On a Wednesday morning a few weeks ago, Jim Elliott found himself in a room at the Sacramento County health department offices, considering scary scenarios of a flu bug run amok.

As communications director of the Elk Grove Unified School District, Elliott was interested because he knows children often pick up and pass on sickness at school. If pandemic flu hits - as some health experts believe is inevitable at some point - schools are likely to be heavily involved.

Unfortunately, Elliott had to leave the pandemic-flu planning meeting before it was over. A court decision involving his district and the constitutionality of the Pledge of Allegiance came down that day, requiring Elliott's attention.

His need to leave illustrates a hard truth about planning for an uncertain disaster: It's easy to be distracted by something else more pressing.

"Unfortunately, we probably will be stuck with a lot of crisis management" if and when pandemic flu strikes, said Dr. Christian Sandrock, a specialist in infectious diseases in pulmonary and critical care medicine at UC Davis Medical Center. "Community planning is the hard part."

Experts in the viruses that cause influenza have mused for years about the growing potential of an especially lethal strain to race around the world.

Their concern is not about the flu bugs that surface every season, life-threatening only to elderly people, infants and folks with weak immune systems. A pandemic flu bug can strike indiscriminately, felling the healthy and infirm alike.

That kind of influenza virus would be a new strain; something that hasn't circulated among people before, one the human immune system isn't armed to fight.

An avian flu - technically identified as H5N1 - spreading in Asia has the potential to be that kind of strain.

According to the U.S. Centers for Disease Control and Prevention, 116 human cases of the avian flu have been reported since January 2004: 91 in Vietnam, 17 in Thailand, and four each in Cambodia and Indonesia. Of those afflicted, 60 died - a whopping mortality rate of more than 51 percent.

The most recent death, the CDC reports, citing information from the World Health Organization, was a 27-year-old woman in Jakarta, Indonesia, who developed symptoms on Sept. 17 and died nine days later.

In this case, as with most of the others, the patient apparently had direct contact with diseased chickens before she became ill. As long as contact with infected chickens is required for people to become sick, officials say the virus won't run rampant among humans.

What they fear is that the virus will change genetically so that it acquires the ability to pass easily from person to person. That change could bring about a pandemic.

With a vaccine against H5N1 only in experimental stages and antiviral medicines in short supply, the public health community has been playing up the value of common-sense hygiene: Wash your hands frequently, cover your coughs and sneezes, stay home when ill.

Beyond that, it's worthwhile for employers, houses of worship and other players in the community to begin thinking through how they would cope in a pandemic, health and emergency preparedness specialists say.

Laura McCasland, communication and media officer for the Sacramento County public health division who organized last month's meeting on preparing for pandemic flu, said issues that people have begun to consider include:

* Workplace telecommuting policies to enable people to work from home;

* How to encourage frightened employees to go to work if they are not sick and they are essential to the operation;

* How a pandemic would affect social and spiritual practices such as churchgoing.

For many in the community, planning is in the earliest stages, if it has begun at all. Elliott at the Elk Grove school district, for example, said he would like to see the district prepare information for administrators to discuss and consider sometime this fall, but nothing is ready yet.

Interviews with a sampling of Sacramento-area employers brought a range of responses.

At Raley's, spokeswoman Nicole Townsend suggested that the subject has only recently come to the company's attention.

"Since this information is just surfacing, we would need time to develop any plans in response to a potential epidemic," she wrote in an e-mail reply.

Global companies such as Intel reacted earlier to the issue. Company spokesman Mark Pettinger said Intel began working in 2003 on a plan for dealing with a pandemic, triggered by the advent of severe acute respiratory syndrome, or SARS.

Pettinger said company practices run the gamut from helping travelers to affected countries avoid becoming ill to making flu shots available.

More broadly, he said, Intel has developed a protocol for assessing the impact of an emerging pandemic "just in the same way our (information technology) folks would assess a potential (computer) virus coming into our systems."

So if a pandemic were to take shape, he said, Intel would consider such things as whether it was time to direct employees to work from home and to cancel travel.

Sandrock at UCDMC said anyone involved with an organization or club, whether religious or sports or otherwise, could and should raise the question of coping with pandemic flu.

As for individuals, one thing they can do to help guard against a pandemic is to get vaccinated against the regular flu, said Dr. Warner Hudson, a UCDMC family practitioner.

That's not because the regular vaccine will protect against a new strain - most experts say it would not. Because viruses trade genetic material all the time, someone infected with a more common strain who happens to be exposed to the avian strain at the same time could become the host that produces the new, killer germ, Hudson said.

FIGHTING FLU: THEN AND NOW

Avian flu , technically identified as H5N1, has the potential to be a pandemic strain. According to the U.S. Centers for Disease Control and Prevention, 116 human cases have been reported since January 2004:

Vietnam -91

Thailand -17

Cambodia -4

Indonesia -4

Of those, 60 died - a mortality rate of more than 51 percent. The most recent death, reported by the World Health Organization, was in Jakarta, Indonesia, where a 27-year-old woman developed symptoms on Sept. 17 and died nine days later. The patient apparently had direct contact with diseased chickens before she became ill.

Officials says as long as contact with infected birds is required for people to become sick, the virus won't run rampant among humans.

The 20th century saw three flu pandemics, all of which spread around the world within one year of being detected:

1918-19, "Spanish flu," caused the greatest number of known influenza deaths: More than 500,000 people died in the United States, and up to 50 million people may have died worldwide. Nearly half of those who died were young, healthy adults.

1957-58, "Asian flu," first identified in China, caused about 70,000 deaths in the United States.

1968-69, "Hong Kong flu," first identified in Hong Kong, caused about 34,000 deaths in the United States.

Source: U.S. Centers for Disease Control and Prevention

About the writer:

• The Bee's Edie Lau can be reached at (916) 321-1098 or elau@sacbee.com.

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