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Interview:  Anthony Fauci Discusses Flu Outbreak


On the medical front, we bring you Carol Pearson's interview with Dr. Anthony Fauci on this year's flu epidemic. Dr. Fauci is director of the National Institute of Allergy and Infectious Diseases.

Carol Pearson: Dr. Fauci, there are some health officials who feel that we are overdue for a major outbreak of the flu. Would you agree with that?

Dr. Fauci: I think that's probably correct. I think those of us in the public health arena and in the biomedical research arena are fairly confident that it's just a matter of time when we'll have another serious flu epidemic, hopefully not, but maybe even a pandemic.

Carol Pearson: In 1918 and 1919, the influenza epidemic killed between 20 and 50 million people. Are we likely to see an epidemic kill that many people again?

Dr. Fauci: No, I don't think so. I don't think we'll see that number of people, because we now have vaccines. Now, the issue with a vaccine is that you've got to be able to stay ahead of the particular flu. If you have a flu virus that's totally different and totally new, then you have a serious problem.

We now have better care of acutely ill patients. We have antibiotics to treat the secondary complications of the influenza, like pneumonia. Those are the things that we have that we didn't have back in 1918. So it's unlikely, even in its worst-case scenario, that you're going to have tens and tens of millions of people dying, but you could still have a serious pandemic that would involve millions of people worldwide and certainly over 100,000 people in the United States.

So no one really thinks that it will be as serious as it was in 1918, when medically we didn't have any tools. We have some tools now. If we're fortunate enough to predict eight months ahead of time what that big epidemic will be, we'll be able to incorporate that into the vaccine for that current year. But you don't always hit a head-to-head, one-on-one match with the vaccine and the virus that circulates.

Carol Pearson: How would you characterize this year's flu?

Dr. Fauci: You know, it's very difficult to make a definitive characterization of this year's flu, because the season is not over yet. We had an early upsurge of cases in the United States. We're seeing the same thing in some countries in Europe and in other parts of the world. If it goes up and stays up throughout the flu season, which would be December, January, February - and then it generally tapers down at the end of February, March and sometimes into April - if it maintains itself, then this year is going to turn out to be a very bad year.

If it peaks and then comes down, it will be a moderate year that just shifted the intensity from January to November and December, which is what we're seeing right now. We are concerned that it will continue, and new sections of the country and the world will then get exposed and infected, and we will have a particularly bad year. But that's something we cannot make a definitive answer on until the season is over.

Carol Pearson: How does someone know if he has the flu, or if he has a common cold? What are the differences in the symptoms?

Dr. Fauci: Obviously the diagnostic test or the laboratory test will definitively tell you, but clinically there are some characteristics of the common cold, common respiratory infection, and true influenza, that are pretty good tip-offs. For example, the common cold generally comes on gradually. You feel really poorly. You have a little sniffles, a sore throat, runny nose, you sneeze, you cough. You don't generally get seriously ill. You don't generally get a fever. You just get annoying upper respiratory symptoms. Maybe you get a complicated sinusitis.

Influenza is much more abrupt. You generally feel well one day; the next day you start to feel very poorly. And you can tell that you're really getting sick. You have high fever, which you almost never have with a common cold. And the fever can go up to 102 degrees Fahrenheit (38 Celsius) or more. You generally have significant muscle aches, headaches, eye pain. And then you start to get respiratory symptoms. Children sometimes can have a variation of that. They can have gastrointestinal symptoms like diarrhea or vomiting. But it is abrupt, it has fever, and it's considerably more serious than a gradual onset annoyance of respiratory symptoms.

They overlap in confusion because influenza can give you respiratory symptoms, cough, shortness of breath, and occasionally even a runny nose or a sore throat, whereas a cold generally gives you just a sore throat, a runny nose some sneezing, and very little lower respiratory symptoms.

End of interview

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