If Avian flu reaches the United States, U.S. officials say local communities will be the first responders to the crisis. In Los Angeles, California health authorities are getting ready for a pandemic that may or may not occur.
The disease, caused by a virus known as H5N1, has been mostly restricted to poultry in Asia and Europe. It has sickened at least 125 people in Asia, however, resulting in the deaths of at least 64 of them. All have gotten the disease after coming into contact with sick birds. Scientists warn, however, the virus that causes this strain of Avian flu could mutate, allowing it to spread more easily to humans.
Scott Layne, associate professor of epidemiology at the UCLA school of public health, says some form of Avian flu will probably reach the United States.
"I think a form of avian flu that can spread in animals, it is very likely that it's going to reach the United States. Question number two is, will a form of avian flu reach the United States that will spread in human beings or be an efficient transmitter between human beings? And the honest answer to that is, we don't know," he said.
He says we have to do everything possible to prepare, just in case.
Health officials says millions around the world could die in an Avian flu pandemic. In a worst-case scenario, it could claim tens of millions of lives.
President Bush has allocated $7.1 billion to deal with a possible outbreak. Preparations in California involve coordinating local agencies for large-scale testing of patients suspected of having the illness. If a flu pandemic occurs, officials may have to quarantine those who are infected.
Sandra Shewry, director of the California Department of Health Services, says the state has spent the past few years building up its public health system, and she says it is ready for the challenge.
"This is an unprecedented threat in public health, and we're fortunate in California to have a lot of the building blocks in place. We have a strong lab system. We have a robust surveillance system. We have some of the leading scientists in the nation here in the state. There is more to do," she said.
Some of those tasks were revealed at a recent public hearing. A state audit found that California's medical disaster plan is more than 10 years old. A plan to coordinate local agencies in a public health crisis has not been revised for more than 30 years. Among the problems found by auditors: The state's disaster planning calls for use of a National Guard medical brigade that has been disbanded.
Los Angeles public health director Jonathan Fielding says his agency is monitoring ill patients to see if a human strain of the Avian flu has arrived here. Hospitals are preparing for a possible surge in patients because of a flu pandemic, which Dr. Fielding says could overburden the system.
"The issue will be trying to control its impact, and I think we have to work very diligently to make sure that the impact is minimized," he said.
Pharmaceutical companies are now working on a vaccine that would target Avian flu, and local health agencies are stockpiling anti-viral medicines in case of an outbreak. California health official Sandra Shewry says the possibility of a pandemic raises questions, however.
"How to get vaccines out to people, what to do with mass casualties, what if our health care delivery system is overwhelmed," she said.
And what would happen, officials ask, if many doctors and nurses became sick themselves?
Public health authorities say other forms of influenza claim the lives of more than 30,000 Americans in a typical flu season, and simple precautions such as frequent washing of hands can limit the spread of the flu. But they say a comprehensive response will be needed for a possible pandemic of Avian flu.