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A Conversation With Tom Frieden

The chief disease detective talks about the Zika virus, flu outbreaks, obesity and zombies in the U.S.

En español | With all the public health dangers the CDC helps track and solve, is there any one thing that keeps you up at night?

The fact that we don't know what the next health threat will be. The latest is the Zika virus, but the one that has the most potential to kill people is influenza. More than 50 million people around the world died during the 1918–1919 flu pandemic. That's why we have epidemiologists all over the world tracking whether new strains of flu emerge.

Prescription overdoses and car fatalities kill more people in this country than threats like Zika or Ebola. Does the media overplay such threats?

It's understandable that when something new comes out that's unfamiliar, scary and has severe outcomes, it gets a lot of media attention. In fact, the Zika outbreak is unprecedented. We've never before identified a mosquito-borne infection that can cause fetal malformations.

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Does Zika have a particular risk for older adults?

We're looking at what appears to be a link between Zika and Guillain-Barré syndrome, which sometimes results in paralysis. There seems to be a higher risk for older people.

The 2014–2015 flu vaccine wasn't very effective because of a mutation in the virus after the vaccine was already being manufactured. How can we avoid this in the future?

We've been working hard to cut down the time needed to make a flu vaccine, but the simple fact is that the best way to protect yourself against the flu is still to get a flu shot.

We're now living longer, but has quality of life kept up with longer life?

That's a very important issue. Health is correlated with quality of life. If you get regular physical activity, have social connections, control your cholesterol, keep your blood pressure at a normal level, don't smoke — these things can make an enormous difference not only in how long you live, but how much you enjoy your life in those years.

With the continuing obesity epidemic in the U.S., what one thing can an individual do to counteract the risks?

Physical activity. Even if you don't lose an ounce, you'll live longer, feel healthier and be less likely to get cancer, heart disease, stroke and arthritis. It's the closest thing we have to a wonder drug.

You're obviously fit. What do you do for exercise?

I walk as much as possible, take the stairs instead of the elevator sometimes, go to the gym as often as my schedule allows.

And what's your favorite exercise at the gym?

I'm a competitive person and I enjoy playing squash. When I play squash, I don't think about work. I just think about hitting that small black ball as hard and as well as I can.

Considering all the outbreaks of foodborne illness the CDC deals with, like the recent investigation of E. coli at some Chipotle restaurants, are there any foods you no longer eat?

When I used to do lots of investigations on foodborne outbreaks, my wife got sick of my looking down a menu and reciting every outbreak that I had investigated that was associated with every item. So I don't think it's any one food. It's really the process of preparing food safely.

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"I would like to put it on record that the CDC has a 100 percent successful record of preventing a zombie attack."

Is the world becoming more healthy or less healthy?

The world is definitely becoming a healthier place. But we're also facing new threats, whether those threats are emerging infectious diseases, drug-resistant bacteria, overuse of antibiotics or opiates — or, because of the interconnections around the world, the greater risk of spread of infectious disease.

What did we learn from the 2014 Ebola outbreak?

West Africa experienced a terrible epidemic. What's less well recognized is that the world avoided a global catastrophe. In the U.S., it became clear that our recommendations were not protective enough because the nursing care is much more intense. As soon as we get new information, we adjust our guidelines to address, with the best available information, how best to protect Americans.

Let's tackle a really serious issue. The CDC was portrayed as a safe haven from zombies in the popular TV show The Walking Dead. Have your top experts determined how many zombies are among us?

Well, I would like to put it on record that the CDC has a 100 percent successful record of preventing a zombie attack.

Candy Sagon is senior health editor of the AARP Bulletin.

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