When referring to the current avian flu circulating mostly in Southest Asia, I totally agree with jshannon's points. If the current strain somehow got to the United States (I assume that's the "here" referred to), there would be few human cases. Might have to kill a few million chickens, though, if it got into our poultry population.

However, let's not forget that not even the experts can predict what the next global pandemic flu strain will be, or even where it will emerge. The current H5N1 strain that worries experts will likely give rise to the next pandemic strain, but maybe not. A different strain, not really on anyone's radar, could also mutate into a highly lethal, highly infectious strain and catch everyone off guard.

jshannon's comment also seems to assume that the next pandemic will come from Asia. Again, highly likely, but not guaranteed. Geneticists believe the Spanish Flu originated in the midwest of the United States. There are plenty of American poultry farms where influenza exists and which could potentially be the biological mixing bowl where the next pandemic strain is created. In the past couple decades, there have already been a number of mass cullings of American poultry to stop influenza outbreaks among the animals.

Practically speaking, all it takes is for a single human with a mild flu to contract avian flu, genetic material is swapped between the flu strains, and suddenly we could have the next Spanish Flu. The chances of creating a lethal human pandemic strain is very, very low, but this sort of human-bird contact happens all the time, particularly in Asia, so it's really only a matter of time until you roll a hard six and unleash the next monster flu.

I don't mean to be overly alarmist because as I said, I agree with jshannon's opinion that our current risk in the US is low if we're talking about the current avian flu out there right now. But the conditions in the next pandemic situation could turn out to be very different from the current state of affairs and everything that the experts and politicians have been saying about the curent avian flu could turn out to be not applicable.

And like jshannon said, even if there's a pandemic, many people will still be dying of the garden variety flu, so try to keep the danger in perspective.

And if a flu pandemic does break out, it is even more important than ever to get a flu shot because it will help minimize regular flu in the population. Quick and accurate case identification is probably THE most crucial phase of any outbreak scenario from the public health perspective, so the less normal flu around, the easier it will be to track a pandemic strain. I know we've had some discussion of the pros and cons recently about flu shots on this forum, but for the vast majority of people, it's a net benefit. Although older people may not derive as much protection as younger people from actually contracting the garden variety flu, the chance of hospitalization and mortality for older folks is much lower if you've been vaccinated with the current flu shot. So, for those of you who grumble that you contracted the flu even after getting a flu shot, it still might have saved your life or at least kept you out of the hospital and you just don't know it.