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The difficulty in providing assistance after Hurricane Katrina could seem like a summer breeze compared to the response that would be needed if avian influenza (bird flu) or another virus creates a pandemic. Healthcare providers could be overwhelmed.

But it is important to keep in perspective that currently avian flu is spread through domestic poultry and the wild bird population. There have been 216 cases of humans contracting the avian flu since 2003, with 122 deaths. While there is concern a pandemic could result in the deaths of millions of people if avian flu mutated to be able to be spread from human to human, that has not yet occurred.

Also, it is important to note that the number of human cases still remains very low considering the wide geographical spread of the virus, said Dr. Mills McNeill, state epidemiologist with the Mississippi Department of Health (MDH).

"Certainly, it's tragic to lose one human from any communicable disease," McNeill said. "But from a global perspective, this indicates the virus doesn't have ability to be rapidly transmitted from person to person. In fact, it's our current belief that the majority of human infections have occurred due to direct contact with infected birds. There may have been a very few isolated human infections from close contact with an ill person, but these are thought to be very small in number. This virus has demonstrated no ability to move rapidly from person to person."

McNeill said it is important not to confuse the arrival of avian flu anywhere in the world with the arrival of pandemic flu. They are two very different things. Right now, avian flu is predominantly a problem in domestic poultry and the wild bird population. And health agencies around the world are monitoring for avian flu very closely, and taking quick action to prevent its spread.

"The good news is the latest reports we are getting is these efforts seem to be making a very big impact," McNeill said. "Despite the fact the virus is difficult to control, the efforts instituted primarily by poultry industries in the countries where they have more experience with the virus appear to be helping. The other good news is the virus does not seem to be moving via migratory bird routes as many people had predicted."

There is a global surveillance system in place to monitor for human influenza. In Mississippi alone, there are 40 reporting sites, known as sentinel sites, such as emergency rooms and doctor's offices that report percentages of influenza-type illnesses on a weekly basis.

McNeill said while the surveillance system is largely invisible to the general public, it is highly functional and responsive to the public health needs of the United States.

The MDH's basic responsibilities include surveillance, early warning to healthcare providers, and then dispensing vaccines and antiviral medications available. MDH has also distributed information about pandemic flu. McNeill said there is a wealth of information including checklists for businesses, families and hospitals at the Web site www.pandemicflu.gov.

"We don't want Mississippians to be alarmed, but we do want Mississippians to be aware of the potential for a flu pandemic," McNeill said. "We want them to know what they can do and what the Department of Health can do to protect health of all Mississippians should an event like this occur. The state has received extra funding to prepare. The training of leadership throughout our state, from the state to the local level of government, is a very wise investment of taxpayer money. We are very happy we are having the opportunity to interact with all levels of government in this planning effort."

Pandemic flu is only one of many possible causes of widespread disease outbreaks. For example, the bubonic plague that killed millions of people during the Middle Ages still exists.

"Plague occurs naturally in many areas of the western United States., primarily in the rodent population," McNeill said. "We do see cases of human infections from time to time. We can't focus just on flu today and not be aware of the possibility of other communicable diseases."

McNeill said because of all of the planning and preparedness the nation has done to prepare for terrorism, the country is better prepared to respond both to terrorist events and emerging infectious diseases.

"We're constantly monitoring for all types of disease threats and outbreaks that might occur," he said.

It is important for all healthcare providers to have a detailed plan in place to prepare for a possible pandemic, says Michael T. Caracci, CEO of Jackson-based Sta-home Health Agency.

"I don't think people really know what kind of disruptions could occur," said Caracci, whose organization employs 800 people. "The community needs to be able to handle itself because another organization from outside won't be coming in to help because they will be busy fighting the epidemic in their area. Healthcare providers may do everything they can and find it isn't enough."

It is estimated that in a pandemic, 40 percent of the workforce would be out sick. That would include the workforce of hospitals, doctors and other healthcare providers. It would also include, for example, 40 percent of the truckers in the United States. How does an area get food, gasoline and other supplies with so many truckers out sick?

"You could run out of food and gas in a couple of days because there are no truckers to deliver it," Caracci said. "You have to think about it a while to realize the total problem."

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