When President Bush recently asked Congress for $7.1 billion to prepare the United States for a bird flu pandemic, growing concern about the H5N1 avian influenza soared.

Bird flu has killed scores of people, primarily in Southeast Asia. But while a heightened alert would be prudent, it is not time to panic, according to an infectious disease expert.

"It''s a serious concern," said Dr. Hillary Babcock, an infectious disease specialist at Barnes-Jewish Hospital in St. Louis. "But to put it in perspective, it''s not an imminent concern. The spread of the avian influenza has been primarily through poultry populations, and, in that setting, has in fact spread from Asia and across into Europe now. But it still has had a lot of difficulty transmitting between birds and humans and has shown very little capability for spreading between people. So, as of now, there is no imminent pandemic threat."

Still, she said, it''s smart to be proactive.

"I do think that pandemic preparedness, in general, is an area that the country needs to do more with, and it''s good that this is prompting us to push forward a little bit more with that," she said. "That kind of pandemic preparedness for avian influenza will also be helpful in preparing for another SARS outbreak, if something similar to that comes up. Or any kind of bioterrorism event as well. This kind of preparing can help us prepare more broadly for a wide range of possibilities."

The federal government has assembled a procedure to handle such a pandemic, said Dr. abcock, who is also a professor of medicine at Washington University School of Medicine in St. Louis. Those steps include improving vaccine preparation and production plus having hospitals and clinics stockpile antiviral drugs and vaccine against the avian virus.

"In the president''s plan, compared to the amount of money spent on those things, there''s a fairly small amount of money set aside for states and local governments to prepare emergency plans," she said. "That''s an area that each state and city government and each hospital and medical facility is going to need to look at and work on to see what they can do to prepare.

"We need, at those levels, to have a strategy available to recognize influenza when it comes through our communities, to be able to test and look for avian influenza, as separate from the regular influenza outbreaks," she said.

It''s also essential, she added, to have "a good public relations mechanism, so we have a way to reach the public with key information about what exactly is happening and what the risks are and what we would like the public to do in response."

Infection control measures should be established to limit the spread of viral illnesses in healthcare settings and the community, Dr. Babcock said. "In healthcare settings, having the ability to isolate patients who are infected, to do rapid resting to identify those patients and to protect our healthcare workers (is important)," she said.

In the community, encouraging people who are sick to stay home and not spread infection should be emphasized, she said. It''s equally important for employers to be on board with this. Additional common sense precautions that should be emphasized include cough etiquette (covering the mouth and nose when you cough), consistent handwashing and avoiding unnecessary contact with sick people.

"All of those things can help also," she said. "I think we''re ready for our current flu season as much as possible. Probably a good side effect of the pandemic concern is increasing interest, hopefully, in getting vaccinated against the regular human flu strains."

But is it possible to coordinate the kind of large-scale preparation necessary to prevent such a pandemic?

"The more time we spend talking about what needs to happen, the more time local communities spend having bioterrorism and pandemic preparedness task forces, trying to connect disparate aspects of the community-the public health community, local hospitals, outreach settings ... all of those things will help," Dr. Babcock said. "So I think we can certainly improve our preparedness."

The clinical presentations of the avian and human influenza strains "are probably pretty similar," Dr. Babcock said.  So healthcare professionals should learn a patient''s background and travel history.

"Most of the distinction would be based on the personal history, epidemiologically, of the patient you are seeing," she said. "The likelihood of avian flu being found in a person who lives in the United States, who has never left the United States, who doesn''t work with sick poultry, is pretty much nil. But if you''re seeing people who have recently come to this country from a country where avian flu is endemic, if they lived on a poultry farm or had sick poultry in their home or yard, ... that is somebody there would have to be a higher suspicion (of avian flu infection) for. So it''s really going to be based, at least here right now, on history from the patient."

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