When Might the Bird Flu Impact the U.S.?

The World Health Organization is warning countries to prepare for a global flu pandemic. What can people expect in the United States? Here, tackling a sampling of your questions is Dr. William Schaffner, an infectious disease specialist and the chairman of the Department of Preventive Medicine at Vanderbilt University in Nashville, Tenn.

Dixie in Virginia asks: Can anyone give us a time frame? Are we expecting outbreaks in the U.S. in the near future? Should we be concerned about the pet store down the street recently expanding the aviary section of birds more than triple?

Schaffner: Unfortunately, the time frame is completely uncertain. We are waiting and watching for what the virus will do. The virus does not have a timetable for its mutation. There is no bird flu in the United States, so you can go ahead and buy that parakeet from the store down the street.

Atul asks: Can I buy some Tamiflu in advance? Will it be enough for me to get through the flu if I catch it? If yes, how much? Do local drugstores carry them, without prescription?

Schaffner: Tamiflu is a prescription drug. No advisory group has recommended that we stock our own personal supplies at home. We don't want to divert useful medication from folks with "ordinary" influenza this season who need to be treated. Also, frankly, past history suggests that many such personal stockpiles simply get lost.

Kathy in California asks: If you are exposed and take a full course of Tamiflu (one tablet, twice a day for five days) are you then immune? Or can you become infected again?

Schaffner: It depends. If the Tamiflu you took actually prevented the influenza infection from really getting established, you might still be susceptible -- or partially so.

Lenore in Manchester asks: When will the public be told how and when to prepare? Without a vaccine and with a limited amount of Tamiflu, will isolation be the recommended strategy? What will the trigger point be for closing public schools and other public gatherings?

Schaffner: The national and coordinated state influenza pandemic preparedness plans are in the works. The World Health Organization tracks influenza internationally and its information will be relayed to us by the Centers for Disease Control -- it will be all over the news in an instant! The response will be a combination of isolation, treatment with Tamiflu and vaccination.

Pamela in Missouri asks: Once an outbreak begins, what are some steps people can take to try to protect them from exposure? Is there any benefit to removing children from school or avoiding public places as much as is realistically possible?

Schaffner: There will be some value in avoiding public places unless such activity is quite important. Questions of school closures, cancellation of recreational activities, etc. will be addressed by local public health officials in coordination with national guidelines.

Terry in North Carolina asks: How effective are face masks if worn when around others, and what type of mask is required?

Schaffner: Curiously, the protective role of face masks in such community circumstances has never been rigorously determined. We know they work in the hospital setting to help prevent both the spread and acquisition of certain kinds of infections. "Face masks" are of various types; generally speaking, the least expensive ones are the least effective.

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