America has been caught with our collective pants down in the past couple of years. First, there was 9/11, then the war Iraq, and finally Hurricane Katrina. In each of these disasters, there were voices crying out in the wilderness telling us of the impending danger. Some voices warned that bin Laden planned to attack America. Some other voices cautioned us about being over-confident about conquering Iraq or finding WMD, and still others expressed alarm about what would happen to New Orleans when a major hurricane hit the city.

While we can't rewrite history, we can learn from it. One of the lessons is to be prepared. The question is what is the next disaster waiting in the wings? What type of catastrophe will whirl into our national psyche next? The obvious answer is some WMD unleashed upon an unsuspecting American city. However, it is just as likely, if not more so, that it will be something about which we haven't thought.

I am not Nostradamus, and I can't read tealeaves. However, I do read a lot and listen to NPR. Several months ago, I heard an epidemiologist warn of a possible pandemic due to avian flu or what laypeople call bird flu. He got my attention by comparing the possible death toll of bird flu to that of the bubonic plague, which first devastated Europe in the mid-14^th century. The Black Death wiped out approximately half of the population of Europe. This epidemiologist could envision a similar or greater cataclysm befalling the world's population as a result of avian flu.

The epidemiologist explained that the morbidity of the plague was high because no one had a natural immunity to it. He indicated that there could be a similar lethality with the avian flu for the same reason. The avian flu virus has been unknown to our immune system. He also explained how the body would react to this new antigen. Our immune system would attempt to isolate the virus and then it would try to kill it. The problem is that the flu would lodge itself in our lungs. The body would endeavor to control the spread of the virus by isolating it to the lungs. The problem with this strategy is that the immune system's defense mechanism would shut down our lungs before the virus could kill us.

Where are we on this catastrophic road that could easily surpass the lethality of the Black Death? Authorities estimate that well over 25 million birds have already died of avian flu. A major reason for this death toll is the lack of sanitary conditions in which chickens and ducks are kept in many parts of Asia.

In 1997, the first case of avian flu crossing over to humans was recorded. There have been several hundred cases of humans contracting avian flu with a 50% morbidity rate. The fear among epidemiologist is that the virus might mutate within human beings and then be able to pass from human to human rather than merely from bird to human. There are no cures or vaccines for avian flu, which is known as H5N1. The only treatment for this pathogen is a drug called oseltamivir, which goes by the trade name, Tamiflu.

If the apocalyptic mutation of avian flu allowed it to spread from human to human, it would decimate the human population of the world. The Spanish flu pandemic of 1918 killed worldwide 20-40 million in one year. The avian flu promises a much higher death rate because of three critical factors: a global transportation network that allows rapid spread of the flu, it is a new strain for which we have no immunity, and the migratory birds that could carry avian flu to all corners of the earth.

Once the shock registers that we are in imminent danger of a pandemic, people want to know whether there is a vaccine for bird flu. The answer is no. If human to human transmission occurs, it would take many months to isolate the virus, develop effective antibodies, produce millions of doses of that new vaccine, and finally administer the shots.

In addition, the worldwide capacity of producing flu virus vaccines is approximately 900 million doses per year or a shot for 13.85% of the world's population. Therefore, if the pandemic were to occur, there would be massive rationing of vaccines, quarantining of large areas of the world, and wearing surgical masks while avoiding any contact with those around us. Beyond that, all those measures wouldn't ultimately work to fend off massive deaths throughout the world. Avian flu is the ultimate WMD.

The only drug that demonstrates some effectiveness in dealing with the symptoms and secondary infections cause by the flu is oseltamivir, which Roche produces under the trade name, Tamiflu. Our government has stock piled enough of Tamiflu for 1% of the American population, and have back-ordered additional doses so that 2% of our population could receive this treatment.

We have been warned. We need to plan a meaningful response to the potential avian flu pandemic before it is too late.