Doctors brace for possible avian flu pandemic.(Clinical Rounds)

Warnings of a potential avian influenza pandemic have the nation and medical community on alert--but those who would be on the front lines appear to be taking the threat in stride.

One of the few concrete steps that physicians can take at this time is to ensure that patients are vaccinated against conventional influenza strains, said Donald M. Poretz, M.D., vice president of the Infectious Diseases Society of America. (See box.)

There doesn't appear to be--and there shouldn't be--major fear or panic in the United States regarding a pandemic at this point, he told this newspaper.

However, European Union (EU) public health experts are alerted by the confirmation of the World Health Organization that the H5N1 strain of the influenza virus has been isolated in poultry in Turkey and Romania, bringing the disease to Europe's doorstep. Among the steps taken by the EU is a ban on imports of live birds, poultry meat, and other poultry products from Turkey and Romania, according to the EU Web site.

"We need to look at the information objectively, and not emotionally. I don't believe anyone can make a statement as to whether or not there will be a pandemic, but the likelihood is that there will be at some point, so one has to be prepared," said Dr. Poretz, professor of medicine at Georgetown University in Washington.

Doug Campos-Outcalt, M.D., said that "everyone I know is fatalistic about it. Everyone knows it's coming, but it's difficult to prepare for."

Beyond hygiene measures, such as hand washing and covering one's mouth when coughing or sneezing, most preparations for a pandemic are "out of the hands of ordinary physicians," said Dr. Campos-Outcalt, chair of the department of family and community medicine at the University of Arizona, Phoenix.