The deadly avian, or bird, flu has spread to Indonesia.  At least four people there have died of the virus in the last two months.  Several more probable cases are being closely monitored. The Indonesian government says it is going to conduct a mass chicken slaughter -- to eliminate all potentially infected poultry.  Vietnamese officials recently made a similar announcement following avian flu outbreaks there.  And the World Health Organization has announced it is ready to distribute its stockpiles of anti-viral medications -- to avert a global pandemic of bird flu.

Chickens have been slaughtered to stop the spread of the avian flu

Indonesian authorities took action to quell public fears about the spread of avian influenza after being accused of responding too slowly to the outbreak.  Now, working to contain cases of bird flu there, Health Minister Siti Fadila Supari says if things get worse, Indonesia could be facing an epidemic. 

The virus has not yet reached that threshold, according to Dr. Anthony Fauci, the director of the U.S. Institute for Allergy and Infectious Diseases.  But, he says the Indonesian outbreak is a signal that the threat posed by bird flu is very real. 

"What we've learned this past week or so with the new Indonesian cases is that the problem is not going away, as opposed to it's a whole new shift in a paradigm or a whole new shift in direction.  It isn't.  It's just telling us that we're still in trouble," Dr. Fauci told us in an exclusive interview.

Anthony Fauci heads the National Institute of Allergy and Infectious Diseases (photo: NIH)

Human cases of the virus are still rare.  At least 60 people have died of avian flu in Southeast Asia since 2003.  Most of them caught the virus through exposure to infected birds.  What experts fear is that the virus will mutate and become much more easily transmitted directly from person to person. 

Dr. Fauci says detecting cases as they emerge is crucial. 

"Because if you're going to go in and try and put the fire out before it really becomes a blaze, a forest fire, you have to recognize quickly where new cases are.  So, general public health measures such as surveillance, getting your public health care delivery system up to par to be able to handle cases if they occur, stockpile drugs, like anti-virals, and get involved in the global effort to develop a vaccine."

But Dr. Fauci also cautions that sustained, efficient spread from human to human should be the trigger for the implementation of anti-pandemic measures.

"Once you start to see the spread get more efficient, and you would want to put a lid on it [stop it immediately], that's when you come in, treat people, vaccinate around it, much the same way as you would try and contain at the site eruption this particular potential pandemic,” said Dr. Fauci. “That would be the triggering point that would do it.  But the way things look right now you wouldn't want to deplete any stockpile based on what we're seeing now."

For the moment, Dr. Fauci and other experts say governments need to continue to take preventative measures and to have procedures in place to contain outbreaks of avian flu -- when they occur.