Press Briefing Transcripts

CDC 2009 H1N1 Flu Media Briefing

Monday, March 29, 2010.

• Audio recording (MP3)
  

Operator: Welcome and thank you for standing by.  At this time, all participants are in a listen-only mode.  During the question and answer question today, you may press star 1 for the question.  At this time, your conference is being recorded.  I turn it over to Mr. Tom Skinner. 

Tom Skinner: Thank you, Shirley.  Thank you.  Welcome to the update on H1N1 in the United States.  It's been a while since we briefed you on H1N1.  It's not gone away.  Some states like Georgia and the southeast are continuing to see the regional activity.  Joining us to put it in perspective is the U.S. Surgeon General Dr. Regina Benjamin and Dr. Anne Schuchat.  Both are going to provide very brief remarks and we'll open it up to your questions.  So Dr. Benjamin, please go ahead. 

Regina Benjamin: Thank you all for joining us today to talk about the continued importance to get vaccinated for H1N1 influenza.  It's a pleasure to be on the call and have an opportunity to speak with you.  I'm joined by assistant U.S. Surgeon General Dr. Anne Schuchat.  As you know, Dr. Schuchat has done an excellent job communicating information during the pandemic.  I treat patients in every flu season and I know the importance of educating the public and keeping them informed as a way to fight the disease.  I'm asking for your help to educate the American people about the importance of getting the vaccine.  The H1N1 flu has made 2009-2010 flu season one of the most challenging in recent memory.  It's persistent in the southeast and now those states are experiencing more local and regional activity.  Remember, vaccination is the single best protection against H1N1.  Approximately 60 million Americans have been infected and there's been 265,000 hospitalizations.  But more importantly, in the United States, close to 12,000 people have died from H1N1.  We're at a critical moment in our national response to this virus and we need to continue to urge Americans to get vaccinated, especially people at high risk from complications from H1N1.  There still seems to be a lot of misinformation out there.  We're seeing higher rates of disease in adults who have chronic conditions like diabetes, cancer, heart disease, asthma, COPD, and other lung illnesses.  Just last week, shipped a supply of H1N1 vaccine reached 121 million doses.  Many Americans are still vulnerable to the H1N1 because they haven't gotten vaccinated yet.  With more vaccine available, all Americans can now get immunized so we're encouraging people to take advantage of the increased supply to protect themselves and protect their loved ones.  Actually we need to get the vaccination message out to minority groups.  They're not participating in the national vaccination at the rate that other population groups are.  It's important to remind minority groups to get the H1N1 vaccine because we know that minorities experienced higher rates of these chronic diseases that I mentioned earlier -- the diabetes, the cancer, the heart disease, etc.  The H1N1 response continues to be an incredible effort by state and local officials, manufacturers, scientists, health care workers, and you, the media.  So we appreciate your help in reminding Americans that vaccination is the best protection against getting the flu.  The H1N1 vaccine is very safe, it's effective, and it prevents death.  Thank you for your work for being factual, reliable, and helpful in getting information to your audiences.  As America’s doctor, look forward to you to keep our communities healthy and safe.  I'll now turn it over to Dr. Anne Schuchat. 

Anne Schuchat: Thank you so much, dr. Benjamin.  Good afternoon, everybody.  My key message this afternoon is that we are continuing to see people with serious illness from the pandemic H1N1 virus especially in some of the southeastern states and vaccination is the best way to protect yourself and those you love from further illness or death.  I'm going to provide a really brief national update and then concentrate on worries and trends we're seeing in the southeast but suggest to us that it's still very important for people to get the vaccinations. I’m not going to use data about vaccine use or coverage but I want to let you know we're expecting to release updated coverage in the relatively near future.  Disease rates are much lower on average around the country than last fall, the H1N1 virus is still circulating and people continue to become ill, be hospitalized, and die from this virus.  H1N1 has been causing more disease, recently, in the southeast where several states are reporting regional or local activity.  Three states are reporting regional activity -- Alabama, Georgia, and South Carolina.  Local activity is reported in Puerto Rico and eight states, mostly in the southeast -- Arkansas, Louisiana, Mississippi, North Carolina, Tennessee, Virginia, as well as further western states like Hawaii and New Mexico.  The activity we see in CDC's influenza surveillance is consistent with flu activity in college campuses in the southeast that was reported by the American College Health Association.  Nearly all of the influenza viruses circulating are the H1N1 pandemic virus.  We have not seen seasonal flu in substantial numbers at all, even to this week, in late march.  Now I just want to briefly return to the situation in Georgia where things appear to be different.  For the past several weeks, the Georgia Department of Community Health has reported an increase in flu-related hospitalization.  On March 5, Georgia requested a team from CDC come to help them with a more in depth investigation and our staff is working closely with officials to analyze those cases, hospitalizations and deaths reported recently in the winter months and compare them to previous flu activity reported in the summer and fall, 2009 H1N1 experience to sort out what might be contributing to the recent increase of flu activity in Georgia.  Recently, Georgia has seen more laboratory confirmed influenza hospitalizations each week than they've seen at any time since October.  The data suggests that the increase in hospitalizations required by the H1N1 strain, not by other seasonal influenza viruses, and we don't have any evidence at this time that the H1N1 virus has changed in Georgia.  It's the same as what we're seeing in earlier months.  Most of the hospitalizations that we've seen have occurred in other adults with underlying conditions that put them at higher risks of severe influenza.  The adults with chronic illnesses or advanced age who are more likely to become severely ill if they encounter the H1N1 virus.  The good news is there's plenty of vaccine available.  Vaccines widely available across the united states at doctor's offices, and pharmacies.  So even if you put off being vaccinated until now, vaccination with the H1N1 vaccine is beneficial.  Particularly in the southeastern state where is H1N1 is circulating intensively, we think it's important for people to take advantage of the vaccine.  And CDC strongly urges people with underlying health conditions and those over 65 to get vaccinated.  The vaccine supplies are plentiful and the circulating virus closely matches the one with the vaccine.  We have an excellent safety record now for the H1N1 vaccine.  Now as we said many, many times, with influenza, the future is hard to predict.  There's much we do not know about why the virus remains more active in some parts of the country and not yet in others.  But we do know that the virus is still around and the vaccine is very safe, and vaccination is the best way to protect yourself or your loved ones from flu.  So I think both Dr. Benjamin and I will be happy to answer questions that the media may have.

Tom Skinner: Shirley, I think we're ready for questions, please.

Operator: Thank you, we'll begin the question and answer session.  If you would like to ask a question, please press star one.  You will be prompted to report your name.  Press star one to ask a question and one moment for our first question.  Our first question comes from Miriam Falco with CNN.  Please ask your questions.

Miriam Falco: Thank you, Dr. Benjamin, Dr. Schuchat.  I have a couple of questions.  Number one, we haven't heard about H1N1 in a while.  Is it really the Georgia and southeast states that have raised the level to bring you on the phone?  And also, someone might be skeptical and say, well, normally you tell us 36,000 people died in an average flu season and we've only had 12,000 deaths.  So this sounds like a pretty good year.  And I’m not putting words in your mouth.  I'm just curious.  How would you answer that question? 

Anne Schuchat: This is dr. Schuchat.  Let me answer both of those questions.  The situation in Georgia is the critical reason that we called the media briefing.  Seeing an increase in cases again in Georgia is unusual and we did want to spotlight that.  Does that mean we're going to see that in other states?  I really don't know. But a couple of the southeastern states are seeing more activity right now than the rest of the country.  So that's the thing that's new today that we really wanted to talk about.  I also want to speak about the deaths.  And I think it's very important to put in contrast what we've seen so far this year with the 2009 H1N1 pandemic virus and what we typically will see in a seasonal influenza.  When we say that about 12,000 people have died from this virus, that estimate includes 90% of those people, about 11,000 are people under 65.  And that's much more deaths in a particular year among younger people than what we typically see with seasonal flu.  We estimate that the rate of death in young people is probably five times higher than what we would typically see with seasonal influenza.  Now the very good news is that the elderly, while not completely immune has been relatively spared and the number of deaths we estimate from the elderly from the H1N1 virus is much lower than what we would typically see with seasonal influenza.  There's a shift to younger people in terms of serious illness, hospitalization, and death.  And that does make it different.  Of course, we think it's important to prevent seasonal influenza as well and recommend vaccines against both each year.  This year, we had the new virus to contend with. 

Tom Skinner: Next question, please? 

Opeartor: Thank you, the next question comes from Steve Sternberger with "USA Today."  You may ask your question.

Steve Sternberger: Thank you very much.  I was wondering, Dr. Schuchat, if there were any geographical trends, any clustering in Georgia?  What have you seen on college campuses?  Have there any -- any factors that give any sort of clues as to how the -- how the virus is circulating in the groups that are getting it? 

Anne Schuchat: The preliminary information is that the hospitalizations are occurring in adults, not in young children, and they're occurring in people with chronic health conditions.  There does seem to be geographic differences in areas that are having hospitalizations now compared with areas that are harder hit last summer, late summer is when georgia had their increase in disease.  But that's preliminary.  And there'll be a full analysis that will be forthcoming in the future.  We wanted to talk about the georgia situation before the investigation was complete because we thought it was important for people to be able to take action.  But the preliminary information is that the geography may be a little different than what we saw in summer and early fall. 

Steve Sternberger: Can you say anything about what the geography may be? 

Anne Schuchat: No, just that the patterns are different.  That's preliminary and that's all i know right now. 

Operator: The next question comes from Daniel with Web MD.  Please ask your questions.

Daniel DeNoon: Thanks, I’m with WebMD.  I want more information on what you're finding in Georgia.  I know this is preliminary?  Different demographics?  Different populations getting hit in the city in the summer in can you give any details that you can on this georgia situation that made you make this call? 

Anne Schuchat: The demographic is adults, which the hospitalizations are in general adult which is relatively similar to what they saw last summer and fall in terms of hospitalizations.  The numbers are that they've had more than 40 hospitalizations for the past week.  For the third week in a row, georgia had more hospitalizations than any other state in the country, from laboratory confirmed H1N1 influenza.  Not necessarily all of the illnesses.  But the laboratory confirmed cases.  I don't have any information about the specifics on race and gender.  That's all i have right now. 

Daniel Denoon: And just to reiterate.  Is there any sense that it's happening in the same communities where we've seen it before or different communities that were relatively spared in the previous wave, if you will? 

Anne Schuchat: There's a sprinkling around the state.  But there may be a shift in terms of the community.  It's a little.  The data on preliminary.  I haven't gotten the -- all of the fine data.  But the Georgia department of community medicine would be available to answer questions if people have them.  I think the key point isn't that we finished all of the i-dotting and t-crossing but there's enough illness down here that it appears to be preventable but we wanted to get the word out to people. 

Tom Skinner: Next question, please. 

Operator: The next question comes from Richard Knox with National Public Radio.  You may ask your questions. 

Richard Knox: I was going to ask some of the questions that Daniel had asked.  Do you have any sense that these hospitalizations are as severe as you've seen?  A lot of people on respirators?  And are they the same kinds of patterns of illness that you've seen before? 

Anne Schuchat: The pattern of illness seems to be the same.  The vast majority of patients whose records have been reviewed so far were not vaccinated.  That's something that couldn't have been looked at last summer and early fall.  We're seeing now cases that are severe enough to cause hospitalizations occurring in people for whom there are indications for vaccines.  They have underlying conditions like diabetes and heart disease but unfortunately hasn't taken advantage of the vaccine yet. 

Tom Skinner: Next question? 

Operator: The next question comes from Mike Stobbe with the associated press.  You may ask your question.

Mike Stobbe: Thanks for taking the question.  One is a follow-up to the previous one.  Dr. Schuchat, most of them -- can you give me numbers or percentages of those who got sick, how many -- what percentage were vaccinated and which weren't?  Does that mean we're looking at pockets of susceptibility or pockets of unexposed and the initial questions to make sure -- are there any other states that are showing increased hospitalizations from swine flu recently? 

Anne Schuchat: The southeastern states are seeing more -- there are three southeastern states reporting regional disease, one step below wide spread disease.  The hospitalization for Georgia appears to be maybe the most complete information we have available right now because it's based on laboratory testing and that's not necessarily done everywhere.  In terms of pockets of immunity, we do think there are geographic differences in the proportion of people that are already immune to this virus.  You can become immune by becoming sick from the virus either by being vaccinated.  And we know there are geographical differences in vaccination right now.  And, of course, there are differences of when communities were hit by the viruses last summer and fall.  It could be that the southeastern states were hit relatively early in the late summer and early fall.  And it could be that their coverage would be a bit lower than some of the other parts of the country because the vaccine came after they had disease and demand may not have been as high.  So it's possible the two factors contribute to perhaps more vulnerability in this part of the -- in the southeastern part of the country.  But it's way too early for us to say we're not going to see increases in other places.  And i think it's important to know that being vaccinate suicide a safe and effective way to reduce your chances of ending up in the hospital with the flu that could have been prevented. 

Mike Stobbe: Was the vaccination numbers lower in Georgia? 

Anne Schuchat: We'll release information.  But Georgia was among the lower states, that's right.

Tom Skinner: Shirley, two, maybe three more questions. 

Operator: Thank you.  Rob Stein with "The Washington Post."  You may ask your question. 

Rob Stein: Thanks very much.  You just mentioned Georgia is one of the first states to see an increase in activity.  Are you concerned this could be the beginning of another wave of infections across the country? 

Anne Schuchat: Of course I can't say whether we'll have another wave of infection, but I’m worried about a different possibility.  I'm just worried that additional cases will be happening day in and day out and people who thought there was no risk anymore.  So less concerned about a big outbreak or a big spike of illness, I’m concerned about the people who will suffer needlessly because there is vaccine available and people, particularly ones with diabetes, heart disease, cancer, pregnancy, will need to take advantage of the vaccine. 

Rob Stein: Thank you. 

Tom Skinner: Next question, Shirley? 

Operator: The next question comes from Michael Smith.  You may ask your questions. 

Michael Smith: This is a question for Dr. Schuchat.  I want a little more data on the Georgia stuff.  You had 30 hospitalizations in the past week.  And three weeks in which they had more hospitalizations than anywhere else -- any oh state.  Two things -- those are absolute numbers, not rates, I assume.  And secondly, can you quantify if -- [ inaudible ]are they continuing to go up? 

Anne Schuchat: The past several weeks, they had more hospitalizations than they had seen really since early October.  And so these are not rates, they're just absolute numbers.  And, remember, they require an influenza test to be performed and we know that many hospitalizations occur without that.  So they're really just a surrogate for the amount of illness that's around.  So basically the situation in Georgia is that from mid February to now, they've seen an increase and consistent higher numbers with hospitalizations each week that are laboratory confirmed to be from influenza with the H1N1 strains and not seasonal strains that are appearing.  We aren't seeing seasonal strains around the country yet and perhaps they won't happen.

Tom Skinner: Shirley, let's make this the last question, please? 

Operator: The last question comes from Stacy Singer with Palm Beach Post, you may ask your questions. 

Stacey Singer: Hi, thanks for taking my question.  I see H1N1 is in the recommended shots for next year in the World Health Organization.  I'm wondering if this year if your get your H1N1 shot this year can you presume you're protected next year from H1N1? 

Anne Schuchat: The critical thing is that the U.S. vaccine supply in the fall will be a vaccine that will include the pandemic H1N1 vaccine strain, but also an influenza B strain and influenza A (H3N2) strain.  Three different influenzas.  We think it's important for people to get the trivalent vaccine.  And getting vaccinated now, the critical of that is to protect you in the months ahead.  We don't know if the H1N1 will continue to circulate in the summer the way it did last year.  We don't know whether international travel, people coming back from the southern hemisphere where we expect there will be a lot of H1N1 disease in their winter season, which is our summer.  Right now we're recommending vaccine to protect people over the several months ahead until the new trivalent vaccine becomes available and people can protect themselves from the three different kinds of flu at this point.

Tom Skinner: This concludes our briefing.  Thank you for joining us.  If you have any additional requests of information, call the main press office at 404-639-3286.  We'll be happy to help you out.  There will also be a transcript from this briefing posted to the CDC division of media relations website hopefully within a few hours.  So thank you once again for joining us.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES