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Sanjay Gupta MD

Fighting the Flu; Why Pregnant Women Are More at Risk for H1N1; How to Protect Yourself and Your Family from H1N1 Scams; How Much Money Should You Pay to Get Vaccinated For H1N1?

Aired November 07, 2009 - 07:00   ET

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

DR. SANJAY GUPTA, CNN HOST: Good morning. Welcome to HOUSE CALL: the show that helps you live longer and stronger. I'm Dr. Sanjay Gupta. Thanks so much for watching.

You know, we've been hearing about it for sometime now -- pregnant women and the H1N1 flu virus. We know they're more at risk. The question is why. We'll tell you.

Plus, can you believe this? There are already swine flu scams out there. Some treatments being peddled online are fake and dangerous. We want to tell you how to protect yourself and your family.

And how much money, if any, should you be paying to get vaccinated against H1N1?

You're watching HOUSE CALL.

(MUSIC)

GUPTA: You know, you, our viewers, have so many questions about H1N1. So, we decided to devote an entire show today to answering as many as we can.

We learned this week of more evidence that the H1N1 vaccine works. Here's what we know. You know, all healthy pregnant women who receive a single dose of the H1N1 flu vaccine will be protected from that flu. That's according to some just released clinical trial data just this week.

Health officials say, so far, the vaccine appears to be well- tolerated and, so far, they haven't seen any serious side effects. Clinical trials on the vaccine have been ongoing since August.

Now, the Centers for Disease Control and Prevention strongly recommends that pregnant women get vaccinated for H1N1. Why? Well, studies show that expectant mothers who develop the infection are more likely to end up in the hospital. And according to the CDC, at least 28 pregnant women have died from this particular infection since it first emerged in April.

Kara Finnstrom reports why these pregnant women are especially vulnerable.

(BEGIN VIDEOTAPE) KARA FINNSTROM, CNN CORRESPONDENT (voice-over): A year of twists and turns for Nancy Brizendine.

UNIDENTIFIED FEMALE: I was like, what?

FINNSTROM: This past spring, an unexpected pregnancy for the 42- year-old, shocked during a celebration. And then just weeks ago, that jubilation turned to fear.

NANCY BRIZENDINE, PREGNANT WITH H1N1: I had like a cough, like sinus infection, infected ear, nausea, fever. And then that's when I went into the urgent care.

FINNSTROM: Nancy tested positive for the H1N1 virus. And the fact that she was pregnant put her right in the middle of a group that experts are most worried about.

DR. ANTHONY DULGEROFF, HIGH DESERT MEDICAL GROUP: Women who are pregnant seem to be somewhat immunocompromised. And it just turns out that women who get the H1N1 tend to get sicker than the general population.

BRIZENDINE: I couldn't even get out of bed and lift my head because I was just so sick and achy.

FINNSTROM (on camera): It's tough enough to fight the ravages of H1N1 at home, but many pregnant women end up waging a much more serious battle. The Centers for Disease Control says pregnant women are four times more likely than other H1N1 patients to end up hospitalized.

(voice-over): Just last week, an expectant woman from El Monte (ph) died from the H1N1 virus. She was 27.

Doctors say, for some reason, the virus seems to cause the most serious complications in women who are both pregnant and young.

Nancy believes age worked in her favor. She got better with Tamiflu and rest. But Nancy wasn't just worried about one baby on the way. You see, Nancy's 22-year-old daughter Kayla is also pregnant, and doctors strongly suspect she also caught H1N1.

UNIDENTIFIED MALE: One more time.

FINNSTROM: The difference? Kayla, who had no health problems, ended up with bilateral pneumonia and on oxygen support.

UNIDENTIFIED FEMALE: I was hyperventilating because I couldn't breathe.

FINNSTROM (on camera): Was she at risk of dying? I mean, how...

DULGEROFF: Yes. Absolutely. Absolutely.

BRIZENDINE: I want to say, I thought, OK -- honestly, I thought, has God given me this baby because he's going to take my other baby? And I don't want that to happen. So -- it was hard. It was real hard, and that's -- I'm thinking, OK. You know. What can I do being here? You know? I need to go to the hospital. I need to be with my baby, but I couldn't.

FINNSTROM (voice-over): Three weeks later, doctors say mother, daughter and both of their unborn girls seem to be doing very well. But still, there are fears.

BRIZENDINE: I'm just worried, like what affects this is going to have on my baby, you know? And what effects the medications are going to have, or what affects are the X-rays going to have?

DULGEROFF: Since the virus doesn't cross the placenta, probably not too much of a threat, at least that we know of. However, there are very high fevers in the mother that could affect the baby.

FINNSTROM: Health officials are urging pregnant women to get the H1N1 vaccination, and Kayla and Nancy agree.

BRIZENDINE: And you have to realize it's not just you. It's your baby, you know? You have to protect both of you.

FINNSTROM: In Lancaster, California, Kara Finnstrom for CNN.

(END VIDEOTAPE)

GUPTA: That's Kara Finnstrom, of course, talking about pregnant women. But health officials have also been recommending children be vaccinated against the H1N1 virus for weeks now.

The two moms you're about to meet want to do what's best for their kids. Of course, they do. But Mary Snow reports, when it comes to the H1N1 vaccine, they have come to starkly different conclusions.

(BEGIN VIDEOTAPE)

UNIDENTIFIED FEMALE: A glass out or something?

MARY SNOW, CNN CORRESPONDENT (voice-over): Laura Wellington says she does what she can to keep her 10-year-old daughter, Izzy, healthy along with the rest of her family. But when it comes to the H1N1 vaccine...

LAURA WELLINGTON, AGAINST H1N1 VACCINE: I'm absolutely not getting the children vaccinated. No. It's not -- the risk is not worth it.

SNOW: Laura has four children and is pregnant with her fifth. She's not against vaccines in general and has paid close attention to information about swine flu and talked to her doctors.

(on camera): Is your main concern side effects? The speed of the vaccine? What's the main concern?

WELLINGTON: Its side effects. Its side effects. It's potential down the line. You know, whenever you put something new into your body, you know, people react very differently to different things that they put into their body. You know, one person, it might be fine for. Another person, it may not.

SNOW: And while Laura is not very worried about her kids getting the swine flu, Amy Pisani is. She's especially worried about her 9- year-old son Antonio, who was hospitalized as a baby because of the flu.

AMY PISANI, FOR H1N1 VACCINE: I am really nervous.

SNOW (on camera): Because you've seen what happened when he had the flu before.

PISANI: I've seen what happened to him and I've seen what happened to other people. I do work for an advocacy group now, Every Child by Two, and I've met a lot of parents who've lost their children to just regular seasonal flu. And I just -- I'm so grateful that that didn't happen to us.

SNOW (voice-over): Amy was able to get the H1N1 vaccine for her son, Nicholas, but she's still anxiously waiting to secure one for Antonio. In the meantime...

PISANI: We have -- we have stuff all over the house. I constantly tell them to wash their hands and the antibacterial gels are on the kitchen table, on the counter in the bathroom. It's a constant issue for us. We think about it all the time. And my kids are pretty paranoid at this point.

SNOW (on camera): Among parents' concerned about the vaccine, one big question is potential side effects. Health officials say they see no proof of any damaging side effects. They do say there may be some soreness or redness in the arm similar to a seasonal flu shot.

Mary Snow, CNN, New York.

(END VIDEOTAPE)

GUPTA: And it's worth pointing out again, so far, health officials say they are seeing only minor side effects. What does that mean? Soreness, redness, some swelling at the site of the vaccine. However, an independent review group has been put together to investigate any safety concerns that arise from the H1N1 flu vaccine. The group is going to monitor reports of serious side effects linked to the vaccine.

This week, a review safety data from the studies of the vaccine in more than 10,000 people, some of them conducted by government and others by the manufacturers, they're going to report those findings to a National Vaccine Advisory Committee. That's a little bit of how it all works.

If you have a lot of questions about the flu, an expert on H1N1 is going to join me, hopefully, with a lot of answers. That's next. You're watching HOUSE CALL.

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GUPTA: And we are back in a very special edition of HOUSE CALL. You've heard the symptoms: fatigue, coughing, body aches, all of those are symptoms of the H1N1 flu which the CDC says incidentally is even more widespread than a week ago. And still, as you know, there's a lot of confusion about who needs the vaccine, how safe it is. We want to answer your questions.

So, to help put things in perspective and help you understand better, we're joined by somebody who we think as one of the best in the business, Dr. Gregory Poland. He's a director of the Mayo Clinic Vaccine Research Group. He also serves as the editor for the medical journal "Vaccine."

Welcome to HOUSE CALL, Doctor.

You know, health officials from the HHS and the CDC have been telling us, you've been telling us the vaccine is safe. And we've been talking a lot about that, as you might imagine, on CNN as well.

But, you know, there is some reason for confusion. One thing I wanted to start off with you. If you look at the actual package insert from the manufacturer of the vaccine, it says this, quote, "The safety and effectiveness of influenza A H1N1 2009 vaccine have not been established in pregnant mothers, nursing mothers or children greater than 6 months of age."

You know, people read that. They hear that messages from you and everyone else. How do you reconcile those two things?

DR. GREGORY POLAND, DIR., MAYO CLINIC VACCINE RESEARCH GROUP: So, I think what we have to do is separate what a company's attorney writes in the package insert versus what the CDC and public health authorities' recommendations are.

So, at the time the company made that strain change and produced that vaccine, studies had not yet been done. But as you know, actually, just two days ago, on the 1st of November, new data were released showing the results of immunogenicity and safety in both younger children and pregnant women, and did not find any safety concerns at all.

GUPTA: Is the -- can you say unequivocally for all the pregnant moms out there listening, is the vaccine safe?

POLAND: What I can say is this, it's a safe vaccine. This vaccine is being manufactured and is no different than the seasonal vaccine that we make. It's being made by the same manufacturers, in an identical manner.

In fact, what's interesting is, had this particular viral strain been identified last November, it simply would have been the new component of the seasonal vaccine that we use and administer to pregnant women every year.

GUPTA: And just to be clear -- and I don't want to belabor this. But even if you look at the package inserts for seasonal flu vaccines, for example, from last year, it says the same thing that I just read to you.

POLAND: Right.

GUPTA: Safety cannot be -- you know, in pregnant women and nursing mothers and children of a certain age. They're still -- they're not very convincing when it comes to those package inserts.

POLAND: No. Right. And as I say, I mean, those are companies' attorneys that write those. And in part, just to make one point clear, the vaccine is not licensed for use in children under the age of 6 months.

GUPTA: That's right.

POLAND: It's not a safety issue. It simply doesn't work well in infants that are that young.

GUPTA: OK. I want you to -- you know, as you might imagine, Doctor, there's been a lot of discussion about this -- I want you to listen what one person said on CNN, Rachel Campos-Duffy. She's a columnist for ParentDish.com. Take a listen to what she said.

(BEGIN VIDEO CLIP, CNN'S CAMPBELL BROWN)

RACHEL CAMPOS-DUFFY, BLOGGER, PARENTDISH.COM: I happen to have an asthmatic son whose asthma at this moment is not -- since the last month and a half has not been under control. We just took him to the doctor today, and made the decision to give him the vaccine. I do not want to take the vaccine for myself, because I am worried about the fetus.

(END VIDEO CLIP)

GUPTA: So, aside from the safety issues now, moving sort of (INAUDIBLE), why do you believe it's important to get the vaccine? How do you address her specific concerns? She got one of her children vaccinated with asthma, but not herself or her other children.

POLAND: Well, in my opinion, she made a very wise decision to get her high-risk child with asthma immunized. I think the important thing, though, is no vaccine is 100 percent effective. We have reason to believe this one will be very effective, but we won't know until the end of the season.

And so, what's important is a principle called cocooning, and the idea there is that the parents, the other siblings that are in close contact around this child should also get immunized to help protect that child against exposure to this virus.

GUPTA: You know, we're still getting a lot of questions from viewers, wondering specifically about the symptoms of H1N1 as well. I actually had the infection. It was laboratory confirmed. I got this terrible cough, lightheadedness, felt miserable.

POLAND: Yes.

GUPTA: But I understand your family also was infected, which is in some ways makes you sort of a double expert. Obviously, behind the science, you also actually saw the symptoms. What did you see?

POLAND: Well, both of my sons were infected with H1N1, and one of them had a very bad headache and sore throat with a low-grade fever. The other had a high fever and a sore throat. The problem is that the symptoms of H1N1 overlap quite a bit with a lot of other respiratory viruses. So, it's very hard to distinguish the two, as you say, without laboratory documentation. And without that laboratory documentation, we would still recommend that when available, that that person get H1N1 vaccine.

GUPTA: We're going to...

POLAND: Because we just don't know.

GUPTA: We're going to probably call on you quite a bit during this flu season. I know we're relying on you a lot. So, thanks, Dr. Poland.

POLAND: My pleasure.

GUPTA: All right.

And for the latest information on H1N1, be sure to logon to our Web site -- lots of good information there. Our health page has all information you need.

Right now, there's a closer look at some hospitals and how they're keeping up with the growing number of flu patients. That's at CNNHealth.com as well. We're also going to check all the medical headlines of the week. That's coming up on HOUSE CALL.

Stay with us.

(COMMERCIAL BREAK)

GUPTA: And we are back with HOUSE CALL. The whole show today dedicated to H1N1.

We're staying on top of this week's medical headlines as well. Elizabeth Cohen joins us for that -- Elizabeth.

ELIZABETH COHEN, CNN SR. MEDICAL CORRESPONDENT: Thanks, Sanjay.

News this week for smokers trying to quit the habit. Researchers found that smokers who switch to those low tar or light cigarettes are actually 50 percent less likely to successfully quit smoking. In the study, almost 20 percent of smokers said they switched to light cigarettes because they thought they were less harmful, when in reality, these cigarettes still have the same amount of nicotine, tar and carcinogens.

Also, the CDC announced 15 more children have died from the flu since their report last week, and 48 states are reporting widespread H1N1 flu activity.

Now, as for the vaccine, the CDC reports 8 million additional doses are supposed to be available this coming week. But how much money should you expect to pay to protect yourself from H1N1?

When HOUSE CALL returns, you won't believe how much one uninsured woman says their doctor's office wanted for her vaccine.

(COMMERCIAL BREAK)

GUPTA: It is time for my favorite segment of the show "Ask the Doctor."

You know, today, I want to bust a couple of big myths about the H1N1 virus and the vaccine. So, let's get straight to a couple of questions.

Lisa asked this one our blog, "I'm confused wondering if we had the virus or not this summer. Not sure why they stopped testing for the virus. Shouldn't the people who had the virus already not get the vaccine?"

Well, a couple important points here, Lisa. First of all, if f you truly had H1N1, you're not going to get it again because your body has built up immunity to this particular virus. However, if you didn't have a lab test confirm H1N1, simply can't be sure whether or not you had the virus. That's where it gets a little tricky.

As far as the second part of your question, health officials stopped testing because they knew the virus was out there and labs are being overwhelmed. Now, only hospitalized patients -- patients who died from the particular infection are being tested to confirm this. The recommendation, best we can tell, is to get the vaccine, there's no harm even if you think you may have had the infection. You're still at risk for seasonal flu as well. So, don't forget to get the seasonal flu shot at the same time, or around that time.

Another question now from Cheryl who wrote this on our blog, "While at my doctor's office, I asked about the H1N1 vaccine. I was told it will be very expensive, like around $300. Since I do not have health insurance, the expense of the H1N1 vaccine will factor into whether or not I get the shot."

Well, let me just be clear on this. Your doctor's office is wrong about that. The H1N1 flu shot is free. And we've checked it out ourselves. The government is paying for all the vaccine. And all you should be paying for yourself is perhaps an administrative fee for your office visit, if that. In many places, that fee is also being waived.

It sounds like cost maybe an issue for you. So, you might want to look for one of these free clinics. But regardless, again, $300 is just way out of bounds. It's supposed to be free. This is something that we checked out again with the government.

Swine flu scams is something we want to talk about. Fake, even dangerous products for sale online that claimed to treat H1N1. We have investigated this. We're going to tell you what to avoid.

Stay with HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL.

You know, the shortage of the H1N1 flu shot has many of us turning to the Internet, some desperate for any kind of cure or prevention. And as Kitty Pilgrim reports, the FDA says be cautious about what you read on the Web when it comes to fighting H1N1.

Take a look.

(BEGIN VIDEOTAPE)

KITTY PILGRIM, CNN CORRESPONDENT (voice-over): People have been lining up all across the country in the hope of getting a swine flu vaccine. The CDC admits that the situation is less than ideal.

DR. THOMAS FRIEDEN, DIR, CENTERS FOR DISEASE CONTROL AND PREVENTION: I think all of us are frustrated that we haven't had more vaccine, that we don't have more vaccine now. When the season is over, it will be a good time to look back and think of what could have been done differently, or better.

PILGRIM: But for the immediate future, people are trying to come up with a plan of their own. The new influenza strain is particularly risky to young children and pregnant women. The FDA is warning people about turning to the Internet to purchase swine flu remedies. Many are fake, some even dangerous.

The FDA has put out a warning list of 140 products listed along with brand name and Web site address, everything from air purifiers to pills and potions.

Ionic Silver asks, could Ionic Silver help fill the gap between now and when H1N1 vaccines are available? The customer service Web site was not functioning for questions about their products.

Simple Clinic says protect yourself now from the swine flu with products for adults and women. But the FDA says it is unauthorized product. Simple Clinic says they take 24 hours to respond to inquiries by email only.

Liquid Tamiflu, which the FDA says is one of the few legal and effective treatments for swine flu is in critical short supply, especially the liquid for infants. The FDA is warning Internet sales of Tamiflu may contain bogus products that have no effect on reducing symptoms.

The FDA says they are being vigilant in monitoring Web sites with false claims. But because the Internet is in constant flux, new Web sites are turning up every day -- Sanjay.

(END VIDEOTAPE) GUPTA: All right, Kitty, thanks.

Here is something else we've been investigating. Does being overweight increase your risks of H1N1 flu complications? A lot of questions about that. We'll have some answers. That's next.

You're watching HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL.

You know, in this week's "Fit Nation" segment, we decided to look at how obesity could affect your risk of getting the H1N1 infection, how it might affect you if you've already gotten it. Now, according to the Centers for Disease Control and Prevention, obesity is not a known risk factor for seasonal flu. However, obesity has been seen in a high number of H1N1 patients with severe health complications.

The question is, what is the connection? Dr. Thomas Frieden, he's head of the CDC, he explains.

(BEGIN VIDEO CLIP)

FRIEDMAN: People who are very obese have a body mass index of 40 or above are at increased risk of complications of flu. Most individuals with a body mass index that high also have other health problems such as diabetes or lung disease or heart disease that may increase their risk of getting severe complications of the flu.

(END VIDEO CLIP)

GUPTA: Now, you know, Frieden does go on to say that the data for overweight individuals is a little bit more mixed than that. It may be that people with a body mass index between 30 and 40 are also at an increased risk of complications. But, you know, to be fair, it's just not entirely clear at this point.

If you are among the 66 percent of Americans who are overweight or obese, and you're concerned about what precautions you can take, rest assured, the basic protections that we've been talking about for sometime now are going to protect you as well.

Health officials remind us that simple things like washing our hands frequently, covering your coughs and sneezes, and encouraging friends and co-workers with flu-like symptoms to stay home from work and social events -- all that can help. And if you got a chance to get vaccinated, do so. Obviously, we've talked about that a lot on the show today.

And, unfortunately, that's all the time we have. If you missed any part of today's show, be sure to check out my podcast, CNN.com/podcasting.

Remember, this is the place for the answers to all of your medical questions. I'm Dr. Sanjay Gupta. Thanks for watching. More news on CNN starts right now.