Monkeypox Home

CDC Telebriefing Transcript

Update: Monkeypox Investigation in the U.S.

June 11, 2003

Note: Due to technical difficulties the telebriefing was joined already in progress.

MODERATOR: Thank you for standing by and welcome to CDC's monkeypox virus investigation update.

At this time, all participants are in a listen-only mode. Later, we'll conduct a question-and-answer session. If you have a question at that time, press the one on your touchtone phone and you will hear a tone indicating that you have been placed in queue and you may remove yourself from queue at any time by pressing the pound key.

If you are using a speaker-phone, please pick up your handset before depressing the one.

If you should require assistance during this call, please press zero, then star.

Our first presenter today will be Dr. David Fleming, deputy director for CDC, and we'll transfer your line into the auditorium and you will hear background noise until the conference gets underway.

[Pause.]

DR. FLEMING: --be happy to open up to questions both from people here in the room as well as on the phone.

As of 2:00 o'clock today, we've had 54 cases of monkeypox infection in humans reported from four states--Wisconsin with 20 cases, Indiana with 23 cases, Illinois with 10 cases, and one case from New Jersey. Approximately ten of those people have been hospitalized.

In response, CDC has been working with affected states, their public health systems at both the state and local level to do the investigation. Currently, we have at CDC activated our Emergency Operations Center, to help us deal logistically with this outbreak investigation, and in addition, CDC has deployed 11 epidemiologists to the affected states, in particular, nine in Indiana and two to Texas.

We have decided today to implement two interventions to help control the spread of this outbreak in the U.S. and to decrease the likelihood that this will become a chronic problem in the United States and the Western Hemisphere.

First, this morning, Secretary Tommy Thompson of Health and Human Services announced the immediate embargo on the importation of all rodents from Africa. As you know, rodents from Africa are believed to be the vector by which monkeypox arrived in the U.S.

This notice also prohibits the sale and transportation of these rodents within the United States.

Second, and in addition, we are also implementing a ban on the sale or movement of prairie dogs between states and also within state boundaries.

Transportation of prairie dogs that are sick. If a person wants to take a sick prairie dog to their veterinarian, of course they can do that. This pertains more to commercial activities related to prairie dogs. These prohibitions are immediate and will remain in effect indefinitely until we get more information.

There have been implemented under the joint authority of CDC and FDA. FDA will take the lead in the enforcement aspects of this.

The second thing that we're doing, as you know smallpox vaccination, because monkeypox is related to smallpox, is an effective way to prevent monkeypox from occurring in people. Studies have shown that smallpox vaccination is about 85 percent effective in preventing monkeypox.

And so we have convened a group of the best experts out there on vaccination, in general, and on monkeypox, in particular. They've recommended to us a limited vaccination strategy using smallpox vaccine and so we're announcing that today.

Again, I'd like to emphasize that this is targeted and focused in the areas that are affected, and we are recommending smallpox vaccination for the public health investigators that are out there in the field conducting the needed public health activity, for health care workers, that may be treating sick people who are hospitalized, or family or other very close household contacts of people who are sick with monkeypox, and finally, for people who have had contact with a sick prairie dog or other animal that's been confirmed to have monkeypox.

In all instances, we're recommending vaccination up to four days after this exposure has occurred, but vaccination can be considered as long as two weeks after exposure.

Finally, I just want to emphasize some of the key public health messages that we have for consumers out there, people who may have prairie dogs in their household, and we'd like to recommend, first off, that people who do have prairie dogs or other small rodents in their household as pets, who've gotten them since April 15th, should be watching their animals for signs of illness.

Signs of monkeypox include basically cold-like symptoms, running or oozing eyes, respiratory disease and a rash. Now in a furry animal, a rash, you figure out it's there by petting the animal and you can actually feel the bumps of the little vesicles.

If animals have these symptoms, please contact your veterinarian or your local health department to assure your animal's properly evaluated.

The biggest risk here,what we're trying to avoid is inadvertently introducing monkeypox into the natural wildlife system in this country. So do not, do not release sick animals out into the wild.

And in addition, any individual who's had contact with a sick animal should be on the lookout within themself and within their family for symptoms of fevers, chills, muscle aches and rash, and if they do develop those symptoms, they should contact their health care provider. In both of these instances, particularly, though, for people who are bringing ill animals to their veterinarian, please contact the veterinarian beforehand so the appropriate measures can be taken in the veterinary office, to avoid exposing this potentially sick animal to other animals that may be in that veterinarian's office.

That's all I wanted to say as far as specific comments. I'll be happy to take questions, first, from the room here.

QUESTION: Dr. Fleming, you said that you had sent some of your personnel to various states in the Midwest plus Texas. Are there reported cases in Texas, and what about other states that you're looking at or dispatching people to?

DR. FLEMING: I said Texas. That was a misstatement. We have sent people to--excuse me--to Indiana and to Texas. I apologize; you're right. And in Texas, the reason that we have people in Texas, it's because the source of the prairie dog, as we're tracking them back from the owners through the distributors, can be tracked back to Texas, and so those individuals are assisting the U.S. Department of Agriculture in a joint investigation to figure out where these animals came from and then to track forward from there to see if there are potentially any other parts of the country that we need to be doing further investigative work.

I'll take a question from the phone now, please.

MODERATOR: Okay. We do have a question from Anita Manning of USA Today. Please go ahead.

QUESTION: Hi, Dr. Fleming. Thank you for doing this. I have about a million questions but I'm so--

DR. FLEMING: Just one [inaudible].

QUESTION: Well, all right, if I'm really limited to one, I do want to know what you're doing with the sick animals. What is supposed to be done with them, and are people supposed to have them euthanized? What is supposed to be done with them?

DR. FLEMING: Well, for animals that are sick and which are diagnosed as the monkeypox, as suspected, we are encouraging, strongly encouraging the owners of those animals to contact either their veterinarian, or if they need assistance in finding an appropriate veterinarian, their state or local health department, so that animal can be evaluated to see if in fact it does have monkeypox.

For animals that are diagnosed with monkeypox, in general, we are recommending euthanasia for those animals.

The key message here is that sick animals should not be released from a household out into the wild.

Next question from the floor here.

QUESTION: Hi. David Wahlberg from the Atlanta Journal-Constitution. Can you tell us how many cases are confirmed by lab tests and can you talk a little bit about what kind of blood tests are being used, and also could you give us some, I guess advice, or sort of a "big picture" for the public, now that we've had, you know, AIDS, West Nile, SARS, monkeypox--are we gonna be seeing more and more of these diseases and what should the public be thinking about along those lines?

DR. FLEMING: Thank you for those questions. There have been nine other cases that have been confirmed by the laboratory to date. Additional testing is going on. In general, this is being done through the sophisticated kind of testing that CDC has been using in all these outbreaks, including PCR testing, electronmicroscopy can give you a good early-on notion of whether or not this is monkeypox, and there's a picture up here of the monkeypox virus as it would appear an electron microscope.

Yeah, it is interesting, isn't it, how these things have been occurring more frequently recently. I think that there are several explanations for that.

First off, this may be coincidence, things tend to happen in clusters, and so that--it may be more, no more complicated than that.

Second, though, with the investments that have been made in this country, and in other countries, to improve public health infrastructure for detection of bioterrorism events, we should take this as a natural consequence, that we're going to be increasingly efficient and effective in identifying these naturally-occurring threats as well, and so, in essence, this is confirmation of, number one, the need to invest in our system, and number two, the effectiveness of that system.

Third, we are living in a world that's increasingly globalized, and so if you look at the amount of travel that's occurring between countries, both of humans and of animals, that's been increasing exponentially. All of these outbreaks are, in essence, related to that globalization, and in that context we should expect that these will become more rather than less frequent. Let's go to the phone.

MODERATOR: Yes, we have a line from Larry Altman from the New York Times. Please go ahead.

QUESTION: Yes, David, can you explain why a ban on the imported exotic animals might not have been put in place before monkeypox was detected here, because of the growth of the animals, because of the threat and the concerns that have been expressed in recent years. I mean, it took this outbreak to put the ban in effect but there are many who said this should have come earlier. Can you speak to that.

DR. FLEMING: Yes. Thanks, Larry, for that question. I think that in this particular outbreak, as we identified the cause, the Department of Health and Human Services has moved rapidly to implement the appropriate control measures with this order today.

Any time one of these outbreaks occurs, however, in addition to implementing the control measures that are necessary to contain it, as it's occurring, afterwards, we need to take a step back and say, What are the additional lessons that need to be learned, that can prevent these kind of outbreaks from happening again in the future?

And surely, part of our thinking that is going to occur as a result of this outbreak is the extent to which regulations regarding import and transport of animals should be implemented in the future. Thanks, Larry.

We'll go down to the floor here.

QUESTION: Hi. Miriam Zalco from CNN. Two questions that are kind of related. First of all, do we know if any other types of animals came in contact with this Gambian rat, which I believe we think is the source of this?

And also do you know what other states have had animals shipped from the distribution center in Texas? And is it possible that there are people out there who don't know that they are infected and just haven't shown symptoms yet?

DR. FLEMING: That was a lotta questions, wasn't it?

QUESTION: But it's all related.

DR. FLEMING: With respect to the animal distribution piece of this, we're right now in the process of working with USDA to track back to the distribution, to specifically determine the extent to which these animals may have been exposed to other animals, and where those animals went. The executive order that--or the order that was signed today did include, in addition to Gambian rats, the additional rodents, and there's five categories and I can give you the details afterwards, that were in the same shipment that came in from Gambia (Editor’s Note: Shipment came in from Ghana not Gambia), and so this ban on imports applies to all six categories of African rodents and not just Gambian rats.

One of the purposes of this news conference today, and the information that's going out to the public, is to make people aware of the signs and symptoms of monkeypox, both in animals that they might have, particularly prairie dogs, and in themselves, so there'll be a heightened index of suspicion, and if people feel that [inaudible] either in their animals or in themselves, they should contact their veterinarian, their physician, or if they need assistance in finding one of those, their state or local health department.

Let's go to the phone.

MODERATOR: Yes. We have a line, a question from the line of Detra Henderson from the Denver Post. Please go ahead.

QUESTION: Thank you, again, for doing this. I was cut off as the conference began, so if you covered this, my apologies.

How the monkeypox moved from the Gambian rat to the prairie dogs and from prairie dogs to humans. Is there any indication that fleas might be involved?

DR. FLEMING: Excuse me. I didn't hear. That fleas might be involved?

QUESTION: Fleas.

DR. FLEMING: No. Monkeypox--we're in a learning phase with this outbreak but monkeypox, from what we know from illness in Africa, it's fairly easily transmitted from animal to animal, and fortunately it's not highly infectious from human to human, but it basically is a result of direct animal contact, either animal to animal or animal to humans, and there's no indication at this point, or need to speculate some other vector like a flea.

QUESTION: Thank you.

DR. FLEMING: I'll go to the floor here.

QUESTION: Thanks. My name is Daniel Yee with Associated Press. So can you tell us some of the long-term recommendations that you'll be having. Will you be making them to like Congress or USDA as far as what should be done for the importation of exotic animals, whether that's quarantine or disease, infections, or any other types of regulations.

And what is the bottom line for people? I mean, how concerned should they be? I mean, do you expect more cases to increase of monkeypox? What should people do, in general?

DR. FLEMING: First off, we have moved quickly to develop an interim order today, that we feel are the, is the appropriate steps to take to prevent the spread of this outbreak as best as possible, within this country to prevent further introduction into this country, and also to restrict the possibility that we might inadvertently export this overseas.

As we move forward, we will really be evaluating the second part of your question, which is what are those long-term steps, what are the lessons learned here? We're not yet at a phase, a place of being able to tell you specifically what those are gonna be, but we are definitely going to be embarking on a process to figure out what those best recommendations are.

This is a problem--I really think that particularly state and local health departments in the affected areas need to be congratulated for--this is a problem that was identified quickly, and as a result of that, in just a matter of a day to a couple of weeks, we've identified the problem, control measures are being implemented, and so I'm confident that everything that can be done is being done to prevent the further spread of this disease.

We do need to have heightened vigilance, both in the areas that are affected as well as around the country, to make sure that we have caught it early and that we're implementing the appropriate steps in all locations.

Go to the phone, please.

MODERATOR: Our next question comes from the line of Tina Hessman of St. Louis Post-Dispatch.

QUESTION: I was also cut off at the beginning of the conference call.

DR. FLEMING: Sorry about that.

QUESTION: So I missed this. You keep talking about the Gambian rat. Has monkeypox been actually confirmed in the Gambian rat?

DR. FLEMING: No. Tracing back the prairie dogs has found this link with this shipment of African rodents that came in. A likely candidate there is the Gambian rat but we, at this point, do not have definitive confirmation of infection in a particular rodent, and that's why this order covers all of the African rodents.

Next question, please.

QUESTION: It's my understanding that monkeypox has been fatal in humans in Africa. Is there a possibility that that might happen here, or is this a different strain of the virus or can you kind of elaborate on that.

DR. FLEMING: This is our first experience with monkeypox in the Western hemisphere, so we're in a learning mode. In Africa, the mortality rate from monkeypox has been between 1 and 10 percent. So that is, I think, a figure that we should be, in essence, anticipating in this country.

Now there are lots of reasons why things may be different here, including improved medical treatment, better nutrition, so in some cases that may be optimistically, a worst-case scenario. But we do need to be prepared for the fact that monkeypox can be a fatal disease and in fact it's because of that consideration that our experts have advised us, felt that it was prudent to go ahead and recommend vaccination for people who could be exposed, who have been potentially exposed.

From the phone.

MODERATOR: Our next question comes from Anita Manning. It's a follow-up question from USA Today. Go ahead.

QUESTION: Hi; me again.

DR. FLEMING: Hi, Anita.

QUESTION: Dr. Fleming, how many people do you think will be offered the vaccine? Do you have any estimate of how many people might be affected?

And the other part of my question, I'm sorry, which is really sort of unrelated, is I'm trying to get the Texas connection. Was the rat--was the shipment of rats that came in from Africa, did it go to Texas, or are you suspecting that the prairie dogs somehow were infected in their natural habitat?

DR. FLEMING: To answer your second question first, the shipment of rodents that came in from Africa did go to Texas and in the Texas facility that received those rodents, there were also prairie dogs. It's that shipment of prairie dogs that went to the Midwest that's been implicated in causing disease (Editor’s Note: The Texas facility mentioned above exported animals to other facilities that house domestic pet prairie dogs that were presumably secondarily infection). So it's tracking back the shipment of prairie dogs that were, in essence, commercially distributed, not prairie dogs in the wild, to this distributor in Texas, and seeing that link with the shipment from Africa, that's where the evidence is at this point.

With respect to the number of people to whom vaccination will be offered, we don't have a good estimate of that at this point because the state and local health departments involved are right now in the process of identifying those contacts.

We specifically designed these recommendations to be fairly focused, however, so I would anticipate that the number of people that would be receiving vaccine will be relatively modest.

Next question on the floor here.

QUESTION: I have a smallpox question too. The--

DR. FLEMING: Sorry; this is just monkeypox.

QUESTION: Well, the vaccination, will it come from the stockpiles that have already been accumulated due to the smallpox program that was put in place earlier this year, and this is yet another thing that public health has to deal with in all these states, and they're already strapped. They've got to cope with SARS, they've got to cope with West Nile virus, they've got to cope with all the homeland protection measures the had to put in place.

How much more can all these state health departments take, and the CDC, for that matter, too?

DR. FLEMING: Thank you for those questions. We are, in essence, a fortuitous position, in that because of all of the energy and work that has been done to develop a smallpox prevention plan in this country and to get vaccines out to state and local health departments to immunize key providers, in fact we do not have smallpox vaccine and trained people in these states who are recommending vaccination, who are able to go out and deliver this vaccine.

So the start-up time to achieve this has been significantly shortened and as a result we're optimistic that in fact we can deliver vaccination to these people in time for it to do good.

The second point that you raise is a very important one and that has to do with the capacity of our public health system to respond to this crisis.

Obviously that's our job and so we are here to identify these problems and do the very best possible work to prevent Americans from becoming sick, and the investments that we've made to date in improving our public health infrastructure as a result of the bioterrorism concerns, have gone a long way towards beginning to build that capacity, but the job is not yet finished, and additional investments do need to be made in the future to make sure that we are prepared, not only for bioterrorism, not only for these other emerging infectious disease threats but from the broad category or preventable diseases, be it cancer or injury or environmental exposure, that public health every day is protecting Americans from.

From the phone. Any more phone questions?

MODERATOR: Yes. We have a question from Delthea Riggs of Newsday. Please go ahead.

QUESTION: Thank you for taking the question. Just very quickly. There are restrictions on who should get the smallpox vaccine and I believe those restrictions were well outlined in the health care vaccination program.

But the restrictions were never--or the guidelines were never clearly made for children and can children be vaccinated?

DR. FLEMING: For the--

[Simultaneous conversation.]

QUESTION: For monkeypox.

DR. FLEMING: --[inaudible] we're recommending a small number, a relatively modest number of people in this country be vaccinated.

There are very definitive exclusion criteria, including as you said, children.

This situation now, this focused, targeted, vaccination recommendation is different in that we're not dealing with a potential risk in the future but the realities that these people have been exposed to this potentially fatal illness.

In that context the risk-benefit changes, and so we are in fact--if people fall into these categories for which we're recommending vaccination, we're recommending that vaccination occur in children, in pregnant women, in individuals who have a history of eczema. We are counseling deferrals and people who are immunocompromised.

Obviously on a case by case basis, this will be a determination that will be made between the provider and the individual, but because of the real risk here of disease in monkeypox, we're recommending a somewhat more aggressive approach of who should vaccination within this very small focus group.

Next question on the floor here.

QUESTION: David Wahlberg. Has there been any evidence yet of person to person spread or spread from animals other than prairie dogs like the one rabbit case?

And how many days elapsed between when the first state got the first report of this and when the CDC was notified last week?

DR. FLEMING: As far as animal to animal or person to person, there has been this one instance where a rabbit became ill as a result of being in contact with a ill prairie dog, and we know from Africa, that that kind of transmission occurs.

Thus far, within the U.S., none of the cases that have occurred have confirmed to be person to person. There have been settings in households where there's been a single sick animal and different household members have become sick at different times, raising a possibility that person to person transmission has occurred, but thus far there's been no evidence of that.

In Africa, the experience is that person to person transmission does occur. Fortunately it occurs at a fairly low rate, much less infectious than smallpox, for example, such that human illness will die out after a generation or two of transmission.

With respect to notification by states to CDC, we have very good links with our state public health partners, and so, in essence, there was instantaneous transmission of infrastructure between the health department system and here.

We are going back and looking at circumstances that preceded that health department notification, to see whether, in retrospect, there were some delays in communication that we can learn from to improve in the future. We don't have that information completely tallied as of yet.

Let's go to the phone.

MODERATOR: We have a question from Richard Knox of NPR.

QUESTION: Hi. Thanks very much.

I gather that there have been some reports in the Midwest of animals that are more widely bought as pets, such as gerbils and hamsters, that were possibly exposed to the sick prairie dogs in some of those shops.

I wonder whether you're following up on that and testing any animals that might have come from those shops.

And secondly, I wonder whether you have any information about how many prairie dogs thus far have been tested and found to be positive for the virus.

DR. FLEMING: Thank you for those questions. We are in the process, right now, of doing exactly the kind of traceback that you're talking about to see whether or not the degree of the potential for mingling of other rodents with these prairie dogs, to see if there's a potential for transmission.

At this point we have no evidence of human cases resulting from that kind of exposure but that's obviously something that's high on our list to investigate and get to the bottom of as quickly as possible.

I don't have specific infrastructure about the number of ill prairie dogs at this point but that's a question that you can contact our press office with afterwards. We can help find that piece of information for you.

Let's do another question from the phone, please.

MODERATOR: Yes. We have a question from John Lowerman of Bloomberg News.

QUESTION: Hi. I've several questions because I was cut off at the beginning of the call like I guess a lot of other people.

DR. FLEMING: Believe me, that wasn't intentional.

QUESTION: Thanks. Thanks for the vote of confidence.

First of all, do you have a count of people?

DR. FLEMING: Cases? Yes.

QUESTION: Of cases; yes.

DR. FLEMING: There are 54 cases reported as of 2:00 o'clock today--

QUESTION: How many states?

DR. FLEMING: From four states, 20 in Wisconsin and 23 in Indiana, 10 in Illinois, one in New Jersey.

QUESTION: Okay. And I want to ask a little bit about therapy. First of all, who will be giving out the smallpox vaccine? Who will determine and who will actually be administering it?

DR. FLEMING: For the most part, it's our expectation that that will be administered by the public health system in the affected areas. That the details of that are currently being developed within each state but there is a trained workforce as a result of our smallpox preparedness for delivering vaccination, and we believe that in most places people will rely on that system because that's going to be the quickest, the most effective way to do it.

QUESTION: Okay. So people can't go to their doctor to get this. They have to be--

DR. FLEMING: Right.

QUESTION: Yeah.

DR. FLEMING: The health department should be consulted for individuals thinking that they may need vaccination and then for those that there is agreement that is recommended, should work with the health department in figuring out how to obtain that vaccination.

QUESTION: Then finally, what's the progress on determining whether Sadafovir [ph] could be used to treat this infection?

DR. FLEMING: There's no evidence, one way or the other, on that point. Our experts, when we asked them about that, quickly realized there's no evidence and said therefore, because of the risks associated with Sadafovir use, it's not something that should be considered unless there is a life-threatening illness that the patient is having, and then in that context it should be made on a case by case basis. The decision should be made on a case by case basis.

Let's go to the floor here.

QUESTION: Hi. Earlier, you mentioned about how rodents and other animals like this can't be sold right now, can't be imported. If pet stores have these animals or even those that are in this large warehouse in Texas, A, what will happen with these animals? and B, while they're there, is there not the potential for more transmission to other animals?

So I mean, how will that be--what happens to these animals?

DR. FLEMING: That's a good question. That's a question that needs to be decided sort of on the specifics of each situation. But CDC, the state and local health departments, and the USDA, would be available for consultation to these distributors or pet store owners to figure out exactly what the right things are to do that best protect the public, best protect the owners, and does right by the animals as well.

Let's go to the phone.

MODERATOR: Thank you. We have a question from Elizabeth Cohen from CNN. Please go ahead.

QUESTION: Hi. Thank you so much for having this teleconference.

Doctor, it sounds like from what you're saying, that we are not going to have sort of a SARSean experience with this disease. In other words, that people aren't going to be getting on planes and infecting other people in large numbers. Is that sort of a correct assessment?

DR. FLEMING: The short answer is yes. Monkeypox is a disease that is potentially transmissible from person to person but at a fairly low level.

In addition, people tend to be sick and so we wouldn't anticipate the same kind of problem that we experienced with SARS.

Let's do one more from the phone.

Before we do that, let me just clarify that the case numbers I've been given are cases under investigation as opposed to confirmed cases, and so expect that these numbers are going to jump around, and as we get more definitive information and can categorize them as suspect or probable or confirmed, of course we'll let you know.

The next question on the phone.

MODERATOR: We now go to the line of Diana Penner of Indianapolis Star. Please go ahead.

QUESTION: Thank you very much for doing this again. The CDC's recommendation to offer smallpox vaccine to the people you've outlined were eligible, does that mean that those people can demand to have the vaccine if they and their doctor decide they should? Or do state and local health departments still retain the right to decide when and whether and how to distribute it?

Also, can you explain why you sent a team of folks to Indiana but not to Illinois and Wisconsin where there also have been human cases, and what will those folks be doing here?

DR. FLEMING: Sure. The decision around vaccination, these are recommendations. The decision around vaccination is going to be made at the local level in consultation between the state health department, the affected individual and their private provider, and, you know, all indications are that that is an important discussion but one that it will be fairly easy to arrive at a consensus.

With respect to the deployment of CDC personnel, basically the investigations are being conducted at the state and local level, and our job here at CDC is to respond to requests for additional assistance.

We are providing that in Indiana, we're working closely with the other affected states as well, but at this point the kinds of support that we're providing to them do not include people on the ground. They have that aspect of it covered right now.

I'll take one more question from the phone.

MODERATOR: We now go to the line of Marilyn Maccione [ph] of the Milwaukee Journal.

QUESTION: Hi, Doctor. Thank you. I have two--one quick question. I want to clarify, you are making smallpox available to pregnant women and children and children, how young? If I heard that right.

And my other question is: Do you yet have a scope, a total number of how many rats were involved and/or how many prairie dogs were involved in that Texas shipment that could have been exposed to the rat? Numbers of animals that you're trying to track down, and whether you have yet found or tested any rats.

DR. FLEMING: Okay. With respect to your first question, yes, in the situation where we are recommending smallpox vaccine, for a very limited group of people who have had contact and therefore are at risk for monkeypox, we feel that the risk of disease is sufficient to make that recommendation for pregnant women and for children as well.

I would like, on the second question, to ask that you contact our press office after this conference call. I've already committed to a couple of other people that we will get some of the specifics on exactly the number of animals involved, the number of animals tested, and we'll have that for you.

Thank you very much, folks. I really appreciate your time and your interest in this story.

MODERATOR: Ladies and gentlemen, that does conclude our conference for today. Thank you for your participation and for using AT&T executive teleconference service. You may now disconnect.

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