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.

Geoff in Cincinnati asks: Is there any way of seeing a difference in this avian flu as opposed to the normal, less lethal, flu? In the description, the symptoms were exactly the same as the regular strain of influenza virus, are there any special ones?

Schaffner: There are no distinctive symptoms, although the relatively few bird flu cases in humans that have occurred in Asia appear to be on the more severe end of the usual spectrum of disease.

Ginny in Missouri asks: Can you get the virus from eating fowl?

Schaffner: Fortunately not. Eating poultry cannot give you bird flu. Influenza is spread by the respiratory route in close contacts.

Josephine in New Jersey asks: Is there a "target" group that this flu tends to hit?

Schaffner: Because this strain of bird flu has not been in the human population before, we would all be susceptible. If the bird flu virus acquires the capacity to spread among humans (it does not yet have this ability), it would spread in the U.S. depending on where in the U.S. it is introduced. As with the "usual" annual influenza outbreaks, we anticipate that the very young, the very old, those persons with underlying diseases (heart and lung disease, diabetes, immune compromise, etc.) and pregnant women would be apt to have the most severe disease.

Rachel in Pennsylvania asks: In reading the fact sheet article on this Web site, it stated that the U.S. has stockpiled Tamiflu for government employees and their families. I find this to be highly disturbing! What about us, the regular American citizens??

Schaffner: Please permit me to correct your impression: the federal government is starting to stockpile Tamiflu for use in all our hospitals to treat persons affected by bird flu (should it strike us).

John in Denver asks: What steps can you take to mitigate the possibility of death if you do catch the virus?

Schaffner: As with influenza, early recognition and appropriate treatment will help folks recover.

Amy in New York asks: Are people getting bird flu only from live chickens, or can it be transmitted by handling raw chicken?

Schaffner: The relatively few times humans in Asia have acquired the bird flu virus it came from very close contact with live poultry.

Mark in Detroit asks: Is there a difference between bird flu and avian flu? I keep seeing similar articles about one or the other and I'm not sure if they're the same. It's very confusing. If they are the same I wish the media would stick with one terminology, i.e. bird flu since that's simpler and easier for most people to understand.

Schaffner: Bird flu and avian flu are similar names for the same virus.

Jocelyn in Oregon asks: I just saw a news program on this and I am pretty scared right now. I try to not let the media spook me, but this, frankly, has me spooked. Should I be worried? Is there anything I can do? Any preventative measures my family and I can take now? Honestly -- is the media trying to spook us or is this a real threat?

Schaffner: This is a genuine potential threat. However, please recall that the bird flu virus has not yet acquired the capacity to spread from person to person. It is not in the United States. I suggest the best we can all do is to stay tuned -- remain aware of what is going on and listen to recommendations from our fine public health authorities.

Elise in New York asks: Should I be concerned about the wild turkey that live in the back woods behind my house? We collect the turkeys' feathers, some for decoration and some for ceremonial uses, so we have handled them recently and in the past.

Schaffner: Pet birds and wild birds (turkeys, for example) currently are not at risk here in the U.S. because the bird flu virus is not in the U.S. If it ever comes, keeping them in the house, away from folks who cough and sneeze would provide them protection.

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