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CNN SUNDAY MORNING
Weekend House Call: Mysterious Outbreak of Pneumonia
Aired March 16, 2003 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
ARTHEL NEVILLE, CNN ANCHOR: The World Health Organization has issued a global health and travel alert for a deadly new form of pneumonia that has already made more than 150 people sick and left at least nine people dead. Medical correspondent Elizabeth Cohen can update us on this alarming and fast-changing story. Elizabeth, good morning.
ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Good morning, Arthel. Arthel, it is changing all of the time. This is a brand new disease. The World Health Organization calls it a worldwide health threat.
This mysterious disease that is so new that officials had to make up a name for it: Severe Acute Respiratory Syndrome, or SARS. The best labs in the world have tried to figure out what's causing it and failed. Scientists don't know if it's a bacteria, a virus, or some other type of infectious disease.
So far, 150 people have become ill, and about nine have died from this disease, where patients get an unusual form of pneumonia. The symptoms: fever greater than 100.4 degrees, cough, shortness of breath, and difficulty breathing. The Centers for Disease Control and Prevention says, if you have those symptoms and have traveled to one of these countries in the past week, you need to call your doctor.
We'll tell you what the countries are. Canada; China, which includes Hong Kong; Indonesia; the Philippines; Singapore; Thailand; and Vietnam. Now this disease is quite contagious. In Hanoi, an American businessman apparently gave the disease to 31 hospital workers. But health experts believe the disease spreads only from close contact. For example, contact among family members or between doctors and patients.
They believe you cannot get it, for example, just by passing a sick person on the street. There have been no cases in the United States. But two infected people did fly through American cities. In the first case, a doctor who had been taking care of people with this disease flew from Singapore to New York, and then Friday night he boarded a plane in New York to go to Frankfurt, Germany. The World Health Organization boarded the plane and quarantined him and his traveling companion.
Now the second case is a little bit different. There was someone who was in Asia and then traveled to Canada and was infected and gave that infection to a family member. That family member then did a trip to Atlanta, went to Atlanta for a business conference and apparently went back to Canada. Is ill, and is apparently now on a respirator.
The Centers for Disease Control is telling people to consider not traveling to the affected countries if they don't have to. Now, we're -- joining us this morning to help answer our questions is the head of the Centers for Disease Control, Dr. Julie Gerberding. And you can call or e-mail her with your questions: 1-800-807-2620. Or you can e- mail us at housecall@cnn.com.
Now, Dr. Gerberding, I want to ask you a question. We have had no confirmed cases in the United States. Do you expect we will see them? It's been in Canada and six other countries.
DR. JULIE GERBERDING, DIRECTOR, CDC: Well, we know that travel seems to be the factor that is the risk here. And we have a lot of people in this country who have traveled to the affected areas. So far, we have no cases, but we are asking our clinicians to be on the alert and for people who are returning home from the countries you mentioned to see a doctor if they get a fever or anything that looks like this illness.
COHEN: And, in fact, when people are getting off the plane from those countries you're handing them a card now. What does that card say?
GERBERDING: The card basically says, if you've been traveling in a specific country and you develop a fever and a cough or a respiratory illness, you should contact your physician and get checked.
COHEN: OK. But it's just anyone who has not been traveling or not had contact with someone who is traveling. Just any old person comes up with a fever and a cough, difficulty breathing, should they panic?
GERBERDING: You know we need to really be specific here about what this is and what it isn't. There are a lot of illnesses this time of year, and we don't want people to be alarmed if they haven't been to one of the affected countries. Right now, it's either being there or taking care of somebody who has been ill with this illnesses.
COHEN: OK. We have a an e-mail from Kirstin (ph) in Hanoi. She writes, "From a naive standpoint of isolation, please tell me, as a foreigner living in Hanoi, how careful do we really have to be of a virus like this?" Dr. Gerberding?
GERBERDING: Well, first of all, we don't know it's a virus. And it's very early in the investigation. So we're keeping an open mind about any of this.
As I said, it's kind of flu season, so we may be confusing this particular illness with garden variety flu in some cases. But we do know that if you are a health care worker and you're not using the appropriate protection, you can be exposed and you can become ill.
NEVILLE: OK. You know what, doctor, we have a phone call coming in right now. I want to go to Vermont, where Nancy (ph) is on the line. Go ahead, Nancy (ph). What's your question?
NANCY: My husband is already in China -- in southern China -- and will be flying back through Hong Kong in the near future. I'd like to know what precautions he can take. And my second part of my question, I'm severely immune deficient myself. I'm wondering if he can carry this back and expose me or our family without being symptomatic.
GERBERDING: You know it's possible that the person could be exposed in these areas. It really depends on where he's been and what he's been doing. That's why we're issuing this general alert. The most important thing is for him to be very vigilant about any fever or respiratory illness and to get to the doctor right away to get checked out.
It doesn't look like people who aren't symptomatic are spreading this. So the symptoms are really the point at which we would get concerned.
NEVILLE: Absolutely. And of course everyone's asking the question, if this new health threat could be terrorism, of course. That's on everybody's minds these days. Should more of a quarantine be in place?
We're going to answer more of your questions when we come back. Plus, should you be buying organic fruits and vegetables. And how do you know what is organic and what isn't? An organic update after this break. You're watching CNN, the most trusted name in news.
(COMMERCIAL BREAK)
NEVILLE: And welcome back, everyone. I'll Arthel Neville. You are watching CNN's Weekend House Call. I'm joined by medical correspondent, Elizabeth Cohen, and the director of the CDC, Dr. Julie Gerberding. And, Elizabeth, I know we have some more e-mails coming in you want to share with us now.
COHEN: Absolutely. Let's share one from Kyle (ph) in new Orleans. He wants to know, "Is this pneumonia possibly a biological release on the world? It seems to have all of the earmarks of scientific-grown issues in reference to resistance and to current antibiotics." I think what he's saying is did someone intentionally release this, thinking that no antibiotic would work against it?
GERBERDING: Well, you know the pattern that we've seen so far is close household contacts and health care personnel who are taking care of sick patients. And that looks like a contagious disease that has a natural transmission pattern. We're keeping an open mind about any possibility right now, but it looks like it's a natural infection at this point in time.
COHEN: And when you say natural, you mean it looks like it's not terrorism.
GERBERDING: Exactly. NEVILLE: That's what everybody wants to know, of course. Listen, we have a phone call coming in now from Eddie (ph) in New York. Go ahead, Eddie (ph). What's your question?
EDDIE: Good morning to all of you. Dr. Gerberding, I know that your alert has informed airlines and hospitals. What is being done to cruise passenger ships who might already be sailing that area and are scheduled to go to that area? What sort of steps can they take to protect themselves?
GERBERDING: Quarantine experts at CDC are also working with the cruise industry and others to make sure that we've got the information out there. This is not a problem that goes back in time very far, so we're really sort of concentrating on where people have been in the last seven days. So we'll get to those people in the same way that we get to the airline passengers.
COHEN: So if you're infected, you're probably going to get sick in the next seven days?
GERBERDING: The incubation period looks like it's about two to seven days.
NEVILLE: Now we have another call from New York as well, coming in from Vivian (ph). Go ahead, Vivian (ph) with your question. Are you still there? OK. Vivian's (ph) not there, but I think her question was going to be related to travel.
I think people are just concerned. I think the lady asked earlier, she said her husband's over in China and he'll be coming home. And wondering exactly what sort of contact that he might have abroad and the possibilities of bringing that disease or the virus back home.
GERBERDING: Well, right now, the WHO is not recommending travel restrictions. So we are not telling people don't go there or come home if you're there. But we are sort of saying use some common sense. If you don't have to go there right now and you're kind of on an elected trip or a vacation, maybe you might want to wait a few days until we sort out what's going on and can give you the best advice.
COHEN: If you had a vacation planned to one of these countries right now, would you take it or would you cancel it?
GERBERDING: If I had a vacation planned I'd take it no matter what. But if I were thinking of going to that part of the world, I think I would look at the situation and think about where I was going and check the Web site at CDC, because we'll have the most up-to-date advice and information there.
NEVILLE: And of course we still have more travel questions coming in. Mark (ph) now is on the line in Massachusetts. Good morning, Mark (ph). Mark (ph), go ahead. Are you there? OK. Mark (ph) is no longer there.
But again, a lot of people -- you already emphasized, doctor, that in fact there's not any sort of travel restrictions placed by the World Health Organization, which I think is very important to sort of reiterate. And, again, Elizabeth, you can chime in here. This is obviously a very serious situation here, but you certainly don't want to instill any sort of panic at this point. Correct?
GERBERDING: Absolutely. Keep in mind that this is just unfolding. We are just getting reports. And the definition of this is very non-specific.
There's a chance that we're mixing this new syndrome up with a sort of garden variety respiratory illnesses. And until we really get the investigations completed we're not going to be able to say very much about how many cases there really are and where the problem is really evolving.
NEVILLE: And you know what, doctor? I have to ask you this, because it almost seems like this came out of the blue. Why are we hearing about this now?
GERBERDING: Well you know we live in a world of emerging infections. We saw that a couple of decades ago with AIDS, and every so often we see something new. That's why we have to be vigilant for anything and keep our system as up-to-date as we can. We want to catch it when it's happening, but we've learned that this will probably be something we live with for the future.
NEVILLE: OK. Dr. Julie Gerberding, thank you very much. Elizabeth Cohen, thank you. Nice to see you as well.
COHEN: Nice to see you.
NEVILLE: You're staying, right?
COHEN: I'm not going anywhere.
NEVILLE: Don't go anywhere, because when we come back we have many more questions. We're going to be getting to those when we come back. But first, getting fit without leaving the office.
(BEGIN VIDEO CLIP)
ANNOUNCER: Logging so many hours in the office can keep some from a regular workout routine. In lieu of a full workout, Memorial Hospital of Rhode Island suggests walking around the office building during breaks or lunch. Try standing when you talk on the phone. Take the stairs rather than the elevator. And when traveling for business, walk around the airport while waiting for your flight and take advantage of hotel fitness centers and pools.
(END VIDEO CLIP)
(COMMERCIAL BREAK)
NEVILLE: And we're back with CNN's Weekend House Call. We're taking your phone calls and e-mails. We're talking about a worldwide outbreak of a mysterious pneumonia virus, Dr. Gerberding, correct? GERBERDING: Well we don't know what's causing this. It could be an atypical bacteria. It could be a virus. We are still in the stage of searching for the agent. We are getting specimens into the complicated laboratories, and I think in the next several days we'll be able to at least rule out some things if we haven't specifically identified yet.
NEVILLE: Let's see, do we have a phone call now coming in from Hilda (ph) in Virginia? Are you there, Hilda (ph)? Good morning.
HILDA: Yes, good morning. My question, I just got back from China and when I got back I did get sick. I went to the doctor and he gave me medication for flu. I want to know more about the symptoms, because now I'm OK, but I do have a cough. So what should I do next?
GERBERDING: Well you know whenever you have an illness or a symptom you can't explain or you are worried about, the first place to go is back to the doctor. And so I would say get in touch and just check it out. It sounds like this is not related, but to be sure if you're worried, find out.
COHEN: And now if Hilda (ph) has not traveled, if our caller has not traveled to one of these countries or doesn't know anyone who has, she probably doesn't have this, right?
GERBERDING: Right now we have no evidence whatsoever that this is popping up in the United States. If you haven't been to the affected area, or you haven't been a health care worker taking care of one of these cases, we don't have any information to suggest you'd be at risk.
COHEN: OK. We're going to take an e-mail from Ivan (ph), now. Ivan (ph) in Bulgaria wants to know, "Has the germ which causes this new dangerously spreading pneumonia been identified? Is it a bacterium, a virus, or a fungus? Are there any effective drugs for it?"
GERBERDING: It looks like this is not a common cause of pneumonia, meaning it's not one of the things we can easily get out of the respiratory secretions in a typical laboratory. But we don't know if it's an unusual bacteria or a virus. We'll have that information, we believe, as the testing is done and the samples arrive. But right now it's too soon to say.
COHEN: As far as treatment goes?
GERBERDING: Well, since we don't know what it is, it's really hard to offer advice on the best treatment. What we're telling doctors is, when you see a patient who might have the illness, start out with the same things you'd use for any kind of community-acquired severe pneumonia. That would probably be some antibiotics. And depending on the flu activity in your area, it could be drugs for influenza as well.
NEVILLE: We have another call coming in, doctor, right now from Sam (ph) in Pennsylvania. Good morning, Sam (ph). Go ahead. SAM: Good morning. Is this disease any more or less severe for children or seniors?
GERBERDING Right now we don't have information about the ages of the affected people. Most of them look like they're in the middle ages because those are the people who are working and taking care of folks. So right now we can't say anything about special risk groups other than the investigation is in its early phases and we'll know more as we go forward.
NEVILLE: And I know, doctor, you said there's not treatment right now because we're not really sure what is being treated. But what about protection against this possible virus?
GERBERDING: We are offering some very specific advice to the health care workers. Since we're not positive how it's being spread, but it is the close contact in the health care environment, we're advising the health care workers to use the special masks to keep their breathing safe. To use face shields if they're going to have contact with droplets or splatter. And to use gowns and gloves and the other kind of standard precautions that we recommend in health care settings. So until we know, we're saying use both those kinds of barrier precautions.
NEVILLE: I see. But not for just regular people.
GERBERDING: No. Certainly not for regular people.
COHEN: Now this is spread through close contact. Let's say, god forbid, that you were infected with this and you and I were sitting at this distance. Could you give it to me sitting next to me like this?
GERBERDING: I don't think so; we don't have any suggestion of that. But if we lived in the household together and we shared our living space intimately, then I think there would be a concern. But, again, let me just say, this is early. We're learning as we go here, and we don't want to draw premature conclusions. Keep an open mind.
NEVILLE: Absolutely. Listen, Misty (ph) is calling in from Kansas. Good morning, Misty (ph). Your question?
MISTY: Good morning. I live in Kansas City and we haven't been traveling, but my daughter is six years old. And they're passing pneumonia around in kindergarten just rampant around here. And I was just -- I'm just concerned about it.
We've been in the hospital this week. We've been in and out. She's doing respiratory, she's doing breathing treatments. And all the (UNINTELLIGIBLE). It's just lingering on. We're having trouble even getting rid of it.
GERBERDING: You know this is that time of year. It's the flu season, and it is the time of year where we see a lot of respiratory illnesses. It's important not to confuse that which is something that's common in the winter months with this syndrome in Asia that we're worried about. But nevertheless, I'm sorry to hear about your daughter.
I'm sure that's disconcerting to everyone. And I hope you're in good contact with your clinician.
COHEN: But, again, if this family has not traveled, it's not this illness, it's something else.
GERBERDING: Yes. If there's not been travel in the family to the affected areas in Asia, I would not be worrying about the SARS syndrome. I would be worried about the kind of things that are often spread in kindergartens and schools.
COHEN: Well, Dr. Julie Gerberding, director of the Centers of Disease Control and Prevention, thank you for joining us to talk about this brand new disease that's going to have a lot more questions in the future, I'm sure.
NEVILLE: Yes, in the very near future. Doctor, thank you very much.
And we are back after this break.
(COMMERCIAL BREAK)
COHEN: Thanks for joining us. As we've been talking about this mystery pneumonia that's made its way to seven countries, including Canada, one final thought. What the CDC is telling people is, that if you've been to one of those countries, it's six Asian countries and Canada, and you have a fever and have had some breathing problems, you need to go see your doctor. If you're having those problems and you haven't been to one of those countries and don't know anyone who has, then you probably just have a regular old illness and don't need to worry about this particular health threat.
You'll want to stay tuned to CNN as this story develops. We'll be back Saturday morning at 8:30 Eastern Time with another edition of Weekend House Call, the place to get your medical questions answered. CNN SUNDAY MORNING continues right now.
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