Nearly half of U.S. physicians (48 percent) surveyed by HCD Research and the Muhlenberg College Institute of Public Opinion Oct. 20-21 had been asked for Tamiflu by at least one patient not exhibiting any flu-like symptoms.

In the same survey, 42 percent believe that "the federal government is very unprepared to deal with an avian flu epidemic, and 37 percent believe that the government is somewhat unprepared." This lack of faith does not stop with the government, however: "43 percent feel that the medical community is somewhat unprepared to deal with a bird flu epidemic, and 32 percent believe that the medical community is very unprepared."

A prominent Australian avian-influenza expert, and the man who discovered bird flu in 1969, Dr. Graeme Laver, has slammed his country's preparedness in the face of World Health Organization praise for Australia's plans.

While WHO Deputy Director Alan Hampson said Australia was in a better position to deal with the potential pandemic than many other countries, Laver disagreed. "The Government is not prepared at all, the strategies they put in place are flawed, completely wrong. ... Quarantine will not keep flu-affected people out of Australia."

Fear of bird flu is also growing stronger in Asia, as Indonesia announced its fourth death from the deadly H5N1 strain and China suffered a new outbreak in the eastern province of Anhui, both Tuesday.

The Asian Development Bank said Monday that even a mild human epidemic of avian influenza could cost the region upwards of $100 billion. A severe outbreak would lead to a global recession, costing as much as $290 billion.

Guenael Rodier, special adviser on communicable diseases to the WHO in Europe, has warned countries that their stockpiles of anti-virals such as Tamiflu will be at risk of looting by the public should a pandemic occur. He advised governments to divide their supplies into smaller stockpiles that could be distributed throughout the country and that they should be guarded by the military.

Meanwhile:

-- A Russian health official announced Tuesday that the country has had an avian-influenza vaccine since May but that it has not yet been tested.

-- Belgian Environment Minister Bruno Tobback has slammed the United Kingdom for a U-turn on the banning of the import of birds to be traded as pets. An Environmental Ministers Council proposed the ban seven months ago, and the United Kingdom was the only country to oppose the proposal. The death of a quarantined parrot from H5N1 last week has seen British ministers seek a Europe-wide ban.

-- In Ottawa, health officials from more than 30 countries have met to discussing planning for the possible pandemic. The main concern was the ability of countries in the developing world to acquire the anti-virals needed to stem widespread infection.

-- The BBC reported Tuesday: "World Health Organization Director General Jong-wook Lee said that countries could not let national boundaries get in the way of combating any future pandemic. ... Mexico (has proposed) that 10 percent of all antiviral drugs produced in wealthier countries be automatically handed over to developing ones. ... Canadian Health Minister Ujjal Dosanjh said that countries could not be blamed for breaking patent laws if the alternative was watching their people die."

The concern with avian influenza is that it might combine with a form of influenza transmissible from human to human and set off a deadly pandemic.

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