Alaskans should be prepared to be on the front lines of a bird flu pandemic, the regional director of the U.S. Health and Human Services Department said.
James Whitfield, who visited Juneau on Tuesday, said he hopes that some day people will think he was "crying wolf."
The best insurance policy is one that isn't needed, the former insurance agent said.
But, he said, Alaska's proximity to and contact with Asia make it vulnerable to the virus that originated there.
"We must be prepared for the public health aspects and the social disorder aspects," said Whitfield, who is based in Seattle. His region includes Alaska, Idaho, Oregon and Washington.
"I hope we get incredibly prepared for the flu and it never happens," he said. But there is a serious chance that the Asian H5N1 avian influenza could become a health and social problem in the United States.
U.S. Health and Human Services Secretary Mike Leavitt spent the last week in Asia, talking with public health officials in countries where the flu already is a reality, Whitfield said.
It has not been found in any flocks or humans in the United States.
Tens of millions of chickens have died or been slaughtered in Asia in an attempt to contain the spread of this deadly virus strain. Migrating birds caused an outbreak this summer in Siberia that killed thousands of domestic foul, and bird experts in Alaska have been testing migratory birds here for the flu, according to National Geographic.
In addition to birds migrating from Asia to Alaska, people move back and forth, Whitfield said. Beyond the international air traffic coming through Anchorage, he said that earlier this year when he was in Savoonga, on St. Lawrence Island in the Bering Sea, residents said they were worried about visitors from Russia stopping on their way to the United States in a community not equipped for a health crisis.
"And they were worried about tuberculosis," he added.
Humans almost exclusively get this virus from birds, and about half die "as best as we can figure," Whitfield said. "That's an incredibly high rate, attributed to the fact that we have no immunities to this flu."
People have to be extremely close to catch the flu from other humans.
"The big concern about a pandemic is that it could mutate to a point where it could be transmitted more easily," Whitfield said.
The Spanish flu, which broke out in 1918 and killed about 50 million people worldwide, is believed to have mutated from a bird flu.
The threat "is not smoke and mirrors," Whitfield said. "It's not fun and games. It's the real thing."
Being prepared, he said, "is the top priority of the secretary. We're not there yet." Whitfield has been talking to officials in the states in his region about plans to address the threat of a pandemic. It could create social crisis as well as a health emergency, so communities, school districts and law enforcement agencies have become involved.
"Imagine the situation when standard flu symptoms can be perceived by people as a death sentence," he said.
Should bird flu become a problem here, "right now we have three ways to slow the spread," Whitfield said. If the time comes when they are needed, he imagines a combination of things would happen.
Isolation and quarantine would limit its transmission among people. Earlier this month, President Bush suggested using the military to enforce a quarantine.
Vaccinations would have to be developed, along with potential antiviral drugs, Whitfield said.
"The fourth piece is the most important of the pieces," he said. "It seems incredibly simple." It involves behavior people should practice before the flu comes around.
"Standard respiratory etiquette is the thing we can all do," he said. That means covering all coughs and sneezes, washing hands and carrying sanitizing alcohol hand gels.
If there is a pandemic, people should be prepared to limit contact with others, possibly staying at home for several days at a time. That means having at least a three-day supply of food and water on hand.
It's like insurance, he said. "You don't get it because you hope you'll use it. Frankly there's only so much the state and federal governments can do."
Tony Carroll can be reached at firstname.lastname@example.org.