CDC expert: 'We're very concerned'
Dr. Walt Orenstein answers flu-related questions
 |
Dr. Walt Orenstein
Story Tools
|
ATLANTA, Georgia (CNN) -- Flu season started early this year, bringing with it widespread outbreaks in at least 13 states and sparking a shortage in vaccine supplies.
CNN anchor Wolf Blitzer spoke Wednesday about the flu fears with Dr. Walt Orenstein, director of the National Immunization Program for the federal Centers for Disease Control, who also answered question from concerned viewers.
BLITZER: Let's get to the big question first, the big perspective. It's a lot worse than a lot of people thought it would be.
ORENSTEIN: It's a very serious influenza year. It's also one of the earliest years that we have on record. We've seen lots of hospitalizations, a number of deaths. We're very concerned. And so, we feel people ought to do whatever they can to try to prevent it or to treat [it] as early as possible.
BLITZER: All right, let's go to the prevention first of all. Supposedly, the vaccine, there's no more vaccine available, although yesterday we were hearing reports that you're trying to import from England and elsewhere?
ORENSTEIN: There is some vaccine in some communities. It's spotty. In a number of communities there is no vaccine. We urge people who have conditions that place them at high risk of complications from influenza, such as severe lung disease or heart disease, to try to work a little harder to try and find a vaccine if they haven't been previously vaccinated.
With regard to increasing our supplies, we're doing several things. One is we're working to get a small number of doses out from one of the manufacturers to the states for the states to get out to counties and others for vaccination. And we are looking at a vaccine that is licensed in the United States in Europe that might be able to be brought here, but that's probably not going to be until sometime in January, before the doses actually get here.
BLITZER: And that could be a little too late for a lot of people.
ORENSTEIN: For some people it could be, yes.
BLITZER: Is this a regional problem? We saw that some states seem to be having worse situations than other states. Or is this nationwide?
ORENSTEIN: This is very typical for influenza. Some areas get hit earlier than others. But it's really nationwide. There are only two areas as of last week that hadn't reported any influenza -- Massachusetts and the District of Columbia. And I would suspect that very soon every state will be reporting significant activity.
BLITZER: It will be all over the country. We're getting swamped with phone calls, Dr. Orenstein.
CALLER: I was wondering if you're already pretty darned sick -- I'm not quite sure what's killing these little kids, but I've got two little ones and myself, and we're pretty darned sick. And I was wondering at what point do you seek antibiotics?
ORENSTEIN: Well, I think the issue of antibiotics depends on whether you have a complicating infection. Certainly anybody who is having difficulties breathing should be seen by a doctor right away, because that could be a bacterial pneumonia, and some of these deaths have been from bacterial pneumonia, which needs antibiotics. Other complications of influenza that may need antibiotics are ear infections, sinus infections and a few other kinds of complicating factors.
So, it really depends, if you're very sick, my recommendation would be to contact your doctor and to see what that doctor recommends after they examine you. Antibiotics don't help for influenza itself. Influenza is a viral infection. There are drugs called anti-virals that can be used, particularly for persons who have high-risk conditions, but to be effective they need to be given within two days of onset of illness.
CALLER: My question is, what do you do if you haven't gotten the flu shot and everyone that you contact is out of the vaccination? Myself and my children haven't received a vaccination yet.
BLITZER: There is this nasal mist, Dr. Orenstein, you might want to talk about as well.
ORENSTEIN: OK. First, for persons 5 to 49 years of age who are completely healthy, there is an alternative called FluMist, or an intranasal vaccine, which is generally very effective. And so, we would recommend you look for that.
Second, if you cannot get it or you don't fit the criteria for that vaccine, what we would recommend is certainly, one, at the first sign of illness to begin taking fluids, to take anti-fever medications, to try and get plenty of rest. And I think we also ask our fellow Americans who are sick to stay home from work. If you've got fever and a cough, you're potentially spreading influenza, and one of the things that you can do is not go to work.
The other things that are important is what we call respiratory etiquette. When people cough, cover your mouth. Wash your hands frequently. Viruses can frequently get on hands. Don't touch yourself unless you wash your hands. Those are kinds of things to decrease the spread, though very difficult with influenza.
BLITZER: Is the flu vaccine safe for women that are trying to get pregnant or are pregnant?
ORENSTEIN: We recommend women who will be in the second or third trimester of pregnancy, which is right now, to get vaccinated. We have had a number of hospitalizations of pregnant women. Pregnant women can have a difficult time dealing with influenza. So, we would certainly recommend the flu vaccine for pregnant women, and we have recommended it for a number of years.
CALLER: I have the flu. And I was wondering, what's the chances that my son, who has been vaccinated, will get it from me?
ORENSTEIN: Normally, we would say that the likelihood would be a 10 percent to 30 percent chance, because flu vaccine is 70 percent to 90 percent effective. And generally, people who get the flu who have had vaccine tend to get milder illness. Because the predominant strain is a drifted strain this year, the protection may be a little lower than that. We don't know how much lower, but hopefully there will be some protection.
BLITZER: Should it be mandatory for children to get the flu shot, just like other vaccines?
ORENSTEIN: Well, I think at this point, we need to try to get children vaccinated, in my opinion, in a voluntary fashion. This is a new recommendation. We just made it, and we feel that the most important thing people can do is get it.
I think when you're talking about mandates in the young population that we have, I'm not sure they would be very effective. I think we ought to take a lesson from this year, and the real lesson for all of us is that we need to get vaccination earlier, that we need to get vaccination in October and November. And hopefully next year, we will have a better supply and people vaccinated on time.
BLITZER: A lot of people, doctor, have said to me, I'm worried about getting the flu vaccine because I hear you can get the flu from the flu vaccine. Or, the other concern out there is that it would make you -- if you're prone to certain illnesses, it could complicate your life miserably.
ORENSTEIN: OK. A couple of things. One, the flu vaccine that is given by shot is a killed vaccine. In fact, it's not only a killed virus, it's split apart and it's purified. It cannot give you influenza. It can give you a sore arm...
BLITZER: That's a myth that you just can demolish.
ORENSTEIN: That's a myth. That's a myth. The FluMist, which is the live attenuated vaccine, can give you some respiratory symptoms such as nasal congestion, a little sneezing, cough, but generally much, much milder than influenza itself. But the injection cannot give you the flu.
BLITZER: Is it dangerous for anyone to get a flu vaccine? Are there certain people, in other words, that you recommend don't get it under any circumstances?
ORENSTEIN: The major concern is those who have very, very severe allergies to eggs. There's a special procedure for them to get it, because the flu vaccine [is] grown in eggs. But aside from that, in essence, you can give it to virtually everybody. It's recommended for persons six months of age and older. There is no flu vaccine available for children under six months of age. The only way to protect them is for people around them to be vaccinated.
BLITZER: And people over 50 should definitely get it?
ORENSTEIN: People over 50 should definitely get it. We are trying to prioritize during this period of shortage, and our priorities would be persons 65 and over and persons with underlying chronic disease. These are the most important people to get the vaccine. Normally, we recommend it for people 50 and over.
BLITZER: All right, Samantha in New Jersey has a question: I have asthma. Should I be especially concerned if the virulent strain of the flu that has surfaced this season reaches my area?
ORENSTEIN: We are -- asthma is one of the conditions we define as high-risk. Yes, influenza can make asthma much more severe and can lead to severe pneumonia. So, I think it is something to be concerned about. We do recommend annual vaccinations for persons who have a history of asthma. And certainly we would think you ought to be in touch with your medical provider as to what you should do should you get sick.
