Now about that flu-shot scandal...

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HONG KONG A global pandemic of avian influenza is "very, very likely" and could kill tens of millions of people around the world, a top World Health Organization official said Monday.

Governments should be prepared to close schools, office buildings and factories in case of a pandemic, and should work out emergency staffing to prevent a breakdown in basic public services like electricity and transport, said Dr. Shigeru Omi, the organization's regional director for Asia and the Pacific.

Such arrangements may be needed if the disease infects 25 to 30 percent of the world's population, Omi said. That is the WHO's estimate for what could happen if the disease - currently found mainly in chickens, ducks and other birds - develops the ability to spread easily from person to person.

Deaths associated with the rapid spread of a new form of influenza would be high, he said.

"We are talking at least 2 to 7 million, maybe more - 20 million or 50 million, or in the worst case, 100" million, he said.

While many influenza experts have discussed similar figures privately, Omi's remarks represented the first time a top public health official had given such an estimate in public. But his remarks on the likelihood that the disease would start spreading easily went beyond the assessment of many scientists, who say that too little is known about the virus to gauge the odds that it will become readily transmissible.

Dr. Malik Peiris, a top influenza researcher at Hong Kong University, said that Omi's range of potential fatalities was realistic and consistent with current research into the A(H5N1) avian influenza virus. The biggest questions, he said, were whether the disease would develop the ability to spread easily from person to person and, if it did, whether it would retain its current deadliness.

"H5N1 in its present form has a pretty lethal effect on humans," he said.

A few analysts have suggested that the death toll could be considerably higher. Dr. Henry Niman, a medical researcher in Pittsburgh critical of WHO as too conservative, said that with more than 70 percent of the human victims of the disease dying so far, the death toll could, in theory, exceed one billion if the disease were to spread rapidly among people, with little if any reduction in the current mortality rates.

But Omi and Peiris each pointed out that the high death rate recorded so far might be overstated, because people with less severe cases of the disease might not be diagnosed as having it.

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I seem to be getting rather apocalyptic here, but there's going to be poop hitting the fan in many ways. And the US government is hardly prepared.