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HOUSE CALL WITH DR. SANJAY GUPTA

West Nile Virus; Skin Cancer Threat

Aired June 4, 2005 - 08:30   ET

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


TONY HARRIS, HOST: Here's what's happening now in the news. Aruba police say they're following a lot of tips, but still no luck yet in finding a missing Alabama teenager in Aruba. 18-year-old Natalee Holloway disappeared Monday while on high school graduation trip. The FBI has joined the search.
Defense Secretary Donald Rumsfeld challenged China today to provide more political freedom to its citizens. He also questioned Beijing's military buildup at a time when he says it faces no threat. Rumsfeld made the comments at a regional security conference in Singapore.

Today is the 16th anniversary of China's bloody crackdown on the pro-democracy movement in Tiananmen Square. Security is tight in Beijing. In Hong Kong, you're looking at a live picture of a candlelight vigil. The student-led protest in 19889 ended with Chinese tanks and troops killing hundreds of people.

I'm Tony Harris. HOUSECALL begins right now.

SANJAY GUPTA, HOST: Good morning and welcome to HOUSECALL. Well, if you plan on hitting the beaches, trails and/or water this summer, you need to watch this show, because this is the season where accidental injuries hit their peak.

We're going to start in the water. We all know the risks of drowning, but as Christy Feig reports, there are other hidden dangers as well.

(BEGIN VIDEOTAPE)

CHRISTY FEIG, CNN CORREPSONDENT (voice-over): Anna Gilcher enjoys swimming at the YMCA with her two children Beatrice and Jillian. She says she never worries about how clean the water is.

ANNA GILCHER, FREQUENTS SWIMMING POOLS: Well, I trust the Y to keep it clean. So I don't think I -- we always take showers before we come in, because that's the rule.

FEIG: The YMCA says their water is tested regularly and their staff gets monthly training.

STEVEN CARTER, YMCA: The YMCA's big on checking levels every hour. The YMCA is always up on training, training our lifeguards, training our supervisors what to look for.

FEIG: But not everyone does. And according to the Centers for Disease Control, public swimming pools are often a breeding ground for illnesses.

MICHAEL BEACH, DR., CDC: It's a communal bathing activity. We share all sorts of things in that water. And so it's not drinking water. It's not sterile.

FEIG: And while chlorine is a great disinfectant, it doesn't kill all germs.

BEACH: There's a parasite called cryptosporidium that's resistant to chlorine, that causes most of the outbreaks that we're hearing about right now. And so it really requires that people understand that when they're ill with diarrhea, they don't go swimming.

(END VIDEOTAPE)

GUPTA: Now besides from being sick, that particular bug is also brought in the pool by people who haven't washed well after using the bathroom. You can prevent getting sick from pool water with a few simple steps.

Like the family in our piece, shower before getting into the pool. Also, take your kids for frequent bathroom breaks and teach them never to swallow pool water. Plus, don't assume that a heavy chemical smell means the pool is clean. In fact, it usually means there are a lot of contaminants in the water.

Well helping us stay healthy while we enjoy the summer is Dr. Erica Brownfield. She's an internist at Grady Memorial Hospital here in Atlanta.

First of all, welcome.

ERICA BROWNFIELD, INTERNIST: Thank you.

GUPTA: Now how do you know if you become sick from pool water?

BROWNFIELD: Well, I think it's important to know that a lot of people, they may not realize that they actually are sick from contaminated pool water, because some of the symptoms are very common to usual viral illnesses.

But some things you can look out for is if people get diarrhea, nausea, vomiting. Other things, they might get a low-grade fever, headache. Those are things you can look out for, but again they're very non-specific.

GUPTA: And you're an internist.

BROWNFIELD: Yes.

GUPTA: So you take care of these sorts of patients. When should someone come to see you? How do you that they need to go to the hospital versus just taking care of it at home?

BROWNFIELD: Right. That's a good question, because again, these symptoms are very non-specific. It's sometimes very hard to figure out when to go to the doctor.

I think as a general rule, if you have a fever greater than 101.5, you have vomiting and diarrhea, and you're unable to keep down oral liquids, you should seek medical attention. If you have bloody diarrhea, you should also.

One last thing. If you know you have a weakened immune system, or you have some kind of illness that predisposes you to more severe disease, you should ask your doctor about the symptoms you're having.

GUPTA: A lot of people focused on children, obviously. I mean, you know, as adults, we obviously get some of these symptoms from time to time. Is there a difference between children and adults?

BROWNFIELD: Just the severity. The younger or the older someone is, the more severe their symptoms can be.

GUPTA: OK. And you know, the more common danger with water, of course, is drowning. Each year, approximately 250 children under the age of 5 drown in swimming pools.

Elizabeth Cohen now takes a look at how you can keep your family safe.

(BEGIN VIDEOTAPE)

ELIZABETH COHEN, CNN CORRESPONDENT (voice-over): It's the second leading cause of death for children after car crashes. But drowning, especially in pools, can be prevented. Experts say never leave your children alone in or near a pool.

HAL STRATTON, CPSC: Constant parental supervision is the only thing that I can guarantee parents will save their kid in a pool situation.

COHEN: If you have a pool in your backyard, safety should come first.

STRATTON: If you're going to build a pool, and you've got kids, I can't imagine that you wouldn't go out and research everything possible to try make that safe.

COHEN: And making pools safe means a fence around the entire pool, all four sides. The gate should shut and lock automatically. And the latch should be out of the reach of a child.

If a house forms a barrier to one side, its doors and windows should have an alarm. The pool itself should have one, too. As an extra precaution, invest in a pool cover. Plus, the American Academy of Pediatrics says keep rescue equipment and a phone nearby.

Elizabeth Cohen, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: All right, Elizabeth, thanks. "Consumer Reports" is also warning that those low-cost inflatable pools may pose extra risks, since many people don't think to put up fences or alarms. Their advice is this. Check with the Consumer Product Safety Commission for local code requirements. As with in- ground pools, fence the pool in and always supervise children in and around the pool area.

Large inflatable pools often don't come with water filters. So make sure to change the water often. Got a lot of questions coming in on this topic.

One from Sheila in Ontario who writes this. "I have two kids under 10 years old and a pool. At what age would you recommend sending children for CPR and first aid training?"

Obviously you want to take care of your children, Dr. Brownfield, but what -- when did do you let them start to train themselves?

BROWNFIELD: I think the only people that know the right answer for that are the parents. They know when the children are able to understand that information and act on that information.

Simple things like teaching children how to call 911, pick up the phone, that's a very simple task that a child can do. And teaching them that can actually be life-saving.

As far as specific ages, there are no recommended specific ages, but the American Red Cross and the American Heart Association does offer classes. And people can contact their local chapter and find out more information.

GUPTA: Is there a minimum age or a maximum age?

BROWNFIELD: Not that I know of. I think everybody can learn. And actually, the younger you are, the more receptive people are to learning. And it might be great to actually start children out as early as possible.

GUPTA: What is the sort of, you know, behind the curtain when you doctors talk about the pools and children? Is there sort of a thing where you say, you know, if your children are under such and such age, you just shouldn't have a pool? Or do you talk more about all of these safety devices?

BROWNFIELD: I think most people talk about safety devices. And again, individual children and individual parents are different. And so one 4-year-old is different from another 4-year-old. So it just is really up to the parents. There is no general blanket rule, but being safe and taking those precautions are the most important things.

GUPTA: OK. Well, we're going to get out of the water and into the woods after the break. Stay tuned.

UNIDENTIFIED FEMALE: Coming up on HOUSECALL, the buzzing, biting and itching days of summer. We'll tell you how to keep the bugs at bay. And later -- grilling tips from an expert. Plus, a decade's old game...

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: Whew, yes!

(END VIDEO CLIP)

UNIDENTIFIED FEMALE: ...turns into a new-age workout.

First, take today's "Daily Dose Quiz." Are tanning beds safer than the sun? That answer, after the break.

(COMMERCIAL BREAK)

UNIDENTIFIED FEMALE: Before the break, we asked, are tanning beds safer than the sun? The answer -- no tan is safe. Tanning beds provide high doses of UVA, which can penetrate into the deeper layers of your skin, and damage your skin's immune system.

GUPTA: All right. By now you've heard how damaging the sun can be to your skin, but the season is no picnic for your skin for other reasons as well.

Elizabeth Cohen is back to guide us through the dangers of summer from bugs to poisonous plants.

(BEGIN VIDEOTAPE)

COHEN (voice-over): The shining rays of summer, we all know how dangerous they can be. Skin cancer will kill almost 8,000 Americans this year. And many dermatologists say they're seeing more cases among children and teens. But you can protect yourself and have fun in the sun.

JIM MORELLI, REGISTERED PHARMACIST: Three things you want to do when you go out in the sun. Number one, wear protective clothing. Number two, always wear a sun block. And finally, if you can, try to avoid the sun between the hours of 10:00 and 4:00. That's really when the rays are the strongest.

COHEN: Another summertime issue, bug bites. Mosquitoes can transmit West Nile virus or encephalitis. Lower your risk by wearing long sleeves and light colored clothes, and staying inside at dusk and dawn when mosquitoes are active.

MORELLI: Well, insect repellents are pretty much indispensable this time of year. Most of those on the market do contain Deet, which is a very effective product, but it's not for everybody. Namely, it's not for children under the age of 2 months.

COHEN: For those looking for more options, the government is recommending two new alternatives to Deet. Picaridin, a man-made, odorless repellent and oil of a lemon eucaplyptus, which is plant based, both offer effective protection from mosquitoes that can carry West Nile Virus.

If the mosquitoes do bite, ice and Calamine lotion can help relieve pain and itching.

MORELLI: Now if you get a rash and you know you've been bitten by a tick, or suspect you've been bitten by a tick, you do want to call your doctor, because tick bites can lead to serious illness.

COHEN: Each year, more than 10 million Americans suffer reactions to poison ivy, poison oak, and poison sumac. You can prevent an allergic reaction if you immediately remove all clothes and shoes that have touched the plant, wash your skin with soap and water, apply rubbing alcohol with cotton balls to the parts of the skin that are affected, and rinse yourself with water.

Most of the bites and burns of summer can be treated at home, but if a problem lingers, you should talk to your doctor.

Elizabeth Cohen, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: All right, Elizabeth. Thanks.

A new survey by the American Academy of Dermatology found this. About 80 percent of teenagers surveyed know that tanning and getting sunburns can lead to skin cancer. Yet 60 percent of them got sunburned just last summer.

That's frightening, considering studies show getting five or more sunburns doubles your risk for skin cancer.

Helping us get the message through to all of our sun worshipers is Dr. Erica Brownfield. She's an internist at Grady Memorial Hospital here in Atlanta.

Let's get back to some of our questions from our viewers because this is an important subject -- suntans, and sunburns, and possible skin cancer as well.

Jeff from Maryland asked this question. "I have two sons ages 10 and 14, who are very active outdoors. They use SPF-30 sport sunscreen. Should they reapply the sunscreen if they're out for prolonged periods (4 or more hours), and if so, when?

You know, people talk about reapplication. And I got to admit, it is a little bit confusing. How often to you reapply? How much sunscreen should you put on? What would you tell him?

BROWNFIELD: Well first let me say, congratulations that you're using the SPF-30. It is important to reapply sunscreen. It's difficult to remember sometimes, but you want to try to reapply it every 1 1/2 to 2 hours. Anytime you go swimming, you want to apply it afterwards. And any time you do any kind of exertional activity, where you're sweating a lot, you want to reapply it at that time as well. GUPTA: Protective clothing, is that something valuable as well?

BROWNFIELD: It is. A lot of people wear white colored clothing in the summertime, because it keeps them cool. And actually, if you look at white color, it only gives you an SPF factor of about 3.

GUPTA: Really?

BROWNFIELD: So it doesn't really protect you. It doesn't scatter the rays and the UV light.

GUPTA: All right.

BROWNFIELD: So you want to do light colored clothing.

GUPTA: If you can do this really quickly, explain to people what SPF means?

BROWNFIELD: So SPF stands for sun protection factor. And it basically, the lower the number, the less you are protected against the UV light. The higher the number, the more protected you are.

GUPTA: All right, and so you said 30. You said you were happy that they were wearing 30? Is that your number?

BROWNFIELD: Thirty is good. Anything above 15 is recommended. I think what people forget is to apply it to areas they may not remember. So their lips, thinning or balding hair, the tips of the ears and the nose.

GUPTA: Why are you looking at me when you said that?

BROWNFIELD: I didn't! So you just want to apply to areas that you may not remember in general.

GUPTA: All right, let's get to another question. Now keep on topic here. Tracy in New Hampshire asks this. "How can parents keep children from getting bitten by mosquitoes? And if they are bitten, what is the best way to treat the bite?"

Kids hate mosquito bites. Everyone hates mosquito bites. So what do you recommend?

BROWNFIELD: Well first of all, the peak sun hours that you want to avoid are actually different times for when the mosquitoes are around. So peak mosquito biting time is from dusk to dawn. So even though it's safe to go out from a sun perspective, it's not safe to go out as far as mosquito bites.

So the first thing is go out when mosquitoes are not around. Second of all, you want to wear protective clothing. So long sleeves, long pants, socks. And then using these chemicals, insect repellants that they just mentioned that also contain Deet.

GUPTA: OK, and you know, we've talked a lot about West Nile previously. And people get concerned about that with mosquito bites. What is your recommendation now as summer comes along? Anything specific regarding West Nile?

BROWNFIELD: Well, I think it's very important to remember we hear about West Nile virus and we all get very concerned. But remember that 80 percent of people who get infected with West Nile virus actually do not have any symptoms at all.

So if you're a healthy adult, you really probably don't need to worry about it. And what you need to worry about are the warning signs that you have a serious case of a West Nile virus.

And these are, if you're known you've gotten bitten by a mosquito, you need to look out for things like headache, confusion, a rash, fever, again, greater than 101.5, atypical symptoms that you might get from a normal mosquito bites.

And again, if you have any weakened immune system, you're older or younger, and you have any of these, you need to be more concerned.

But remember that most people do not get sick from it.

GUPTA: OK. We're getting good advice from Dr. Erica Brownfield.

Coming up on HOUSECALL, the inside scoop for a safe cookout. Stay tuned.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: You don't have to be a mathematician to be a good grill expert, but you've got to remember the right temperature.

(END VIDEO CLIP)

UNIDENTIFIED FEMALE: Grilling to perfection. We'll show you how, just ahead on HOUSECALL.

But first, more of this week's medical headlines in "The Pulse."

(BEGIN VIDEOTAPE)

CHRISTY FEIG, CNN CORRESPONDENT (voice-over): Every year, about 1 million Americans get an extremely painful rash known as shingles, but new research may offer hope. A study in "The New England Journal of Medicine" found an experimental vaccine reduces the risk of the condition by half. And those in the study who got the vaccine and still got shingles got a much milder case. The study was funded in part by the maker of the experimental vaccine.

And new research shows loving your body may be the key to weight loss. A new study in "The Journal of the American Dietetic Association" says instead of trying fad diets, obese women who changed their eating habits and accepted their bodies improved their long-term health.

Researchers found non-dieters focused more on feelings of hunger and fullness and not on calorie consumption, leading to improvements in cholesterol levels, blood pressure and self-esteem. Christy Feig, CNN.

(COMMERCIAL BREAK)

TIME STAMP: 0851:19

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Summertime means grilling time for many of us. Unfortunately, summer and grills together make the perfect breeding ground for bacteria. Cases of food poisoning increase during this warm and often humid season.

So here are some tips to keep bad bacteria away from your barbecue. First, start with a clean grill.

TONY VOLK, FOOD SAFETY ED. PARTNERSHIP: You've got to clean it. Clean it well before you get on. And then turn that temperature up to high. That high temperature's going to really burn off any bacteria that's there.

GUPTA: With the charcoal grill, preheat your charcoal for at least 25 minutes before cooking. Once the grill is ready and before you bring out the food, wash your hands.

VOLK: You need to wash at least 20 seconds to get rid of all that dirt and bacteria that may be clinging to your hands after you've been out preparing the grill.

GUPTA: And before you lay out those burgers, make sure you have the right thermometer.

VOLK: You can see that it has an LED readout. Tells you exactly what the temperature is when you touch the tip of this instrument to the center of the meat.

GUPTA: If the temperature outside is above 90 degrees, place the meat you're not immediately cooking inside a chilled cooler. And remember, keep poultry and beef apart on the grill, and includes using a different thermometer.

VOLK: You don't have to be a mathematician to be a good grill expert, but you got to remember the right temperatures. For instance, 160 for hamburger. 145 for medium rare steaks. And 170 for boneless chicken parts. It says 170. 170 is perfect. We know that filet is done.

GUPTA: Be sure to place the cooked food on a clean platter, not on the same one that held the raw meat. And then you'll be ready to enjoy a delicious and hopefully safe summer.

UNIDENTIFIED FEMALE: Cheers!

(END VIDEOTAPE)

GUPTA: All right, but what about those leftovers? Experts say food left unrefrigerated for more than two hours may not be safe to eat. So here's a tip. Keep a cooler nearby if you're away from a refrigerator.

We're talking with Dr. Eric Brownfield. She's an internist and assistant professor of medicine at Emory University School of Medicine.

Doctor, what's the biggest mistake that you see that people make who come to you with food poisoning?

BROWNFIELD: That's a little difficult to answer because most people don't know how they got food poisoning. But I would say the common kind of stories we hear, people are using marinades that they used on uncooked food. And then they go back and use it on food they just off the grill. And that's a big no-no. So you don't want to do that, number one.

Number two, they're not washing their hands. Number three, they're cross-contaminating.

GUPTA: Yes.

BROWNFIELD: So they're cutting up meat on a chop block that's uncooked meat. And then they go back and use the same chop block or same knife. And they don't realize they're, you know, spreading those germs around. So those are big things.

GUPTA: OK, so someone's not feeling well. They're feeling maybe a little lightheaded. They may be throwing up a little bit, having a low-grade fever. When do they need to come see you?

BROWNFIELD: Again, this is another important issue. A lot of people will get food poisoning. A lot of people are going to have nausea, vomiting. And the key is you don't need to come and rush into the emergency room with this.

The things you need to look out for, again, high fever greater than 101.5, if you're having vomiting to the point where you cannot keep down fluids, that's an indication to come in. If you have bloody diarrhea, if you have just a headache, confusion, just more serious than your typical GI bug, you need to seek medical attention.

And I would say give it about two to three days on your own. And if you're not better after three days, then you can call your doctor.

GUPTA: It might be unpleasant a couple of days.

BROWNFIELD: Right.

GUPTA: What should they do in the meantime, though, just try and drink fluids and...

BROWNFIELD: I think as long as you don't have any of the warning symptoms that I just mentioned, and also in addition, if you don't have a weakened immune system, kind of sit back, you know, baby yourself with fluids. Gatorade is not a good option. You want to use other oral solutions. So Pedialyte, those kind of electrolyte solutions are best. You eat a bland diet. And just try to, you know, take Tylenol or whatever for the pain.

GUPTA: Sounds like mom's advice, which was always good advice as well.

And we're getting advice from Dr. Erica Brownfield. We're also going to have more ways to have fun and stay safe during this summer. That's coming up.

UNIDENTIFIED FEMALE: They're affordable and portable. From a toy you grew up with, to a gym standard. What's new? We'll fill you in after the break.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSECALL. Looking for a fun way to stay in shape this summer? Well, our bod squad looks at a kids' toy that's become a workout tool.

(BEGIN VIDEOTAPE)

HOLLY FIRFIR, CNN CORRESPONDENT (voice-over): That was then.

ROBERT DOTHARD, FITNESS TOGETHER: Ooh, yes!

FIRFIR: This is now. Forget hula hoops. These are heavy hoops loaded with three to five pounds of extra weight to help you burn even more calories during your workout. They'll set you back about $50.

"Consumer Reports" magazine May article on exercise aids recommends three fitness devices. The heavy hoops, the stability balls...

DOTHARD: She's toning up the bicep.

FIRFIR: ...and tubing, because they're affordable and portable.

Robert of Fitness Together likes the versatility each brings in working multiple muscle groups.

DOTHARD: So the ball has a whole host of uses. Working the outer thighs is just one of them. I know what you're saying, it's summertime. I want to tone up the abs a little bit. I want to be nice and flat, just like Kara. So supersize not too far back, not too far forward. She's working the entire abdominal area.

FIRFIR: Whether you choose the stability balls, the hula hoops, or tubing for your next workout, they're all designed to help you get in shape and have fun doing it.

Holly Firfir, CNN.

(END VIDEOTAPE) GUPTA: Holly, thanks.

If you're looking for more information on staying safe this summer, check out the Centers for Disease Control website at www.cdc.gov. You're going to find tips and help hot lines for everything from food poisoning to tick bites.

Well, we're out of time for today. Dr. Erica Brownfield's been our guest. Thanks a lot.

BROWNFIELD: Thank you.

GUPTA: Lots of good advice today.

Make sure to watch every weekend as well for another edition of HOUSECALL. Also, tune in two weeks from now. We're going to focus on the dads in our lives, an important topic, I assure you.

E-mail your questions on everything from daddy weight gain to baby proofing your home. All that to HouseCall@cnn.com.

END

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