williams. good evening. with the flu at epidemic levels, already in some american cities and now with the media coverage of it, it's all having a predictable effect. while it's late in the game, people are streaming in to get flu shots, hoping to avoid a very serious illness. the kind that has overwhelmed even some hospitals. one doctor in minnesota where there have been 27 deaths due to the flu said today the spread of this virus this winter is pretty much unparalleled. some places are running out of inokay legislations. others are dealing with the sick. in a moment, what the doctor says about what to do if this strikes. but we begin with a doctor who has visited three hospitals in the flu zone over just the last three days. we have two reports to start off with tonight, beginning with dr. nan nancy snyderman at the hospital of the university of pennsylvania in philadelphia tonight. nancy, good evening. >> good evening, brian. state by state the number of cases of influenza and influenza related deaths continue to tick upward. in the state of pennsylvania, more than 20 people have been killed by this virus, and in the meantime, doctors and hospitals across the country are just scrambling to keep up. at 15 months,ca leave hollins is one of the youngest victims. he has spent the last three days in the hospital. >> he cried and cried. he would just look at me and give me like a sad look, like -- help me. >> washington's children's national medical center is seeing a nearly 30% increase in emergency department visits. >> it's our very young and our very old, as well as our immune compromised patients. so by very young, definitely children under 2 and even under 5 are at higher risk of complications. >> at saint luke's patients medical center in pasadena, texas, where there has been an uptick in flu cases, the elderly are a major concern. >> they come in very weak and ill and think it's a simple flu, but then the complications set in. >> in chicago, the department of health is trying to stem the tide by offering free vaccinations, but there are shortages. the city of summerville, massachusetts ran through 700 doses of vaccines. >> we exhausted our supply on tuesday of this week. >> there has been a run on flu vaccine this season. the cdc says 128 million doses have been delivered. only 135 million have been made. this year's flu is especially virulent and can spread quickly. experts say you can be exposed to the virus six feet away from a person who coughs or sneezes. and once you are infected, it's easy to pass it on to family and co-workers, even before you have symptoms. and adults can be contagious 24 hours before they feel ill and be sick up to a week afterward. children may be contagious longer than a week. doctors say emergency rooms should be the last resort. >> they put people at exposure just by coming to the emergency department. >> patients should only go to the hospital in cases of severe dehydration, difficultly breathing or if they have a chronic illness. dr. nancy snyderman, nbc news, philadelphia. this is kevin tibbles in port washington, wisconsin, where like many businesses, iconic american shoemaker, allen edmonds, can't afford to lose people to the flu. you don't want these people to be sick. >> no, we can't do our job if these people are sick. >> reporter: so staff meticulously spray and wipe down all common areas to beat back the germs. and the company's 500 wisconsin employees are constantly reminded of the flu outbreak and taught how to prevent it. >> hand sanitizer. >> reporter: across the country, businesses are already taking a hit, like at the hair spa in charlotte, north carolina. >> they're cancelling their appointments, they're rescheduling, they're coming in coughing. it's been bad. >> reporter: many companies like b & h photo in new york are now hiring private companies to provide flu shots to employees. >> you have a nice day. >> reporter: you may not know it, but the flu virus can live on a surface for up two days. and yet only about a third of us even bother to clean our desks or key boards once a week. when was the last time you cleaned yours? and here's an incentive. the average desk is 400 times dirtier than the average toilet seat. and while this flu season is shaping up to be serious, it comes with added worry in a tough economy. >> sick workers today are worried about losing their jobs, 38% of them don't get paid for their sick days. so they're coming in sick, they're infecting others. >> reporter: experts say, to fight the flu, businesses should limit the number of meetings, let those who can work from home, and make sure hand sanitizer is plentiful. and employment experts say that's good advice, because one sick employee could infect the entire staff and that could wind up costing companies a lot more. brian? >> kevin tibbles in wisconsin. nancy snyderman in philly before that. thank you both. and let's talk about what to do if this hits and what caregivers need to know. dr. tanya bennenson is our chief medical officer here at nbc. doctor, thank you very much for coming in. i know you handed out 300 inoculations today alone. let me ask how this strikes people differently. let's say a 20-year-old young, vigorous, healthy person versus a 65-year-old who may not be. >> well, people respond differently to the flu shots and have different immune symptoms. so a 20-year-old will actually have a more effective response from the flu shot than someone who is 65. now, as far as getting sick, it's really very individual. but a 20-year-old will probably recover more quickly than a 65 year-old. >> and they say when this flu hits, you go down like a redwood tree. this hits you very quickly. what do doctors like you use to treat this with? what's your recommendation to people, and especially to caregivers taking care of people with this? >> well, we hear it over and over again. prevention, first of all, is the key. so if you haven't had your flu shot yet, it's not too late. we should still get it. it does take two weeks to kick in and that's important. so sooner the better. so get it now. prevention like we just heard in the piece, hand washing, covering coughs and sneezes. staying home from work is crucial. we have a problem in our country the show must go on and we have to show up for work. if you have sick, you should stay home and stay home until you don't have a fever and that's without medication for 24 hours. so this is a big change in our culture. but we really need to stay away if we're sick. >> and there are anti vir rals and keep up with fluids and acetaminophen but not too much. >> contact your dock tore. there are treatments for anti virals and if you're home with someone, try to treat them. >> to go doctor, thank you as always. the fight over guns and the news of another school shooting breaking at the very same time they were meeting at the white house trying to figure out what to do about all of the gun violence in this country, post newtown. our report tonight from our white house correspondent, kristen welker. >> reporter: another school shooting today. this one at a high school in rural kern county, california, leaving two wounded and a shotgun suspect in custody. >> i don't know why someone would go into a school and hurt innocent people. just with what happened last month. >> reporter: while in a conference room across the country at the white house, vice president biden continued exploring ways to deal with the issue of gun violence. >> there's a real, very tight window to do this. >> reporter: today his passports heard from gun rights groups, retailers who have seen an uptick in sales since the shooting and a representative from the national rifle association. >> there is a surprising -- so far -- a surprising recurrence of suggestions that we have universal background checks. >> reporter: but there was little sign that the white house and the nra found any common ground. after today's meeting, harsh words from the nra's president. >> the administration was able to say they checked the box and say they talked to the representatives of firearms owners, and is the groups that support the second amendment and now they were going to try to proceed with what they wanted to do. >> reporter: the nra reports, since the newtown shooting, its membership has swelled by 100,000, now standing at 4.2 million. and at an oklahoma city gun store, owner miles hall says his customers are preparing for tighter gun laws. >> what was interesting is who was doing the buying. this wasn't anybody crazed or anything about that. they were just people who wanted to have something before the government said they couldn't have it. >> reporter: experts say the politics of gun control have shifted since newtown. >> the tragedy of what happened in newtown and the previous tragedies behind have clearly training changed the game on gun control in a way that's historically unprecedented. there is now a demand for action of the sort we just haven't seen before. >> reporter: now tonight the vice president meets with representatives from the entertainment industry, some critics argue that the glorification of violence in video games, movies and television shows is part of the broader problem that really needs to be addressed. brian? >> kristen welker at the white house for us tonight. kristen, thanks. president obama today formally nominated his chief of staff, jack lew, to be the next treasury secretary. as the second-term churn gets under way now. though it looked for a time like the president might nominate susan rice to be his next secretary of state, when that didn't happen, this latest wave of nominees appear to have something in common. and as nbc's andrea mitchell reports tonight, people are noticing. >> reporter: it is the white house photo that could be called all the president's men. adviser valerie jarrett is there, we're told, hidden behind the guys. as president obama filled his top cabinet post with nominees named jack and chuck and john -- >> it's time for me to move on. >> reporter: -- it was like "mad men" goes to washington, except peggy leaving ruth marcus. >> whatever guy becomes chief of staff, i think it's actually interesting there are two women who are deputy chiefs of staff and no one has talked about them as possibilities at all. >> reporter: one of the two deputies, nancy ann de parcel, a harvard lawyer, is leaving next week. epa administrator, lisa jackson. so is labor secretary, hilda solice. disappointing some women who helped reelect the president. >> we have different life experiences. they're not better or worse than men's, but they're different. >> reporter: to some, it was dejavu all over again, two decades after this report on "nightly news." today clinton rejected women's groups. he was visibly angry critics are ignoring sub cabinet appointees who are female. >> they would be counting those positions against our administration, those bean counters doing that, if i had appointed white men to those positions, and you know that's true. >> reporter: the obama white house says it has many women in sub cabinet posts and hasn't finished naming its second-term team. still, some say team obama could use some of those binders full of women. andrea mitchell, nbc news, washington. there's news out of the world of sports. we learned today former nfl star linebacker, junior seau, who committed suicide at the age of 43 last may had the same brain condition diagnosed in at least two former nfl players who also took their own lives. seau's family asked that his brain tissue be analyzed after his death. test results from the national institutes of health show he had a brain disease called cte, caused by repeated blows to the head. symptoms can include memory loss, aggression and depression. now to a life or death struggle that has captured attention around the world. 11 whales trapped under the ice, running out of breathing room. and just as a rescue mission was ramping up, something unexpected took place. it's all happening way up in remote northern quebec. and nbc news chief environmental affairs correspondent anne thompson has our report. >> this is a scene of beauty and bewhich woulderment. the ocean's top predators, killer whales, fighting to breathe in canada's hudson bay. this pod of orcas has become an international sensation. watching whales that can grow to 8 tons, taking turns coming up for air in a hole the size of a pickup truck. a marine biologist at chicago's shed aquarium. >> they're a very social animal, used to living and traveling in groups so they work together as a dynamic group. >> the 1800 residents of nearby could do little more than take pictures. >> i'm very sad. not to be able to help. >> reporter: if the story sounds familiar, it may be because hollywood made a movie of a similar rescue called "big miracle." >> it's going to be okay. >> reporter: based on three great whales trapped in alaska's frozen waters in 19 88. >> been going on for 13 days now. >> and local residents cut a two-and-a-half mile path through the ice for the whales. such measures weren't needed in canada. this morning, residents woke up to find the whales gone, free because of shifting winds that apparently broke up the ice. but the whales should not be in hudson bay in january. author david kirby says they are confused by our warming world. >> the fact that there was no ice for so long in hudson bay, the whales came in, they stayed too long, and then the ice froze up. >> reporter: struggling to survive on a changing planet. anne thompson, nbc news, new york. >> still ahead, as we continue on a thursday evening, a big warning tonight for women. it's about ambien and other brands of sleeping pills, and what can happen for some. and later, it will be one for the ages at the oscars. a race for best actress, far starters, like we've never seen before. copd makes it hard to breathe, but with advair, i'm breathing better. so now i can be in the scene. advair is clinically proven to help significantly improve lung function. unlike most copd medications, advair contains both an anti-inflammatory and a long-acting bronchodilator working together to help improve your lung function all day. advair won't replace fast-acting inhalers for sudden symptoms and should not be used more than twice a day. people with copd taking advair may have a higher chance of pneumonia. advair may increase your risk of osteoporosis and some eye problems. tell your doctor if you have a heart condition or high blood pressure before taking advair. if you're still having difficulty breathing, ask your doctor if including advair could help improve your lung function. get your first full prescription free and save on refills at advaircopd.com. starts with arthritis pain and a choice. take tylenol or take aleve, the #1 recommended pain reliever by orthopedic doctors. just two aleve can 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[ voice of dennis ] indeed. are you in good hands? helps provide many with, day and night relief [ voice of dennis ] indeed. of heartburn symptoms caused by acid reflux disease. there is risk of bone fracture, and low magnesium levels. side effects may include headache, abdominal pain, and diarrhea. call your doctor right away if you have persistent diarrhea. other serious stomach conditions may exist. don't take nexium if you take clopidogrel. ask your doctor if nexium, the purple pill, is right for you. find out how to save on nexium at purplepill.com. makers of ambien need to lower their dosage because of what can happen the next morning. the story here, the effect is especially risky for women. our report tonight from nbc's tom costello. >> looks like the south 5 is miserable still. >> reporter: it's the morning rush hour, but is that driver in the lane next to you fully awake? the fda says it's received more than 700 reports of driving-related mishappens and terrible accidents related to common sleeping aids like ambien. drivers too drowsy to concentrate the morning after taking a sleeping pill. in carey kennedy's case, she claims to have taken ambien in the morning and crashed into a truck. >> i remember getting on the highway, and then i have no memory. >> reporter: now, with research showing sleeping medications can remain in the bloodstream longer than previously thought, especially in women, the fda has ordered the makers of ambien and others to cut in half the dose for women from 10 to 5 milligrams. also cut extended release formulas. and suggested similar doses for men. >> i have seen everything from them nodding off while they're talking to me to them talking like in tongues. >> reporter: dr. daniel eisenberg is the chief of cardiology at st. joseph medical center in l.a. >> between 8 and 12 hours would be the minimum amount of time before i would get into a car and drive. >> reporter: at the cleveland sleep disorder center, wkyc reporter monica robins took an ambien, then tried driving in a simulator as her concentration deteriorated. three hours in, she crashed. >> i don't remember seeing a speed limit. this is a very serious crash. you went into the concrete barrier. >> reporter: americans will fill 60 million prescriptions for sleeping pills in 2013, and only taking one, say the experts, can dramatically increase your risk of having an accident. the maker of ambien today stood behind the drug but said these medicines should not be used if individuals are unable to get the recommended seven to eight hours of sleep. but at current doses, the fda warns, that may not be enough. tom costello, nbc news, los angeles. and we're back in a moment with a big change coming to the happy meal that may leave some kids unhappy. hi, i'm phil mickelson. i've been fortunate to win on golf's biggest stages. but when joint pain and stiffness from psoriatic arthritis hit, even the smallest things became difficult. i finally understood what serious joint pain is like. i talked to my rheumatologist and he prescribed enbrel. enbrel can help relieve pain, stiffness, and stop joint damage. because enbrel, etanercept, suppresses your immune system, it may lower your ability to fight infections. serious, sometimes fatal events including infections, tuberculosis, lymphoma, other cancers, and nervous system and blood disorders have occurred. before starting enbrel, your doctor should test you for tuberculosis and discuss whether you've been to a region where certain fungal infections are common. don't start enbrel if you have an infection like the flu. tell your doctor if you're prone to infections, have cuts or sores, have had hepatitis b, have been treated for heart failure, or if, while on enbrel, you experience persistent fever, bruising, bleeding, or paleness. 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[ phillips' lady ] live the regular life. we replaced people with a machine.r, what? customers didn't like it. so why do banks do it? hello? hello?! if your bank doesn't let you talk to a real person 24/7, you need an ally. hello? ally bank. your money needs an ally. you can tell by those red curtains, it's that time of year in hollywood. award season is under way. golden globes this weekend here on nbc. and the academy award nominations were announced today and had a few plot twists of their own. nbc's kristen dahlgren has our report from los angeles. >> the 2012 nominees -- >> reporter: in the race for best actress, it is one for the ages. the oldest and youngest best actress nominees ever. 85-year-old emmanuel reve of "amore" and 9-year-old quvenzhane wallis, who was just 5 when she auditioned for "beasts of the wild." now her small indy film about louisiana's bayou will take on some giants for best picture. nine, in all. "beast" director bested some of hollywood's biggest for a director nod. many were shocked at the snubs. "argo's" ben affleck, again ton turn teeno, and "zero dark thirty's" cakathryn big low lef off the list. >> it's unusual but also inevitable since the best picture category is now bigger, almost twice as big as the best director category. >> reporter: "silver lining's playbook" nominated in all acting categories. daniel day lewis is almost considered unbeatable in "lincoln." but a world away from hollywood on the streets of kabul this morning, it wasn't about the big names, but one you likely never heard. fawad mahameti, up for an oscar. a reminder of the true magic of movies. and then even without a canned acceptance speech, just being nominated really can change lives. >> i'm so happy. >> reporter: kristen dahlgren, nbc news, hollywood. >> that's the spirit. that's our broadcast on a thursday night. thank you for being here with us. join us tonight for an all-new "rock center" at 10:00, 9:00 central. i'm brian williams, we hope to see you right back here tomorrow evening. good night.

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