Impact Of Swine Flu Examined

Where we are in the course of the swine flu epidemic? Has the H1N1 virus behaved as expected? What about the production and distribution of vaccine? Dr. Anne Schuchat, director of the National Center For Immunization and Respiratory Diseases, discusses the severity and impact of swine flu so far.

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MICHELE NORRIS, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Michele Norris.

MELISSA BLOCK, host:

And I'm Melissa Block.

Now an update on swine flu. Where we are in the course of the epidemic? Has the H1N1 virus behaved as expected? And what about the production and distribution of vaccine?

We're going to put those questions now to Anne Schuchat. She is chief health officer for the H1N1 response with the CDC. Thanks for being with us, Dr. Schuchat.

Dr. ANNE SCHUCHAT (Director, National Center For Immunization and Respiratory Diseases): My pleasure.

BLOCK: Give us some sense of the total estimated numbers you've seen.

Dr. SCHUCHAT: Since the virus emerged in April, we estimate in the first six months, 22 million people became ill with the virus. About 100,000 people were hospitalized and about 4,000 people died. Right now, 43 states are experiencing widespread disease.

BLOCK: And one question that's been hanging out there is: Has H1N1 peaked? Are we past the peak of this virus?

Dr. SCHUCHAT: In some communities, we are seeing decreases in influenza-like illness. Sometimes hospitalizations and deaths will lag behind what we see in influenza-like illness. And of course when we see increases and decreases, it doesn't really mean that there's the all clear sign. So we're really holding our breath a bit in the places where the disease is starting to come down.

We can look back at previous pandemics, for instance, the 1957 one. And what happened was there was a lot of disease in the fall, just like we're seeing now. Disease decreased in December, but then after the first of the year, illness, including death, actually increased again, and they had another wave of severe flu illness in the early spring and late winter. And of course, we're vaccinating aggressively to try to prevent the chances that that will happen.

BLOCK: I guess the risk would be if people hear, you know, H1N1, the epidemic has peaked, the risk would be that people would not get vaccinated, perhaps, and be vulnerable in the spring.

Dr. SCHUCHAT: Well, you know, it'll be great when there's less disease. So we're all for that. But what we fear is that people will think the risk is gone before we can conclusively say that. We know that right now that there's an awful lot of influenza everywhere in the country. The fact that it was a greater risk of flu two or three weeks ago doesn't mean that there's still not a lot of transmission going on, and that's why we're hoping to increase further the number of people that have been vaccinated.

BLOCK: The influenza that's out there now, how much regular, seasonal flu are you seeing, as compared with swine flu?

Dr. SCHUCHAT: You know, I'm asking about that every day. And so far we've seen very few seasonal strains. You know, often they don't start to show up in great numbers until December or January, but we've really seen just a handful of strains that aren't the H1N1. So I think that we really need to stay tuned.

We don't know if we'll have a big problem with seasonal strains this year. Almost every year we do, but in some times during a pandemic, the H1N1 strain or the other pandemic strains in the past have crowded out the seasonal strains. That would be great if that happens, but we really don't know if that will be the case, and that's why, of course, so many people have gotten the seasonal flu vaccine already this year.

BLOCK: I wanted to ask you about vaccination. Back in the summer, you said that the U.S. would have about 150 million doses, and we're well short of that. How's production going? Where are we in reaching that goal?

Dr. SCHUCHAT: As of today, 61.2 million doses of the H1N1 vaccine have become available for the states to order. Of course, we're not anywhere near where we hoped to be by this time of year, but progress is being made and more and more doses are coming available.

BLOCK: Dr. Schuchat, what's the biggest surprise been for you with H1N1 flu?

Dr. SCHUCHAT: I shouldn't have been surprised, but I have been surprised about this disproportionate toll that it's taking in pregnant women. I think I'd never lived before a pandemic before, and I actually hadn't seen the really sorry and just the tragic stories of healthy pregnant women coming down with such difficult diseases.

So that's been hard to take as a public health expert, and, of course, a reason that we strongly recommend pregnant women who have cough or fever, respiratory symptoms, to take that seriously and seek care and get antiviral medicines and, of course, to be vaccinated before they get such symptoms.

BLOCK: Dr. Schuchat, thank you very much.

Dr. SCHUCHAT: My pleasure.

BLOCK: Anne Schuchat is chief health officer for the H1N1 response with the CDC.

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