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Anderson Cooper 360 Degrees

New Likely Flu Cases Showing Up in the U.S.; Senate Plans Emergency Hearings Tuesday on Flu Outbreak; Accused Craigslist Killer is in Debt, Might Have Also Targeted Men

Aired April 27, 2009 - 23:00   ET



ANDERSON COOPER, CNN ANCHOR: Tonight, swine flu fears, flu facts and breaking news: new probable cases being reported this time in New Jersey. White House officials, meeting this evening, scrambling to get out in front of a swine flu outbreak that is widespread and apparently growing.

As you look at the empty streets of Mexico City there behind me, the death toll there in Mexico is rising and so is the number of cases.

In the United States and all around the world, the World Health Organization now calling this a level 4 outbreak, with level 6 being an all-out pandemic. President Obama calls it cause for concern, not alarm.

Tonight we're going to give you the facts, not hype. We're not going to stoke unnecessary fear. Tonight, the facts you need to know so you can do something useful with your concern. Let's get you up to speed on the big picture.


COOPER: As world leaders scramble to prevent a pandemic, the threat spreads here at home. Eight states are now reporting suspected or confirmed cases of the swine flu. South and North Carolina and New Jersey are the latest added to the list.

But by far, the greatest outbreak is at this Catholic high school in Queens, New York, where scores of teenagers have fallen ill.

MAYOR MICHAEL BLOOMBERG, (I) NEW YORK CITY: More than 100 students are sick. And we now have information that 28 of them have confirmed human swine flu and another 17 have probable swine flu.

COOPER: The Obama administration has issued a public health emergency for the country, and the President urges calm.

BARACK OBAMA, PRESIDENT OF THE UNITED STATES: And this is obviously a cause for concern and requires a heightened state of alert. But it's not a cause for alarm.

COOPER: It is a much different situation in Mexico City, many venturing outside wearing masks. But the city is mostly shut down. Countrywide, nearly 2,000 hospitalized as possible cases and officials suspect the deadly new strain has claimed more than 149 lives.

A profile of the victim reveals why this airborne killer is so worrying.

GREGORY HARTL, SPOKESMAN, WORLD HEALTH ORGANIZATION: The great majority of cases that we've seen so far have been in otherwise healthy young adults. This would tend to tell us that it is a virus which has the ability to cause a great deal of mortality and illness.

COOPER: Beyond Mexico and the U.S. around the world, new cases reported. Canada, Scotland, Spain, with several other nations awaiting test results.

At Tokyo's Narita airport, they're using heat sensors to detect if arriving passengers have a fever, one of the symptoms of the swine flu.

The CDC advises Americans to avoid nonessential travel to Mexico. And tonight encouraging news from the CDC, saying lab testing reveals the virus is susceptible to two anti-flu drugs on the market, including Tamiflu.

The White House has ordered doses sent to the affected states and the border. And in Washington, simple advice to stopping a catastrophe.

JANET NAPOLITANO, SECRETARY, DEPARTMENT OF HOMELAND SECURITY: Washing hands, staying home from work or school. If you feel sick, covering your mouth if you cough or sneeze. These are straightforward and simple measures, but they can materially improve our chances of avoiding a full-fledged pandemic.


COOPER: Well, if there is a front line in this fight, this virus, it is clearly Mexico right now.

360 M.D. Dr. Sanjay Gupta is there tonight. Sanjay, how bad is it in Mexico?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Well, so many of the early cases were treated at this hospital right over here. They are catching up. They're trying to figure out just how bad this is. What we wanted to figure out is where did this start? Where is it going?

Let's start at the beginning.


GUPTA (voice-over): It started off like any other flu, springtime, in one of the world's largest cities. But within a week, Mexico City would look like this.

It's hard to believe this, but what you're looking at is a uniformed officer carrying a rifle outside a public hospital. (on camera): We are here outside one of the largest public hospitals in Mexico City. We can't get inside.

They're very concerned about crowds gathering in the wake of the swine flu. There are lots of patients inside. Many of them waiting to see doctors, many have been here for several hours. They have their masks on.

But this is what the situation has become here in Mexico City.

(voice-over): Chaos, and yet patients need care. They continue to flood in all day, all night. The question is how do you treat what you don't understand?

(on camera): They came in. They were in their 20s, 30s and 40s. They weren't the elderly or the very young that you typically associate with the flu. But these were people in the prime of their lives. They were getting sick. They were dying. And the doctors here were mystified.

Over the next couple of weeks, they had a medical mystery to solve, and a lot of that solving took place right behind these gates.

We also spoke with Mexico City's mayor.

How worried are you?


GUPTA: Very worried.

(voice-over): The hospitals are overwhelmed not only with patients, but also with press. But we were able to get in.

(on camera): I tell you what, been next to impossible to get into a hospital like this one.

Finally, I told them I was a doctor. They let me in with a small camera so we could try to figure out how they are taking care of these patients with the swine flu. Let's take a look.

(voice-over): We now know over the last two weeks nearly 2,000 people came to hospitals like this one in Mexico and around 150 died.

(on camera): As you can see, this is one of the hallways where they're taking care of a lot of the patients with the swine flu.

As you can notice here, there are no patients in the hallway. They're trying to keep all the patients sequestered in the room.

(voice-over): But the key to all of this is figuring out who exactly needs treatment.

(on camera): One of the things that is so critical in an outbreak like this is trying to identify patients early. For patients at hospitals like this for two weeks before anyone can figure out what was going on. Finally someone realized that there was probably a virus that the world had never seen before. And they went to laboratories like this one to try and sort that out.

(voice-over): The hospital management did not want us to see these hospital workers. Upset because they weren't given masks or meds. They came out anyway and told us.

Under all the pressure, Mexico City in springtime is starting to show cracks. And everyone is hoping the swine flu can be controlled and soon.


COOPER: Sanjay -- and I guess the bottom-line question is, how dangerous is this? And, you know, how risky is it for people watching right now at home?

GUPTA: I think statistically, for any of your viewers, Anderson, it's very unlikely they're ever going to get the swine flu. So that should be a sort of calming a little bit to them.

But I think what's sort of more important is that we're having a hard time figuring out just how deadly this is. We have around 150 deaths in Mexico, as you've heard, but we don't know how many that's out of total. 1,300 people went to the hospital, but there could have been a lot more people who had mild illness as well.

So the fatality rate's really sort of hard to sort out here. You know, we do hear about some of these cases in the United States now. There have been no deaths. There's been one hospitalization. It could be that it's sort of early in the natural history of this. But so far it seems like the fatality rate might be lower than we thought.

COOPER: Do we know why, in Mexico, it seems, you know, with flu often it's the very young, the very old who die. That doesn't seem to be the case here. I've heard the median age for this, the average age of victims has been teenagers -- 16, 17, 18.

A, is that true, and why would it be striking, killing people who aren't normally the ones who would die from the flu?

GUPTA: It is true. And this is a bit counterintuitive. When you think about the flu -- seasonal flu, the flu that we're accustomed to, it typically tends to have its worst ramifications in people who don't have as well developed immune systems, so the very elderly and the very young. They just can't fight it off.

What's sort of counterintuitive is that with this particular virus, it's in the people who have robust immune systems. As their body starts to respond to try and fight off that virus, they produce tons of inflammatory cells. And those inflammatory cells can sort of flood the lungs.

So in essence, it's not the virus itself that's so problematic but the body's reaction to it. And we've seen that before. That's the same sort of situation with SARS. And it's been the same situation with some of the pandemics of years past.

And that's one of the red flags that got public health officials concerned about this -- Anderson.

COOPER: There's a lot more questions I'm going to ask Sanjay, including why there have been so many deaths in Mexico and the cases here in the United States are so mild.

Could it possibly be a different virus? That's just one of the questions we'll ask Sanjay and several other doctors right after this next break.

But we do have more breaking news back in Washington -- late word tonight that the Senate's going to hold emergency hearings tomorrow on the outbreak -- expected to testify, officials from the CDC, as well as Dr. Anthony Fauci, who runs the National Institute for Allergy and Infectious Diseases.

They have got a lot on their plate, certainly, working with public health authorities in all 50 states. Eight states now have now confirmed or suspected cases, from one in Kansas, to 28 here in New York City.

Erica Hill is actually tracking the spread right now in America.


ERICA HILL, CNN CORRESPONDENT (voice-over): On this beautiful spring day, a dark cloud hangs over New York. With 28 confirmed cases of swine flu and plenty of close quarters in this city of more than 8 million, some New Yorkers are worried.

UNIDENTIFIED MALE: I am so scared, because I actually live in Queens.

UNIDENTIFIED MALE: It was shocking to hear that it was in a high school in Queens.

HILL: That high school in Queens is St. Francis Prep.

DR. THOMAS FRIEDEN, HEALTH COMMISSIONER, NEW YORK CITY: These confirmed cases of human swine flu were, in all likelihood, contracted in New York City at the school community at St. Francis.

HILL: A group of students at the private school recently returned from a trip to Cancun. But not all those infected went to Mexico.

Fourteen-year-old Frederick Jolin's father tells CNN his son isn't even friends with any of the kids who went, yet he tested positive. Frederick spoke to WCBS.


UNIDENTIFIED FEMALE: Why? JOLIN: It was like -- it's at a point like anybody could get it. Like, you could die from it.

HILL: In South Carolina, Newberry Academy's hallways and classrooms are empty today. Thirteen students recently returned from Cancun; 12 came back sick. So did one adult. The school is now waiting on test results to confirm whether their symptoms were actually swine flu.

ROBERT DAWKINS, HEADMASTER, NEWBERRY ACADEMY: It's real easy to see how it got so many of them. They were a self-contained group for five days and four nights on buses, airplanes and in resort rooms together.

HILL: The school is closed until at least Wednesday on the advice of health officials.

A Kansas man who also infected his wife was in Mexico City on business. And one of the most recently confirmed cases, a 9-year-old Ohio boy, is also just back from Mexico.

But in Texas and California, there are cases that don't involve recent travel to or from Mexico. Something health officials at every level are taking into account as they follow the developments across the U.S.

And back in New York, even the heartiest commuters are taking the warning seriously.

UNIDENTIFIED MALE: I'm going to wash my hands after I take my hand off this pole for sure.

UNIDENTIFIED MALE: Every time I get off the subway, when I get to work, when I get home, I wash my hands.

HILL: A small gesture that could make the difference.


HILL: Now, one thing to point out, there's been a lot of attention. I know, Anderson, you said this at the top of the show, the goal here is not to further cause any panic.

One thing that was great to see, is even in hearing from that headmaster in South Carolina today, he was very calm about the entire situation and said that he hadn't really heard from parents who were all that upset.

That everybody seemed to be taking the news well, taking it in stride...

COOPER: Right.

HILL: ... and taking the necessary precautions.

COOPER: Yes. Erica, I appreciate it. Thanks very much. By the way, a lot of people have flights that are booked and paid for to and from Mexico. And we thought you should know that even before the State Department today warned against nonessential travel, airlines began waiving change fees for travelers going to or through Mexico.

So basically you can most likely reschedule or change your connections without paying extra. You should check your airline for details tonight.

As always, a lot more on the blogs, the live chat, including a piece by one of our guests tonight, Dr. Nathan Wolfe, Director of the Global Viral Forecasting Initiative.

He'll also be on the live chat throughout this hour answering your questions. So check it out at, the live chat. It's happening now. I'm about to log on myself. Erica Hill also has her live Web cast during our breaks tonight.

There's a lot more on this throughout the hour. Dr. Nathan Wolfe joins us next along with a global health specialist just back from Mexico, Dr. Carlos Del Rio as well as Dr. Sanjay Gupta in Mexico City.

Also you'll hear from one of the girls at this New York high school. The school is closed. It's being disinfected today. She was rushed to the hospital this weekend with a 103 fever. Find out what it feels like to be infected.

And later, new revelations in the Craigslist case, this thing just gets stranger and stranger. About how deep in debt the suspect is, and now authorities say the med school student was also going after men online. We'll explain that.

And only on 360, Suze Orman opens up about life before the fame and fortune; part of a look at the world's most influential people. We'll be right back.


COOPER: Updating our breaking news, another state apparently touched by swine flu, New Jersey with five probable cases among people who traveled to California or Mexico. All said to be mild like the rest of the known infections here in the United States.

Beefed-up surveillance at American airports right now, though nothing yet like this. Take a look, this is airports in Japan and China using infrared scanners. Anyone running a fever is stopped, questioned and in some cases quarantined.

There's a lot we do not yet know about this swine flu. A lot of questions to be asked like why the American cases have been so mild so far but so many have already died in Mexico.

Let's "Dig Deeper" with Dr. Sanjay Gupta in Mexico City, Dr. Carlos Del Rio, Professor of Global Health at Emory University just back from Mexico, also Dr. Nathan Wolfe, Director of the Global Viral Forecasting Initiative.

And if you watched "PLANET IN PERIL," you'll remember Dr. Wolfe spent time with us in the forests in central Africa, where he tracks the spread of viruses from animals.

Sanjay, do they have -- I mean, here people are being treated with Tamiflu. Do they have enough Tamiflu in Mexico and enough masks to go around?

GUPTA: Well, they don't. And simply put. Although they've been trying to distribute as many masks as possible. This is a very large city, as you know, Anderson, population of around 20 million.

They had about four million of these masks, and they were passing them out. They ran out at some point. In fact, there were protesters outside the hospital, as you saw earlier, mainly complaining about the lack of masks even though they were treating patients who were infected.

Also with regard to the Tamiflu, about a million treatments, we hear. Again, not enough, if this started to get bigger, within Mexico City alone.

COOPER: Dr. Del Rio, you just returned from Mexico. What's your assessment of how the government there is handling this stuff?

DR. CARLOS DEL RIO, PROFESSOR OF GLOBAL HEALTH: I think, Anderson, that the government response has been swift. I think it has been good. The key strategy they have followed is that of social isolation, making sure people are not gathered together.

As Sanjay said, this is a city of 20 million. It's the ideal city to have an outbreak like this. The subway itself transports more than five million people a day.

So the number of people that are in contact with each other is very, very large. The possibility of transmission is very large. So closing schools, closing sports events, closing social events, closing churches on Sundays, all those things hopefully will have some impact in trying to decrease transmission.

That has been the strategy being followed and hopefully we'll see over the next several days that that is beginning to take effect.

COOPER: Dr. Wolfe, what do we know about swine flu? I mean, how does it spread from a pig to a person? And also, you told me right before you came out that this actually started in birds long ago.

DR. NATHAN WOLFE, DIRECTOR, GLOBAL VIRAL FORCASTING INITIATIVE: Right. So the way that the virus is transmitted among pigs is quite similar to the way that it's transmitted among humans.

So these are sort of respiratory droplets, aerosol spread from pig to pig. And presumably the transmission from pig to human would be much the same. Now, the interesting thing about influenza viruses in general, these are primarily originally wild bird viruses. But they have a tremendous amount of capacity to jump around. So viruses from humans can go to pigs. Viruses from pigs can go to humans. Bird viruses can go directly to humans and to pigs. And then these viruses can mix.

COOPER: And what makes this so scary -- so spreadable right now is that it doesn't -- you don't have to have affiliation -- you don't have to be -- interact with a pig. Basically, it's person to person.

WOLFE: That's right. So presumably at some point this virus was a pig virus, it jumped into a human. At that point it was capable of going from human to human. And that's really when these outbreaks spark and begin, and that's obviously what happened here.

COOPER: Sanjay, at this point do we know why -- we talked before the break about why there have been so many deaths in Mexico, why the cases here are so mild.

Is it possible it's not the same virus?

GUPTA: Well, there could be a variant of the virus. And that is certainly one hypothesis out there. The answer to your question, after talking to lots of doctors on the ground here, we don't know.

It could be that it's earlier in the whole natural history of a disease here in Mexico. So we're seeing those deaths here, haven't seen deaths yet in the United States. But even as Dr. Besser from the CDC have mentioned, we may see some deaths in the United States.

It could also be that you know, we weren't talking about swine flu that much even at this time last week. So patients who had the flu who decided to sort of ride it out at home may be going in now instead and getting it checked out.

So I think the level of concern may be higher. And that could be helping people.

You know, let me just point out, Anderson, the hospital behind me continues to be busy, even so many weeks now after that first swine flu death.

An 11-year-old was taken to the hospital earlier, admitted, ambulances continue to go in and out. Armed guards outside there because they worry about the crowds gathering and whether or not families might gather out here and be somewhat concerned about things.

So that's sort of the scene here as well, Anderson.

COOPER: Dr. Del Rio, Dr. Wolfe was pointing out to me that some 35,000 people in the United States die every year just from regular flu.

So is this just hype about this? I mean, why should people be paying, you know, so much attention to -- why should they be concerned, or should they be? DEL RIO: I think the reason to be concerned is 35,000 people die in the U.S. from regular flu, but we had a vaccine for regular flu.

This is a totally new virus. The population has not been exposed to it. There is no previous immunity to this virus, and therefore that's the scary component of it. You have a virus to which there's no pre-vaccination, there's no prior immunity, and therefore the lethality rate may be a lot higher than of other influenza viruses.

In bird flu, for example, the estimated mortality is about 50 percent, 40 percent to 50 percent. In these cases, what we're seeing in Mexico, it's a mortality rate of about six to 10 percent, which is about what was seen in the 1918 Spanish flu outbreak.

COOPER: Dr. Wolfe, you track these viruses all the time. And you've been doing it for many years. You say people shouldn't be surprised by this. Why?

WOLFE: Well, essentially we live in the incredibly interconnected world. And in a virus that previously might have gone extinct in some rural village has the potential to really get to Tokyo or Paris.

COOPER: Air travel, roads.

WOLFE: Air travel, planes, trains and automobiles.

In addition, sort of this contact with animals continues, ok? And that's really the source of all of these outbreaks.

What's happening with swine flu is by no means unique. It was the same sort of phenomena led to H5N1, the bird flu. The same thing leads to Ebola outbreaks that are often localized. Even HIV is a virus of animals that entered into humans.

So this represents a very sort of similar phenomena, something that we've been seeing for ages and we will continue to see far into the future.

COOPER: We're going to continue to talk about it tonight. Dr. Wolfe is actually going to be online on the live chat as soon as we go to a commercial break and throughout this hour.

He'll also be back on the program later on answering your questions. But if you have questions for him, go to the live chat at He'll answer your questions there.

Also I want to thank Dr. Carlos Del Rio for taking the time to be with us tonight. And we'll also talk to Dr. Sanjay Gupta later in the program as well from Mexico City.

Thank you all.

As we said, Dr. Wolfe will be online at

Coming up though next, you're going to meet a young girl, a teenager who was rushed to the hospital this weekend with 103 fever. She didn't even go to Mexico, though, but there are a lot of folks in her school also came down with this virus.

We'll talk about what she has been going through. You'll actually hear from her what it feels like to have this thing.

Later, you've seen the steps being taken. The question is, are they enough? President Obama today suggesting we're falling behind in research.

We'll take a closer look at research and readiness for a major outbreak, whether it's this swine flu or the next possible virus that can create a pandemic. We're "Keeping Them Honest."

And it's not a bull in a china shop, but its close. How did it get in a grocery store? What happened when it did? All of it caught on tape, that toward the end of the program tonight.

We'll be right back.


COOPER: U.S. medical officials have no idea how many Americans may be sick with swine flu or incubating the virus. The biggest outbreak here so far, of course, has been in New York where more than 100 students at a Queens high school have fallen ill. You see them right there, sanitizing the school.

It was closed today so the cleanup crews could basically scrub it top to bottom. Some of the students who got sick recently traveled to Cancun.

But not all of them. Sixteen-year-old Arianna Anastos wasn't on that trip, but her friends were, and she got sick, sick enough to send her to the hospital this past weekend.

I talked to Arianna and her father, Chris, earlier in an exclusive interview.


COOPER: Arianna, how are you feeling right now?

ARIANNA ANASTOS, LIKELY HAD SWINE FLU: I'm feeling a lot better now.

COOPER: When did you first start to feel sick, and what did you feel like?

A. ANASTOS: I felt sick on Thursday. I was really dizzy. And I started having a fever and a cough. And I had trouble breathing.

COOPER: How bad did the fever get?

A. ANASTOS: About 103 by Saturday.

COOPER: So then what did you do about it?

A. ANASTOS: I went to the hospital with my mom. And we waited for about an hour. And I got tested by the strep throat test and the nose swab.

COOPER: You haven't been to Mexico. How do you think you got it?

A. ANASTOS: Probably from someone else. I mean, like, you know, people touch the railing on the school, and then I touch them, so any possible way.

COOPER: Chris, you must have been incredibly concerned. How did you deal with this?

CHRIS ANASTOS, DAUGHTER LIKELY HAD SWINE FLU: Well, it was terrible. On Saturday morning she looked like she was run over by a truck, really. It really scared us. But...

COOPER: What do you mean by that? How did she look?

C. ANASTOS: Well, she was on the couch lying down with her eyes closed, could not move, could not even open her eyes. I had a wet towel over her eyes to keep her temperature down.

COOPER: So you went...

C. ANASTOS: And that would be...

COOPER: Arianna, you went to the hospital on Saturday. Did they give you Tamiflu?


COOPER: So how soon after taking the Tamiflu did you start to feel better?

A. ANASTOS: After two pills, I started feeling better.

COOPER: How do you deal with the fear about spreading it? I mean, Arianna, were you worried that you might give it to other family members?

A. ANASTOS: Yes. I mean, my parents would, like, come into the room, but they would wear masks and gloves. And they wouldn't allow anyone into the room. And they wouldn't allow me, like, to touch anything in the house, or else my mom would spray it with Lysol. So, yes, no one got sick.

C. ANASTOS: We took every precaution we could to prevent the spreading. And obviously, my wife and I and my other daughter did not get it. So, it worked for us.

COOPER: So, they gave you masks at the hospital, and you make sure to wear those around the house? C. ANASTOS: Yes, yes. They really did a good job. They explained to us what we need to do. They gave us the equipment. And we just followed the direction, and nothing happened to us. And Arianna is almost 100 percent.

COOPER: Well, I'm glad Arianna, that you're feeling better. It's amazing what a difference two pills can make. And I'm glad you were able to get the Tamiflu...


COOPER: ... and I'm glad you're feeling better, and I'm glad no one else in your family caught this.

A. ANASTOS: Thank you.

COOPER: Arianna and Chris, thanks so much for being with us.


COOPER: Well, swine flu is a microscopic threat that crosses borders easily and invisibly making every U.S. airport a potential entry point.

So what is being done to stop it from coming into the United States? We'll have the latest on that ahead and we'll bring our doctors back to answer your questions.

Also ahead, some stunning developments in the Craigslist killer case: why police may soon expand their search for victims to include men. Plus, the latest on the suspect's summer wedding plans.

And New Yorkers looked up today and saw this, an airliner flying low, an F-16 chasing it. What it was, why New York's mayor is furious and so, apparently, is President Obama. We'll be right back.


COOPER: Well, health officials around the world are facing a huge unknown. They have no way of knowing if the swine flu outbreak that's causing so much worry will escalate into a full-fledged pandemic. As we've said, the U.S. government has declared a public health emergency, a move that President Obama qualified today as a precaution.

Take a look.


BARACK OBAMA, PRESIDENT OF THE UNITED STATES: The Department of Health and Human Services has declared a public health emergency as a precautionary tool to ensure that we have the resources we need at our disposal to respond quickly and effectively.

(END VIDEO CLIP) COOPER: But as we just pointed out in a world where people travel far and often, containing any flu outbreak is a major challenge.

Thelma Gutierrez has the latest on efforts to stop swine flu from spreading from Mexico to America.


THELMA GUTIERREZ, CNN CORRESPONDENT (voice-over): The San Isidro port of entry south of San Diego is the world's busiest land border crossing. More than 100,000 people cross here each day. Customs officials say they're on heightened alert. But despite news alerts and evidence of growing numbers of those infected with swine flu virus, traffic here is still heavy as usual.

Customs and border patrol agents are closely watching people crossing into the United States, and those who appear sick get a secondary screening. As for air travel, flights are still arriving in the United States from Mexico though federal officers are watching passengers for signs of illness. And some travelers are wearing masks.

But travel headed toward Mexico is about to plunge. Travel advisories issued this afternoon now warn Americans not to go to Mexico if they don't have to.

JANET NAPOLITANO, SECRETARY, DEPARTMENT OF HOMELAND SECURITY: They encourage individuals to avoid any nonessential travel to Mexico for the time being. You may ask how long will the alerts be operative, and the answer is, we don't know.

GUTIERREZ: With their frequent briefings and decision to distribute antiviral medications to states, experts say the government generally gets good marks for its swine flu response.

There is concern, however, that if the outbreak explodes into a pandemic, public health laboratories will be overwhelmed. A recent report says budget cuts have resulted in the loss of 11,000 state and local public health jobs.

JEFF LEVI, TRUST FOR AMERICA'S HEALTH: That could really be a threat because it would delay our ability to identify what's going on. And that's critical to a rapid response.

GUTIERREZ: experts say hospitals don't have enough beds, masks, gloves or ventilators.

IRWIN REDLENER, COLUMBIA UNIVERSITY: I think the country needs on the order of a couple of 100,000 additional ventilators over what we have now.

GUTIERREZ: at the old-town Mexican cafe in San Diego, family members like Herb Lizalde (ph) worry about loved ones in Mexico who are required to wear masks and take extreme precautions in their daily lives. HERB LIZALDE, RESTAURANT OWNER: The military's handing them all out. So it's kind of a thing that they have to do.

GUTIERREZ: Required measures that give so many Americans with family in Mexico a little peace of mind.


COOPER: Thelma, with tens of thousands of people going through, what exactly are customs agents doing during this, what they call the heightened alert?

GUTIERREZ: Anderson, right now they're calling it passive observation. They're not out asking each and every one of the cars that are going through whether or not they're sick. Instead they're looking for very obvious signs of the flu.

They say if they spot someone who appears to be very sick, they can pull that person over, question them. And then if need be, they have a quarantine area where they can actually place these people and then turn them over to health officials. So far they say they haven't even found one of those cases, so that's good news at this point.

COOPER: All right. Thelma Gutierrez, thanks.

As we said there's no way to know if this latest swine flu outbreak will escalate. We certainly hope it doesn't. The last thing we want to do in this program is fuel any alarm.

That said, public health experts have long been worried that we won't be prepared when the next flu pandemic hits. And there's good reason for their concern.

Tom Foreman tonight is "Keeping Them Honest."


TOM FOREMAN, CNN CORRESPONDENT (voice-over): Back in 1976, a swine flu scare spurred announcements on TV and calls for nationwide vaccinations.

But a congressional report last fall says more than 30 years later we're still not ready. The government wants enough vaccine developed and available to inoculate all 300 million citizens in six months for any kind of flu. But at best, current American production might protect one in five.

At the Center for Infectious Disease Research and Policy, Dr. Michael Osterholm.

DR. MICHAEL OSTERHOLM, UNIVERSITY OF MINNESOTA: We have made investments in this country. In fact, the United States has made more investments in influenza vaccine work than any other country in the world. But it's still a long way from having a modern, efficient and really very effective influenza manufacturing infrastructure available. FOREMAN: The report finds multiple problems. Vaccine production techniques are old and slow. With little profit in developing new ones, American industry shows little interest. And while foreign producers could help, in a pandemic, they'd likely keep their vaccine at home.

The U.S. government could spend more money developing drugs called adjuvants that stretch vaccine supplies. Europe is ahead of us on that. And in times like this, everyone likes such ideas.

UNIDENTIFIED MALE: We want to be aggressive.

FOREMAN (on camera): But when the crisis passes, governments, industry and the public lose interest quickly.

In 2006, an avian flu scare had governments worldwide vowing to stockpile enough Tamiflu, a drug that treats flu symptoms. Not even a vaccine. And yet shortages remain.

OSTERHOLM: If this virus does result in a human pandemic in the next weeks and months, we are going to be in a world that is going to need a lot of vaccine that it's not going to have.

FOREMAN (voice-over): Keeping them honest, we were warned.

UNIDENTIFIED MALE: Swine flu? Man, I'm too fast for that to catch me.

Tom Foreman, CNN, Washington.


COOPER: Answering your questions online right now is Dr. Nathan Wolfe, epidemiologist. You can log on to the live chat at to talk with him. Also Erica Hill's Web cast on the flu outbreak during the break.

Scores have been killed, hundreds sickened. The danger continues. We'll talk to Dr. Sanjay Gupta and Dr. Nathan Wolfe, answering your questions ahead.

And also tonight, the alleged Craigslist killer. Surprising new developments, bizarre new developments. A report that may change the investigation. Police say the suspect may have also been targeting men online.

And later, fighter jets, what looked like Air Force One flying over New York, New Jersey, rattled a lot of nerves in this city. It led to evacuations. What was behind this flight? The story ahead.


COOPER: Tonight, police may have found a possible motive for the accused Craigslist killer. Reports out today revealed that med student Phil Markoff was in serious debt. We'll tell you how much in a moment. At the same time, some new developments on the investigation including a woman who says she was his first victim. The biggest surprise, perhaps the strangest, is an allegation that Markoff may have been targeting men on Craigslist as well.

Randi Kaye has the latest in tonight's "Crime and Punishment" report.


RANDI KAYE, CNN CORRESPONDENT (voice-over): The victim profile in the "Craigslist Killer" case may be on the verge of a makeover. A spokesman for the Suffolk County D.A.'s office tells me the hunt for victims could include men if evidence warranted.

(on camera): Investigators may want to talk to this man, who told NBC he fears he could have become another of Philip Markoff's alleged victims. He says Markoff contacted him twice on Craigslist, once last spring and again in January.

UNIDENTIFIED MALE: I posted an ad on Craigslist under "Male for T" which stands for "males for transsexuals."

KAYE (voice-over): The man says Markoff answered an add in the "Casual Encounter" section of Craigslist -- the same place investigators say Markoff found his other alleged victims. His lawyer says he's not guilty.

The man told NBC Markoff e-mailed explicit pictures of himself from the Yahoo! address sexaddict5385.

DON CLARK, FORMER FBI SPECIAL AGENT-IN-CHARGE: If this person is truthful, then the likelihood is, is that he's not the only one male that's out there. There are probably many others.

KAYE: Markoff's lawyer did not return calls about this allegation or about this court document obtained by CNN that shows Markoff is broke.

This paperwork signed by a probation officer shows Markoff has been unemployed for some time and that the 23-year-old medical student is $130,000 in debt from student loans. That qualifies him for a court-appointed, taxpayer-funded lawyer.

Could that be why he allegedly robbed a woman of $800 in this Westin Hotel? The stripper who says she met Markoff here told CBS's "48 Hours" he erased his number from her cell phone, cut the hotel phone line, and this.

UNIDENTIFIED FEMALE: He picked up a pair of my underwear that were on the floor and put them in his pocket.

KAYE: And Markoff's upcoming summer wedding? Seems it's been canceled. The band hired to perform now says on its Web site, due to circumstances beyond our control, August 14th is now available to book. Randi Kaye, CNN, New York.


COOPER: I guess that's no surprise there.

More breaking news on the swine flu outbreak. Where is it? How bad is it? And what you can do.

We're taking your questions with Dr. Nathan Wolfe and Dr. Sanjay Gupta. You can e-mail, tweet or Facebook us.

Also tonight, how a 747 ended up flying low over Manhattan not far from ground zero. A photo op -- believe it or not. Who thought that one up? We'll tell you and tell you why President Obama is fighting mad about it.

And later, take a look at this. A bull in a grocery store sent customers running. It is our "Shot" tonight, coming up.


COOPER: Well, when Suze Orman talks, people listen, a lot of people. The personal finance expert's advice is followed by millions. Her tips on money, stocks and savings have made the best-selling author a business icon and one that's earned the respect of many Americans.

Her achievements are being honored by "Time" magazine, who has named her one of the world's 100 most influential people. The issue comes out Friday. You'll also be able to see a 360 special on Friday, "The World's Most Influential People."

Tonight, a little preview with business journalist Suzy Welch interviewing Suze Orman. Take a look.


SUZY WELCH, BUSINESS JOURNALIST: Somebody tweeted me, "I love Suze Orman. I don't know if she's ever walked in my shoes."

SUZE ORMAN, PERSONAL FINANCE EXPERT: Are you kidding? I absolutely -- this is why Suze Orman is Suze Orman, because I have walked in those shoes. I've walked in the shoes of credit card debt. I've walked in the shoes of being ashamed that my parents didn't have any money. And I wanted to be like all the other kids, and I wasn't.

Why do you think I was a waitress until I was almost 30 years of age, having been one for seven years? Making $400 a month. I've walked in those shoes. I lived in my car for months. I've done all of that.


COOPER: For more of Suze Orman, for more of that interview, you can go to And don't miss the "Time 100 AC 360 Special: The World's Most Influential People" this Friday night. See who else made the list. It should be a fun night.

Right now, Erica Hill back with a "360 News and Business Bulletin" -- Erica.

HILL: Anderson, swine flu fears hitting Wall Street, coupled with concerns ahead of a very busy week of quarterly reports. That combination led to a sell-off today. The Dow off 51, both the S&P and the Nasdaq also fell.

Saying "I Do" in Iowa. Same-sex marriages officially began today in the state. The first couple to exchange vows, Melissa Keaton and Shelly Wolfe. Iowa's highest court legalized same-sex marriages there on April 3rd.

In New York and New Jersey, a photo op causing a panic. A backup of Air Force One and two F-16s flew over Lower Manhattan and Jersey City this morning. The catch here, no warning to residents; even the mayor says he didn't know. The White House says it was a photo op and insists that city officials were notified. The mayor actually said he was furious, Anderson. And if the reasoning behind any of this was to keep it classified, he thinks it is ridiculous and poor planning. A lot of New Yorkers would probably agree.

COOPER: It's unbelievable that this thing happened -- that somebody thought that was a good idea.

And the mayor says if he would have known, he would have said don't do it, especially not in Lower Manhattan.

COOPER: Yes. Seriously. Erica, thanks.

Join the live chat happening at Virus hunter Nathan Wolfe taking part. He and Dr. Sanjay Gupta are also answering your swine flu questions next on this program. They'll tell you what you need to know.

And a bull in a grocery store; the invasion caught on tape. See what an employee did to try to stop him. It's our "Shot of the Day," something to make you smile with all of this heavy news -- smile before going to bed.

We'll be right back.


COOPER: Earlier we asked you to send us your questions about swine flu. There are so many unknowns in this story. We're going to some of those questions now answered. 360 MD, Sanjay Gupta joins us again from Mexico City and Dr. Nathan Wolfe is here in New York. He's an epidemiologist and director of the Global Viral Forecasting Initiative which is basically an early warning system for pandemics. He's essentially a virus hunter.

Sanjay, our first question comes from a CNN iReporter. Take a look.


UNIDENTIFIED MALE, CNN IREPORTER: I have a question. You see people wearing face masks and in an attempt to protect themselves from the influenza virus, but isn't it true that the virus is so small that they can make it through the pores of the mask? So why wear a mask in the first place?


COOPER: Sanjay?

GUPTA: Yes. The mask is not foolproof. I think that's for sure. Although, it can prevent large doses, if you will, of the virus from entering our nose or mouth and getting into our lungs, and that's sort of the idea of it. It can't be used in isolation.

One of the things we're really learning down here in Mexico City is that there's a lot of concern about the virus sort of hanging on inanimate objects like keyboards, ATM machines -- it's one of the things the Minister of Health pointed out to me. It could get on money, as well. It could get on your hands. So less hand shaking and there's not the customary greeting of kissing on one cheek and there's a lot of hand washing.

Anderson, we talked about hand washing all the time but it's probably never been more important than it is now.

COOPER: Doctor Wolfe, we have a question from Emily who posted this on the AC360 Facebook page. She says, "Would getting a flu shot help to reduce our chances of catching swine flu?"

DR. NATHAN WOLFE, DIRECTOR, GLOBAL VIRAL FORECASTING INITIATIVE: Good question. This is early stages of the outbreak. Certainly it is the case that if our initial reports are correct and that this virus is mosaic including parts of human viruses, there may be elements of some protective immunity but I think the current wisdom is probably these vaccines are not going to afford much if any in the way of protection against this particular virus.

COOPER: Sanjay, you agree with that?

GUPTA: Yes. I think that -- you know, this is sort of made up of several different components. So could the flu shot provide a protection against one of the components? Perhaps but I think to Nathan's point, it is not going to be enough. It is not a vaccine for swine flu overall.

COOPER: We have another one. This is coming to us via Twitter. Natasha wants to know -- I'll give this to Dr. Wolfe -- what makes swine flu different from any other flu that kills 30,000 plus a year? Why the worry?

WOLFE: Well, one primary reason for concern is the lack of immunity, the likely lack of efficacy of the current vaccines against this particular strain. Part of it is just unknown. Any time a novel virus enters into the human population particularly if it's in a family like influenza that has a potential to cause massive pandemics, this is a reason for concern, something we need to watch very carefully which is obviously what's being done now.

COOPER: And the strange thing is, in Mexico it's killing people in their late teens, 20s who are not normally the victim of the flu; it's usually the very young or the very old.

WOLFE: Yes, that's right. And I think one of the things that happens sometimes is that actually the body's own immune system responds in a very particular way that can cause illness. So in these cases, it's a healthy immune system which causes harm to these individuals. Whereas, in particular strains with more harm for the young and old, it is actually a weakened immune system which is causing harm.

COOPER: Sanjay, this question is for you. We have a question, this from the AC360 the blog. Juanita asks if this means she should cancel her trip to Puerto Vallarta in July. Should people be canceling travel that far down the road?

GUPTA: Boy, Puerto Vallarta sounds nice right about now. I think you're going to have to wait and see a little bit Juanita on that one. See how this outbreak sort of develops over time. There are no specific travel advisories although non essential travel should be sort of thought about before coming to Mexico. It's April now. You have a couple of months I think to decide on that one.

COOPER: And Sanjay, bottom line, for people in the United States watching this right now is what? Just, you know, be aware of it. Don't freak out. Wash your hands. Be aware of people around you?

GUPTA: I think so. You know, we don't exactly know where this thing is going to head right now. The numbers are small right now. We're paying attention to it because this is a new virus; one that we haven't seen before and we don't have natural immunity to it. It may fizzle out and it maybe something that we talk about in years from now as something that just happened but never really amounted to anything.

But if it's turns out to be something more than that, then people need to have as much knowledge as possible about this and a lot of sort of how we deal with this is going to be on an individual basis, sort of containment even at the family level.

COOPER: Do you agree with that?

WOLFE: I do. The other thing that I would just add to that is we don't know what's going to happen with this particular virus. What we do know is that it's part of a pattern that we are seeing. Viruses continue to enter into human populations from animals and they're going to continue to affect us.

Part of what we are doing right now, it is very important. I mean, this is like response to a heart attack and you definitely need to respond to heart attacks.

But an important point is that these things are going to continue to happen so we need to try to move a little bit earlier in this process and to try to be able to predict and possibly even prevent much earlier in this process by for example doing some of the work that we do which is to actually monitor individuals who have close contact with animals. Potentially then we could catch these things before they hit Mexico City, before they spread.

COOPER: You're actually tracking viruses as they cross over from -- your tracking what viruses cross over from animals to people all around the world with your Global Viral Forecasting Initiative.

WOLFE: That's right. What we know is that's the commonality to all these things; whether it be SARS, Ebola, HIV. They all come from animals. And so what that gives us is the potential to create a monitoring system which can catch these things at the moment that they're entering so they're constantly pinging at us. And so if we do catch them at that point, we may be able to really make a difference.

COOPER: Well, let's hope so. Dr. Wolfe, it's great work and appreciate what you're being. Thanks for being on the program tonight and Sanjay as well. Stay safe down there, Sanjay.

The "Shot" is next. Something to kind of make you smile or at least be glad you weren't at this supermarket. Wait until you see how the employees tried to stop a bull running around in this supermarket. Crazy.


COOPER: All right Erica. For tonight's "Shot," something you do not see every day thankfully and really something you never really want to see unless it's on YouTube, of course. The clip comes to us from Ireland where you can see a bull trots into a local supermarket. The bull meanders down the aisles, checks out the storage room...

HILL: Looks for the specials.

COOPER: Some of the people just flat-out run. Others put up $barricades to try and stop the bull. One guy used shopping carts to barricade the fellow in. That didn't work. The bull escaped apparently from a livestock market. Its owner...

HILL: Can you blame him?

COOPER: I know -- is a farmer. The farmer's actually running down the aisle after the bull. And then does an about face as the bull kind of charged after him.

HILL: Poor bull.

COOPER: I know.

HILL: He just didn't want to be eaten.

COOPER: He was later caught. No one was hurt apparently. We have no idea what's now happened to the bull -- the said bull.

And there the bull leaves.

HILL: I hope he got to go live in a nice pasture somewhere.

COOPER: That's what we'll say happened.

HILL: He could roam the aisles of the pasture.

COOPER: Exactly.

That does it for 360. Thanks for watching.

"LARRY KING" starts now. I'll see you tomorrow night.