The report, issued Thursday by the Center for Strategic & International Studies in Washington, D.C., is designed as a one-size-fits-all manual on minimizing exposure and infection rates in case of a disease outbreak.

But its authors are particularly pushing its strategies at a time when health experts are warning that an avian-flu-driven pandemic could reach U.S. shores.

If that happens, "We don't have to stop the disease in its tracks on Day One," said David Heyman, senior fellow and director at CSIS' Homeland Security Program. "We can stop the disease in theory by reducing its transmission," he said at a news briefing in Washington.

The report might especially be useful for cities and states, Heyman said, which he claimed weren't given much guidance in President Bush's pandemic-flu plan unveiled earlier this month.

But while the CSIS report includes limited and flexible use of quarantines, Heyman told United Press International that that option should be viewed as a last resort.

Quarantines carry a stigma due to their threat to civil liberties and can mean different things to different people, he said.

However, smaller quarantines such as blocking off a specific section of a city -- as is done now for presidential speeches -- might be feasible, he said. "The question is, can you quarantine a large community? No one has an answer ... but that doesn't mean you can't limit exposure" to potentially infected individuals, Heyman said.

In any case, some of the most potent weapons against an aggressive outbreak are also the most mundane, the report suggests, like washing hands, covering the mouth when coughing and maybe even chucking some quaint but risky cultural norms like shaking hands.

These common-sense measures should be put to the test this winter when the nation grapples with seasonal flu, Heyman said. "I would like to challenge the government to see if we can get (illness rates) down just through good hygiene."

He argued that the Bush pandemic-flu plan, which features developing avian-flu vaccines and stockpiling anti-virals -- won't be enough by itself.

Not only does the plan short-change the states in crisis management, it was decidedly frugal on state funding as well, dolling out $100 million to each state for its pandemic arsenal.

But Heyman argued that that amounts to "only pennies" in the face of an adversary that could kill up to 1.8 million people and hospitalize another 10 million.

So states and local authorities are left with a "small amount of money and little guidance" on how to protect the public from swiftly spreading sickness, Heyman said.

He said the CSIS report is aimed at filling that gap, offering up to health officials strategies such as how to broaden the scope of crises response by including in their plans not only the sick, but also groups like potential spreaders who are asymptomatic but may have been exposed to the disease. Officials might opt to monitor this latter group for symptoms and advise them to remain at home for a period of time, the report advises.

It also contains a "toolkit" to limit healthy people's exposure to a contagious bug, with approaches ranging from individual hygiene measures such as hand-washing to community-wide restrictions, like canceling public events and limited mass transit.

Heyman noted that the recent debacle in New Orleans caused by Hurricane Katrina demonstrated that city and state officials are largely left to their own devices when an emergency hits, at least in the initial days of the crisis.

He told UPI that response to the report from federal and state officials so far has been "great." Heyman said that, in developing the report, CSIS researchers drew from interviews with first responders -- ranging from emergency workers to goods and services suppliers -- in high-risk cities like New York, Washington and Chicago.

The researchers also spoke with officials in foreign countries that were recently rocked by another infectious killer, Severe Acute Respiratory Syndrome.

But does Heyman agree with health experts on how real the avian-flu threat is?

"Four things have to happen (for a pandemic to occur)," he told UPI.

"The disease must be contagious, must be infectious to humans, must be lethal, and can be transmitted form person to person. We've got three of those four things now," he said.

Moreover, Heyman added, the three flu pandemics that occurred in the 20th century have all been avian-flu-based.

Officials from the Centers for Disease Control and Prevention were unavailable for comment at publication time.

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