Editorial: Winged migration

The recent appearance of avian flu in Eastern Europe is no cause for panic, but it provides a good impetus for better preparation.

Countries worldwide are recognizing the threat of an influenza pandemic, avian or otherwise. Canada, for example, hosted a two-day international conference last week for senior health officials from about 30 countries, and both the United Kingdom and New Zealand have recently revised their plans for containing and responding to flu outbreaks.

The avian flu is now in headlines because scientists believe the virus could mutate into a more contagious and deadlier strain. But health officials have been worried about the potential for new flu pandemics for a long time. That is why some health experts are puzzled by the lack of urgency they see in the United States: U.S. officials seem to be hoping for the best rather than preparing for the worst.

Among other concerns, critics say U.S. health officials have not done enough in the area of disease detection, which is essential to containing outbreaks. For several years, experts have urged U.S. health agencies to deploy syndromic surveillance systems. Such systems analyze data from hospitals, pharmacies, medical labs and other sources in search of patterns that indicate potential outbreaks.

After the 2001 terrorist attacks, many health officials said such alert networks are vital to the country's defense against bioterrorism. But to be effective, the health care industry must widely deploy such systems, canvassing as much territory and harnessing as much data as possible. That has not happened, critics say.

One constant problem is funding. Many state and local health departments have asked the federal government for help in paying for surveillance systems, but they say the funding often falls short.

The situation is difficult to gauge, which is disconcerting in itself. As U.S. officials join the rest of the world -- we hope -- in updating their plans for responding to a pandemic, they need to conduct an honest assessment of the country's surveillance capability and identify the resources necessary to make it sound. It would be better to face that task now than to revisit the issue in a lessons learned report after disaster strikes.

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