Though there is no evidence yet of sustained effective human to human transmission, the possible repercussions of such a scenario have led the government to prepare on a domestic and international level.

"Avian influenza is a global problem and it requires a global response in order to protect our communities, our nations, and the world," Dobriansky said in a speech at the Nixon Center earlier this week.

The Lowy Institute for International Policy, an independent think tank, released a report earlier this year in which it estimated that a mild pandemic scenario would claim 1.4 million lives globally and cut the world GDP by about $330 billion. The institute predicted that the worst situation would lead to 142.2 million deaths worldwide and cost the world economy $4.4 trillion.

"Avian influenza is not merely a health issue," Dobriansky said, "It has economic ramifications, social ramifications, security ramifications."

The State Department, she noted, considers an outbreak such a serious threat that it has formed a special avian influenza action group.

The U.S. framework for action on the issue focuses on the three areas: preparedness and communication, surveillance and rapid detection, and response and containment.

The World Health Organization reports that the world is not adequately prepared for the H5N1 strain of avian influenza that has killed at least 130 people.

The economic impact of an influenza pandemic could be felt in several ways, Dobriansky said. Directly, sickness, death and medical care would burden the nation. Indirectly, absenteeism due to people staying home to care for others or remaining home to prevent the spread of the disease would reduce economic activity. Simply the indirect effects, Dobriansky said, could lead to a disruption in vital government services.

Another indirect cost could spring from perceptions of personal insecurity or uncertainty, and could be facilitated even by smaller human outbreaks or outbreaks limited to animals, Dobriansky said.

"We learned this in particular from SARS," she said.

Due to the decline in travel, tourism, and investment, the severe acute respiratory syndrome outbreak cost an estimated $40 billion, Dobriansky said. The World Bank estimates that an avian influenza pandemic could cost the global community $800 billion per year.

The Department of Health and Human Services estimates a pandemic influenza virus with virulence similar to the 1918 global flu pandemic strain could kill 1.9 million Americans. Such a disease could cause more death and illness than any other public health threat, the department said.

"Because of the interlinked nature of the global economy, clearly the economic costs in one individual country will be multiplied throughout the global economy," Dobriansky said.

In the event of a pandemic, declined consumer demand and a disrupted transportation systems could interrupt trade, Dobriansky said. Capital could retreat to safe havens in the United States and European Union, threatening financial stability and social fabric. Consumers could reject imports based on fear, and the government could implement damaging trade barriers and border control in an attempt to halt the spread of the disease.

America is developing policies in conjunction with the international community with these fears in mind, Dobriansky said. She emphasized that closing the borders would be the last option, since the State Department believes it would not decrease total illnesses or deaths, but would interrupt substantial commerce and delivery of essential services.

The economic and political tensions and panic from an outbreak, animal or human, could lead to recessions and further to social upheaval if fear is used for discrimination against ethnic and religious minorities, Dobriansky warned.

"For these reasons in particular," Dobriansky said, "transparency and communication are absolutely essential."

The United States is supporting public communication campaigns in 46 countries to help their populations understand avian and pandemic influenza and how to guard against infection, she said.

President George W. Bush launched the International Partnership on Avian and Pandemic Influenza last September as part of these efforts. America has pledged funds to prepare for a possible pandemic at home and abroad, assisted other nations in developing preparedness plans, and plans to preposition a U.S. stockpile of antiviral drugs in Asia.

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