The Centers for Disease Control would let us know and the various state health departments would be involved. This happens every year with regular influenza.
Question: Is there an added risk for those who frequently travel abroad?
Answer: The concern is for that very small proportion of international travelers who find themselves out in the agricultural areas of China, Vietnam, Thailand and the like.
In those circumstances, they will find that those farmers are using precautions and they should be careful. Spend as little time as needed there, don't get close to the chickens and certainly wash yourself very quickly when you leave. If you have soiled garments or shoes, handle them carefully and get them cleaned.
This is not to be a major concern until early cases are discovered and start to spread, and when that happens we would hear a lot just as we did during the era of SARS. They can travel from one country to another and when they land they can spread the disease. There's also some spread on airplanes because one of the things we know is you can start exhaling the infective virus 24 or 48 hours before you get sick, so you can be completely healthy and transmit the virus.
Question: How concerned do you think Americans should be?
Answer: There should be a degree of concern, but free-floating anxiety doesn't help us very much.
I regard this a little bit like the levees in New Orleans. There has to be a sense in the population that the national influenza preparedness plan be completed and that we actually engage in it. Now, this costs money and so the average person can let their member of Congress know or send a note to the White House that says you are concerned about the bird flu.
It's a little bit like hurricanes in New Orleans – we don't know when it's going to come but we know it will come, so let's spend some money. I think it's worrisome that in this era there are proposals to reduce the CDC's budget; that seems awkward as we're trying to prepare ourselves for pandemic flu. The CDC is the lead agency that would active at the whole public health system in our response.