He spoke of the National Press club for about one hour. Good afternoon. Welcome. Im an adjunct professor at George Washington university and 107th president of the National Press club. The National Press club is the worlds leading professional organization journalists committed to our professions future through our programming with events such as this while fostering a free press worldwide. For more information about the National Press club please visit our website press. Org. On behalf of our members worldwide i would like to welcome our speaker and those of you attending todays event. Our head table includes guests of our speaker as well as working journalists who are club members so if you hear applause in our audience i note that members of the general public are attending so its not necessarily evidence of a lack of journalistic objectivity. I would also like to welcome our cspan and public radio audiences. Can you follow the action on twitter using the m pclunch. After our lunch speak concludes well have a question and answer period. Now its time to introduce our head table guests and ask each of you to stand briefly as your name is announced. From the usedenses right, thomas snyderman. Barun. Jmal iliani. Ruth katz, director of the Health Medicine and Society Program of the Aspen Institute and member of the Cdc Foundation board. Anna miller associate editor at psychology magazine. John lewis cofounder and executive director of the Peggy Lillis Memorial Foundation and guest of dr. Frieden. Donna lagier reporter for u. S. Today, vice chair of National PressClub Speakers Committee and former president. Doris mar fwmpb olis president of Editorial Associates and National PressClub Speakers Committee member who organized todays luncheon. Faith mitchell, president and ceo of grant makers in health and guest of dr. Friedens. Susan heavy correspondent for reuters. Carolyn block publisher and editor federal telemedicine news. Hirito. This time last week dr. Tom frieden was busy cramming for his july 16th appearance before the House Committee on energy and commerce. The director of the centers for Disease Control dr. Frieden had been summoned to washington to answer questions about the startling and potentially Dangerous Lab errors at the cdc and while that topic is likely to come up again here today, dr. Frieden joins us to explore a much bigger and broader issue, looming Worldwide Health threats including the pathogens that put modern medicine at risk. Hell explain the mr. Mers coronavirus a disease that has no known cure and has recently immigrated to our country. It haunts the Arabian Peninsula and is showing up in travellers through other destinations far away. The virus has reached an arrival in the United States, sent hundreds of cdc staff into emergency mode. And some now refer to this illness as public enemy number one. Other issues that dr. Frieden will tackle this afternoon includes the dramatic increase in the number of measles cases in america and the growing threat that draws new pathogens pose. They can hitchhike rides and crisscross the globe detain. Hell update us about the new program the cdc launched three weeks ago combat drug resistant pathogens. Some of these killers microbes jump from an mols to humans and a growing number of them are resistant to currentry known drug treatments. Dr. Frieden has been director of the cdc since june 2009. A physician with training in internal medicine, Infectious Diseases, Public Health, hes known for his expertise in tuberculosis control. From 1990 to 2002, dr. Frieden worked for the cdc starting as an epidemic Nuclear WeaponsService Officer at the new York City Health department. Fluent in span injuries hes a graduate of 0 Berlin College and received both his medical degree and masters of Public Health degree from colombia university. He completed his training at yale university. Dr. Frieden has won many awards and honors and has published more than 200 scientific articles. His talk today is titled mers public enemy number one . Dr. Frieden last appeared last september. Ladies and gentlemen, please join me in welcoming back to the National Press club, dr. Tom frieden, director of the centers for Disease Control and prevention. [ applause ] thank you very much. Its great to be here. And thank you so much to the National Press club, to the president and Doris Margolis for the invitation and thanks for your interest in health and what i would like to do is talk to you about some of the biggest threats facing us today. Some of you may have heard about problems at the cdc laboratory where weve had two safety lapses in recent months. These lapses should never have happened. The cdc laboratories are some of the best scientifically in the world and now were taking rapid and Decisive Action to make sure that they are also some of the safest laboratories anywhere in the world. Ill be ethiopia talk about that later but right now i want to talk a little bit more about some of the challenges that we face. Sometimes at cdc problems like the one that has come to light recently, occur because people are so used to working with danger. Were currently mounting a substantial response in west africa where three countries in that region are battling eboli. Theres more than 1,000 cases and 600 deaths from eboli. I had been in uganda, which is as you imagine a cave with a very large python, about 15 feet large and about 10,000 bats and those bats turns out our researchers have identified have a 5 infection with the mabird virus. Its similarly fatal and there were two infection, one fatal one not a few years back and our staff went in there to try to figure out and understand how the bats were moving around the region and what might be able to be done to control mabird there. I asked werent you scared to go into this cave that had 10,000 bats, lots of them with mabird often fatal virus and this notorious python and they said the python didnt worry us and the bats didnt worry us because we were wearing those moon suits and the mabird didnt worry us because we have the protective equipment on. The cobras worried us. [ laughter ] and underneath their moon suits they had to wear leather chance so if they had a cobra strike they wouldnt be killed by it. So we have to always remember above aldo no harm needs be more than a motto. It needs an organizing principle for all of our work. Now, like other Health Care Workers i have my personal experiences with risk, sometime back i was working in rural latin america on Public Health programs in communities and im sorry to say this over lunch i wont go into details communities that didnt have great sanitation and i became extremely ill. It was in the brief period between medical school and starting internship and residency and i had learned in medical school what a rigor was but if you ever had a rigor you under its not a shaking chill, its a violent shaking chill so violent the bed shakes. Its a reflection of having grand negative bacteria in your blood and i became quite ill. I returned to the u. S. Feeling a little bit better to start my internship and i was tested and found to have an organism from poor sanitation, it was in my bloodstream, i was very ill with it. Highly infectious. Ten xx organisms can infect another person and just give you a sense of scale you can fit about a million organisms on the head of a pin. So when i went in for testing the doctor said you not shagilla and resistant to every antibiotic known. I said i have to start my internship. [ laughter ] and the Infectious Disease attending said you need to go home. But we always want to be part of the solution. In health that can be part of the problem. So now a little footnote to that story. That episode of illness i did eventually get better not as quickly as i would like and recovered completely. About a year later, a new drug came on the market and two players later i wrote an article published in jama on the inappropriate use of medicine. So i have a quiz for you. What are the six organisms all have in common besides the fact that they are all Infectious Disease. Thats too easy. Mers. Eboli. Measles. Tuberculosis. And cre. Any guesses for what these three, what these six diseases all have in common these six Infectious Diseases. Yes. They are preventable. Yes. They are all preventable. Thats one thing they have in common. How about how they spread . Is there something in common. You have eboli from bats, mers maybe from camels. Some are airborne, some are not. Three quarters of the new infections we face are zornonic. No. They are all very importantly spread in hospitals. We can be part of the problem if were not careful. All of them and ill talk a little bit more about that. Now when i went to medical school they taught me to use some fancy words. I know reporters never use fancy words but, you know, we dont say we gave to it them in a hospital. We dont say the doctor made him sick. We use fan sip 50 cent words to avoid the uncomfortable truth. My most favorite of all we know exactly the cause of his illness, its i diopathic. It means we dont know what causes it. Another definition is patient is sick and the doctor is an idiot. Now mers is very concerning because like sars which occurred a decade ago it has a high case fatality rate. Maybe as high as 30 . Mers also could cause significant not only illness but economic dislocation. Sars cost the world more than 30 billion in just three or four months. Were learning more about mers and that quiz i gave earlier was actually the key lesson we learned as we work close wli the saudis and were now work very closely with them on a variety of investigations and control measures, we found that the overwhelming majority of mers cases in recent months or in the past six to 12 months have been associated with hospitals. Theyve been spread in hospitals, patients, staff, visitors, others associated with hospitals. Thats bad news and good news. Bad news because it shouldnt have happened and should be able to prevent it. Good news because we know how to turn off that tap. We know how to protect Health Care Workers and other through Infection Control measures and i received an email last week from the saudi minister of health to our staff who reported that in the past ten weeks they not had a single case of mers in a Health Care Worker now they they implemented stringent control measures. When you know how something is spreading you can stop it. Theres still more we dont know. We dont have a prevention. We dont have a cure or a vaccine. We dont know how it jumped from animals to people. It does seem that camels have perhaps been infected by bats and perhaps have Something Like mers whether its direct contact with camels orca medal products. Were under taking studies to find that out the prevent it. When we under something the better we the prevent it. The next pandemic is not likely mers unless it mutates the capacity to develop easily from person to person. It may not be an influenza like the one that emerged in china and thats a wonderful story of how we have global collaboration. But maybe the thing that we are most at risk for is not the thing that we dont know but something thats hiding in plain sight. Something that could kill any of us. Something that could undermine our ability to practice modern medicine. Something that could devastate our economy and something that could sicken or kill millions. Now, someone here in this room, Christian Lillis knows about this problem. Christians mother peggy was a beloved kindergarten teacher. She went in for a routine root canal procedure. Within a week she had sepsis. And tragically at the age of 56 she died. Christian and others have carried the standard to make clear what is the human face behind the tragedies that we read about because in Public Health were at our best as bill fagy said when we see and help others see the face s and lives behind the numbers. I think of a 15yearold who loved music had a congenital, a mall formation, not major and went in for a routine check up. Two days later had a resistant bacterial pneumonia and died easter weekend. I think of josh nahem, a young man from colorado, 27 years old, loved skydiving. Had an injury from skydiving. Got infected, began to recover then developed a highly resistant organism and also died at the age of 27. Joshs mother victoria has Christian Elisabeth hasselbeck been be a activist, an advocate information proving the way we address infections in this country. Antibiotic resistance could affect any of us. In fact, 2 million americans get resistant infections each year. 23,000 americans die from infections each year, resistant infections each year and another 14,000 americans have deaths like christians mother from or contributed by. Im an Infectious Disease physician. I treated patients for many infections. And i treated patients with no antibiotics left. I felt like a time traveller going before the time of antibiotics. We talk about the preantibiotic era and antibiotic era. Soon we can be in the postantibiotic era. Antimicrobial resistance is getting worse. It creates two problems that are worthying of a little separately. One of them are the thing that we usually think of as infections. Urinary Tract Infections, wound infections. Were seeing more and more resistance from those organisms. But theres a second problem that we may not think of notally and that is how important in control of infections is to the practice of modern medicine. 600,000 americans a year get cancer chemotherapy. When we give cancer chemotherapy we drive down the bodys defenses so we can wipe out the harmful cancer cells and patients get if he verse and serious infections and we can keep them in check until the bodys resistance comes back. So cancer chemotherapy may be at risk. We have more than 400,000 americans who are in dialysis. Infections commonly complicate dialysis if we throes ability to treat those infections it will make dialysis much more difficult to do. Modern treatments for everything from arthritis to asthma suppress the immune system. Our ability to give these cuttingedge treatments is at risk because of the spread of Drug Resistance. Every day we delay means that it will be harder and more expensive to fix this problem tomorrow. Bacteria are evolving very quickly. We need to move quickly to get ahead, to catch up and to control it. Its possible to keep resistant bacteria from spreading. Its possible for some pathogens to actually reverse the level of Drug Resistance but only if we act now and act decisively. What weve seen is that organisms can start in hospitals. Our most resistant organisms start in the hospital. Now we see it go out in the community so now the most common pathogen recovered from patients with cuts and wound infections in the emergency room are mrsa. Its not too late. We know in cre we still largely are dealing with a hospital infection. We can keep it in the hospital. We can shrink the numbers and crow it. If we dont then common infections like urinary Tract Infections could be untreatable. To stop Drug Resistance we need fundamentally to do four things. First, we need better detection, second better control. Third, better prevention. And fourth, more innovation. On detection, we need realtime systems to find out whats happening around the country. In fact, this week cdc will be launching for the first time a system that will allow any hospital in the country to track electronically automatically with no extra work after the initial uploading work all of the antibiotics dispensed in that hospital and all the antibiotic resistant patterns of patient whose have infections. That will allow doctors to be empowered with the right information at the right time to make the right decision so that they can give a patient antibiotics that are needed neither too broad nor too narrow. So better detection is the first step in controlling drug resistant organisms, to allow us improve prescribing practices, to identify outbreaks, to figure out our outbreak control measures are working. The second key step has to do with control. As with the quiz earlier, much of this is a problem and we have to take seriously above aldo no harm. Too many infections are being spread in our hospitals. Too many patients are coming in with one condition and leaving with an infection that they didnt come in with. But prevention requires work across many facilities, even the best of hospitals cant do it alone. They need to intersect with the Nursing Homes wthe outpatient providers, with other facilities in their communities and that can best to be done with Public Health departments serving a convening, collaborating and facilitating role. State Health Departments will be key to revers