating fried fish boosts your risk by more than 35 percent.

Now back to our top story. We're heading into the peak of flu season. With all the dire warnings of no vaccines and now the news about surpluses, this has been a flu season of many surprises.

Christy Feig has the latest number. And yes, they may surprise you.

(BEGIN VIDEOTAPE) CHRISTY FEIG, CNN MEDICAL CORRESPONDENT (voice-over): Just several months ago, a shortage of flu vaccine left many people unable to get a shot at all and those at high risk for the flu waiting in lines for hours for their vaccines.

UNIDENTIFIED FEMALE: I'm almost 400th in line.

UNIDENTIFIED FEMALE: If you can't get a ticket, you don't get a shot.

FEIG: This fall, the CDC was asking everyone to save the available vaccines for those at highest risk for the flu. But the government says many of those who fell in those groups didn't even try to get a vaccine, because they didn't think there would be any available.

So now instead of a shortage, there's an abundance, a fact that has at least 25 states now offering the vaccine to anyone who wants it. And now the CDC is changing the national recommendations.

ANTHONY FAUCI, DR., NAT'L INSTITUTES OF HEALTH: Before it was 65 and over. Now they're saying if you're 50 to 64, you should wind up getting vaccinated because we have doses now that are not being used.

FEIG: Although experts say this flu season has been mild so far, flu cases have been reported in every state with about 10 states reporting widespread activity. The flu season generally peaks in February, so experts are recommending people check with their doctors again for flu shots.

Christy Feig, CNN, Washington.

(END VIDEOTAPE)

GUPTA: Thanks, Christy.

And it's worth pointing out that while most young healthy people get through the flu season without any problems, more than 200,000 people are hospitalized and about 36,000 Americans die every year due to complications from the flu. And today, we've got the authority on the flu and flu vaccines here with us. The director of the Centers for Disease Control and Prevention, Dr. Julie Gerberding.

Welcome.

JULIE GERBERDING, DIR., CENTERS FOR DISEASE CTRL.: Thank you.

GUPTA: I know you're very busy, so thank you for taking some time for us.

GERBERDING: We're happy to be here.

GUPTA: How's it been going for you? Flu season busy, not that busy for you?

GERBERDING: You know, this has been a challenging time for everyone, including the people who had trouble getting flu vaccine. Though, we've had to deal with a national shortage of vaccine, and at the same time, we've got some locations that have too much vaccine and other locations where people are still looking for it.

GUPTA: And just this week. you announced that you're dropping the restrictions on several states around the country. Why is this happening now?

GERBERDING: Well, what's going on is that the demand for flu vaccine is very variable. And we've got areas where the people who really needed to get vaccines didn't step up to the plate or couldn't find it. So we still have a lot of very high risk people who haven't been vaccinated, but their demand has gone down as maybe their frustration with trying to get doses of flu vaccine has gone up.

GUPTA: I mean, is it simple as sort of flying some flu vaccine from one state to another to try and meet the demands in certain states where there's too much in others?

GERBERDING: Well, it isn't quite that simple, but we have done some of that in states that had too much. They did share with states where they were still lacking.

But when you get down to the level of the doctor in the clinic, sometimes it's very difficult to get the exact amount of vaccine to that particular doctor.

One of the things we did today at CDC was to make the supply of that vaccine left at the manufacturer available to providers who can purchase vaccine. And if they end up not using it, they can return it with a refund. So this can allow individual doctors to reach out. They don't have to go through the health departments.

GUPTA: Right.

GERBERDING: They can just get it themselves.

GUPTA: You know, a lot of people sort of think as the flu vaccine. And they don't think it's that big a deal. It's not that hard to make. This year, obviously, a lot of people paying more attention to it. Should people have known earlier that they weren't going to have enough flu vaccine, even as early as the summer or fall of this past year?

GERBERDING: You know, we always say flu is unpredictable, but flu vaccine supply is also unpredictable. And we started out the year very hopeful that we would have the highest amount of doses ever. And we ended up losing about half of that. So once we knew that we weren't going to have the doses, we had to make the best use of the supply that we did have. And that's been challenging.

GUPTA: A lot of people say it's not profitable to make the flu vaccine. American companies don't want to get involved. Why is that? Is it a financial issue?

GERBERDING: Well, of course, there is a financial component to it. But you know, making flu vaccine is really tricky because we make it in eggs. And you start with an egg, which is not sterile. And you have to end up with a vaccine product that's completely safe and available for people.

So many things can go wrong in that process that the manufacturers take on a lot of risk. And that's what happened with Chiron this year. They weren't able to get their vaccine product cleaned up from those eggs.

GUPTA: Obviously, it's a huge problem if you can't get enough flu vaccine. Does the Centers for Disease Control or other parts of the government do anything to incentivize companies to make the flu vaccine to offset their costs to make it easier to get the vaccine to the people?

GERBERDING: Yes, but we do some things to help. And we will be taking more steps in the future. One of the things we do is we buy a stockpile of vaccine so that if we have a shortage, we have some in reserve.

And that's what we're using right now for these last doses this year. But we also will be working more aggressively with the manufacturers to try to modernize the production. Get away from this egg process and get to something...

GUPTA: Yes.

GERBERDING: ...that is a more modern approach.

GUPTA: How are we going to do this year? It's all - you know, we're sort of at the end of January now. What's your prediction for the rest of the year?

GERBERDING: Flu's unpredictable. And I can't tell you yet if we peaked or not, but flu is out there. We've got ten states with widespread activity. Lots of people are at risk. It's not too late to get vaccinated. And we really want people to keep looking for vaccine, to contact the providers. And we'll also be notifying providers that they can get the vaccine from the manufacturer.

GUPTA: We're going to talk more about that. We're getting lots of good information from the woman who's in charge of the CDC. Dr. Gerberding will be answering your questions about the flu when HOUSECALL returns. Stay with us.

UNIDENTIFIED FEMALE: How can you protect yourself and your children from getting the flu? Some easy to follow steps that could save you from feeling miserable.

Plus...

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: She said it was so bad that many of the houses had the caskets lined up on the porch.

(END VIDEO CLIP)

UNIDENTIFIED FEMALE: Surviving the 1918 flu outbreak. Could it happen again? That's coming up.

But first, take today's daily dose quiz. How long is someone with the flu contagious? That answer after the break.

(COMMERCIAL BREAK)

UNIDENTIFIED FEMALE: Checking the daily dose quiz, we asked how long is someone with the flu contagious? The answer is you can pass along the virus one day before you start sniffling and sneezing and continue for seven days after you start showing symptoms.

GUPTA: So the message there is if you're not feeling well, stay home. You'll feel better faster and not spread your germs to your friends and co-workers.

We're talking about the flu this morning. Lots of people get confused about whether they have the flu or just a bad cold or another infection.

With the flu, you almost always have a fever and a headache. And sometimes these are rare with colds. You may also feel very tired, have aches and pains. While these can happen with colds, they're usually more pronounced with the flu.

We're talking about battling the flu and getting that all important flu vaccine with Dr. Julie Gerberding. She's the director of the Centers for Disease Control and Prevention.

Thanks again for being with us. Lots of people very curious about this. People pay more attention to the flu this year probably than in a long time. Lots of e-mails coming in.

Let's get to one now. This is from Kim in Missouri. "Flu shots have just become available to the general public in my county. Is it too late to have a shot?"

GERBERDING: It's absolutely not too late. And we don't know when flu is going to peak this year. And there's still time to get vaccinated. We've got a lot of people who need to get vaccinated.

GUPTA: Now is there ever a time when it's too late?

GERBERDING: Well, once the season is over, it's too late because we anticipate there will be a new virus the next year. So the best time to get it is before it arrives, but even if it's present and you haven't gotten it yet, you can still get protected from the vaccine.

GUPTA: And obviously, a lot of people asking these questions because there was concerns about not having enough flu vaccine. You know, Chiron wasn't able to produce for enough - for the flu vaccine this year. What is the plan for next year? Is Chiron going to be asked to do this again? Is there another company sort of in the wings that will produce the flu vaccine? GERBERDING: You know, we have some uncertainty about whether Chiron will be ale to get their production up online. And even if they do, how much they can produce.

So we're planning with the assumption that we won't necessarily have the full supply from Chiron. So we'll probably be starting the year out with more restricted emphasis on the high priority groups. And of course, in the meantime, we're going to be shopping internationally to try to get as many doses of vaccine lined up from other markets as we can.

GUPTA: Does that scare you? I mean, to basically say already next year we know that we're going to start a start with some restrictions on who can get the flu vaccine? Because the message always is go get your flu shot. But you're saying now obviously in January that for next year, may not have enough.

GERBERDING: Well, we would like to have a dose for everyone. And we don't think we're going to be in that situation next year, but we do know that people are incredibly cooperative.

The folks who really need it are those in the high priority groups because they get the serious complications and, of course, kids between the ages of 6 and 23 months. So we -- by planning ahead and getting those people targeted out the starting gate will get pretty close to getting the kind of coverage for those groups that we'd like to see.

The people who are otherwise healthy, of course, still have the flu mist options, the nasal vaccine. And I know that manufacturer is going to work on making sure they've maximized their production. But we're really going to have to get started on the right track of focusing on the people who need it the most.

GUPTA: Right. And you just mentioned children. That takes us right to another e-mail from a concerned mom in Missouri. Jamie writes, "I have a nine-month old son. His pediatrician's office told me they will not give him a flu shot because he does not have any pre- existing health problems. I thought all children, ages 6-23 months, needed a shot. How do I protect my son?"

And you know, Dr. Gerberding, obviously we talked a lot on CNN and you do about the requirements, but this is a examine of a 9-month- old child whose doctor is telling them you don't meet the requirements.

GERBERDING: Well, the CDC recommendation is that all children between the ages of 6 and 23 months get the flu vaccine. This is the first year that recommendation was made. And not all the providers may have gotten the word because in the past, it was more of an optional situation.

GUPTA: Yes.

GERBERDING: But the reason for that is not so much the kinds of complications that seniors get, but we know kids with flu get hospitalized. And some kids with flu do get very sick and die. By vaccinating them at this age, you can keep them out of the hospital and really reduce some of the complications.

GUPTA: Jamie may need to tell her pediatrician that. Remind your pediatrician of the guidelines. Everyone at home, don't go away. More HOUSECALL coming up after the break.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: We believe we are closer to a pandemic now than we have ever been in the last 36 years.

(END VIDEO CLIP)

UNIDENTIFIED FEMALE: Could another major flu outbreak happen? You might be surprised by the answer.

But first, more of this week's medical headlines in the pulse.

(BEGIN VIDEOTAPE)

FEIG (voice-over): Obesity and weight gain may put you at a risk for developing kidney stones, according to a new study in the Journal of the American Medical Association. The study found men over 220 pounds had a 44 percent increased risk for stones. And women at the same weight had about a 90 percent increase.

And a newly published study finds the popular arthritis drug Vioxx may have caused up to 140,000 cases of coronary heart disease in the U.S. FDA researcher and whistleblower David Graham led the research, which found that Vioxx users had a 34 percent increased risk of heart disease, compared to users of other arthritis drugs.

Merck, the manufacturer of Vioxx, voluntarily pulled the drug off the market last year, but disagreed with the conclusions of this study. Information from the study was released last year, but the study wasn't published until now at the request of Graham.

Christy Feig, CNN.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSECALL. It's being called the worst epidemic we've ever known, worse than the black plague, killing more Americans in one year than died in all of the wars of this century combined.

Could it happen again? Elizabeth Cohen has the story.

(BEGIN VIDEOTAPE)

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT (voice-over): It's hard to imagine now.

KAREN WILBUR, 1918 FLUE PANDEMIC SURVIVOR: She said it was so bad that many of the houses had the caskets lined up on the porch. One, two, and some even had to make their own caskets.

COHEN: Karen Wilbur was a tiny baby just a few weeks old when the 1918 flu epidemic hit.

WILBUR: I was very young when she told me the whole story. And she said it was terrible. Most people -- most houses were afflicted with at least someone getting the flu.

COHEN: Wilbur was lucky. Half a million Americans lost their lives during the 1918-1919 flu pandemic. Some 40 million people died worldwide.

KANTA SUBBARAO, DR., NIAID: The 1918 pandemic was the most significant infectious disease event in the last century.

COHEN: In just a few months, more people died of the flu than in all four years of World War I. The deaths mounted from October through January. 851 people in New York City died of the flu in one single day.

And now, the World Health Organization warns another pandemic is on the way. It's only a matter of time.

These big global epidemics occur on average about four times every century. There was the 1918 Spanish flu. Then the 1957-58 Asian flu, which killed 70,000 Americans. Then the 1968-69 Hong Kong flu, which killed 34,000 Americans.

A flu pandemic happens when a virus appears that's genetically different from previous viruses. People's immune systems have never seen anything like it.

Scientists around the world are always on the lookout for these viruses like the avian flu. First recognized in 1997, the virus usually jumps from birds to humans. It's a virulent bug. Some 70 percent of those who get infected die.

Luckily, there's been only one confirmed case of human-to-human transmission. But as scientists work on a vaccine for the next possible flu outbreak, this year's vaccine problems point out one of the systems greatest weaknesses -- flu readiness. Even if scientists did come up with a vaccine fast enough, could it be manufactured and distributed in time to save lives?

Elizabeth Cohen, CNN, New York.

(END VIDEOTAPE)

GUPTA: Thanks, Elizabeth.

And as we heard at the top of the show, researchers are saying the deadly avian or bird flu can likely be spread between humans.

So is another flu pandemic inevitable? And are we prepared? Answering tough questions about this this morning, the head of the Centers for Disease Control and Prevention, Dr. Julie Gerberding. Welcome again, doctor.

GERBERDING: Thank you.

GUPTA: Does this -- this avian flu kind of scares me. I got to tell you when you hear the numbers, you hear - you know, in 1968, 34,000 people died of the Hong Kong flu. And then every 30 years or so another epidemic occurs. Are we due? Is this going to happen?

GERBERDING: You know, we are due. And I think we're watching the situation with the avian flu very carefully, taking the steps that need to be taken now to help prepare and most importantly detect the transfer of that virus into people. But it is a very worrisome situation.

GUPTA: What do we do? Are we preparing a vaccine against the avian flu if it starts to spread from human to human?

GERBERDING: Well, no, the strain that's there right now is not being efficiently spread. But we are making a stockpile of vaccine for it just in case. A small amount of vaccine will be entering clinical trials. And we'll have it on hand to hopefully contain the initial round of spread if it does move into people.

But it's also possible that that virus could evolve and not necessarily respond to the vaccine that we have. So we're also stockpiling drugs to help treat people and also to prevent flu from spreading.

GUPTA: And that's an important point. You know, in the past, we look at the numbers that died. Now we are very different society back then in terms of the way we took care of people in terms of our technology, our resources. How deadly could a flu pandemic epidemic be again today?

GERBERDING: Well, the good news is that our medical care has improved. And we do have drugs. And we have the capability to at least scale up the vaccine supply over time.

But the worrisome part of this is that the world has changed. We have much more migration of people, much more connection between people in one community and another. And the opportunity for this to spread overnight to the globe is something we learned with SARS. And we have to take that very seriously.

GUPTA: Does this keep you up at night?

GERBERDING: Well, it doesn't keep me up at night, but it certainly is motivating a lot of preparedness activity at CDC. We're taking it very seriously.

GUPTA: And we're glad you are, because a lot of people very concerned about this. And we're certainly going to be keeping an eye on it with you.

Is it a cold or is it the flu? Coming up, find out why you're so sick. Stay with us. UNIDENTIFIED FEMALE: What's making you sick? Is it your desk, your co-workers, your kids? Tips for a healthy winter coming up.

Plus, looking for some comfort food this winter season? We'll tell you about some of your favorite foods that may be healthier than you think.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSECALL. Thought all the good foods were off limits? Well, think again. Our bod squad has some hope for all of the chocolate and cheese lovers out there.

(BEGIN VIDEOTAPE)

HOLLY FIRFER, CNN MEDICAL CORRESPONDENT (voice-over): It's said an apple a day keeps the doctor away, but there are a number of other foods once relegated to the dietary dungeon that you may be surprised to learn are actually good for you.

Low on iron? Beef up your diet. Experts recommend eating lean beef for its wealth of iron and zinc, not to mention protein. Keep servings to about four ounces and stick with lean cuts like sirloin or flank steak.

Lower your risk of heart disease with a little chocolate. Research has shown chocolate, particularly the dark form, is rich in polyphenols, which prevent LZL or bad cholesterol from adhering to the arteries.

Get a little nutty. Experts say the monounsaturated and polyunsaturated fats found largely in nuts have heart protective benefits. But keep calories in check by limiting servings to about a handful a day.

Say cheese. Though high in fat, cheese is a good source of CLA, a nutrient that may help with weight control and blood sugar level.

Watching your cholesterol? You don't have to skip eggs. According to two studies from the Harvard School of Public Health, eating up to one protein and vitamin rich protein egg per day does not increase a healthy person's risk of health disease or stroke.

Holly Firfer, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: Holly, thank you.

Besides eating right, there are still more things you can do to avoid getting sick. Go to cdc.gov/flu. There, you're going to find tips to stay healthy this season. Plus, if you're already sick, find out if have you the cold or the flu. And don't also forget cnn.com/flu. Just one of the great articles we found is your desk making you sick? Hmm, check it out. Dr. Gerberding's been our guest today. Thank you so much for taking time out of your busy schedule. It's been really informative. A lot of people concerned about the flu are glad you're there and doing your job on this.

GERBERDING: Well, thank you. We appreciate your interest.

GUPTA: We'll keep checking in with you as well.

Make sure to tune in next weekend for another edition of HOUSECALL. That's 8:30 Eastern. Remember, this is the place for the answers to your medical questions. Thanks for watching.

I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

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