Health officials in California and New Mexico are pressing their states to stockpile anti-viral medication. Massachusetts Gov. Mitt Romney (R) is urging residents to fill their pantries in case everyone is forced inside for an extended period. And Los Angeles airport officials are drawing up plans to quarantine passengers.
Across the country, states are reassessing their pandemic plans as fear of the deadly avian flu swells globally. Once largely limited to Southeast Asia, the disease has been detected in birds in Turkey and Romania in the past month. And the World Health Organization reported that avian flu killed a man in Thailand last week , bringing the virus' human toll to 61. The deaths have occurred in Indonesia, Vietnam and Cambodia as well as Thailand.
The state precautions are not unprecedented. For years, health experts have advocated stronger defenses against global outbreaks of a variety of diseases. But the potential for a pandemic -- a global outbreak of an infectious disease -- has ratcheted up the concern. "Right now, I think that people are uncomfortable that they don't have the right answers to all these things," said Patrick McConnon, executive director of the Council of State and Territorial Epidemiologists, which studies epidemic diseases.
He suggests that state officials build on research compiled during past health scares, such as anthrax and severe acute respiratory syndrome, or SARS. Another guide could be the national pandemic plan that is expected to be released by federal authorities soon. "The whole field is evolving month-to-month," McConnon said, suggesting that states update their pandemic plans as often as possible, including deciding who would get vaccinated first in an outbreak or how to enforce quarantine. ( Click here for a listing of state pandemic influenza plans .)
C. Mack Sewell, the state epidemiologist for New Mexico, said his state's efforts, which include improving its disease surveillance system by better tracking of hospitalizations and deaths, are aimed at bolstering the state's response in case federal defenses fail. He said his state is considering whether to buy its own supply of Tamiflu, an anti-viral medication, out of concern that the federal government might have insufficient supplies of the drug, which is designed to limit the severity of avian flu.
As of now, the federal government has dosages for just a few million Americans. Sewell concedes that buying the drug would be difficult with countries from all around the world trying to get it. "If there's a pandemic, states are going to be standing in line for the federal stockpile," Sewell said. "What's going to happen to a state like New Mexico?"
In California, the push for a stockpile of Tamiflu comes as officials have tested 25 potential human cases of avian flu in the past 18 months. All came back negative.
Even as the preparations continue, health officials said no one should panic over the avian flu. At this point, it remains mostly a bird disease, although 118 humans have contracted the disease worldwide , according to the World Health Organization. And for the disease to become a pandemic, it needs to mutate from its present form to become more easily transmissible between human beings -- a step that has not yet occurred.
For both these reasons, state officials must strike a balance between proper caution and improper panic, said Dr. Matthew L. Cartter, Connecticut's epidemiology program coordinator and an expert on state pandemic planning.
"I always keep in mind that we need to remember history," said Cartter, pointing to the 1976 swine flu scare that lead to mass vaccinations. The epidemic never came, he said, and a few patients actually got sick from the vaccinations.
Despite that scare, Cartter said government officials did not seriously consider planning for pandemics until the Sept. 11, 2001, terrorist attacks and the subsequent anthrax mailings, which raised the possibility of bio-terrorism. "That's what brought meaningful funding for public health emergencies," Cartter said.
Yet more is needed, he said. Emergency planners across the country need to draft comprehensive pandemic plans that lay out how to administer vaccines and quarantine sick residents. Lawmakers shouldn't panic over avian flu, but they should use the scare to prepare for the eventual global outbreak.
"We are overdue for a pandemic," said Cartter. "It's important for people to start with the assumption that we can't stop a pandemic, but we're trying to reduce the people who get sick and die."