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Lou Dobbs Tonight

Deadly Outbreak; Swine flu in Mexico; Not a Cause for Alarm; Swine flu and the Border

Aired April 27, 2009 - 19:00   ET

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

LOU DOBBS, CNN ANCHOR: Wolf, thank you. Good evening everybody.

This country tonight facing the prospect of a significant outbreak of the deadly swine flu, the federal government already preparing for the possibility of a pandemic, the World Health Organization is raising the alert level for a possible pandemic, and Homeland Security Secretary Janet Napolitano now says Customs and Border agents are passively screening people arriving from Mexico. Critics however are demanding a much more aggressive approach.

The federal government also facing charges it's not prepared to deal with this emergency. There is no Health and Human Services secretary, surgeon general or the director of the Centers for Disease Control and a top CDC official and one of the country's leading authorities on infectious diseases among my guests here tonight.

We begin with dire new warnings about the worsening outbreak of swine flu. This outbreak is spreading from Mexico to the United States and around the world. There are already at least 40 confirmed cases in the United States according to the Centers for Disease Control. No one in the United States has died, but there are rising concerns the outbreak could become a global pandemic. The World Health Organization today raised the global alert level for a possible pandemic which means there is now sustained human to human transmission of the swine flu virus. A senior United Nations official declaring the outbreak cannot be contained. Louise Schiavone has our report.

(BEGIN VIDEOTAPE)

LOUISE SCHIAVONE, CNN CORRESPONDENT (voice-over): Across the nation a public health emergency and attention to the challenge at the highest levels.

BARACK OBAMA, PRESIDENT OF THE UNITED STATES: This is obviously a cause for concern and requires a heightened state of alert.

SCHIAVONE: Dozens of cases are now confirmed across the nation, most in New York, others in California, Texas, Kansas and Ohio, there's been one hospitalization, several but not all of those sick in the U.S. have recently traveled to Mexico, as did President Obama three days after the first swine flu case was suspected there. The White House says he is completely healthy, but officials now say other Americans should avoid visiting Mexico. Unlike Mexico where the virus first erupted, the U.S. has recorded no swine flu fatalities, but authorities take no comfort in that. DR. RICHARD BESSER, ACTING DIRECTOR, CDC: I wouldn't rest on the fact that we have only seen cases in this country that are less severe.

SCHIAVONE: As for U.S. border policies, at certain ports of entry in some cases, travelers from Mexico who are clearly ill might be evaluated and even judged unfit to enter the U.S., but the homeland security secretary is not convinced that there's any point to a large scale program to stop sick travelers from Mexico at the border.

JANET NAPOLITANO, U.S. HOMELAND SECURITY SECRETARY: People could be coming through now even under passive surveillance who actually have the flu...

SCHIAVONE: Napolitano's declaration of a health emergency freeze access to anti viral drugs releasing a quarter of the nation's stockpile to Americans who might need them.

(END VIDEOTAPE)

SCHIAVONE: Lou, across the nation and around the world there are lots of unanswered questions. Is it possible to contain this disease with stifled coughs and sneezes and lots of hand-washing? How severe will this get? Or could this be the outer edges of a pandemic? Lou?

DOBBS: Louise, thank you very much -- Louise Schiavone from Washington.

Tonight local health officials are reporting more cases of swine flu in California. Health officials now say there are 11 confirmed cases in California. That compares with the seven reported previously and local officials in Texas are reporting another case making three there so far. That raises the national total to at least 45 subject to confirmation by the Centers for Disease Control.

The biggest cluster of swine flu cases in this country is in New York; 28 cases have been confirmed in New York City. There are another 17 suspected cases, all involve students from one high school. Deborah Feyerick has the very latest for us from the New York City Department of Health -- Deborah Feyerick.

DEBORAH FEYERICK, CNN CORRESPONDENT: Well, Lou, what we can tell you is that emergency rooms around the city in fact are bracing for a surge of people to show up exhibiting flu-like symptoms so they're on the alert. They're taking stock of their inventory, EMS workers are being told to wear gloves and masks and to make sure that they ask people exactly where they have traveled to or whether they may have come in contact with somebody who may have been infected.

Now as you mentioned, the confirmed member of cases stands at 28, with a possible 17 more, bringing the number up to 35. This is something that infectious disease specialists expected because they say you can't just have a couple of cases because it is being transmitted human to human. Lou?

DOBBS: Deborah, thank you very much -- Deborah Feyerick. In Mexico, the government today increased the number of people there believed to have been killed by the swine flu to at least 149. As many as 2,000 people may have caught the virus since it was first reported back on the 13th of April. There are also six confirmed cases in Canada; two people in Scotland; one in Spain also have become ill from the flu. All three recently traveled to Mexico.

There are suspected cases as well in New Zealand, Brazil and Israel as well as several European countries. The U.S. government today advised Americans to avoid all nonessential travel to Mexico. Homeland Security Secretary Janet Napolitano said travel alerts to Mexico will remain in force as long as necessary. Earlier the European Union's health commissioner advised Europeans not to travel to Mexico and the United States to areas affected by swine flu. The European Union later retracted its comments, saying the commissioner was speaking in a personal capacity.

The government of Mexico today announced sweeping new measures to control the spread of swine flu. All schools in Mexico will be closed until May 6th. Officials say they are also considering more drastic action. CNN's chief medical correspondent Sanjay Gupta is in Mexico City and reports now for us. Sanjay?

DR. SANJAY GUPTA, CNN SR. MEDICAL CORRESPONDENT: Well we are sort of at the place where so many of those early cases were seen, Lou. You know what's so interesting is that I think a lot of people in the public health community here were expecting an outbreak of some sort, but they were expecting the avian flu and they were expecting it to be in Southeast Asia, so I think it took people here a little bit by surprise.

In fact, the mayor of Mexico City, a population of 20 million here, just really started finding out about this last Thursday. Some drastic measures were taken, as you just mentioned, but at the same time, there's only about four million of these masks for this large population of people. There's only about a million doses of the TAMIFLU, this anti-viral for this population. So it's not a panicky situation by any means, but people are concerned, are they going to be able to protect themselves and get treated?

DOBBS: Well Sanjay, I heard that your crew and you had trouble gaining access to some of these hospitals. What can you tell us about that?

GUPTA: You know it's so interesting. This is a public hospital behind me. Lou, I don't know if you can tell, but there are big steel gates over here.

DOBBS: Right.

GUPTA: There are armed guards. That's not something you typically see in front of a public hospital. These are places that are supposed to welcome the population. They are concerned about crowd gatherings. They are concerned about us as well. What we came to find out was that there were protests going on inside the hospital by the hospital workers themselves. Why, because they couldn't get enough masks and they couldn't get enough of the medications as well. These are people treating these patients. Interestingly enough, right across the street there's a store that sort of stockpiled these masks and started selling them even though the government was giving them away for free. We eventually did get in one of these hospitals, Lou. We wanted to find out how they were treating these patients because we think the lessons learned there might be lessons the rest of the world can possibly apply.

DOBBS: Absolutely, 149 fatalities, just about 2,000 people estimated to have been infected. Nearly everyone suspects the number is far larger than that. Let me ask you Sanjay, with Mexico is our near neighbor. It is obviously in need of assistance. We have TAMIFLU in our public health system. We have masks. Why are we not doing both the neighborly thing and the intelligent thing which is to help out our neighbors and send TAMIFLU and send those masks to the government of Mexico?

GUPTA: It is the intelligent thing because in the end it benefits really everybody. The public health goal in situations like this, containment, you want to try and contain this thing before it starts spreading around the world, which as you know it's already doing, but to still try and lessen those numbers.

I don't know. I'm not sure exactly how those decisions are made. I sat down, I talked to the mayor of Mexico City. He said he would under any circumstances accept help from other places including the United States should that help be needed. For the time being, they say that they sort of have things under control. But being here for a couple of days now, it's controlled chaos. That's what it is, Lou, so I think the request for that help may be coming.

DOBBS: All right, Sanjay, thank you very much. Take care of yourself. We appreciate it. We'll be checking in with you -- Sanjay Gupta -- Dr. Gupta in Mexico City, the epicenter of this outbreak of swine flu.

Well as if Mexico City didn't have enough trouble, an earthquake struck central Mexico today creating even more anxiety among the Mexican people, the epicenter of that quake in a city 130 miles south of Mexico City. The tremors causing tall buildings in Mexico City to sway, office workers, as you can see, running into the streets. There were no reports of any injuries or deaths.

Up next here, Homeland Security Secretary Janet Napolitano says she has ordered only passive surveillance to stop the spread of swine flu from Mexico. And President Obama says this outbreak is not a cause for alarm. We'll examine what this administration has done and has not done about this outbreak in Mexico.

(COMMERCIAL BREAK)

DOBBS: President Obama today trying to reassure Americans the federal government has a clear plan to deal with swine flu. President Obama said the outbreak is not a cause for alarm, as he put it, but he did acknowledge that swine flu is a cause for concern. Ed Henry has our report from the White House.

(BEGIN VIDEOTAPE)

ED HENRY, CNN WHITE HOUSE CORRESPONDENT (voice-over): From the president on down, the Obama administration is moving quickly to calm Americans about a possible pandemic.

OBAMA: And this is obviously a cause for concern and requires a heightened state of alert, but it's not a cause for alarm.

ROBERT GIBBS, WHITE HOUSE PRESS SECRETARY: What we're doing is a precaution and not to alarm people.

UNIDENTIFIED MALE: We don't want people to panic at this point.

HENRY: But the potential of a public health crisis comes amid glaring holes in the White House's response team after the botched nomination of Tom Daschle as secretary of Health and Human Services. The second choice Kathleen Sebelius is awaiting possible Senate confirmation Tuesday so a Bush holdover is serving as acting health secretary. And there's an acting director at the Centers for Disease Control, putting the White House in the awkward position this weekend of having health news announced by Homeland Security Secretary Janet Napolitano.

NAPOLITANO: The Department of Health and Human Services will declare today a public health emergency in the United States.

HENRY: But a prior presidential directive already mandates that Napolitano's department is in charge of coordination on such a crisis. And White House aides note there's no evidence the personnel gaps have backfired.

GIBBS: Our response is no way hindered or hampered by not having a permanent secretary at HHS right now.

(END VIDEOTAPE)

HENRY: Now the White House today was also forced to tamp down some speculation about the president's personal health after his visit to Mexico City earlier this month after a Mexican newspaper reported that someone who had given the president a tour died a day later. In fact, the White House put out a statement late today saying that this man in Mexico actually died a week after his visit with President Obama. They stress that President Obama's health was never in danger when he was in Mexico City and that his doctors say he's fine now. Lou?

DOBBS: And with the statement, Ed, that there's no problem, at least in the estimation of White House Press Secretary Robert Gibbs, no Health and Human Services secretary, also 19 top posts still unfilled, as well as the head of the CDC and the surgeon general. Who is leading that effort amongst the professionals then, the full-time staff?

HENRY: Well there's an acting director at the CDC. There was also acting officials at the surgeon general's office. Let's not forget they also don't have a surgeon general yet, and there's an acting secretary at the Health and Human Services Department, it's actually a former Bush official. It's not even an Obama official, though they do hope that as early as tomorrow the Senate will finally confirm Kathleen Sebelius, the second choice for Health and Human Services secretary. All this of course stemming from the Tom Daschle debacle -- that really put this White House behind in terms of getting a health secretary in place, and obviously right now it's something that they wish they certainly had. Lou?

DOBBS: And we should point out that Kathleen Sebelius' confirmation held up and challenged on the basis of her positions on abortion. And there is in your judgment a likelihood that that confirmation will proceed?

HENRY: You're right that conservatives have largely held it up because of her views on abortion. There's an expectation in talking to both Democrats and Republicans on the Hill that her confirmation is very likely, at least as early as tomorrow. Certainly this crisis is likely to push that along, Lou.

DOBBS: All right. Thank you very much -- Ed Henry from the White House.

U.S. officials tonight warning Americans against nonessential travel to Mexico. But Homeland Security Secretary Napolitano said closing our border with Mexico is not the answer. Instead officials at border crossings, seaports and airports have been ordered to be on the alert for people coming here who appear to be sick. Casey Wian has our report from our southern border with Mexico.

(BEGIN VIDEOTAPE)

CASEY WIAN, CNN CORRESPONDENT (voice-over): The San Yisidro (ph) port of entry south of San Diego is the world's busiest land border crossing and it was every bit of that Monday, despite the rapidly spreading swine flu virus that originated in Mexico. Customs and Border protection says traffic remains normal at about 540,000 people per day.

NAPOLITANO: You would close the border if you thought you could contain disease -- the spread of the disease, but the disease already is in a number of states within the United States so the containment issue doesn't really play out. And this particular flu, you can actually have it for a couple of days before you show any symptoms.

WIAN: Napolitano says CBP (ph) agents are screening border crossers, those who appear sick are directed to a secondary inspection area where they are interviewed by trained agents or medical personnel and potentially denied entry. But that's not enough says Congressman Duncan Hunter who represents San Diego. He wants the Obama administration to consider restricting cross border traffic and prepare a plan to close the border.

In a statement Hunter said "given the San Diego community's close proximity to the border and the fact that nearly 340,000 people enter the U.S. through southern California's ports of entry every day, the necessary precautions must be taken to ensure this virus does not spread any more than it might already have."

Homeland Security Secretary Napolitano who has recently spoken of the need to balance border security with commerce says appropriate cautions have been taken.

BESSER: There's no single action that will control an outbreak, but the combined actions that we're proposing and that are being undertaken around the country will help to stem the tide of any infectious disease outbreak and this one in particular.

WIAN: And given the fact that hundreds of thousands of people cross the nation's southern border illegally each year the effectiveness of closing the legal ports of entry would be limited.

(END VIDEOTAPE)

WIAN: Customs and Border Protection said so far it has not uncovered a single case of swine flu among anyone crossing the Mexican border in California. One individual in Calexico (ph) was hospitalized but that case turned out not to be swine flu, Lou.

DOBBS: All right. Let's hope that record holds up. Thank you very much, Casey.

WIAN: Absolutely.

DOBBS: Casey Wian reporting. Up next here, a wild finish at a NASCAR race in Alabama sends several fans to the hospital. And we'll have much more on the swine flu outbreak, the risks of those who travel to and return from Mexico and those who come in contact with them. We'll have the latest. We'll be right back.

(COMMERCIAL BREAK)

DOBBS: As we reported here a group of students from New York stricken with swine flu, those students had recently been in the Mexican resort of Cancun, a popular destination for American students and tourists, particularly at spring break. Now other Americans returning from Mexico such as these you see here arriving at Chicago's O'Hare (ph) Airport are concerned about a link between their visits and swine flu. Ines Ferre has our report.

(BEGIN VIDEOTAPE)

INES FERRE, CNN CORRESPONDENT (voice-over): Newberry Academy in South Carolina closed it's doors on Monday after learning that some senior students had gone to Cancun for spring break and returned home with flu-like symptoms.

ROBERT DAWKINS, HEADMASTER, NEWBERRY ACAD.: Suddenly out of the 13 that went we had 11 that were either sick or had been sick since they got back and then an additional one got sick this past weekend.

FERRE: In New York where at least 28 swine flu cases have been confirmed some high school students at Saint Francis School had traveled to Cancun for their spring break, but Mayor Bloomberg was cautious to connect the two.

MAYOR MICHAEL BLOOMBERG (I), NEW YORK CITY: We believe that this at Saint Francis may have come from Mexico but even that you don't know for sure.

FERRE: The Mexican Tourism Board says that in January and February of this year nearly 900,000 Americans flew to Mexico. Last year Cancun located on the Yucatan Peninsula, was the top Mexican destination with almost 2.5 million American visitors. Mexico City came in second. The country's health secretary on Monday admitted that the first outbreak of the virus was detected on April 2nd in the state of Veracruz.

Since then Mexican authorities say probable deaths have appeared in 10 states including Mexico City, Mexico State, Veracruz and Oaxaca. They're investigating at least 149 deaths in connection with the outbreak. Almost 2,000 people have been hospitalized with over 700 patients still in the hospital.

JOSE ANGEL CORDOVA, MEXICO HEALTH SECRETARY (through translator): We must recognize that this is the highlight, the high point of this epidemic and the number of cases will likely increase.

FERRE: Schools in the entire country are closed until early May.

(END VIDEOTAPE)

FERRE: And major airlines are making it easier for people who wish to change their travel plans to and from Mexico. They're waiving change fees for rerouting or rescheduling those trips, Lou.

DOBBS: And it looks like a good time to evaluate that, certainly. Thank you very much -- Ines Ferre.

We'll have much more on the swine flu outbreak here in just a few moments, but first five congressmen today arrested in a demonstration outside the Sudanese Embassy in Washington, D.C. The members of Congress part of a group of 50 people protesting genocide in Darfur. The lawmakers arrested after they refused a police order to remain behind a barricade outside the Embassy.

Other stories we're following across the country tonight: In Alabama, seven fans were injured at a NASCAR race, a car flipped and slammed into the safety fence in midair. Debris from both the car and the fence flew into the stands striking several people. The track's medical director says none of the injuries miraculously are life threatening.

In Pennsylvania two football rivals were given a chance to settle a score after 15 years. In 1993, the annual game between Eastern Pennsylvania and rival Phillipsburg (ph), New Jersey end in a tie. There was no over time in high school back then. Popular sports drink maker Gatorade gave the players one more chance. Players from the 1993 team rosters trained with NFL stars for two months and yesterday played in a rematch game, Phillipsburg won, 27-12 in front of a crowd of more than 10,000 -- sorted out finally.

Up next, we'll tell you what happened in the last major outbreak of swine flu in this country, more than three decades ago, and the latest on how the federal government is responding to this outbreak. A top official from the Centers for Disease Control joins me here next. We'll be right back.

(COMMERCIAL BREAK)

DOBBS: "The Big Issues" tonight -- the deadly swine flu outbreak continuing to spread from Mexico to this country, around the world. The federal government is already preparing for the possibility of a pandemic, but there are serious questions about the effectiveness of the federal government's response so far. Customs and Border Patrol agents are only passively surveilling travelers arriving from Mexico and the number of swine flu cases in this country continues to rise.

The Centers for Disease Control has confirmed 40 cases so far. Local health officials tonight report another five cases in California and Texas. Federal government officials are now saying Americans should consider how they would respond if this outbreak were to turn into a full blown epidemic. Flu outbreaks are of paramount concern of course to public health officials.

The disease spreads quickly to mutate into new strains for which there is no vaccine. The 1918 so-called Spanish flu pandemic remains the most devastating in modern times, killing tens of millions of people around the world, an estimated 50 to 100 million people. But officials hope that lessons learned from a 1976 outbreak in this country can lower the impact of this current outbreak. Bill Tucker has our report.

(BEGIN VIDEOTAPE)

BILL TUCKER, CNN CORRESPONDENT (voice-over): It's all hands on deck, but government officials are trying to reassure the public.

ROBERT WOOD, STATE DEPARTMENT SPOKESMAN: What we want to do, we don't want people to panic at this point. We're taking all the appropriate steps that we feel need to be taken right now.

TUCKER: That's a far cry from the government's handling of the swine flu outbreak in 1976. The death of one soldier at Fort Dix in February of the flu similar to a strain of influenza from 1918 that killed at least 20 million people worldwide set off national alarm bells. Eight months after the death and with no subsequent reported deaths from the virus, the government began a $135 million vaccination program.

UNIDENTIFIED MALE: Get a shot of protection, the swine flu shot.

TUCKER: A program that was stopped after at least 41 deaths and the sudden outbreak of a rare neurological disorder among people who had been vaccinated. Of the many lessons learned, there is one basic lesson we shouldn't ignore say public health officials.

DR. RICHARD WENZEL, FMR. PRES. INSTIT. FOR INFECTIOUS DISEASES: Anybody who tries to predict influenza does so at his own peril.

TUCKER: There are simply too many unknowns at this point for health officials to make authoritative statements beyond monitoring and tracking the disease. That's easier said than done, though, even for the medical community.

DR. HARVEY FINEBERG, PRESIDENT, INSTIT. OF MEDICINE: The specter of 1918-19 hovers still over the public health establishment. That swine flu worldwide pandemic was the greatest natural disaster of the 20th century. It's the worry about such a possible cataclysm that motivated the public health authorities to try to act in 1976 and is still in the background today.

TUCKER: Bill Tucker, CNN, New York.

(END VIDEOTAPE)

DOBBS: Well joining me now to give us more insight into this swine flu outbreak is Dr. Anne Schuchat. Dr. Schuchat is director of the CDC's National Center for Immunization and Respiratory Disease. Doctor, great to have you back with us here.

DR. ANNE SCHUCHAT, CTRS. FOR DISEASE CONTROL: Good evening, Lou.

DOBBS: The number of cases in this country, now at 45, the latest that we have seen, the expectation I assume is that it's going to rise significantly, is that a fair statement?

SCHUCHAT: We aren't focusing on the numbers now, but we do expect more cases and probably more states to be affected. We're trying to do is make sure we're responding aggressively and that people have the information they need to protect themselves, their families and their communities.

DOBBS: One of the ways that the response is taken at least so far which has drawn criticism as we reported here is that as Secretary Napolitano, the secretary of homeland security has said, conducting passive surveillance, is that in your judgment an adequate response.

SCHUCHAT: You know, I think that we're acting aggressively. We have quarantine personnel in the United States all the time and they do quite a bit in collaboration with airport authorities. And we're suggesting people defer nonessential travel, really think carefully how important that trip is and also what's going on back home that you might not want to be away from.

DOBBS: Obviously this originated in Mexico where it continues to worsen and the health minister there saying they expect this to be nowhere near the peak of the outbreak. Dr. Sanjay Gupta has just reported on a shortage of flu shots available, tamiflu, would it not be both compassionate, intelligent and reasonable for the united states, the centers for disease control, whatever agency is relevant here to provide additional flu shots to the folks in Mexico, they're our neighbor, they're also in proximity to the united states and to provide more masks and support?

SCHUCHAT: Let me clarify a few things.

DOBBS: Sure.

SCHUCHAT: The vaccine that we have right now, the seasonal flu vaccine, we don't think that will be effective against this particular swine flu virus. We are taking steps to grow the virus here up into a vaccine seed strain that can be handed off to industry should we need to produce a vaccine in large quantities. So seasonal flu vaccine is a great idea, I hope you get one every year and it's a great way to protect yourself against regular flu, but we don't think it will prevent the swine flu that we're seeing right now. On the other hand you asked about assistance for the people of Mexico who are having a difficult time and we're all thinking about them right now particularly with the earthquake they just experienced. The world health organization and the global community have been working together for the past several years to look into issues like stockpiling materials that could be available to countries in need and the U.S. government as well has designated a portion of our own assets for potential international use. So I think all eyes are on Mexico now hoping that -- hoping that things get better and trying to learn more about what's going on.

DOBBS: I suppose I have got to be a little more direct, what I'm really saying here, admiral, these are our neighbors, these people need some help and while it's very nice of the world health organization to study issues and to be somewhat abstract about it, I'm talking about more specific and more immediate help for the folks in particularly Mexico city who are short of masks and tamiflu and we have supplies of both, should we not be responding on a humanitarian basis.

SCHUCHAT: I know that there are discussions ongoing about that. We have teams in Mexico working in a tri-national effort with Canada, the U.S. and Mexico. We have sent epidemiologists, we have sent lab specialists and we're working closely with them to ensure that we can assist.

DOBBS: Give us your best judgment right now as we have looked at an outbreak that has reached now to New York, to California, to Texas, around this country, what are the -- what is your best judgment about a peak here? Does it look like it's strained or is it so vague and so unreadable as to remain just a large question mark for every one of us.

SCHUCHAT: Influenza is notorious for being difficult to predict so I don't really want to predict how long things will be progressing and whether we're going to see things get much worse or whether we'll be lucky. It's very important that people pay attention to this. Your viewers should know they can take steps to protect themselves and their family. Simple things like washing their hands, covering a cough or a sneeze and staying home from work or school when they're sick. Those are things that people think are corny, but we actually think they're a good idea.

DOBBS: And a number of doctors suggest to quit shaking hands, should we take a holiday from hand shakes which are all American. SCHUCHAT: I think hand washing is the important thing here, and if you don't have access to soap and water, alcohol gels can be good. People just think hand washing is an old kind of thing, but it's actually a really effective tool to reduce infectious diseases and something that you really can't go wrong doing more of.

DOBBS: By the way, on a lesser point to validate your call for us to get those annual flu shots, yes, doctor, I do get my flu shot each year.

SCHUCHAT: Thank you, Lou.

DOBBS: Up next, 28 confirmed cases of swine flu in New York City, the largest in this country so far, one of the nation's leading authorities on infectious disease s joins me and despite the rapid spread of swine flu, the federal government says the nation is prepared to hand it will outbreak. We'll have a great deal more coming right up.

(COMMERCIAL BREAK)

DOBBS: The Obama administration has declared a public health emergency to combat the swine flu outbreak. But there are concerns about how the federal government will hand it will outbreak. The fear is that the administration hasn't filled top positions at critical health agencies of the Lisa Sylvester has our report.

(BEGIN VIDEOTAPE)

LISA SYLVESTER, CNN CORRESPONDENT (voice-over): Secretary of Health and Human Services, the U.S. surgeon general, the director of the Centers for Disease Control and prevention, and the head of the Food and Drug Administration. What do all these have in common? They're all vacant positions under the acting director. As the nation worries about the spread of swine flu, some key roles remain either unfilled or held by acting managers, something politically conservative think tanks are finding disturbing.

JAMES CARAFANIO, HERITAGE FOUNDATION: Clearly they don't have the leadership team in place to deal with a national health emergency. That's just true.

SYLVESTER: Kansas governor Kathleen Sebelius has been nominated to head up the department of health and human services but hasn't been approved by the Senate. There are 18 other candidates awaiting confirmation, including the U.S. surgeon general, the FDA commissioner and the assistant secretary for preparedness and response. Those tasks have fallen to other officials, like Janet Napolitano and the acting head of the CDC Richard Besser to take the lead. White House Press Secretary Robert Gibbs insists the infrastructure the administration has in place is enough. He says the president has been getting multiple briefings daily.

GIBBS: The president's interest and knowledge on this issue as well as preparations that we're taking, we feel confident leave the government in a strong position to respond. SYLVESTER: Governor Sebelius could be confirmed by as early as Tuesday.

(END VIDEOTAPE)

SYLVESTER: And one other thing, there are only two labs in all of North America, one in Atlanta and the other in Canada that have the resources to con firm a swine flu case.

DOBBS: Lisa, thank you very much; Lisa Sylvester from Washington.

Up next here, what you need to know to protect yourself and your family from the swine flu. Leading expert on infectious diseases joins us, Dr. Martin Blaser is my guest here next, we'll be right back, stay with us.

(COMMERCIAL BREAK)

DOBBS: Joining me next here, Dr. Martin Blaser who's an expert on infectious diseases, we're going to be taking a look at what you can do to protect yourself and your family from this swine flu outbreak. But at the top of the hour, "NO BIAS, NO BULL" with Roland Martin in for Campbell Brown. Roland?

ROLAND MARTIN, CNN ANCHOR: Hey Lou. The latest developments on the story we have all been talking about, the outbreak of swine flu. There are no cases being reported tonight. The U.S. government is issuing new travel alerts and warnings and the World Health Organization has raised its global alert level. We'll get into all of those things as well as talk to a student who may have caught swine flu on a rent trip to Mexico. We'll see how the U.S. government is responding to all of this and we'll have a panel of doctors here to tell you how to avoid an infection. We're taking your calls at the top of the hour.

DOBBS: Thank you very much Roland

New York City has the largest number of combined cases in the United States. Joining me now is Dr. Martin Blaser. He's chair of the Department of Medicine at the University of New York School of Medicine; Dr. Blaser, leading expert on infectious disease. Great to have you with us doctor. Let's start with the severity of this outbreak. Your best judgment, have you got a sense of where we are right now with this, a sense of our future?

DR. MARTIN BLASER, NYU SCHOOL OF MEDICINE: Well, I think that Dr. Schuchat is correct, we're early in an epidemic. There's been an epidemic that's been going on in Mexico for probably a couple of months.

DOBBS: That long.

BLASER: Yes, maybe even a little longer. I was just looking at some figures today. And now it's spilled over into the United States, it's in five different states at least, it's probably in many more states, but we're a big country and this is only 40 cases and it's behaving right now like ordinary influenza, the kind we have every year, except that it's very late in the year.

DOBBS: It's very late in the flu season.

BLASER: Right.

DOBBS: And the idea that one group of kids from New York, from Queens would be in Cancun, a destination for spring break, and that they would be the only kids to come back with an influenza. The odds of that would be pretty high against, would it not?

BLASER: I think there are probably going to be a lot more cases that are turning up. And as in California and Texas, there's evidence of human to human transmission, where two people in a school or a father and a daughter have gotten ill. So the virus is spreading. The only good thing is that it's late in the flu season and the influenza fortunately doesn't seem to like warm weather so much.

DOBBS: Yet Mexico is a very warm climate, right now it's a much warmer climate than for example New York City. Why would it be taking hold and be so virulent there?

BLASER: It started earlier. You know, if there was going to be a flu outbreak, I would much rather have pun that starts in May than one that starts in February, for example. Because of the seasonality.

DOBBS: Is that the choice, the cycle of influenza virus to come in the fall after leaving at the end of the flu season? They're migratory in that sense, are they not? Some of them.

BLASER: It is not really a choice. This is an act of nature, and but -- but flu peaks in the winter and then it goes down in the spring and all but disappears in the summer and then begins to come back in the fall and rises again in the winter. I guess my prediction is to see pretty much the same thing.

DOBBS: Again in the fall?

BLASER: This one will peak at some point and it is going to be submerged and then come back I think pretty big in the fall and winter. That's good news for us. If this is correct. Because it gives us a chance to develop a vaccine to be enough time that we could prevent a lot of --

DOBBS: Development of the vaccine typically takes at least, what, two months? Six weeks.

BLASER: Well, usually in the normal course of things, it is eight to nine months but they're going to really compress it a lot.

DOBBS: I have said it makes no sense to me. I called for straightforwardly the United States government to send masks and to send tamiflu to Mexico City. They're operating with too few masks, too few of just about everything necessary in Mexico City but importantly tamiflu and other anti-virals. Why would we not do that? First out of compassion and then because they're our neighbors, it is the intelligent thing to do.

BLASER: I agree with you. I awe should give tamiflu. I don't know how many doses will be need. We have a big stockpile. We are at the beginning of the outbreak with warm weather coming so we could -- we could easily afford to give them tamiflu.

DOBBS: Does it surprise you that we have not already taken steps to do is that that?

BLASER: I'm not sure what's done or not.

DOBBS: Politics of public health, it is expressed and doctors don't want to offend on public health is made up of doctors, of course, thank goodness, but we are seeing the sort of strange statements like we don't want to control or carefully monitor fevers at our borders, our sea ports, our airports. Homeland security talking about passive surveillance. That's counter intuitive to I think most of us who are laymen. Why would we not want to do that?

BLASER: America is very involved in freedom and personal freedom and that is something we have to -- we have to make our actions concordant with the philosophy and beliefs but in the time of an epidemic, you have to do serious things and we saw that with SARS and right now again, we are pretty early in the epidemic in the united states. It may come to it later.

DOBBS: Doctor, as you carefully couched your answer, let me ask you this, would you rather be too early or too late with securing those entry points into the United States?

BLASER: Clearly, it is better to be too early.

DOBBS: Do you think we run the risk of not being early enough if we don't act relatively soon?

BLASER: It depends on what the actions are. It has to have a relationship. At this point, for what I know, I don't have any major fault with the federal government. They're taking it seriously as they should and the world health organization.

DOBBS: The testing taking place in Winnipeg and CDC. I'm told the only two laboratories to determine it's swine flu. How could we be in that position?

BLASER: I anticipate they'll release reagents and know-how that state and local labs can do it, as well.

DOBBS: So we could go beyond two laboratories that could be definitive?

BLASER: Sure.

DOBBS: All right. Thank you very much, we thank you for being with us here. Thank you.

BLASER: Thank you. DOBBS: Up next, several office buildings have been evacuated as the air force caused a panic in Manhattan in New York City. We'll have the full story here for you next and the unbelievable explanation.

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DOBBS: Alarm and panic in New York City today. Two U.S. air force jet flighters flew over the city at low altitude. For many New Yorkers, there was a troubling reminder of 9/11 as the presidential 747 and an F-16 fighter jet flew near the city over the World Trade Center site. The white house military office said it wanted a new file photo of the president's aircraft with the Statue of Liberty. It appears no one in that office, however, bothered to tell the mayor of New York City about the flyover. President Obama learned about the incident this afternoon. White house official said that the incident created a president who was, quote, furious. It turns out that they did alert the mayor of New York's office but someone in his office didn't inform Mayor Bloomberg.

It would be something to be furious about that someone would make a decision about an aircraft like this near the city for whatever reason for a photo-op. I would like to assure the air force and whoever made this decision that the president doesn't need a marketing plan to decide to get into air force one. It's just my suspicion that this was a complete waste of taxpayer money and the time of very important air force personnel.

President Obama today had another reason to be a little upset as he laid out his plans for his counsel of advisers of science and technology. Something caused President Obama to stumble in the remarks at the national academy of science.

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OBAMA: And I will charge them with advising me about national advisories to sustain a culture of scientific innovation. In addition to John -- sorry. I just noticed that I jumped the gun here. Go ahead and move it up.

(END VIDEO CLIP)

DOBBS: Apparently the president and his teleprompter operator were slightly out of sync leaving him momentarily speechless and I will assume it was the teleprompter operator's error as it is never, ever, ever the fault of the one reading. Right, Mr. President?

And a reminder to join me on the radio Monday through Fridays for "The Lou Dobbs Show" every afternoon in New York. Go to loudobbsradio.com for the listings in your local area.

Thank you for being with us tonight. Good night from New York.

"NO BIAS, NO BULL" starts right now. In for Campbell Brown is Roland Martin. MARTIN: Thanks Lou. Tonight we're following breaking news. The swine flu outbreak, there are new developments in a story everybody's talking about all over the place. More cases reported here in the U.S. we have new warnings to share with you and smart folks to answer your questions and separate fear from reality. Let's start with correspondent Erica Hill. What do we know right now about the swine flu?