Bird flu poses as big a threat to the world as ever, and people need to worry about it more, U.S. senators and health leaders are saying.
The H5N1 avian flu virus could cause a human pandemic at any time, killing perhaps millions, yet preparations are slow, they told a recent Senate hearing.
Federal health officials said they were working to raise preparedness, although progress has been slowed by budget limitations and the generally poor state of public health in the U.S.
"I am concerned that there is not as much public awareness or concern today as there was a year ago," Pennsylvania Republican Sen. Arlen Specter told the hearing of the Senate Appropriations subcommittee on health.
"You don't want to unduly alarm people. (But) I think people are unconcerned."
Part of the reason may be influenza's seasonal nature. A year ago, H5N1 in birds was bursting out of Asia and making a quick march across Europe, eventually reaching the Middle East and into Africa.
But it didn't spread much in the summer and autumn.
It has started to become more active again. Hungary confirmed an outbreak in geese on Wednesday, the European Union's first case this year.
Five people have died of the H5N1 virus in Indonesia since January 1, and new cases in poultry have been reported in Japan, Thailand and Vietnam. China, Egypt and South Korea have also reported cases in recent weeks, with three new human cases in Egypt and one death there this year.
H5N1 is known to have infected 269 people worldwide since late 2003 and of these, 163 have died.
"People who fail to prepare for a flu pandemic are going to be tragically mistaken," Julie Gerberding, director of the U.S. Centers for Disease Control and Prevention, told the hearing.
"It is inevitable," she added. "I don't know when and I don't know which virus will be the culprit."
Mutating and evolving
H5N1 is currently the most likely, said Anthony Fauci, head of the U.S. National Institute of Allergy and Infectious Diseases.
"It's moving biologically," Gerberding said. "It's mutating and evolving."
She said the CDC would encourage states to act out pandemic scenarios. "We think this is ultimately the best way to end up with the preparedness we need," she said.
Gerberding said a delay in passing 2007 spending bills has hurt efforts to prepare. Congress is currently funding the agencies through what are known as continuing resolutions, not permanent budget commitments.
In late January, the U.S. House of Representatives hopes to pass a continuing resolution stretching through the end of the fiscal year, Sept. 30.
And public health had been neglected for decades in the U.S. "We were in a very deep hole on the state and local level," Gerberding said. "We were starting from behind."