University of pittsburgh, one of the nations major health centers, in cooperation with the American Medical Society and United StatesPublic HealthService Bring you the silent invaders, an uptotheminute report on asian influenza. How do you do . Im carl ives. Throughout history, mankind has wage many battles in order to protect his family or nation against misfortune, disaster, or even possible extinction. While sometimes these wars have been catastrophic, it was the catastrophe of 1918, when an influenza epidemic swept through our own nation as well as the entire world. Unlike the battles of nation against nation, or humanity against the forces of nature where man has often have the opportunity to prepare himself, the battle against disease throughout the centuries have found men in the unfortunate position of having to combat this enemy only after it had been infiltrated his community and infected much of the population. Recently, you have become aware of a pandemic, or worldwide epidemic which originated in the far east and is now known as asian influenza. Because of the alertness and efficiency of the United StatesPublic Health service and the world health organization, a detection system similar to that of the aircraft spotting, has been established throughout the world and has enabled us to recognize and follow the progress of asian influenza as it circles the globe. Health authorities expect an outbreak this fall and winter in the United States, but not in such portions as in the 1918 epidemic. Now, the man upon whose shoulder rest the responsibility for preparing the United States, is the Surgeon General of the United StatesPublic Health service. Dr. Bernie, i imagine you and your staff have been gathering a tremendous amount of material on asian flu. Seems everyone has had talked about influenza, but i dont think anybody knows what it is. Carl, it is one of the upper respiratory infections like a cold, only caused by the flu virus and the difference between the asian influenza and the influenza we have been having the past few years is that this strain began this strain of the virus begin in hong kong and spread from hong kong to the rest of the world, including the United States. Every year, influenza is a problem in our communities and im sure it is in yours too. Why are we so concerned about it now . Even in the outbreaks weve had so far in this country, the attack rate has been 15 to 20 of the population. And this attack rate occurs and about four to six weeks. For example, and metropolitan pittsburgh, approximately 1 Million People. If we have this here, you would have approximately 200,000 people who would become ill and a 46 week period. And this, of course would make a tremendous impact upon the economy of this particular area. Thats understandable. Weve all heard of outbreaks here in this country, dr. Bernie. How far has it spread . It spread all over the United States. The first cases occurred on the east coast rather than on the west coast among Navy Personnel in rhode island. The second occurred in navy and civilian personnel in san diego. Since that time, since the first of june, it has spread in localized outbreaks through the boy scout jamboree, louisiana, and all of the states in the United States. I didnt realize that was asian flu that hit our own jamboree in our own state. It was. Not many people have died as the result of asian influenza in the rest of the world many do you think the same will hold true in the United States . We have the belief now based on the experience of asian influenza in other countries, south america at the present time where it is at epidemic proportions and as a result of the outbreaks in this country so far that it is a mild infection with a very low mortality rate, and we believe it will continue to be both a mild infection and a very low death rate. Is there the possibility asian flu might turn into a killer . That is a possibility, of course, and it has happened in preceding years, in 1888 when we had a large epidemic, and eventually the 191819 epidemic when we had a mild influenza epidemic in the spring of 1918 and in the fall, we had a large outbreak of very virulent influenza followed by serious complications and another wave hit us in february or march of 1919. At that time, in that whole period, we had about 20 million cases in the United States and about 850,000 deaths. In the first place, we had a mild strain of influenza. In the second place, we have the antibiotics to combat any complications that might arise, which we did not have in 1919. Dr. , with the disease spreading so rapidly, what exactly now are we doing to combat it . Actually, we are trying to do three things. One is to develop as rapidly as possible the only preventative agent we have against influenza and that is the vaccine against this particular strain. That is being done in six of the large pharmaceutical manufacturers in this country. The u. S. Medical team in tokyo sent it back to this country and given to the Public Health services, we distributed is to the manufacturers and they began to manufacture the vaccine before we had the first case in this country. Now, our job is to get more the vaccine available and to get the public to use it. Number two, we have to be prepared to take care of the individuals that become ill. We have been working since early june with the American Medical Association, the American Hospital association, voluntary groups, and others, to prepare for taking care of those who become ill, and finally, the matter of having an alert and informed public. One who will be aware of the facts without being unduly alarmed. Certainly this program of the Westinghouse Broadcasting to have an alert, but not an alarmed public. Well, you and your Public Health service crew have certainly seemed to make Great Strides in order to get us ready for this possible epidemic in such a short time. Weve had a lot of help, i can assure you, in doing this. It hasnt been a one man or one organization show. We have the full cooperation of the American Medical Association in the educational and medical care part and then in working with the manufacturers, who manufacture the vaccine and stop other activities and develop their staffs. I think we can all be proud of the industry which we have in this country. It is another example of the knowhow and expeditious way in which Free Enterprise through american industry can do it a good job. The vaccine was given to the Industries Middle of may, and within three months, the vaccine was being released to our National Institutes of health as being a safe and effective vaccine. That gives me a good example of teamwork and very expeditious work by the manufacturers. Another example of this teamwork and to illustrate this isnt a oneman show, we have with us this evening, dr. James a. Crabtree, an associate dean of the university of pittsburg Public Health who will help explain how asian influenza spread throughout the world. How do you do, dr. Crabtree . The asian flu has covered a lot of territory in a short time, but i would like to know how did it all get started . The exact point of origin of the influenza virus is not unknown, but the current epidemic had its beginning, as indicated, in hong kong and singapore. This was in early april. By mid april, the disease had become indeed epidemic in both of the cities and remain so throughout the rest of the month. From hong kong and singapore, the disease rapidly early may moved to the island of almost of and here, it is estimated as many as half Million People were attacked within a short amount of time. In may, it next made its appearance in borneo and japan. From the major shipping centers from the several areas, the disease very rapidly scattered into widely separated places as malaya, indonesia, guam, and the philippines. The first cases also in late may, the disease was reported as far away as australia and on board several ships en route from australia to San Francisco. The first appearance of the disease in the United States was on june 2. This date is important, because it means only a short six weeks from the time the first cases were reported in china, they were in the United States. This indicates the rapidity with which influenza like diseases can spread over the world. By midjune, this disease had practically circled the globe, including southeast asia, south west asia, the middle east, europe, australia, and north america. Late in june, the disease made its appearance in north africa, introduced probably by the muslims returning from their pilgrimages to mecca. So that finally in late early july, the disease made its appearance in chile, south america. In three short months, every continent on the globe has been involved in this great pandemic. Dr. Crabtree, you mentioned it had been reported on ships en route to San Francisco and several cases were definitely diagnosed among our fleet at newport, rhode island. Wouldnt it have been comparatively simple to have isolated these known cases and prevented the spreading of them and prevent them from coming in at all . Unfortunately, not so simple for the reason that quarantine against influenza is not effective. Had it been possible for all of the cases on board the ships to have been isolated, it would have had little effect on the actual spread of disease because undoubtedly there were many more people on board these same ships who by reason of a more recently acquired infection would have shown no symptoms whatever of the disease and, therefore, they could not have been readily identified if they were passing through a quarantine station. I see, well dr. Burney mentioned we had approximately 25,000 known cases in this nation. Are they all bunched in one area or has the virus spread all over . The virus is spread all over. We have some maps here in the studio that the Television Audience can see, which graphically shows how the disease has spread in the United States, starting from new folk, rhode island, and the west coast. During the month of june, the disease spread to salt lake city, utah, iowa, cleveland, ohio, and a few cases along the east coast. If we could have the map showing the spread in july, we see that these, starting from these original centers, has literally moved in practically every direction throughout the country. Then, the final map speaks for itself in that it indicates that this virus has become very well seeded in every state in the country, certainly in every major region of the country. I think ive got a pretty that idea of how influenza spreads, dr. Crabtree, but im still wondering about the virus itself. What kind of animal is it . , carl i like to bring into one of our staff, who is the associate director of our National Institute of allergy and infectious diseases, and ask him to answer this question and any other scientific questions you might have. Thank you again, doctor bernie. Take your time and come see as tonight, im going to ask but it will seem like a silly question, but i will like to know what is this virus like . Well, to begin with. It is a specific disease, caused by a specific virus this virus was first isolated in 1931 by the Rockefeller Institute and in 1933, shown as a human disease by british scientists. Now we know that there are three Major Classifications of virus. Types a, b, and c. More recently, a new type, fourth type, d has been described in japan. This a, b, c, and d. Is that the asian flu . Thats what confuses me come to a, b, and c . Type a influenza is the influenza which commonly causes epidemics and pandemics throughout the recent years. The asian type of virus is a type a and causes the kinds of disease we have had in recent year. However, the composition of this asian type is different from that which we have described in the more recent strains so that a person who is immune to the older strains is probably not immune to this new strain, and thus, the vaccines developed in recent years by dr. Francis and others have probably no effect on this invader from asia. I guess this is one of the reasons i never get into medical school. A new vaccine has to be made each time a new strain comes along . That explains why we dont have the vaccine in stock . That is right. I think everyone has been hearing the good deal about the asian flu story, but how will they know if they have the asian flu . I think you will know. Sometimes, it is a little difficult to diagnose it because symptoms maybe are similar to other respiratory viruses or bacteria. That could be absolutely certain, we must use laboratory assessments. One is the actual isolation of the virus and the second is the demonstration of antibodies which appear in the blood of the person who has the disease. This often takes a little time and it really doesnt help the patients position very much, but it is important for us to know what kind of disease is prevalent in the community and to discover what the type is and follow its course. I see. Naturally, the thing people are most concerned about is the vaccine, first of all, and particularly how it works in the system. It seems to me being made from real influenza virus, wouldnt there be danger in being vaccinated . There is no danger at all. The vaccine is completely killed during the process of being prepared. The vaccine is made by injecting the virus into chicken eggs, where the virus grows and then processing the fluids, the vaccine is made by the manufacturers. It requires about 40 days to manufacture and to test the vaccine. Dr. Burney, i can breathe a lot easier knowing how the vaccine is made and there isnt any live virus in it. Im certainly impressed with the way your Public Health operates. Up until now, i think you have given me and the rest of the audience a complete picture of the asian flu. I doubt weve given a complete picture because we left out one of the most important groups of our total team in meeting the challenge, and that is the American Medical Association, which represents the physicians throughout our entire country. We have worked with them from the beginning of this and have had complete support and understanding from that group and i would like to present to you here now the secretary, general manager of the of the organization. I believe your home port would be chicago . Thats right. Can you explain a little more about this possible flu epidemic . In planning for a possible epidemic, the medical profession has three responsibilities. Keeping doctors informed on the progress of the disease, spearheading the mobilization of all medical personnel, concerned with caring for the sick, and informing the public on what to do once the virus has spread. The doctors are being informed about asian influenza through our weekly journal and through many scientific periodicals published by the various state and county medical societies. They are being encouraged to cooperate with the Public Health service in detecting the virus and spread from community to community. They are being informed of the technical aspects of the disease with instructions regarding the administration of the vaccine. The American Medical Association has asked every medical society to organize a committee of those who would be involved in an epidemic so an agreement can be reached in advance on such matters on vaccine priority, the handling of hospital admission procedures and so forth. If in a pandemic does strike, the medical profession will use every means of communication possible, newspapers, radio, and television, to tell the general public what to do. It is important, we feel, that families know the symptoms and points to follow in the home care of a victim. What are the symptoms . The asian influenza is characterized by rapid onset fever of 104 degrees, headache, sore throat, aching muscles, and extreme weakness. Recognition of symptoms is important early in an epidemic. Once the asian flu takes hold in a community, youll know what it is without checking the symptoms. When you do get asian flu, how do you care for it at home . Ideally, your doctor should be called and his instructions followed. However, in an epidemic situation come you may not be able to give your case at he may not be able to give your case as complete attention. These are things to remember. First, keep away from others. Second, go to bed. Third, drink a lot of fluids, water and fruit juices, and forth, if your doctor recommends it, take a fever reducing agent. Fifth, call your doctor if any unusual symptoms develop. What do you mean by unusual symptoms . Well, primarily those that would indicate the onset of some lung involvement. Heavy cough, rapid breathing, blueness of the lips. Now, i will ask dr. Burney to summarize our discussion. This fall and winter, we may see serious outbreaks of influenza in the United States as a consequence of the epidemic which began in the far east. Unlike situations in the past, we believe the size and severity of the epidemic can be minimized in this country. That is the opinion of experts, that there is no need for hysteria or panic. The influenza in the first place, we are prepared for the invasion and in the second place, we now have the means to a new vaccine to help prevent this influenza. Perhaps the story infection by influenza virus can be summarized in this manner