CDC's Acting Head On Swine Flu

More cases of swine flu were reported Wednesday in the United States. Dr. Richard Besser, acting head of the Centers for Disease Control and Prevention, talks about the spread of the virus.

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ROBERT SIEGEL, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.

MICHELE NORRIS, host:

And I'm Michele Norris. The World Health Organization has raised the level of concern about the new swine flu virus to five; that's five on a scale of six. The virus has been identified in nearly a dozen countries now and the W.H.O.'s move is a strong signal that a global epidemic is imminent. In the U.S., states have begun receiving medical supplies from a national stockpile. In Washington, Secretary of Homeland Security Janet Napolitano defended the administration's decision to keep the borders open. And this, all this, and no one can say for sure whether this flu is going to act like a regular seasonal flu or something far more dangerous.

SIEGEL: Dr. Richard Besser is the acting director of the Centers for Disease Control and Prevention. He's in Atlanta. Welcome to the program, Dr. Besser.

Dr. RICHARD BESSER (Acting Director, Centers for Disease Control and Prevention): Thank you.

SIEGEL: Another day has passed. What has the CDC learned about the swine flu that it didn't know yesterday?

Dr. BESSER: Well, what we've learned is what we had feared and that is that we have had the first death from this new virus. This occurred in a child from Texas, a 23-month-old, and was reported by the Texas Health Department earlier today.

SIEGEL: And does that news or the news of the spread of the disease so far as you have tracked it - does it suggest to you the scale at which we are likely to experience this entire outbreak in the U.S.?

Dr. BESSER: I don't think so. What we're seeing is in Mexico a much more severe situation than we have yet to see in this country, and we haven't yet understood why that's the case. The initial cases that we identified here were mild. As we continue to look for more cases, I anticipate that we're going to see a much wider spectrum of disease - that we are going to see more individuals who've been hospitalized and unfortunately I do think that there may be additional deaths.

SIEGEL: And are you working on the supposition that the difference between what's happened in Mexico and what's happened here is that simply we're at a much earlier stage of the outbreak?

Dr. BESSER: I think that's hard to say. That's one of the hypotheses, that we're earlier. There are other ones. There's the possibility that in some way the virus over time, being transmitted from person to person, has reduced its ability to cause severe infection. There's the possibility that there are treatment differences so that patients in Mexico either presented later or were treated in a different manner. These are all things that we're looking at and we are in Mexico as part of a tri-national team trying to answer some of those questions.

SIEGEL: This morning I heard a talk radio show host call for sealing off the border with Mexico. In fairness, I think he was calling for that before the flu outbreak as well. You've acknowledged that sealing borders is an option that people talk about in the abstract when thinking about such things, but it's not realistic here. Why not? Can you explain to people why that isn't realistic?

Dr. BESSER: Well, you know, in thinking about border closure, you need to think about what impact would that have on the transmission of this infection. In our overall pandemic planning, as we've been planning around the avian flu, the bird flu scenario, there was an idea that if this originated far from our shores, we might be able to, as an international community, swoop in and quench it, so that it wouldn't leave the area in which it had started and wouldn't spread around the globe.

In a sense, isolating it away and coming in and treating and keeping it there. We're not dealing with that scenario. The value in that situation, whether you're looking at modeling data or just thinking it through, of closing a border is really that it's not effective and it would be an inappropriate use of our energy while we're trying to direct our energies and efforts towards things that we think will have the greatest impact on control.

SIEGEL: Dr. Besser, one other question - it's a little odd. There's evidently some concern about the name swine flu. Now you've been pretty good about not using that phrase, I hear, today in our conversation. Is the point that the pork producers frankly are very upset about people shunning pork because of this, and we want to stop saying swine? Why is there a need for a different name for the disease?

Dr. BESSER: Well, I think there are a number of factors and you're right today I've been saying much more H1N1 and there are several reasons. The first is that there is in people's minds an association with eating a food as a route of transmission and that can lead to inappropriate control measures by the public. If you think that to protect yourself you should just avoid pork, that's really not letting you take the proper measures for control which are really hand washing, use of alcohol gels, covering your coughs and your sneezes with your sleeve or your elbow, avoiding people who are sick and staying home when you have flu-like illnesses.

SIEGEL: Well, Dr. Besser, thank you very much for talking with us.

Dr. BESSER: You're very welcome.

SIEGEL: That's Dr. Richard Besser who is the acting director of the Centers for Disease Control and Prevention in Atlanta.

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