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Flu Season

Four children have died in Colorado from the flu in recent days, and other states have reported an unusually high number of cases this early in the season, prompting strong warnings from health officials. Jeffrey Brown talks to Dr. Julie Gerberding, director of the federal Centers for Disease Control and Prevention.

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  • RAY SUAREZ:

    In recent days, four children in Colorado have died of the flu, and other states, including Texas and Nevada, have reported an unusually high number of cases this early in the flu season. All this has prompted strong warnings from health officials. Yesterday, Jeffrey Brown talked with Dr. Julie Gerberding, director of the Federal Centers for Disease Control and Prevention.

  • JEFFREY BROWN:

    Dr. Julie Gerberding, welcome.

  • DR. JULIE GERBERDING:

    Thank you.

  • JEFFREY BROWN:

    You recently put out a national warning that the flu season could be much worse than usual, why, what are you seeing?

  • DR. JULIE GERBERDING:

    Well, we're seeing two things, one is the season is off to a rapid start this year. We already have flu activity in 39 states and we have got two states, Texas and Nevada, where there is widespread involvement. But in addition we're seeing that there is a strain of flu — the H3M2 strain — that isn't in this year's vaccine. The vaccine probably will offer protection against this strain, but it may not be as good as we would like it to be. So we're encouraging everyone to get their flu shot now.

  • JEFFREY BROWN:

    Well, gets go back and break this down a little bit. Do we know why it's hitting earlier than normal?

  • DR. JULIE GERBERDING:

    You know, it's very difficult from year to year to predict how the season will unfold. It's not unusual to get off to an early start. And sometimes the peak happens as early as December, but the signs this year suggest that we are seeing more cases in more states than would be typical and that's a hint that we better get on the ball and get the vaccine out there and get people immunized.

  • JEFFREY BROWN:

    What about why it would be especially bad in particular places, Colorado, Texas, a number of other states?

  • DR. JULIE GERBERDING:

    You know, we don't really know why it starts in one place and seems to spread more effectively, but we can do know that the most important thing is to get the population vaccinated because that can really dampen an outbreak in any particular jurisdiction.

  • JEFFREY BROWN:

    A number of the recently reported deaths in Colorado have been young children. Who is most at risk?

  • DR. JULIE GERBERDING:

    Well, everyone is at risk for flu but the people who are at risk for the serious complications or death are usually the older people, especially people over age 65 — people who have any chronic medical condition and people young children between the ages of 6 and 23 months who are often hospitalized for the complications of flu. So those are the people that we are especially concerned about flu complications in.

  • JEFFREY BROWN:

    This new recommendation for the young children jumped out at me. Why, why the new recommendation for children? I think you said between 6 months and 23 months?

  • DR. JULIE GERBERDING:

    Yes. CDC has been working with others to evaluate the benefits from flu vaccine, and one of the things we have learned is that if children in that age group do receive the vaccine, they're much less likely to be hospitalized, and so the main reason for encouraging immunization in that age group is to keep those kids out of the hospital.

  • JEFFREY BROWN:

    Let's go back to the other issue you raised which was about the strain that seems to have developed or appeared that was not planned for. Explain that.

  • DR. JULIE GERBERDING:

    Well, you know, the key to understanding flu is that it's constantly evolving. That's why we have to get a flu shot every year, and the strain that was in the vaccine is an H3M2 strain along with two other strains. It's a H3M2 strain called H3M2-Panama. That strain is one that can cause severe disease, but it has evolved a little bit and now is more like the strain H3M2-Fujian so the vaccine has Panama, the strain that seems to be causing an increasing number of cases this is year is Fujian and there is not a perfect match between what's in the vaccine and what people are exposed to. We know from the laboratory that there will be some cross protection between these two strains, but it might not be optimal. We also know from past experience that when we see the situation where the vaccine strain isn't a perfect match we still get protection from the flu vaccine but we won't know until the season unfolds how good the protection really is.

  • JEFFREY BROWN:

    But right now…

  • DR. JULIE GERBERDING:

    It's also important that there are other viruses out there, other flu viruses that are in the vaccine and people need to get the vaccine because it will help protect them.

  • JEFFREY BROWN:

    So right now your recommendation is that the vaccine out there is still going to help against this other strain?

  • DR. JULIE GERBERDING:

    That's our expectation based on experience in the laboratory samples, so we are not pessimistic about the effectiveness of the vaccine. We just are a little worried because the season is getting off to such a rapid start. And it's very important that people recognize this year we have enough vaccine to go around — for doctors and nurses we are also — have improved the reimbursement rates so cost should not be an issue and people just need to get out there now and get this flu shot.

  • JEFFREY BROWN:

    I also understand that this year's strains are known to be especially virulent from past experience, is that a concern?

  • DR. JULIE GERBERDING:

    Again, this H3M2 strain that we're seeing right now just traditionally is sometimes more likely to be associated with hospitalization or death. So because it can be slightly more severe, sometimes very much more severe, we're on the lookout for more flu complications, given that this strain is what we're seeing predominantly in the United States right now.

  • JEFFREY BROWN:

    So in addition to getting the vaccine are there other things people should do at this point?

  • DR. JULIE GERBERDING:

    Well, one thing that would help is that when people see their clinicians they should ask their clinician if they have had the vaccine, because we really need to make sure that health care workers are protected. Flu can spread in hospital settings or other health care environments, and when health care workers come in contact with people who have the flu, they can serve as mechanisms for transmitting it. So not only do we want the patients and the people at risk for influenza to be vaccinated but we want to be especially emphatic that health care workers get protected this year and patients can help with us that.

  • RAY SUAREZ:

    Okay, Dr. Julie Gerberding of the CDC, thank you very much.

  • DR. JULIE GERBERDING:

    Thank you.