Today on CNN Newsroom

The latest news and information from around the world. Also connect with CNN through social media. We want to hear from you.
April 28th, 2009
07:33 AM ET

Planning for a pandemic: "The threat remains"

Less than two weeks ago, former Health and Human Services Secretary Louis Sullivan talked about the importance of planning for a potential widespread flu epidemic. Noting that many experts think we are closer to the next pandemic than any time since 1968, Dr. Sullivan said: "pandemic planning should be viewed as an insurance policy against the economic damage that would result from widespread sickness, absenteeism, and death."

Dr. Sullivan joined Heidi Collins in the CNN Newsroom this morning.

soundoff (24 Responses)
  1. michael armstrong sr.

    dear doctors its good thing we was prepared for the swine flu all this being ready stuff makes me less worried about a measels out break or ebola or chicken pox . lets face it if that happens were frickin doomed.

    April 28, 2009 at 9:00 am |
  2. Tanners Dad

    It is ironic to me that less than a 100 people come down with the flu in a couple of cities and it is hold the horses, bar the door, red alert Captain Kirk. Children are being diagnosed with Autism every 20 minutes, babies are dying from SIDS (vaccine injury) and girls are dying from the HPV Vaccine, yet no reaction from the CDC and AAP. It is just the business of divide, lie, deny and ignore as usual.

    I am not sorry today I am on my soapbox. If you do not want to read a rant then click away. I am sorry for the world, as a society we have our head in the sand and our priorities messed up. I want a emergency command central set up for Autism and Vaccine injury now. I want truth, transparency, and Action. 99.999% will feel better after a couple of days of snezzing, coughing, & fever. People dealing with Autism can deal with it for 90 Years. The sentence for murder is less!

    Our world is full of followers. I know it will only be time now until the battle against Autism and the mistreatment of children is won. I know it will be before 2030. It is my job to move that date back to today. I know the tide has turned because pied piper has started to play and the first domino has fallen. 10 states have passed weak but real Autism Insurance Reform bills. The other states will follow. The mandate from the people has been made.

    Now once the Insurance Companies have to pay the even the ½ to ¼ of the therapy bills for ABA Applied Behavioral Analysis of $25,000 to $50,0000 per child with Autism per year they will soon freak out. State programs are already stressed and they pay about 15% of what is needed. The Insurance companies are another money making machine. Some brilliant executive is going to bring it up…Why are we paying for this? It is a side effect and collateral damage from vaccines. The people already pay for that through the money that is tacked onto every vaccine. MAKE THE PHARMACEUTICAL COMPANIES PAY. That amazing thought will be communicated at some point this year. Mark my words.

    After the Insurance companies wake up to the fact that money is being taken out of their pockets and Pharmaceutical companies have to pay. The Pharmaceutical companies will turn to the Government to protect them. Money makes the world go round and these days the world is spinning fast. Pharmaceutical Companies Fasten your seat belts it is going to be a bumpy ride. What does not kill you makes you stronger… Stop sacrificing the children of the world.

    What can you do today...

    If you are a parent... Love your child unconditionally. Do not let your child feel they are any less because they cannot communicate the way we do or look after themselves. Do not forget to look after yourself and your significant other. ( If you don't have one find one...There is someone out there for everyone. You deserved to be loved also). Join a church. Speak to your friends. Keep up the good fight.

    If you are Friend... If you have resources please consider supporting Generation Rescue as they move the agenda towards services and support programs. If you do not have financial resources provide respite services... Babysit, go with a parent to the grocery store, or running errands. Be there to listen.

    If you are in the medical community it is time to wake up and do something...
    If you are in the insurance industry it is time to make the people responsible pay...
    if you are in the media it time to tell the truth...
    If you are in the government it is time act...
    If you are in education it is time to educate...
    If you are in a religious community it is time to rally the troops to support families...
    If you are involved in a Autism group please invite them to join the Move to Heal Autism By 2030 (MTHA)

    If you are in the New York City Office of Autism Speaks... remember that $50,000 you took from my community this fall could have helped to pay for my sons therapy this year.

    If you are in contact with amanda peet and have a child with Autism invite her over to experience our lives first hand and but out of our childrens and the future of others children.

    If you are impacted by autism (that means you are part of the human race) Join me in the fight. Join causecast with your own cause or mine. Make a difference in our world. now. State your change! Then make it happen.

    If you happen to have some sleeping pills, sleep ideas for children with autism, or want to come spend the night let me know.... I need a nap.

    Say a prayer for all those dealing or not dealing with their "Autism Like" conditions. Say a prayer for the Travolta family may all their souls rest now...

    If you are in the pharmaceutical industry it is time to pray...

    People it is just time to deal with Autism....

    April 28, 2009 at 10:52 am |
  3. Anonymous

    I have been feeling flu like symptoms and I have had a couple of friends with recent flu symptoms. How do you know when you should go to the doctor?

    April 28, 2009 at 10:52 am |
  4. Debby Hall

    I HAVE THE FLU! I want to know if it is a seasonal flu or swine flu.
    I recently attended a convention with 1000 people and since then a couple of my friends and myself have come down with the flu. Is there someplace I should go to be tested in order for the CDC to monitor what states the swine flu is in ... or not?

    April 28, 2009 at 10:58 am |
  5. elizabeth bergeron

    I have a friend that lives in Ms. she has family in Texas . A co-worker of her nephew has a 9 yr. old son thats been tested positive for swine Flu and been hospitalized in Lake Jackson, Texas .... Lake Jackson hospital ......

    Why are the news media and news papers still saying no swine flu in Brazoria county ? My mother in law also lives in this county and people have a right to know the truth .

    Hospitals must report all cases , mild or other wise to health officals ...

    April 28, 2009 at 11:00 am |
  6. Diana Grillo

    You need to spend some time reporting on Single Payer Healthcare, especially now with the threat of a Pandemic.

    In my opinion we need to tell the full story about the companies that control our Healthcare system, their failure to deliver quality healthcare to all people. This is so important to report and you just don't do it.

    Insurance companiel are making money while people are not being covered for essential medical services. There are so many people that do not have Healthcare and that number is going up as I write this.

    This issue is so important , I hope someone really reports on this in a comprehensive way that makes a difference.

    April 28, 2009 at 11:01 am |
  7. robyncaffrey keyser west virginia

    this is a coment on ' the threat remains !

    also here are some tip's that might " help !

    when u have a feaver " all my growing days was said to sweat the feaver out of you. as i always did that with my kids growing up and in a few days the feavr was gone. when it's cold in the room ' germs will spread ( look at every hospital and clinic )
    you will always see it's cold in that room" i alway's did wash all my dishes in hot water. as "' hot water "' kill's germs and when you wash dishes in hot water" you will never see any print's
    ( whats so ever ) especily ' i have all black dishes'

    so try that " ( sweat ) the feaver out by staying in a hot room. dressig really with piles of cloths on. stay away from cold rooms , as the germs spread in the cold. wash off any dirt in hot water."

    April 28, 2009 at 11:10 am |
  8. Gloria Garrett

    In 1976 our neighborhood in Miami gathered at a local church to receive our Swine Flu inoculation. President Ford and the news media urged all Americans to be inoculated to prevent the spread of the Swine Flu. About two weeks after receiving the shot my left leg was paralized for about a week. The doctor at the time said I was extremely fortunante because some people were paralized from the neck down. As a result of that reaction doctors have advised me against ever taking a flu shot. At the time doctors did not know what to call this reaction but I have since learned that it was Guillian Barre Syndrome. Is this the same type of Swine Flu of 1976 and will the vaccine I received in 1976 protect me from the Swine Flu of today?
    Thank you,
    Gloria Garrett

    April 28, 2009 at 11:18 am |
  9. Jim Price

    Heidi, thanks for asking the hard questions. I really liked Dr. Sullivan's answers. I think the best we can expect is what Dr. Sullivan called "moderate". Hopefully if we are really hit with this possible pandemic, our governments' response won't be like Katrina.

    April 28, 2009 at 11:19 am |
  10. Billy G.

    Does the Swine Flu epidemic only spread to the north? What part does Central or South America play in the story? It's hard to believe that the virus has not spread to these countries. Do these countries have the same reporting abilities as the infected countries?

    We know how the flu jumps between humans but there aren't many people speaking about how the swine flu started? Where and how did it jump from an animal to a human? And what we can do to stop it. This is a good time for Robert Kennedy Jr. to promote his stance concerning water pollution and the transfer of mutant virus. An example of a mutant virus exist in the US and is found in 'intersex fish." The viruses spread from animal to humans via the water and the food supply.

    From what I’ve read, it is very likely that the virus was transferred in the water that originated polluted from the hog wash run off from a {company's} hog plant in Perote, Mexico.? We had similar issue with {that company}, in the US. Maybe it’s a NAFTA problem

    We are now blessed with a powerful tracking system from Google. The tracking system is excellent, but it only tracks the virus after it starts to spread.

    Let’s prevent the cause of the virus and possibly save on healthcare cost definitely save the world’s environment. I’m not a tree hugger but you must admit that this problem is just another reason to go green.

    April 28, 2009 at 11:20 am |
  11. Rodrigo Hernandez

    Re: Swine Flu Outbreak Raises Questions

    People at the Center for Disease Control are questioning the strange fact that
    so many cases in Mexico City have proven fatal, while the cases in the U.S. have
    been mild.
    My own question is if the HIGH ALTITUDE OF Mexico City could have
    something to do with the difference in virulence; if so, there could be a clue in here
    to combat this virus soon!

    April 28, 2009 at 12:02 pm |
  12. don mcmahon

    i recieved a swine flu shot while active duty onboard uss robson ddg-12. what evev happened to that and also i seen the army lost some vials of some type of virus, which they did not say about 2 weeks ago ??????????????????????????????? something wierd

    V/R Donald McMahon U S N ret. 1989

    April 28, 2009 at 12:09 pm |
  13. Greg F

    Being that I have no health insurance, and I keep hearing that there is no specific cure for swine-flu, why should I bother to go to a doctor is I get sick? It's not like he can cure it, right? And charge me how much?

    April 28, 2009 at 12:21 pm |
  14. Rodrigo Hernandez

    Infomatio for the moderators/Re: my comment.
    Adapting to High Altitude

    There are two major kinds of environmental stresses at high altitude for humans. First, there are the alternating daily extremes of climate that often range from hot, sunburning days to freezing nights. In addition, winds are often strong and humidity low, resulting in rapid dehydration. Second, the air pressure is lower. This is usually the most significant limiting factor in high mountain regions.

    Air pressure decreases as altitude increases


    Click here for more information
    about the earth's atmosphere


    The percentage of oxygen in the air at two miles (3.2 km.) is the same as at sea level (21%). However, the air pressure is 30% lower at the higher altitude due to the fact that the atmosphere is less dense–that is, the air molecules are farther apart.

    When we breathe in air at sea level, the atmospheric pressure of about 14.7 pounds per square inch (1.04 kg. per cm.2) causes oxygen to easily pass through selectively permeable lung membranes into the blood. At high altitudes, the lower air pressure makes it more difficult for oxygen to enter our vascular systems. The result is hypoxia , or oxygen deprivation. Hypoxia usually begins with the inability to do normal physical activities, such as climbing a short flight of stairs without fatigue. Other early symptoms of "high altitude sickness" include a lack of appetite, distorted vision, and difficulty with memorizing and thinking clearly. In serious cases, pneumonia-like symptoms (pulmonary edema ) and an abnormal accumulation of fluid around the brain (cerebral edema ) develop, leading to death within a few days if there is not a return to normal air pressure levels. There is also an increased risk of heart failure due to the added stress placed on the lungs, heart, and arteries at high altitudes.

    When we travel to high altitudes, our bodies initially develop inefficient physiological responses. There is an increase in breathing and heart rate to as much as double even while resting. Pulse rate and blood pressure go up sharply as our hearts pump harder to get more oxygen to the cells. These are stressful changes, especially for people with weak hearts.

    Initial inefficient response to low oxygen pressure

    Later, a more efficient response normally develops as acclimatization takes place. More red blood cells and capillaries are produced to carry more oxygen. The lungs increase in size to facilitate the osmosis of oxygen and carbon dioxide. There is also an increase in the vascular network of muscles which enhances the transfer of gases.

    Beginning of successful acclimatization to low oxygen pressure

    However, successful acclimatization rarely results in the same level of physical and mental fitness that was typical of altitudes close to sea level. Strenuous exercise and memorization tasks still remain more difficult. In addition, the rate of miscarriages is usually higher at altitudes above two miles.

    Increased fitness level after successful acclimatization to low oxygen pressure

    On returning to sea level after successful acclimatization to high altitude, the body usually has more red blood cells and greater lung expansion capability than needed. Since this provides athletes in endurance sports with a competitive advantage, the U.S. maintains an Olympic training center in the mountains of Colorado. Several other nations also train their athletes at high altitude for this reason. However, the physiological changes that result in increased fitness are short term at low altitude. In a matter of weeks, the body returns to a normal fitness level.

    Enhanced fitness level for a short period of time after returning to low altitude

    Who Is Most Likely to Have High Altitude Sickness?

    Most lowland people begin to develop hypoxia symptoms at 1-2 miles altitude. However, there are some permanent settlements in the Andes Mountains in South America and the Himalaya Mountains in Asia that are at altitudes of 3 miles. Mountain climbers have reached peaks that are over 5 miles high, but only by using tanks of oxygen to assist in breathing. The highest peaks are too high for any human to acclimatize naturally.

    Climbers at the top of Mt. Logan, Yukon
    Territory, Canada (19,850 feet altitude)

    There is considerable variability between individuals and between populations in their ability to adjust to the environmental stresses of high mountain regions. Usually, the populations that are most successful are those whose ancestors have lived at high altitudes for thousands of years. This is the case with some of the indigenous peoples living in the Andes Mountains of Peru and Bolivia as well as the Tibetans and Nepalese in the Himalaya Mountains. The ancestors of many people in each of these populations have lived above 13,000 feet (ca. 4000 meters) for 5,000-10,000 years.

    Peruvian Indian woman and Tibetan man
    (Her cheeks are red primarily due to increased blood
    flow near the skin surface. More red blood cells help
    her get oxygen to the tissues of her body.)

    The implication is that natural selection over thousands of years results in some populations being genetically more suited to the stresses at high altitude. However, different populations respond physiologically to low oxygen pressure in somewhat different ways. The primary solution of Indians from the high mountain valleys in Peru and Bolivia has been to produce more hemoglobin in their blood and to increase their lung expansion capability. Both result in an increase of oxygen carried by the blood. In contrast, the common solution of Tibetans and Nepalese who live at high altitudes generally has been to breathe faster in order to take in more oxygen and to have broader arteries and capillaries, thereby allowing much higher rates of blood flow and subsequently greater amounts of oxygen delivered to their muscles.

    Whether you personally will experience high altitude sickness in the future may be at least partly a consequence of your genetic inheritance. Those individuals who have low expression levels of the PDP2 gene generally have more severe symptoms. This gene codes for a protein that assists in the conversion of food into fuel for our bodies. In some way, it apparently also helps in acclimatization to low oxygen pressure.

    Previous Topic
    Return to Menu Practice Quiz
    Next Topic


    This page was last updated on Friday, March 13, 2009.
    Copyright © 1998-2009 by Dennis O'Neil. All rights reserved.
    illustration credits

    April 28, 2009 at 1:47 pm |
  15. Sam

    My daughter travelled to Mexico with her Spanish class for spring break. She spent several hours in the Mexico City aiport on March 31st. On April 5th she came down with an extreme virus. She initially experienced severe body aches, fever, headache, sore throat. At that time she was in Merida, Mexico. On April 6th she once again returned back through the Mexico City airport, and was so sick she was taken to the Mexico City Airport doctor's office. There, because she was having difficulty breathing, she was given oxygen by the doctor. Then, to help her with her fever, aches and pains and dizziness, she was given an injection of a drug called Metamizol. We, her parents, subsequently conducted a google search and learned that Metamizol has been banned in the USA and much of Europe since the 1970's because in some cases, on the second dose, patients' bodies create an immune reaction to the first dose and there is a significant rate of death from this reaction. When I google "Metamizol," I am cautioned never to give it to anyone under the age of 19, never to give it to anyone experiencing breathing difficulties, and never to inject it unless there is a dire emergency, and always to avoid using if aspirin or tylenol is available instead, due to its risks. Nonetheless, I learn that this analgesic is widely available and routinely used all across Mexico. It may even still be widely available in corner shops, over the counter. My daughter was prescribed a second dose by the airport doctor, but we did not give it to her (she was home, in Seattle, by then. So we will never know if she might suffer from this deadly second dose reaction.) She continued to be sick, coughing and sneezing, for over two weeks, and ended up taking amoxicylin for a related earache. Her ten year old brother and I also got sick, on April 11 or 12, but we had a much milder version. We coughed and sneezed and felt extremely tired for just a few days. It seems as though there is a dramatic difference in the number of deaths associated with this virus, between the US and Mexico, and it seems as though it may be useful for an investigative reporter to thoroughly look into the kinds of analgesics that are being used in Mexico that are different than those used in the USA. Everyone knows that aspirin can cause Reyes Syndrome and fatalities in some children with fever. Perhaps Metamizol, or another inappropriate medication, is causing an adverse reaction and deaths in swine flu patients in Mexico. I suspect some doctors and hospitals in Mexico will not want to admit they are administering this suspect drug to patients, a drug that is banned in much of the rest of the world, so an investigative reporter will have to be persistent to get to the truth about this, and about what other medications and practices are different in Mexico than in the US. Also, since it is available over the counter, patients may have taken it routinely for aches and chills without telling their doctor. I would really like to hear and read a CNN news story from this angle, looking at suspect medications in Mexico. You could start by interviewing the doctor at the Mexico City airport and ask her why she uses this drug, particularly with patients who are experiencing breathing difficulties. I wish someone would look into this. Even if this medicine is not related to the swine flu deaths, it would be important to shed some light on this ill advised practice of using less desirable medicines in Mexico. (My daughter is fine now, and says her whole trip to Mexico was absolutely wonderful until she got sick. She stayed with lovely families and she was very glad she went.)

    April 28, 2009 at 2:23 pm |
  16. David

    Hi Heidi, good morning.

    So, the healthier I am, the more vulnerable I am to this virus because my immune system responds so powerfully to it that it could kill me. That's kind of terrible but it does make sense.

    This is one thing that I've read. On the other hand things in the US seem just fine so that's good. Although we are just below the red alert level so there is the possibility of a widespread outbreak here.

    I am glad you did a report on Mexico City's packed subway system. Mexico City relies heavily on mass transit. Not surprising for a teeming metropolis of 20 million.

    I was on the AC360 blog last night and there were hundreds of questions about travel, so I wonder how this eruption of swine flu virus is impacting travel to Mexico. On the one hand it seems to be discouraging the "green shoots" of economic recovery overall, on the other hand it might be a good idea to go on a vacation to relieve a little stress and so be healthier overall and that then makes me more susceptible...?

    I hope this post of interest and they can mitigate if not contain this outbreak. It was troubling to see those people in Mexico looking so worried. My thoughts and prayers are with them and I'm very sorry that anyone has lost their life to this illness. Question. Can the Red Cross provide masks and Tamiflu if needed?

    Sometimes I am overwhelmed by the nonstop coverage, but I love how helpful and thorough it is.

    April 28, 2009 at 2:59 pm |
  17. robyncaffrey keyser west virginia

    also heidi '

    in 1982 me and my husband and 2 boy's at that time moved to tampa floida'
    we moved back to new jersey in 1985' my oldest boy was age 2 and i was 5 1/2 moths with my sec boy. ( anyway ) what im getting at : is
    when my sec boy was born, he was born with a weak lung. and when we moved back to new jersey , ' every winter ' my son that was still in my stomich ( from the move to florida ) ' he was stricken with " green dry crust on his left eye ' every winter ( as you would get with a bad cold going through your body'
    from the ' atmosphere and the climit ' change , living in florida for 4 years . then the move to new jersey .
    so it's so possible that the ' swine flu ' is from mexico's atmosphere.
    ( remember ) the cold spreads germs, the sweat kicks the germs off. and hot water helps kill the germs.
    in new jersey " all the garbage gets collected every 2 weeks. then the one who opperates the truck, will take a garden hose, and rinse out every dumpter that 's empty.

    April 28, 2009 at 3:03 pm |
  18. Sarrah Terry

    Should children and seniors get a "booster" flu shot? Earlier this year a news report indicated that those who got flu shots in Oct/Nov had diminished protection for any flu illness occurring in April/May or the summer. This information would be helpful to a great many people. Secondly, why has the U.S. and other affected countries closed their borders in order to isolate cases and stop further spreading. The WHO thinks this is serious – we should too!

    April 28, 2009 at 6:33 pm |
  19. Billy G.

    To find the Swine Flu virus, would it make sense to trace the endemic water supply from nearest hog farm or farms, to Mexico City? We may also find the amount of infection rates in relation to the local populations. .

    April 29, 2009 at 1:13 am |
  20. robyncaffrey keyser west virginia

    att : heidi
    please let me refraze my last coment.
    a cold room will not spread the germs, as you can see in hospital rooms and in doctors offices , it's always cold.

    at night time after i wash all my dishes '( this might sound strange' but i will toss and turn at night ,if anybody puts a dish or a spoon in my kichtin sink , after i had all ready washed the kitchin up. so if anybody gets up in the middle of the night , to get a glass of milk or makes a sand': they will put the dirty dish in the frigg)
    as i dry the sink out at night when i clean it. i got that from pest controlls, ( putting the dishes in the frigg )
    as every place we moved to , i had the house exteminated and the pest controll told me you have to dry the kitchen up at night , as roaches would collect on any drops of water left on the sink, counter,
    he was the one who told me to put the dishes in the frigg at night, as germs dont spread in the cold and when we were living in new jersey they would come around collecting garbage twice a week, and then the guy would take a garden hose , and hose the dumpters with hot water , as hot water kills the germs

    April 29, 2009 at 9:34 am |
  21. robyncaffrey keyser west virginia

    o" when i was 5 1/2 months and on my way to florida , then 3months after he was born his one lung was weak, and when we moved back to new jersey, after my son turned 5 he had the green crust on his eye' ( that you would get when you have a cold in the eye. anyway i rushed him to the hospital, the doctor checked him over
    and said to me' he was born with a weak lung' and the crust on his eye was from the atmosphere " being in a higher climit in florida.
    i am so so sorry' as the coment before was wrong, a cold room will not spead germs, and all my kids had bad colds leading to flues. and they always had bad headakes, runny noses , itchy watery eyes ,
    and alot of times had high feavors. well growing up' my mother and father would bunddle us kids up real worm, and then days after the feavor was gone, ( ive always ) dressed my kids really worm , when they were burning up' and i would give them liquid tylenol

    but ya sweat the feavor out.

    a cold room" germs wont spead ( remember all hospital rooms+ doctors exray rooms, are really cold.

    and hot water kills the germs

    and always keep the kichen clean and dry for un wanted roaches
    ya know i seen alot of movies on tv where in prison pictures
    people always had roaches and aunts crawling in there ear. they had infections in the ears and throats . that could play a bib part in the ones who deid from this flue

    April 29, 2009 at 9:56 am |
  22. Dan De Anda

    Does the swine virus die if a person dies? Also how do you handle a family member that has just been identified as contaminated?

    April 29, 2009 at 10:18 am |
  23. David

    That is some serious and worrisome confirmation in your interview with Dr. Sullivan about how we need to be more prepared for what is basically a once in a lifetime flu pandemic.


    Are people in the southern hemisphere worried or anxious right now? Seems like people in Mexico have been dealing with this flu for a long time.

    What airports in the US are taking the best precautions with travellers? International airports like O'Hare would I assume be way out in advance on this.

    Are there hard numbers, and how can we verify them, of people in the US who are infected? This is such a nasty virus, shouldn't we get on top of it as soon as we can?

    I heard the incubation time for this swine flu is 48 hours. So if I come in contact with someone who has this flu, should I be on special look out over the following two days?

    Glad to hear about the tri-national approach. Are we keeping abreast of all develoments in Mexico, seems like, but also Canada?

    The creativity and detail in the analysis of this virus is amazing.

    The upshot of all this is that I think your coverage is getting right at the heart of everything that has to do with this outbreak.

    Very sad to hear about the death of the toddler in Texas. I hope we do contain this flu as soon as possible.

    Hope these comments help.

    April 29, 2009 at 1:26 pm |
  24. Roman Strutz

    excellent day, your web site is genuinely unquie. Anways, i do appreciate your function

    March 12, 2015 at 6:40 pm |

Post a comment


CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.